This website is for me, an MD, very provocative. The fund of knowledge of many of you is quite impressive. I am saying this with 60 years of medicine under my belt. Yes, I am an old timer and the end of this year I will retire at age 81. My focus for 40 years has been on prostate cancer and prostate diseases. Here's my take on what many of you find challenging.
1. Each individual is a UBO (unique biologic organism) and given your different ages, different meds and supplements, along with variable diet and life styles, it is not reasonable to equate your health status.
2. The essence of good medicine is to understand, as best as possible, the status of each individual. Status is the biological reality coupled of that person coupled with all the ramifications of mental health, diet and lifestyle as well as genetics and epi-genetics. Without a proper assessment of status, optimal strategy is essential some level of speculation. The rule of thumb, therefore, is ACCURATE STATUS ➜➜➜ OPTIMAL STRATEGY AND THERAPEUTIC INDEX.
3. The use of erythropoietin (EPO) should never be taken lightly. More is not better and in all of biology it is usually the Goldilocks Principle (GLP) that works best for each person: not too hot, not too cold, but just right. If you look at biological systems, key words are balance and communication. The cross-talk between every body system is real. I call this SAIN (Systems Analysis & Integrity Networking) medicine. Currently, the way medicine is practiced is insane.
4. Those of you on multiple meds and supplements should keep track of your status using some form of flow sheet. If there was a way to do a Zoom conference vis-à-vis Nelson, I could share this approach with you. A flow sheet is crucial since it involves the principles of (a) cause and effect, (b) chronology of events, and (c) titration (balancing dose vs. desired effect). An example of the latter and how it is not used is the typical advise to patients regarding taking Vitamin D. Take 1,000 IU/d says the MD-- but he or she never obtains the lab test to ascertain the serum level of (25-OH)-D3 and whether or not it is adequate. We do the same biologically ridiculous thing with aspirin (ASA) when we use a "one size fits all" approach and advise everyone to take 81 mg/d. Some people with activated coagulation systems require more than that to optimize platelet aggregation and adhesion and others may be very sensitive to ASA and require less or perhaps no ASA at all. Again: "status."
So for the guys on many meds, including testosterone, EPO, HCG, etc, the testing of not only the hematocrit (HCT) but also a consideration to check serum viscosity, and to measure estradiol given the HCG use and to realize that an elevation in estradiol has many biological effects, including salt and water retention. And not knowing about diet and what foods are inherently high in Na+ (sodium) and the effect that might have on exercise tolerance and on pulmonary function is important. And not only that but E2 will stimulate prolactin and have many adverse effects on health in the basically healthy male but even moreso in men with prostate diseases.
Real medicine is an art and that art has become endangered. The time spent between MD and patient is now limited as physicians devolve into employees of health corporations whose bottom line is the bottom line.
With all this said, I would say that the level of intellect shown on this site is way up there compared to the many forums I have checked out over the last 30 years.
