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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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<blockquote data-quote="J. Keith Nichols MD" data-source="post: 71233" data-attributes="member: 15691"><p>I appreciate your question and thanks for opening up another can of worms in SHBG. I can provide you with the literature about how important SHBG is to your health. I treat the entire person so it is quite difficult when we focus on trying to cure all ones ills with T alome. I also look into coexisting medical illnesses which may impact a persons health and wellbeing, I look at psychosocial issues which may be contributing to symptoms (some of my patients work at 2 jobs basically 7 days a week to make ends meet and no amount of T or thyroid is going to cure their fatigue). Some have serious relationship issues which no amount of T is going to repair. So I focus on the whole person including their diet and exercise regimens. So once we look at all othe factors that can impact a their wellbeing and discus that, then we begin optimizing their hormones. I obtain a baseline T , and begin T (I also initiate thyroid, DHEA, Vit D3, pregnenolone , etc..). If I have All their hormones in a optimal range and their free T 50 or greater with no improvement then I would look to other issues such as adrenal fatigue etc.... I just have not run into that patient yet. When you increase T, you increase E2 , which increases SHBG which is all good. I cringe when I see people trying to "increase my T by lowering my SHBG". SHBG is good. I overcome a increase in SHBG by increasing T dosage. Maybe since I am just a simple boy from Georgia I follow a KISS (keep it simple stupid) mentality. By addressing the whole person, optimizing free T and not being afraid of a number, not blocking E2 or SHBG, and optimizing free T 3, I have just not run into the problems I read about on this and other websites. Trying to do too much all at once and over complicating the process just confuses the patient. If we just initially focus on the most important issues (T, thyroid, DHEA, diet, exercise, melatonin, pregnenolone, supplements, Vit D, and not blocking E2, medical comorbidities , and psychosocial issues) and optimize those, then I have not had a issue with lack of improvement.</p></blockquote><p></p>
[QUOTE="J. Keith Nichols MD, post: 71233, member: 15691"] I appreciate your question and thanks for opening up another can of worms in SHBG. I can provide you with the literature about how important SHBG is to your health. I treat the entire person so it is quite difficult when we focus on trying to cure all ones ills with T alome. I also look into coexisting medical illnesses which may impact a persons health and wellbeing, I look at psychosocial issues which may be contributing to symptoms (some of my patients work at 2 jobs basically 7 days a week to make ends meet and no amount of T or thyroid is going to cure their fatigue). Some have serious relationship issues which no amount of T is going to repair. So I focus on the whole person including their diet and exercise regimens. So once we look at all othe factors that can impact a their wellbeing and discus that, then we begin optimizing their hormones. I obtain a baseline T , and begin T (I also initiate thyroid, DHEA, Vit D3, pregnenolone , etc..). If I have All their hormones in a optimal range and their free T 50 or greater with no improvement then I would look to other issues such as adrenal fatigue etc.... I just have not run into that patient yet. When you increase T, you increase E2 , which increases SHBG which is all good. I cringe when I see people trying to "increase my T by lowering my SHBG". SHBG is good. I overcome a increase in SHBG by increasing T dosage. Maybe since I am just a simple boy from Georgia I follow a KISS (keep it simple stupid) mentality. By addressing the whole person, optimizing free T and not being afraid of a number, not blocking E2 or SHBG, and optimizing free T 3, I have just not run into the problems I read about on this and other websites. Trying to do too much all at once and over complicating the process just confuses the patient. If we just initially focus on the most important issues (T, thyroid, DHEA, diet, exercise, melatonin, pregnenolone, supplements, Vit D, and not blocking E2, medical comorbidities , and psychosocial issues) and optimize those, then I have not had a issue with lack of improvement. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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