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nothingbutquestions

Clomiphene Citrate (Clomid)

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easy44

Ask and you shall receive! Lol

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garg

I asked my doctor about this and how/why everyone is using it.

 

He said basically WTF…

Of course he/she did. He/she doesn't get a kickback from the pharmaceutical rep for giving you clomiphene. He/she only gets extra money when they prescribe the $300/month stiuff...

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samatm

Any pics...?

<<<<<<<<<< Laughing button pushed>>>>>>>>>>>>>>>>>

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Headshot

Greetings! Had a chance to research testosterone and diabetes relationship, and found 2 interesting post.

 

http://www.drugwatch.com/2014/07/28/testosterone-th

 

http://www.everydayhealth.com/hs/low-testosteron

 

Neither link will open for me.

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RogerDat

 

Low Testosterone Guide

 

 

The Link Between Low Testosterone and Diabetes

 

Research shows that low testosterone and diabetes are connected. Find out how and learn about treatment options.

cs-low-t-diabetes-722x406.jpg

 

 

 

The connection might not seem obvious at first, but low testosterone and diabetes often go hand in hand. In fact, men with type 2 diabetes are twice as likely to have low testosterone as men who don't have diabetes.

However, the link between these two conditions does not mean that low testosterone actually causes diabetes. It is possible that some of the lifestyle factors that increase the risk of diabetes also increase the risk of low testosterone.

The good news? In addition to sticking to a heart-healthy diet and exercise, certain treatments may help both low testosterone and diabetes.

Low Testosterone and Diabetes: What’s the Link?

Low testosterone levels in men are associated with insulin resistance or reduced insulin sensitivity, says Ahmer Farooq, DO, assistant professor of urology at Loyola University Medical Center in Maywood, Ill.

When you have insulin resistance, your body produces insulin but doesn't use it properly. As a result, glucose builds up in your blood rather than being absorbed by cells. Insulin resistance can lead to type 2 diabetes and increase your risk for a number of health problems, including heart disease.

A study published in 2013 in the journal BioMed Research International found that low testosterone levels may help predict if a man will develop insulin resistance or type 2 diabetes in the future. According to the researchers, in a group of more than 300 obese and non-obese men, 44 percent had both type 2 diabetes and low testosterone, compared with 33 percent who had low testosterone but did not have diabetes. The researchers also noted that 25 percent of those with type 2 diabetes and low testosterone were not obese, concluding that low testosterone is linked to insulin resistance regardless of body weight.

Yet, body weight can be a factor. A 2010 study published in the journal Diabetes Care found an inverse relationship between body mass index (BMI) and testosterone levels in men with type 2 diabetes. That means that as a man's BMI increases, his testosterone level falls. Obesity may also be a reversible risk factor for low testosterone levels.

Research also suggests that low testosterone could be a complication of type 2 diabetes involving the pituitary gland. A 2004 study published in The Journal of Clinical Endocrinology & Metabolism found that one-third of 103 men with type 2 diabetes had low levels of what’s called free testosterone, or testosterone circulating in the blood that is not bound to a protein called sex hormone binding globulin. Researchers also found that the pituitary glands of these men were not producing enough luteinizing hormone, the hormone that triggers the production of testosterone in the testes.

Managing Diabetes and Low Testosterone

Low testosterone symptoms can include decrease in sex drive, erectile dysfunction, loss of muscle mass, depression, and a lack of energy, Dr. Farooq says. Low testosterone can also cause a decline in bone mass and osteoporosis as well as an increase in belly fat.

Farooq says a heart-healthy diet and exercise should be part of the overall treatment for both low testosterone and diabetes. In fact, a 2011 study published in the Journal of Clinical Endocrinology & Metabolism found that certain lifestyle changes, such as losing weight and getting regular exercise, not only raise testosterone levels but also result in a number of other health benefits for overweight men with low testosterone and type 2 diabetes. Another study published in 2013 in the journalHormone and Metabolic Research showed that overweight men who ate fewer calories each day experienced significant increases in their testosterone levels.

