Ask Dr Rand McClain

[Fatboy]

Hello Doc!

I’m going to try to be a minimalist so this post doesn’t run away from me but as an FYI I’m happy to provide more info and blood work if needed.

I have recently lost 100 pounds. I did so by ketogenic eating, working out like a mad man and sometimes intermittent fasting. No supplements. I currently weigh 280 and ALL my weight loss/hard gaining has stopped. After practically forcing my doctor to run the test my total test came back at 270. (Imagine what it was when I was 100 pounds heavier and eating a low fat diet) He refuses to do anything because 270 is “within normal reference range” even though I explained to him that the society of endocrinologists says that’s normal for an 80 year old.

I’m in my early 30’s and planning to have kids soon so impotence is not desirable to me. I don’t need to be a massive man just a healthy man with dry hard muscle would be great. I’ve done tons of research and my goal is to reach a side effect free total test level of 1,000 or more with a good healthy lipid panel.

The drugs im strongly considering are Aromasin, Enclomiphene and SR9009 for its lipid benefits more so than performance although I’ll take any advantage I can get. If that didn’t set me up nicely I would consider adding HCG or HMG.

Is this a good or acceptable strategy? I know I’m no doctor but I have to do something and I’m battling with zero energy and a grey outlook on life. I need to make a decision and I need to make it now. Please help because no doctor in my small town will.

Lastly, despite low T my libido has always been sky high. Does that signify anything relevant that I should be considering?

 

[Amacher]

How would I take glucophage with rhGH?

 

[Amacher]

Hi Amacher,
Of course, everyone is different, but the pituitary usually picks up where it left off pretty quickly. I refer to it as similar to a gas powered engine as opposed to a diesel. The length of time using HGH and one's age plays a very large role in the speed at which you regain your "normal" function. However, you state your baseline is 78 ng/mL and you are diagnosed with GH deficiency. Since you have deficiency (78 ng/mL is definitely low for IGF-1 compared to what you were likely producing at 20 years old which would be closer to 300 to 350 ng/mL), to regain that "baseline" shouldn't take very long, and won't make that much difference to you whether we see 68 or 88 ng/mL, because this is a relatively low IGF-1. Things to consider when evaluating your "optimum" level of IGF-1 would include whether you are a vegan or vegetarian, have diabetes or other metabolism issues, and your age. To more directly answer your question, yes, likely weeks rather than months if you are otherwise healthy and don't have a diagnosis of GH deficiency. This can be accelerated through the use of secretagogues now such as ibutamoren, GHRP-2 and 6, Ipamorelin, and sermorelin.

Thank you for the reply Dr. McClain,

I don't know if you ready previously, but I am a 28 year old male, former collegiate football player, 6'2" 340 lbs, 26% bf, and diagnoses with AGHD by my endocrinologist. I am on 250mg of Test E as part of my TRT as well as 0.3mg of Genotropin ED. I am satisfied with being on 250mg of Test E per week, but want to increase my rhGH dose to 1.2mg (4IU) or even as high as 1.5mg (5IU). My endo requested blood work to be done, and one of them included IGF-1 serum levels. I stopped taking my prescribed Genotropin dose for ten days.

On the morning of tenth day, I fasted, and had my blood drawn at 1pm (I woke up at 8am that morning). Now, I did a blood draw with a private lab before the blood draw with my endo, and by taking 0.3mg rhGH-Genotropin, my IGF-1 serum levels were at 340 ng/mL, which is really high (interval: 87ng/mL to 255 ng/mL). Hopefully, by taking ten days off of my rhGH daily dose, my IGF-1 serum levels are <87ng/mL or def in the lower tier of that interval. Do you think my levels will drop off low enough, so my endo will prescribe me more Genotropin? That is the goal here. I want more legally prescribed rhGH from my doctor, and my insurance pays 100% of it!

Thanks,

Ryan

 

[Vince]

Hi Dr. McClain.
One of my main reasons I'm trying to improve my thyroid levels, is the positive effect it has on LDL cholesterol. Free T3 increases the production of the LDL receptor which binds the LDL cholesterol. The more efficiently the liver cells make this receptor the faster LDL is cleared from the blood. It also effects the production of an enzyme called HMG-CoA reductase which is the exact enzyme that cholesterol drugs target. The journal of Preventive Cardiology.

A new member recently posted this, I was wondering your thoughts.

I have high TPO antibodies and a TSH. of 5 and without symptoms and was seeing a prominent hormone specialist on the West coast. He said there is actually no medical evidence that thyroid replacement is necessary in the asymptomatic patient. He suggested that thyroid replacement is advocated by the pharmaceutical companies.

