Seeing Dr. Mariano tomorrow!
- 10-16-2008, 09:55 PM
Seeing Dr. Mariano tomorrow!
Excited to see Dr. M tomorrow for the first time - I hope it will be the beginning of a new, better life for me with more energy and free from worries over mild ED.
Some test results he ordered that stood out to me are these:
Total T: 460 (280-800)
Estradiol: 15 (8-43)
Cortisol: 22.1 (4-22)
TSH: 1.31 (.45-4.50)
T3: 114 (80-200)
T4: 9 (4.5-12.5)
Albumin 5.5 (3.3-4.9)
Triglycerides 329 (<150)
HDL Chol: 31 (>39)
I kind of expected higher Estradiol. Of course the high Tryglicerides are bad. Anyone care to comment. This is all new to me and these numbers are very confusing. In the two previous T tests I had done by my Uro and and Endo, I scored Total T of 237 and 434. Both failed to offer any treatment whatsoever.
- 10-17-2008, 11:01 AM
Dr Marianco will start most likely from scatch.
Myself I would start with comprehensive test.
But if you would decide to go small,
thyroid and lipids.
You may want to print my long list and take it with you, post #44 here;
between blue lines:
- 10-18-2008, 05:38 PM
I agree, I didn't post everything ... there was so much. Bottom line is my meeting with Dr. M was very enlightening and I found him to be as knowledgeable and easy to talk to as I'd hoped.
Without getting into specifics, he feels my problem is metabolic, and that my poor sleep quality and poor diet are responsible for a hormonal system that "sputters." He said my Estradiol is actually low, and this might be more to blame for libido problems that the T level - very interesting. He's got me on 3 prescriptions and 9 supplements/vitamins designed to give me more restful sleep and address nutritional imbalances in my diet, along with orders to eat better!
I'm very pleased with the visit - it was the most involved 2 hours I've ever spent with a doctor. I have great hope!
10-18-2008, 06:33 PM
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
10-18-2008, 10:02 PM
Can you say what prescriptions/supplements he put you on for sleep support?Originally Posted by Eisenhower
10-19-2008, 11:11 AM
10-19-2008, 11:27 AM
10-19-2008, 11:34 AM
One thing I'm woried about is that from reading online, it sounds like both Clonidine and 5-HTP can CAUSE erectile dysfunction. Any help here? I'm going to call Dr. M and ask about this. I sure don't want to make things worse in that regard.
10-19-2008, 05:32 PM
I am a patient of Dr. Mariano's, and I too am taking clonidine for the same reason as yourself. While there is a small chance that the clonidine and/or 5-HTP could cause erectile dysfunction, you have to understand that this would only be temporary, drug-induced dysfunction, rather than a chronic dysfunction caused by a "faulty" or damaged component of your body itself.
To be blunt, what I'm saying is that even if the treatment does make your **** limp for a few hours, the ultimate goal and direction of said treatment is one that results in the restoration of "normal" functioning, without the need for drugs. There may be a few side effects - and if you find them intolerable I am sure Dr. Mariano will come up with an alternate treatment plan - but Dr. Mariano knows his stuff; you're in experienced and dedicated hands.
I have personally not encountered any sexual problems from the clonidine, and in fact have seen an improvement in my ED as time goes on with the treatment.
10-20-2008, 06:11 PM
I think you need numbers for free and/or bioavailable test, to complete the picture. Your thyroid numbers look good. Cortisol is a little high, but that doesnt suggest a problem. I would not be looking to thyroid medicine as the cure.
Some sort of TRT may help, but again, I think we need the above referenced info.
Good luck with your appt.
10-21-2008, 12:40 AM
Dr. Mariano felt my low E2 was likely the problem with my libido, since, as he put it, 460 T wasn't that bad. But he never mentioned boosting the E2. That may come later, I suppose, right now he wants to address my sleep and nutrition.
But theoretically, are there options for boosting E2? I never hear about that, I guess since high E2 seems to be more common.
10-21-2008, 01:52 AM
if you take some OTC supplements to get your T up, the E2 should fall into place. you may wish to consider taking tribulus and maca (for libido and adrenals). better yet, hCG (prescription) or clomid (prescription or research chemical).
glad your appt went well. dr. M is a good doctor.
10-21-2008, 08:19 AM
total t= 460
I always thought the ration between T and E should be better than 30:1, so I wonder why DR. M wants to raise estradiol? In my opinion, increasing estradiol and keeping testosterone the same will hurt libido.
10-21-2008, 09:23 AM
Dr. M didn't say he wants to raise to raise E2, I was just asking if that is possible. He wants to treat the sleep and nutrition and I suspect see if T and E2 come up then ...
10-21-2008, 10:45 AM
Would you mind telling us what the 5-HTP dosing schedule is like? I assume it is once a day, at bedtime - but that may be incorrect. What is his recommended dosage per dose?
BTW - I think 5-HTP is awesome.
10-21-2008, 11:38 AM
I hope that your diet and sleep can get it done. I don't know, as I still have not gotten control of my sleep and had to turn to HRT. But my numbers were a fair amount lower than yours.
Typical 5HTP dose is 100 mgs at night. Personally, it doesn't make me tired, but it still may be good for sleep quality, and it may make you tired. I have postural orthostatic tachycardia (adrenalin surges when I change positions) and clonadine did not help my issue. But it may help yours.
10-21-2008, 02:57 PM
What state is Dr. Mariano located in?
10-21-2008, 04:05 PM
California, Monterey specifically. It's a nice drive down to Monterey from San Jose, which is the closest major airport.
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