In addition to lifestyle changes, your prescribed diabetes treatment plan may include oral medications and/or insulin therapy. A 2014 study published in the European Journal of Endocrinology showed that in people who had just been diagnosed with diabetes, insulin treatment for diabetes also increased levels of sex hormone binding globulin, which translates to more testosterone in the blood stream.

If low testosterone continues to be a problem for you, your doctor may prescribe testosterone replacement therapy, Farooq says. It's important to follow up with your doctor or a certified diabetes educator when you're on these treatments. In some cases, testosterone replacement may increase your insulin sensitivity, and your treatment strategy for type 2 diabetes may need to be adjusted.

But Farooq says that testosterone replacement therapy isn’t for everyone. Before being prescribed medication for low testosterone, men must first be diagnosed through a blood test. Men who may not be candidates for testosterone replacement include those with prostate cancer or breast cancer. Although results are mixed, some research has shown that testosterone replacement therapy may stimulate the growth of prostate cancer and breast cancer. Other potential risks of treatment include infertility and sleep apnea.

"Men need to know that there’s hope for whatever they have and that they shouldn’t feel ashamed,” Farooq says. “If they have any worries about their testosterone levels or any sort of medical issue, they should get it checked out."

Continue to work with your doctor, and you can effectively treat and manage both your diabetes and symptoms of low testosterone.

 

 

Testosterone Drugs Not Effective in Men with Type 2 Diabetes

Posted 

 

July 28th, 2014

by Michelle Llamas & filed under Dangerous Prescription Drugs.

A A

testosterone-drugs.jpg

 

Testosterone therapy did not help aging, obese men who have Type 2 diabetes and reduced testosterone levels with sexual symptoms and general health, a new study shows.

Berlin-based Bayer Pharma AG who makes the testosterone drug Nebido funded the study published in The Journal of Clinical Endocrinology & Metabolism.Researchers found it is unlikely that testosterone therapy could improve erectile function or general health in study participants because testosterone levels are not the only reason for these medical problems.

This is the latest study that calls the effectiveness of the drugs in question. The controversial treatment also has some doctors and patients questioning its safety.

The drugs’ cardiovascular risks led a number of men to file lawsuits against testosterone manufacturers for such complications as heart attacks, strokes and mini-strokes.

“The presence of self-reported depression, but not baseline testosterone levels, was associated with worse aging male symptoms. Similarly, the presence of microvascular diabetic complications, but not testosterone levels, was associated with worse erectile function,” the study said.

The study involved 88 patients aged 35 to 70 with Type 2 diabetes. The test subjects had mild to moderate aging symptoms and erectile dysfunction. The men were randomly assigned to 40 weeks of intramuscular testosterone treatment or a placebo.

Authors used self-administered questionnaires at 0, 18 and 40 weeks to measure general health and sexual symptoms. In addition, they measured total testosterone levels and other biochemical markers through fasting blood tests at 0, 18 and 40 weeks.

The research found that there were no substantial improvements in men using the placebo compared to the treatment.

The study concluded that the trial does not support the use of testosterone therapy to improve general health or sexual symptoms in aging men with Type 2 diabetes.

 

Low Testosterone May Not Be Caused Solely By Aging

While the study did not find that hormone replacement therapy was beneficial for this subgroup of patients, it did find a relationship between other health conditions in these men that may contribute to low testosterone (Low T).

Study authors said comorbidity – the presence of more than one medical condition simultaneously – causes problems that can’t be cured simply by taking additional testosterone.

Obesity, Type 2 diabetes, cardiovascular disease and depression are comorbidities that affect testosterone levels in men. The study results suggest that treating comorbidities instead of using hormone therapy might be more beneficial.

“The fact that constitutional and sexual symptoms were associated with depression and with microvascular complications of diabetes, but not with circulating testosterone levels, is consistent with the possibility that prevention and care of comorbidities and of diabetes-related complications may yield more marked symptomatic benefits than testosterone therapy,” researchers wrote.

This was not the first study to explore the effectiveness of hormone replacement therapy in men with comorbidities such as obesity and depression.

Obesity, in particular has a staggering effect on T levels. Previous studies conducted by Bayer showed that obesity is a major cause of Low T, and 75 percent of very obese men have low levels of the hormone.

