Seeing Dr. Mariano tomorrow!

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    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.

    Eisenhower

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    Quote Originally Posted by Eisenhower View Post
    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.

    Eisenhower
    You have presented very few tests.
    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.

    Good luck.
    --------------------------------------------------------
    You may want to print my long list and take it with you, post #44 here;
    between blue lines:

    http://anabolicminds.com/forum/male-...oodtest-2.html
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    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!

    Eisenhower
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    Quote Originally Posted by Eisenhower View Post
    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!

    Eisenhower
    Looking at your labs your e2 was way too low. We are setting the percedent at now lower then 18 on ultrasensttive e2 on our clients. You can set this even higher if you are on thyroid meds. You main problem is a no brain, cortisol and insulin are slowing t4 to t3 conversion probably producing high levels of t3. Dr M is very good. He works at reducing cortisol, but properly modulating sleep. He probably got you on klozpine for sleep which reduced adrenaline and calms cortisol. The guy is very brillant especially being psychitrist. Knows hormones inside and out. Eating better does help but what to eat in what ratio is the key to recovering health. I would love to work in conjunction with him handling his patients nutritoinal supplementation plans because hey both will fully compliment one another.
    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.
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    Quote Originally Posted by Eisenhower
    He's got me on 3 prescriptions and 9 supplements/vitamins designed to give me more restful sleep
    Eisenhower
    Can you say what prescriptions/supplements he put you on for sleep support?
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    Sure, for sleep it was Clonidine and 5-HTP.
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    Quote Originally Posted by Eisenhower View Post
    Sure, for sleep it was Clonidine and 5-HTP.
    like I did not already now..
    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.
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    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.
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    Hey Eisenhower,

    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.
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    Quote Originally Posted by Eisenhower View Post
    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.

    Eisenhower

    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.
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    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.
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    Quote Originally Posted by Eisenhower View Post
    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.
    fwiw, clonidine did NOTHING for my sleep. 5HTP did little. neither caused erectile issues -- take it after you have sex, to mitigate. if you have a serious sleep disorder, i would recommend seeing a sleep medicine doc, so you can get a polysomnogram. that's what i did, and i ended up having severe apnea, even though i do not present with the physical characteristics typical of someone with this disorder -- large neck, heavy set, etc.

    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.
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    total t= 460
    estradiol= 15
    ratio= 30:1

    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.
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    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 ...
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    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.
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    Quote Originally Posted by Eisenhower View Post
    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 ...
    I still think you need to know your free and/or bioavailable T, and am surprised no one has echoed this, particularly Jans. I do understand some don't see value in this number. My doc does.

    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.
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    What state is Dr. Mariano located in?

    Thanks,

    Mike
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    California, Monterey specifically. It's a nice drive down to Monterey from San Jose, which is the closest major airport.
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