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Messages - Joe Sixpack

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Mitochondria and fasting always seem to come up together.  IIRC one of the benefits of fasting is that it activates autophagy, your bodies own cleansing process.  Autophagy in turn cleans up damaged mitochondria so that your body will generate fresh new ones.  Fasting as well as intermittent fasting is becoming a hot topic.  It seems like every other day I am reading about some new study showing a new dimension on how fasting is beneficial. 

I tried a two day fast a while back.  The first day sucked and was hard to get thru.  But day 2, I felt great. 

Most guys w/ prolactin issues are concerned with sexual function.  But you seem to be connecting prolactin to bone density.  Can prolactin have bone density impacts? 

I doubt that you'd be able to take Focalin and a dopamine agonist at the same time.  I would bet that your doc would have concerns that the combo would elevate your blood pressure too much. 

I agree.  The brown bottle does make it pretty inconvenient.  I'm sure the brown color protects the product from sun better.  But I keep my stuff in a dark cabinet anyway.  So the brown color isn't helping me in any way.

Oh no.  This is a big loss for men's health.  Dr. C was one of those guys who was always moving men's health forward.  Horrible news, especially for his clients and patients. 

One of the things that bugs me is the high numbers cited for estradiol in young men. The studies I've seen put the figure around 30 pg/mL. In the study cited by PeakT here the estradiol levels drop with age, at least in healthy subjects:

20-29: 28.0 pg/ml
30-39: 25.7 pg/ml
40-49: 24.7 pg/ml
50-59: 22.1 pg/ml
60-69: 21.5 pg/ml
70-80: 21.9 pg/ml

Many of us would guess that estradiol levels would rise as we put on weight with aging, right?  However, the data above shows that that is decidedly not the case and estradiol levels to tend to fall as the decades roll by.  This is part of the reason that so many men end up with osteoporosis.  And making the matter worse is that our SHBG levels climb, leaving us with less free estradiol as we age as well.  (SHBG binds to estradiol as well as testosterone.)

Most importantly, notice that youthful estradiol levels are 28 pg/ml for men in the 20's and about 26 pg/ml for men in their 30's according to this study.  This is a powerful argument that youthful estradiol levels fall right in the 20-30 range recommended by my old clinic.

Now someone might object and say, "But these included overweight and sick individual which would skew the results."  Sorry, but the researchers were one step ahead of you and only "healthy, non-obese subjects" where allowed in the study.  Average BMI was actually 24.6+/-2.5 kg/m^2.  This means that the highest BMI man in the study was 27.1.  So the argument seems weak that normal weight men tend to be high in estradiol.  In fact, notice that at no age were natural average estradiol levels above 30 pg/ml.

It should be noted, though, that, just as testosterone symptoms can be variable from individual to individual, there is no doubt that estradiol symptoms and levels can fall in the same category.  For example, the standard deviation in estradiol values for the 20-29 year olds was 23.43 pmol/.  This means that the top threshold for "normal" estradiol, if we look at one standard deviation up from the mean, is 34.4 pg/ml.  Thus, one could argue that youthful testosterone could be up to the mid 30's for a significant block of men.  The point is not to come up with hard and fast rules but rather to point out that youthful estradiol levels are generally not overly high.
Great info Cat.  I wonder if E2 levels used to be higher in the past, before T levels in western men started declining.

I have had some heart issues after starting TRT.  Sometimes it felt like my heart was beating too hard and sometimes I had a weird breathlessness sensation.  I am starting to believe that for me it is related to elevated blood pressure.  BP would be easy for you to check and rule out as a cause for your sensations.

my blood pressure has been excellent for years. (it gets taken maybe 3 times a year.) so excellent i have no idea what the numbers are. i just ask them "is that good" and they always say yes. what you are describing sounds about right. it was like being a little breathless when i was doing absolutely nothing and i'm not a pound overweight or inactive. no risk factors that i know of.

my doc wants a holter? test. a few days of heart monitoring which i will not be getting now because i assume things will return to normal. time will tell.
They gave me a holter to wear for a few days.  And luckily enough, I had one of those out of breath spells while wearing it.  The holter showed nothing wrong w/ my heart.  So that was kind of a relief.  It's worth your while to try it out.  I failed to mention that my symptoms seemed to correspond loosely to TRT dose changes.

I tried stinging nettle and tart cherry exxtract to lower my sky high SHBG.  Didn't do squat.