Last year, two studies, the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study and the European Male Aging Study (EMAS) found that comorbidities – and not aging – may be to blame for Low T.

The authors also said it was not clear whether hormone replacement drugs were beneficial or safe.

 

Benefits of Testosterone Questioned

The study comes as researchers question the effectiveness of Low T medications.

Several studies link the medication to pulmonary embolism and deep vein thrombosis – two types of dangerous blood clots. Low T medications also put women and children at risk from accidental skin exposure. Two of the drugs – AndroGel and Testim – carry black-box warnings for secondary exposure in children.

In the past years, low testosterone – known as hypogonadism – has become a popular diagnosis with a $2 billion industry behind it. While this condition is a real problem for some men, the medication is now in the mainstream being used as a lifestyle drug.

Medications that include Axiron, AndroGel and the yet-to-be-released Rextoro promise youthful longevity for older men who are going through the normal aging process. The medications are said to help with low libido, fatigue and decreased muscle mass. Clinics across the country offer men quick and simple access to the medications.

In early 2014, the Food and Drug Administration (FDA) opened an investigation into the link between some Low T products and heart attacksstroke and death.

In September, the agency’s Bone, Reproductive and Urologic Drugs panel will meet with the Drug Safety and Risk Management committee to discuss the benefits and risks of the treatment, particularly in the case of heart safety.

 

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garg

This is a thread about Clomiphene, a drug that makes your body produce more testosterone. It is not about all the testosterone replacement drugs out there that work by adding testosterone to your system. This added extra testosterone causes your body to stop producing testosterone, which causes a myraid of problems like shrunken gonads, etc. Any warning on these testosterone replacement drugs (not clomiphene) does not necessarily apply to the use of clomiphene.

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A_Simple_Man

These 5 reasons make me interested in trying this Clomid:

The 5 Main Reasons Clomiphene Citrate (CC pill, or Clomid) May be a Good Alternative to Testosterone Replacement Therapy in Men with Low Testosterone Due to Secondary Hypogonadism:

 

1. Clomiphene citrate (CC pill) stimulates the body's own production of testosterone

 

2. Clomiphene citrate (CC pill) doesn't interfere with the body's checks and balances of testosterone

 

3. Clomiphene citrate (CC pill) comes as a pill easily administered by mouth

 

4. Clomiphene citrate (CC pill) is generic and very cheap

 

5. Clomiphene citrate (CC pill) has little side-effects and low risk of developing these side-effects

 

But the question I have is about becoming addicted to Clomid in order for my body to produce testosterone.  I certainly don't want to get "Clomid-ia"  :yahoo: In all seriousness it sounds like a great supplement for aging men with Type 2 Diabetes who have a young, sexually excited partner who wants a child.  I may just try it but at this moment I am not motivated enough.  Lets continue to watch RogerDat's progress.  Keep up the great reporting RogerDat.

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RogerDat

I agree, but the "rest of the story" adds depth to the benefits of clomid verses the testosterone injections.

See my graft, the sugar levels dropped lots, and that is what led to the additional info. I have a lot more, but will post a separate post.

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Headshot

The question I have is about becoming addicted to Clomid in order for my body to produce testosterone.  I certainly don't want to get "Clomid-ia" 

 

From the article

 

 

While some hypogonadal men require continuous use of clomiphene citrate, for others it can be used for a 3-6 month time period and then discontinued.

 

It sounds like there is a possibility of taking it short-term (3 to 6 months) to kick start testosterone production in the body, and then wean off the drug if the body picks up on testosterone production on its own. I'm guessing that will depend on what other lifestyle changes you implement (like more exercise). A lean body produces more testosterone than a fat body, but the lack of testosterone can create a fat body, so it seems like a self perpetuating downward spiral if you allow the testosterone levels to drop unchecked. Certainly, though, if you don't work on your weight at the same time you are taking clomiphene citrate, the effect will not be long-term for a short-term exposure to the drug. I think it needs to be a one-two punch (clomiphene citrate and regular exercise) if you want your body to take over testosterone production without long-term usage of the drug.

