Dr Rotman what disease state contributes to high SHBG? I always thought this was mostly hereditary.
Hi Guys,
I am always willing to answer any questions involved with TRT and it's urological implications. Will check back frequently answer all your questions. Thanks !
Two questions about HCG monotherapy with high doses like 5000 iu per week:
1) From what I've realized by researching, the guys often have problems with aromatization during high doses HCG mono and difficulties in dealing with the situation. In your experience, what would be the best ways to deal with it?? Make use of an AI?? If so, what would be the best type, dosage etc??
I do not have many patients on very high doses oh HCG therefore my experience is limited. The patients however that I have managed on these doses, responded to aromatase inhibitors. In addition, recent studies demonstrate slightly elevated estradiol levels are not harmful without any associated symptoms. I would rather have slightly high E2 than very low E2 which complicates matters.
2) I also noticed that the guys have troubles in getting off of high doses hcg monotherapy, with hormone imbalances (like too much drop in testosterone etc). What is the best way to get off of hcg monotherapy?? Do some pct?? If yes, what would be the best pct in that case??
Dr Roman, I always had a too short frenulum that causes somd discomfort when my penis is erected. I´ve been considering to have cut. However I see that there are big veins under and around it. It is a risky to have cut?
I am 56 years old, on TRT for 9 years. My PSA has always been 2.3 - 2.4. In the last year, it's jumped to 3.6. My urologist wants to do a prostate biopsy which I am not looking forward to at all. Is there any way to lower PSA? I've read that if you do not ejaculate for 48 hours or more prior to blood draw, the result may be lower. (Incidentally, in the last year I've had more sex than I've ever had in my entire life. Could this be the cause of the elevated numbers?) Do you have any thoughts about this? Thanks.
Dr. Rotman,
Thank you again! I'll repeat how great it is of you to participate in this forum and he'll those of us trying to take reasonability for our health.
I'm​ 42 and have been on TRT for around 8 years. Beginning in January I actually changed from the 2ml every 2 week protocol, to a more reasonable .4ml every 3.5 days subq. 2 weeks ago I began .5 mg anastrozole the day after my shot to deal with the (sensitive) 70 e2 level I have struggled with.
My question is what could be possible causes of urination issues including weak stream and not emptying that show up with increasing severity leading up to the day of my shot then go away completely for around 24 hours following my shot then began to build again. I only began to notice them the last month or so but may just be because I'm paying attention now.
My last PSA was between 1 and 2. I'm going to have another panel ran in 4 weeks or so to quantify the protocol changes I have made.
Thank you again!
Hi, doctor, I'm interested in your view of this study, where Testosterone on PC patients caused INHIBITION of prostate-cancer cells proliferation.
"Dr. Khera presents results from his own research, showing that at lower androgen concentrations than the optimal level, increasing androgen concentration promotes proliferation of prostate cancer cells. However, at the higher concentrations, further increasing androgen concentration results in a dose-dependent inhibition of proliferation.[31] He introduces an RCT currently in progress that his team got FDA approved (NCT00848479), which will investigate the safety of testosterone replacement therapy starting 3 months after radical prostatectomy."
link to article> http://www.agelessforever.net/anti-...-on-testosterone-prostate-cancer-and-bph-luts
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507510/
The study you quote was done in patient with castrate resistant prostate cancer so it is very specific. These are very advanced prostate cancer patients with a poor long term prognosis. Now, giving patients who had prostate cancer and are cancer free is an area where a few urologists including myself are selectively treating hypogonadal patients. This is being done at major cancer centers as well such as Memorial Sloan Kettering.
No, that's not what this research concludes.Hm, so it is possible to cure cancer with androgen deprivation therapy and then, when it's cured to continue with TRT safe without cancer coming back ? I thought that patients on Androgen Deprivation Therapy has to be for life on it.... Which is very bad quality of life....
Hi Doctor, wow, so much good info on this board. I'm fairly new here but my question deals with HCG. I started Androgel in 2012, my doctor didn't know a lot about hcg or an AI and in fact my estradiol levels were never checked until recently. Due to a job/insurance change I recently switched to T Cyp injections (120mg/wk) which are so much better, wish I had done it earlier. I was also prescribed hcg at 500 iu a week (low, I know). We are done having children so my only goal is to reverse testicular atrophy and get my testicles back to their, hopefully, former glory. My questions are;
1. For someone who was on trt for roughly 5 years without, what would be your hcg protocol?
2. I know everyone is different but what could be expected as far as seeing results, and is it even likely?
Thanks for your time![/QUOTE
Some of what you recover depends on age, but 500 iu weekly of hcg should be sufficient with your protocol history.
No, that's not what this research concludes.