madman
Super Moderator
ANOTHER QUICK UPDATE
Had cardiologist appointment yesterday July 8. New doctor. His exact words... you are way too young and too good of shape for Erectile Dysfunction. I will do my best for you but I believe this is hormone related. He ordered
CT Coronary Calcium test (first doctor to ever order one).
Lipid Profile
Lipoprotein (a)
Echocardiogram
He said if everything checks ok with the lab tests. No need for a Echocardiogram. Just disregard the Echocardiogram.
I had a session with a new Endocrinologist today (July 9). He said after 5 years of being on Test Cyp and still having Erectile Dysfunction... I can assure you... I will be your last doctor to see. I guarantee I will fix this. Your insurance may not cover some of the drugs I will prescribe... but your problem will be solved. (Yes, I like his confidence. But... I'm still preparing for another doctor failure.)
He said... I would like to see what your body produces naturally (hormone wise.) But I'm not going to make you go through all that... (coming off of Test Cyp.) Here are the labs I have ordered for you.
Total Testosterone
FSH
LH
DHEA Sulfate
Prolactin
Estradiol LCMS
Progesterone LCMS
IGF-1
Cortisol Random
CBC
Comp. Metabolic Panel
Hemoglobin A1c
Lipid Panel
T4 Free
TSH
Vitamin B12
Vitamin D 25-Hydroxy
From our 10 minute conversation he told me he doesn't believe in Free Testosterone or Bioavailable Testosterone markers. He said the tests aren't accurate enough. Too many flaws in the test. Oddly he didn't order an SHBG. He did say it is important but apparently not on the initial examination???
We continued to have the conversation... I told him... you know how your stomach growls at you and your immediate animal instinct is to make something to eat? I mean... it's automatic right? You're hungry... you eat. There's no in between... in guessing if you're hungry or not. When you see an attractive girl with big boobs... an amazing body... and you don't desire her?? You don't sit there and debate if you want her? You go and get it! And if you don't... there's something very wrong with you. Well... that's where I'm at. I have no interest in sex. I have no interest in the act. When the sh## don't work... it don't work. But in all reality... it should work! The doctor responded... I have never heard of anyone describe it the way you just did. But I 100% get your point. He said get your labs done... and see me in about 2 weeks.
Like I said men... giving this Endo a chance... we'll see what happens.
This is pure nonsense!
Although there is no standardized FT assay as of yet you can still use/rely upon the gold standard ED assay and yes although there can be chance of an inaccurate result now and then due to operator error as it is a painstaking technically demanding procedure for the most part if you are using a reliable lab it should be good to go.
Even than if you have doubts than you can easily use/rely upon calculated FT which would be the linear law-of mass action cFTV as it has already been validated twice when compared against a higher order reference method ED assay let alone the CDCs new standardized Equilibrium Dialysis assay.
Yes cFTV tends to overestimate slightly but it is nothing to fret over!
Your doctor is a f**KING idiot!
Again although TT is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the benefits.
You are wasting your time flying blind here as you have no clue where your trough FT sits.
Going to be running around in circles and judging by the most recent labs you posted let alone some of your previous threads I responded to you are most likely still running a high trough FT level!
You are hitting a high-end trough TT 863 ng/dL and from what I remember your SHBG has always hovered between 14- low 20s.
With a high-end trough TT 863 ng/dL and low/lowish SHBG let alone even if you had normal SHBG your trough FT will be f**KING HIGH!
Remember what I have stated numerous times on the forum over the years, tread lightly when it comes to how high you run your trough/steady-state FT level as running too high a FT can be just as bad in many ways as having too low a FT especially when it comes to mood, libido and erectile function!