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garg

I ran across a few articles by a Dr. about clomid use. The may interest some here.

 

Part 1: http://jeffreydachmd.com/clomid-for-low-testosterone-part-one/

 

Part 2: http://jeffreydachmd.com/clomid-for-men-with-low-testosterone/

 

Part 3: http://jeffreydachmd.com/2013/04/clomiphene-clomid-adverse-side-effects-part-three/

 

Sorry, too much to cut and paste. You'll have to follow the inks.

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nothingbutquestions

Thank you to all who have contributed to this thread I started.

I disliked the idea of adding exogenous testosterone to my body whether cream, grl, patch, or injection so I started Clomid and have been using 25mg eod almost 70 days now.

For those who like numbers, my Total T was 559 tested on the day I started and 60 days later it tested at 937. You won't hear me complaining.

Morning wood daily. Less tired. More motivation to be productive.

No side effects..

It works for me.

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Irenicus

Been over two months on Clomid 12.5 MG Mon Wed Fri.

 

Stuff works.  Haven't done the 90 day blood test but all my lifts at the gym have skyrocketed.  People also noting the increase in muscle mass.  

 

Can't say the effect it has on penile rigidity as haven't had that problem yet - am 48.

 

Yeah, it's for real.  No side effects noted.

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nothingbutquestions

Great to hear clomiphene is working for you as well. I noticed even without returning to the gym, my once-again youthful T levels were causing a shrinking in my waistline.

Thank you for posting your experience; I am sure it will help someone.

 

Here's the caution: when T rises, E2 is sure to follow and things may start to drop off. Many keep on hand an Aromatase Inhibitor such as ARIMIDEX aka Anastrozole  which hopefully you will never need, but honestly you probably will - a tiny 5 mg eod is what most report is effective to get back on track.

For me the signs of rising E2 can be seen in symptoms of BPH - frequent desire to urinate, awakening at night to pee, reduced/restricted flow urine flow. It has always been my personal experience that when I reduce my E2 levels these symptoms disappear.

 

Bottom line Clomiphene increases you body's own T production and Anastrozole keeps it by restraining aromatase which wants to turn it into E2.

May all your days start with morning wood.

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cvgtpc1

I am giving it a shot. 48 years old. Test level 460.  Taking 25 mg on Monday, Wednesday, and Friday. (Splitting the 50 mg pills).

 

On it for 30 days.  Started cuz I was feeling lethargic quite a bit.  All my lifts in the gym have gone up and my bodyfat level is dropping. Feeling better as well - more energy.

Gonna get test level checked in another couple of months to see if any actual change.

 

460 is still a good level and in the US at least a US MD wouldn't treat you for low T.

 

I tried shots and gels and couldn't get them till T levels went below 300.  Tried them though and didn't see enough change to warrant taking them.  Now finding losing weight (gym/diet) and learning to leave work at work is working better than any med.

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Here's the caution: when T rises, E2 is sure to follow

 

E2?

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Bill H

I spoke to my Urologist at the VA when I was back in the States, he is also the staff fertility specialist.  He was very positive about the Clomiphene and the VA will supply them.  He wants me taking 25mg a day as opposed to the 12.5mg every other day routine I've been on.  My cost here is 100p per pill (50mg) at the local pharmacy.  So I split the pills to get the 25mg and my cost per day falls to 50p.  I've been on the higher dose now for about 6 weeks and everything is better with no side effects noted.

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contraman
learning to leave work at work

 

That is the best medicine in the world :)

Edited by contraman

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Bill H

That is the best medicine in the world :)

 

I always thought that honor belonged to a very old single malt Scotch.   :unknw:

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nothingbutquestions

There are several forms of Estrogen: E1 Estrone, E2 Estradiol, and E3 Estriol. 

E2 Estradiol is the most active and, in excess OR when lacking sufficient. messes us up.

Each guy has his own "sweet spot." When we were young under 45, everything worked automagically.

After 45 (for me it was 51), aromatase levels increase and T levels drop and E2 rises. Since most docs are clueless, it's everyman for himself to find what works for him.