It's Rand McClain. I believe he is associated with Defy Medical

​

https://www.excelmale.com/forum/sho...tart-thyroid-medication-until-TSH-reaches-10!
​

 

[NB1988]

Hello, Dr Rand

First, thanks for taking time to answer our questions. I have low t (260ish range) and am a 29 year old male. I just started taking 140mg test weekly. I have a condition called sphincter of oddi that I'm hoping to cure with trt. It's a female dominate diesase that seems to be effected by hormones. Which I might be able to confirm, because it has gotten worse on this first week of just test. So, my question is have you heard of these disease? Or have any experiance with handing it? Or maybe know of something I should ask for from my trt center?

Thanks

 

[Craig2016]

Hello. I have a few questions for Dr Rand, and I hope I am in the right place. My questions relate to SARMS.

First, what are the possible effects of SARMS on Estrogen, specifically E2 and is there any possibility of getting gyno symptoms arising from SARMS?
Secondly, if SARMS are not the direct cause of Gyno, what could possibly be the cause?

To explain, the context: I had bloods run before the start of my cycle: Test was at 14.7 and E2 was at about 87 pmol/L. Then I started a cycle of the SRMS RAD140 at 20gm per day (and GW501516). After 6 days i noticed puffy nipples. I then ran bloods and the results were that Test was at 6.7 and E2 was at 50 pmol/L. Does this mean i was Estrogen dominant?

This confuses me because, most of the articles I see say SARMS should not affect estrogen? But it seems that RAD 14 had this effect?
If I ran RAD 140 again, what should I do? If I take an AI (like Arimadex or Aromasin) will that not decrease E2, too much?

Also if I take a cycle of Test P, Test E or even Anavar, is it likely that these symptoms will recur. Should I take an AI in ALL cases?

I would like to figure out what is going on with the chemistry here.

 

[Nelson Vergel]

Dr McClain may reply soon, but I wanted to chime in. SARMS increase IGF-1 and decrease testosterone/estradiol ratio, two factors that may be involved in gynecomastia in men with genetic predisposition to it. Watch this video (you can start at 33:45)

Estradiol Lecture by Nelson Vergel

 

[Pursuit_Sanus]

Hello Dr. McClain,

Appreciate your time and knowledge you spend to answer questions on the forums. I recently had a 23&me dna test done and found I have a lower expression of MAO-A gene (oxidizes serotonin, dopamine, epinephrine, norepinephrine). I've been on TRT for a little over two years and have struggled to get things balanced out. I feel like most of the time has been spent chasing unwanted side effects. Mood swings and acne initially. *** seemed to clear the acne. HCG always left me feeling a little unbalanced although it did give a libido and sensitivity boost. If I stay off the HCG, my testicles ache almost constantly. I was told recently this lower expression of MAO-A gene can make getting things dialed in quite tricky as this makes me more sensitive to androgens and estrogens. Do you have any experience with this or read up any on how genes can affect this?

 

[Mark_Smith]

Hi Dr McClain,

I have been suffering from "Post Finasteride Syndrome" for over 10 years. The majority of doctors around the world believe that this condition is extremely complex and there is no known cure.

What is your take on Post Finasteride Syndrome? Is it curable?

My situation is that I took Finasteride for around 6 months and at some point (I think when I discontinued it) my free testosterone fell to below range as well as my LH with FSH being very low. Would you suspect ongoing estrogen dominance here?

I have tried TRT, PCT and low dose Arimidex which have not made me any better. Free T and LH remain low over 10 years later.

I do not have sensitive E2 testing in my country and so my E2 has often come back mid range.

Also how do you work around E2 testing if sensitive testing is not available?

Appreciate your response.

 

[joshmaximus]

Dr. McClain, do u recomend to your patients to supplement with dhea and pregnalone while on trt to backfill pathways? I have a lower dhea level sinc being on trt and started supplementing with both. Just curious your thoughts on supplementing them.

 

[Vince Carter]

I wouldn't hold my breath

Rand McClain DO
Member
Last seen Jun 27, 2018

 

[joshmaximus]

I wouldn't hold my breath

Rand McClain DO
Member
Last seen Jun 27, 2018

Vince are u replying to me?

 

[Vince Carter]

Vince are u replying to me?

Dr Rand hasn't been here in four months so you might ask elsewhere if you want an answer. No one else seems to get it this apparently.

 

[Tommy Wall]

Well I think the threads have come to an end by now

 

[joshmaximus]

Dr Rand hasn't been here in four months so you might ask elsewhere if you want an answer. No one else seems to get it this apparently.

Gotcha thanks

 

[Mark_Smith]

Vince Carter, people "get it" but some are desperate for answers to their health which is why they still ask questions here.

Nothing wrong with that.