I have had some heart issues after starting TRT.  Sometimes it felt like my heart was beating too hard and sometimes I had a weird breathlessness sensation.  I am starting to believe that for me it is related to elevated blood pressure.  BP would be easy for you to check and rule out as a cause for your sensations.

Correct.  That is my trough.  And as you mention, I don't have much of a trough since I inject 3x / week as well as use topical cream daily.  This way I am much more stable than most people.  I also have to have a pretty high TT number because of high SHBG.  My free T is within normal range.

Testosterone, Hormones and General Men's Health / Re: Sleep Aids
« on: December 29, 2018, 05:42:11 pm »
HaHa congrats man. I also retired at 55. The absolute best decision I have ever made in my life.
I just turned 65 last month. Hard to believe it has been 10 year.
Now a days I can believe I ever had time to go to work 50 hours a week.

I hope you've made your bucket list it time to start.
Trust me there are many things you can do at 55 you won't be able to do a 65 get those done first.
Thank you my friend.  So far so good!

Testosterone, Hormones and General Men's Health / Re: Sleep Aids
« on: December 28, 2018, 05:26:15 pm »

FWIW I have had multiple sleep studies done.  I do have some sleep disturbances.  But in 3 studies, those disturbances did not warrant a CPAP device.
Thank God. I don't know how people sleep with those bulky gadgets on their faces. I could not do it. What if you found work that has a 2nd or 3rd shift.
Maybe you could sleep better during the day after working a night shift?
I just retired this month.  We'll see if that has any beneficial impacts to my sleep.  I should be able to cut back on the coffee, which in turn should help me get to sleep easier.   As a side note.  I highly recommend the retirement life!!

Testosterone, Hormones and General Men's Health / Re: Sleep Aids
« on: December 27, 2018, 08:15:00 pm »
I want to ask the crowd what supplements you use to help get to sleep. 

I was doing well on 1 MG of melatonin + 500 MG of L-Tryptophan.  But lately the Tryptophan has been giving me stomach upset.  So now I am looking for something to take its place.  I also was taking Ambien and Diphenhydramine several years ago.   They work very well, but both have been associated with long term dementia, so I don't want to take them if I can avoid it. 

What do you all use to help your sleep?

Melatonin/herbal complex I've used for years and had great results.
Which product?

I'm on TRT and have classic metabolic syndrome insulin resistance but not diabetic. I've tried Metformin (through Defy) a couple times but can't tolerate the fatigue it causes.  I have the dawn phenomenon also with overnight fasted glucose in the 120 to 128 range. Even taking 500 mg Berberine at bedtime does nothing for the fasting glucose levels. My postprandial glucose usually runs 110 to 116 depending on what I ate. 

Interesting comment.  How is it that you are diagnosed as insulin resistant?  Do they use your A1C level to check that?
I have heard that Metformin causes gastric distress, but hadn't heard of the fatigue thing.  I have heard that these side FX go away after a few weeks.  How long were you able to take the stuff before you gave up?  Did you also get upset stomach?  How much MET were you on? 


Dr. N's approach to super high T levels and high estrogen levels is interesting but is not fully accepted by his peers.  There is concern about long term effects and safety of both high T and high E levels.  I personally like his logic and he apparently has a lot of happy patients.  So I wish him success.  There always has to be pioneers that advance things forward in order to make progress.  Maybe he is doing so with his ideas.  He certainly gets a lot of reaction, both positive and negative.

Thanks, Joe. I've gathered that Dr. N is polarizing in the T community, but haven't seen any substantive responses to his approach. Does anything come to mind -- maybe an article, podcast, lecture? I'd love to see/hear a well-expressed counterpoint before I hop on the "super high T levels and high estrogen levels" train, which is the direction in which I'm leaning. Like you, I also like Dr. N's logic -- it seems reasonable to me -- but I don't want to risk my longterm health.
There were a few threads over at Excel Male forum where Dr. N had some back and forths with Dr Saya.  There was another thread there started by Dr. Chrisler where they brought Dr. N's ideas into the conversation.  The first thread was back in 2017 IIRC.  The one w/ Dr C was from Oct 2018.  You could probably search for these by looking for postings by their user names.   I have a ton of respect for all doctors mentioned and they all make very good arguments.  So it makes for interesting reading.

Here's a study showing directly that an AI can reduce SHBG:

... sex hormone binding globulin (SHBG) significantly decreased in women on AIs compared to no AIs at 24 months ...
Good catch Cat.  I didn't know AI's could do that.

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