This works for me, and I am happy to share it and see that it also works for some of you.

For me, if I can sleep through the night, awaken with morning wood, pee without any issues, then life is good.

Increased drive, slimming waist, better outlook, these are all plusses.

Keep in mind, Test numbers are ONLY NUMBERS. What matters is how YOU feel.

IF at 460 everything is great then don't mess with success. If at 700, there are still issues, , you might want to investigate this or some other way to lower your E2 and increase your T.

FYI, yes your ball sacs will grow.

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RogerDat

Here is an article about T causing the prostate gland to shrink, and increase urine flow, an effect I have noticed.

http://www.empoweryourhealth.org/vol1-issue2/Testosterone-and-Mens-Health

 

page22-top.jpg

Today’s man, especially the mature man, is under assault. Each night as he tunes into the evening news or his favorite TV sports event he cannot escape the relentless attack on his masculinity. One after another prime time advertisers remind him that he is no longer as young as he once was- he spends too much time in the bathroom trying to urinate and too little time in the bedroom having sex. He is encouraged to “Speak with your doctor.” But which doctor should he speak to about these problems? Both urination and the ability to have sexual intercourse require normal male genital function. In the past, his Urologist, someone familiar with male genital anatomy, may have been consulted to help him cope with these problems. Today, however, he might want to chat with his Endocrinologist who has a better understanding of the male sexual chemistry needed to allow a man to urinate effortlessly and acquire and maintain penile erections firm enough to allow him to have and enjoy sexual intercourse.

One hormone (testosterone) plays a critical role in man’s problems with urination and sexual function as he ages. With advancing years, the testosterone made in a man’s testicles enters his blood stream and then penetrates his prostate gland. There, under the influence of an enzyme (5-alpha reductase), testosterone is transformed into another hormone dihydrotestosterone (DHT) and it is the increasing level of intraprostatic DHT that is the culprit responsible for the age-related increase in the size of a man’s prostate. His prostate gland is anatomically positioned right next to his urethra (the tube in the penis through which man urinates). Pressure from the bulging prostate on the urethra causes a blockade impeding the flow of urine, making it difficult for a man to release all the urine stored in his bladder. He is left with a sensation of fullness, as well as a need to urinate more often. Years ago, prostate surgery to whittle down the size of the prostate was the only way to alleviate pressure on the bladder so that urine could flow more freely.

Now that we know that the hormone DHT is directly responsible for prostate growth, there are other options. Some men have low DHT levels because they are born without the enzyme needed to transform testosterone to DHT. These men have tiny prostate glands that never enlarge. To mimic this experiment of nature, medications (finasteride (Proscar) and dutasteride (Avodart)) have been developed. These medications block the conversion of testosterone to DHT and short-circuit the stimulus to prostate growth. Treatment with either medication brings about a decline in the amount of DHT stored in the prostate. As DHT levels within the prostate decline, the prostate becomes smaller and no longer impinges on the urethra allowing men to urinate more freely.

Testosterone and Sexual Function in Young and Not-So-Young Men

There is a moment in every man’s life, coinciding with the teenage surge in testosterone release into his blood stream, when he wakes every morning with an erection and quite suddenly starts to experience sexual feelings. The morning erections are due to a diversion of blood flow into specialized spongy tissue in his penis called corpora cavernosae. As the pressure within these areas increases, his penis swells and then becomes rigid enabling him to have sexual intercourse. As a young man, the flow of blood into his penis is free and uninterrupted so that he can experience an erection without difficulty. His interest in sex (libido) is, however, testosterone dependent. As long as blood flows freely in his body, he can experience erections; and, as long as his testicles churn out a full quotient of testosterone, interest in sex is sustained. Unfortunately, over time as a man gets older he may acquire new habits and problems that disrupt both his natural sexual energy and sexual potency. For instance, he may not always eat properly, exercises less, starts to put on weight, becomes addicted to smoking cigarettes, and could be prone to the development of diabetes and high cholesterol levels. These are behaviors that individually and collectively start damaging blood vessels in his body limiting the flow of blood to his vital organs. If blood flow through his coronary arteries is diminished, he has chest pain (angina), whereas leg cramps (claudication) are the natural consequence of diminished blood flow to his lower extremities. An inability to acquire or maintain an erection is inevitable if blood flow to the penis is compromised.

Fortunately, there are now three different medications sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) to help with this problem. All increase blood flow to the erectile chamber of the penis and improve a man’s chance of acquiring and maintaining an erection in response to sexual stimulation. They were thought to be the only medication men with erectile dysfunction would need to become sexually potent again. Unfortunately, none of these medications are always effective for all men. Some men fail to benefit from these medications because in addition to low blood flow they also have low serum testosterone levels. In the original studies of sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) men with low testosterone levels were not allowed to participate. We now know why. It turns out that an enzyme within the penis nitric oxide synthetase (NOS) must be present in ample amounts for all of these erection enhancers to work. Men with low testosterone levels have low NOS levels and that is why they do not have erections after using sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis). Testosterone treatment normalizes testosterone levels; and, once this occurs, men can once again experience erections when they use either sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis). Not only is the maintenance of a normal testosterone level vital for a man’s sexual health, it now appears to be critical for his emotional health and possibly his longevity as well. Recent studies indicate that when men experience depression all do not respond equally to antidepressant medication. Some men, especially those with low testosterone levels, remain depressed until testosterone treatment is added to their antidepressant medication.

Testosterone and Longevity

Surprisingly, there are other risks for men with testosterone deficiency. Men with low testosterone levels do not live as long as men with normal testosterone levels. In one study, 794 men had serum testosterone levels measured and then followed for 11.8 years. Those with the lowest serum testosterone level (241 ng/dl)* were more likely to have died during those 11.8 years than age-matched men with normal testosterone levels.

Testosterone and the Annual Physical

Today, men show up for their annual physical and can expect to have measurements of height, weight, blood pressure, A1c to check for diabetes (one out of every three men with age-related diabetes have low testosterone levels), as well as a cholesterol screen. Considering the importance of testosterone in man’s sexual, and emotional health, as well as his longevity, perhaps it is now time for serum testosterone measurements to be included as part of the routine annual physical for all men.

*(280-800 ng/dl is the normal male testosterone range.)

This article is concurrently being published in Review of Endocrinology

drrichard.jpgRichard Spark, MD, FACE, received his undergraduate training at Yale and his medical degree from Case Western Reserve University School of Medicine where he was elected to Alpha Omega Alpha. His research papers have been published in several major medical journals. Dr. Spark is co-author of the recently published AACE Clinical Practice Guidelines on Hypogonadism and Erectile Dysfunction. Dr. Spark has written three books on men’s health and has also written for articles that have appeared in the New York Times Sunday Magazine and the New Republic. He and his wife have been married for 48 years and they have four wonderful children, one grandson and twin granddaughters.

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nothingbutquestions

Never rely on one article, one test result, or one man's opinion. Do your research and see what works for your body. You are all that matters.

 

Current research shows the medical researchers still do not know why the prostate grows. They see the symptom and design a way to fix the symptom, but they do not understand the root cause.

BUT they will sell you drugs that might fix the problem and have a few "side effects" for no extra charge.

 

I'll stick with having my own body produce a higher level of testosterone and keep my E2 in check. Works for me.

 

Ran across a great quote: "You cannot outexercise a poor diet."

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cvgtpc1

 

 

Ran across a great quote: "You cannot outexercise a poor diet."

You got that brother....much easier to skip the Big Mac than eat it and burn it off...

Here is an article about T causing the prostate gland to shrink, and increase urine flow, an effect I have noticed.

http://www.empoweryourhealth.org/vol1-issue2/Testosterone-and-Mens-Health

 

 

page22-top.jpg

Today’s man, especially the mature man, is under assault. Each night as he tunes into the evening news or his favorite TV sports event he cannot escape the relentless attack on his masculinity. One after another prime time advertisers remind him that he is no longer as young as he once was- he spends too much time in the bathroom trying to urinate and too little time in the bedroom having sex. He is encouraged to “Speak with your doctor.” But which doctor should he speak to about these problems? Both urination and the ability to have sexual intercourse require normal male genital function. In the past, his Urologist, someone familiar with male genital anatomy, may have been consulted to help him cope with these problems. Today, however, he might want to chat with his Endocrinologist who has a better understanding of the male sexual chemistry needed to allow a man to urinate effortlessly and acquire and maintain penile erections firm enough to allow him to have and enjoy sexual intercourse.

One hormone (testosterone) plays a critical role in man’s problems with urination and sexual function as he ages. With advancing years, the testosterone made in a man’s testicles enters his blood stream and then penetrates his prostate gland. There, under the influence of an enzyme (5-alpha reductase), testosterone is transformed into another hormone dihydrotestosterone (DHT) and it is the increasing level of intraprostatic DHT that is the culprit responsible for the age-related increase in the size of a man’s prostate. His prostate gland is anatomically positioned right next to his urethra (the tube in the penis through which man urinates). Pressure from the bulging prostate on the urethra causes a blockade impeding the flow of urine, making it difficult for a man to release all the urine stored in his bladder. He is left with a sensation of fullness, as well as a need to urinate more often. Years ago, prostate surgery to whittle down the size of the prostate was the only way to alleviate pressure on the bladder so that urine could flow more freely.

Now that we know that the hormone DHT is directly responsible for prostate growth, there are other options. Some men have low DHT levels because they are born without the enzyme needed to transform testosterone to DHT. These men have tiny prostate glands that never enlarge. To mimic this experiment of nature, medications (finasteride (Proscar) and dutasteride (Avodart)) have been developed. These medications block the conversion of testosterone to DHT and short-circuit the stimulus to prostate growth. Treatment with either medication brings about a decline in the amount of DHT stored in the prostate. As DHT levels within the prostate decline, the prostate becomes smaller and no longer impinges on the urethra allowing men to urinate more freely.

Testosterone and Sexual Function in Young and Not-So-Young Men

There is a moment in every man’s life, coinciding with the teenage surge in testosterone release into his blood stream, when he wakes every morning with an erection and quite suddenly starts to experience sexual feelings. The morning erections are due to a diversion of blood flow into specialized spongy tissue in his penis called corpora cavernosae. As the pressure within these areas increases, his penis swells and then becomes rigid enabling him to have sexual intercourse. As a young man, the flow of blood into his penis is free and uninterrupted so that he can experience an erection without difficulty. His interest in sex (libido) is, however, testosterone dependent. As long as blood flows freely in his body, he can experience erections; and, as long as his testicles churn out a full quotient of testosterone, interest in sex is sustained. Unfortunately, over time as a man gets older he may acquire new habits and problems that disrupt both his natural sexual energy and sexual potency. For instance, he may not always eat properly, exercises less, starts to put on weight, becomes addicted to smoking cigarettes, and could be prone to the development of diabetes and high cholesterol levels. These are behaviors that individually and collectively start damaging blood vessels in his body limiting the flow of blood to his vital organs. If blood flow through his coronary arteries is diminished, he has chest pain (angina), whereas leg cramps (claudication) are the natural consequence of diminished blood flow to his lower extremities. An inability to acquire or maintain an erection is inevitable if blood flow to the penis is compromised.

Fortunately, there are now three different medications sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) to help with this problem. All increase blood flow to the erectile chamber of the penis and improve a man’s chance of acquiring and maintaining an erection in response to sexual stimulation. They were thought to be the only medication men with erectile dysfunction would need to become sexually potent again. Unfortunately, none of these medications are always effective for all men. Some men fail to benefit from these medications because in addition to low blood flow they also have low serum testosterone levels. In the original studies of sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) men with low testosterone levels were not allowed to participate. We now know why. It turns out that an enzyme within the penis nitric oxide synthetase (NOS) must be present in ample amounts for all of these erection enhancers to work. Men with low testosterone levels have low NOS levels and that is why they do not have erections after using sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis). Testosterone treatment normalizes testosterone levels; and, once this occurs, men can once again experience erections when they use either sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis). Not only is the maintenance of a normal testosterone level vital for a man’s sexual health, it now appears to be critical for his emotional health and possibly his longevity as well. Recent studies indicate that when men experience depression all do not respond equally to antidepressant medication. Some men, especially those with low testosterone levels, remain depressed until testosterone treatment is added to their antidepressant medication.

Testosterone and Longevity

Surprisingly, there are other risks for men with testosterone deficiency. Men with low testosterone levels do not live as long as men with normal testosterone levels. In one study, 794 men had serum testosterone levels measured and then followed for 11.8 years. Those with the lowest serum testosterone level (241 ng/dl)* were more likely to have died during those 11.8 years than age-matched men with normal testosterone levels.

Testosterone and the Annual Physical

Today, men show up for their annual physical and can expect to have measurements of height, weight, blood pressure, A1c to check for diabetes (one out of every three men with age-related diabetes have low testosterone levels), as well as a cholesterol screen. Considering the importance of testosterone in man’s sexual, and emotional health, as well as his longevity, perhaps it is now time for serum testosterone measurements to be included as part of the routine annual physical for all men.

*(280-800 ng/dl is the normal male testosterone range.)

This article is concurrently being published in Review of Endocrinology

drrichard.jpgRichard Spark, MD, FACE, received his undergraduate training at Yale and his medical degree from Case Western Reserve University School of Medicine where he was elected to Alpha Omega Alpha. His research papers have been published in several major medical journals. Dr. Spark is co-author of the recently published AACE Clinical Practice Guidelines on Hypogonadism and Erectile Dysfunction. Dr. Spark has written three books on men’s health and has also written for articles that have appeared in the New York Times Sunday Magazine and the New Republic. He and his wife have been married for 48 years and they have four wonderful children, one grandson and twin granddaughters.

I was told the opposite, that T therapy would enlarge the prostrate and cause less....

 

Wish I had the results some of you have but wasn't doing it for me so stopped.

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BigAl

Never rely on one article, one test result, or one man's opinion. Do your research and see what works for your body. You are all that matters.

 

Current research shows the medical researchers still do not know why the prostate grows. They see the symptom and design a way to fix the symptom, but they do not understand the root cause.

BUT they will sell you drugs that might fix the problem and have a few "side effects" for no extra charge.

 

I'll stick with having my own body produce a higher level of testosterone and keep my E2 in check. Works for me.

 

Ran across a great quote: "You cannot outexercise a poor diet."

What is you're dosage level? And at what level did you start to have to keep your e2 in check? Or is it a time issue not dosage issue? I know manybof the gym guys are dosing at up to 50mg twice a day. Which is double the females fertility use rate and what.... Eight times the the 25mg twice a day??

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nothingbutquestions

As men our enemy is not T, but a lowered level of T due to an elevated E2. DON't LISTEN TO CRAP! Do your own homework! Learn how your body works! Our prostate are small when our T levels are highest from ages 15 to 40. Then T levels drop and the Prostate grows. 2+2=4

 

At 66, I wanted to be what my mind thinks I am. Not the guy I saw in the mirror. Now my time exercising is finally paying benefits and I like what I see and how I feel.

I took my T level at 600 plus and raised it to 900 plus (see my previous post) using 25 mg e.o.d at night because that is when your body makes everything.

IMHO, twice a day is crazy. Your body does not work that way. I take the AI the same way - 1/4 mg e.o.d. at night.

 

You can't fix stupid.Too great a doseage too often is a recipe for disaster. Everything in moderation; nothing in excess.

 

Test your T and, if possible, Free T. You want to use the lowest possible dose to achieve you goal - and nothing more. For me that was 25 mg e.o.d. Keep the AI on hand.

 

I cannot help you with when the E2 became a problem, except as time - post 60 days, but it might be T level related just as easily. Remember I didn't see a  problem until the Prostate swelled. I know the problem disappeared in 3 days after the I started the AI, but I do not know whether it started as quickly as it stopped. It may have been slowly developing, maybe not. Right now with the AI, that is totally academic. Praise God, everything is working.

 

I will test again in late November to verify my T is still above 900 and to see if my Free T has gone up since starting the AI. It certainly feels that way, but the tests will simply document it.

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