What Tests should one run for ED
- 11-15-2008, 07:41 AM
What Tests should one run for ED
Prepping myself up to see the Endocrinologist in a month or so.
I was wondering guys what tests would you expect to see a competent Endo run to get to the bottom (yes yes...skip the doubt entendre) of erectile dysfunction
I believe we would want:
Estradiol (is that Eostrogen or however its spelt?)
Further question: Pituitary and Thyroid tests? Should I be asking for those or are those enmeshed in the tests for all of the above.
Tear that to shreds but I am curious as to what is the bomb when it comes to covering bases. I am trying to get up to speed on what hormone situation/ combination of situations reeks havoc on the Erectile function. The doctors here play us patients as nitwits. I had one saying my LH as per below is best left low since if it is higher than what it is that means the brain is having to compensate for the Testicles not producing enough Testosterone. Well to my mind and understanding the LH below sucks as does my testosterone (Free T sucks). So that story doesnt cut with me.
The only blood test done so far are those by my GP and they read:
Testosterone: 10.00 nmol/L (6.0 - 30.0)
S.H.B.G. 24 nmol/L (15 - 70) - I
F.A.I. 41.7 & (18.0 - 210.0) -
Free Testost: 233 (170 - 500)
FSH: 3.9 (IU/L (1.0 - 18.0)
L H: 1.0 (1.0 - 12.0)
Prolactin 7.5 ug/L (<20.0)
- 11-15-2008, 08:15 AM
I would suggest a urologist. Blood pressure, cholesterols, stress test, t3, t4, tsh, hepatic panel, sleep test, PSA, DHT....If all else fails you can get checked for a venous leak. More evasive. Can you get erections when you masturbate? Do you get morning erections? Are you in a committed relationship? Have you tried Zma? There are signs if you can read them maybe it could help you discover the cause.
11-15-2008, 08:22 AM
A good selection of things I can familiarise myself on in that list you provided. Excellent help because I dont want them cutting corners with testing on me this time.
I have to see my Urologist first anyway so he can perform this rather than Endo as you say.
No I cant get erection from masturbation. Thats the part that freaks me out a bit. I only started to get morning erections after a Varicocele operation Sept 29. Before then I couldnt even get that. The morning erection is quite good. For months pre op I just had nothing in the morning.
I have a lovely wife but she is working overseas for an American company at the moment. She will be with me when she resigns in 3 months.
I know there are things (supplements) to try that work for some (Sustain Alpha etc)but I dont want to try them yet while testing is going on. I want to see just how my results pan out. But certainly its pretty bad when you cant get it up by masturbation in my case. Thats something I never thought I'd ever suffer from.
11-17-2008, 11:11 PM
11-18-2008, 03:39 AM
11-19-2008, 11:46 AM
Remember, you cannot will yourself to have an erection. In fact, you don't have to do anything to have an erection - if you are sufficiently aroused, it will happen automatically, so it is a matter of just relaxing and focusing on arousing thoughts, images, videos, whatever, not on how hard you are. Likewise, whenever you find yourself thinking about your erection, you should not try to make yourself stop. Instead, just try to gently refocus your attention onto something that is arousing to you.
Keeping these things in mind might be helpful, but do not expect immediate results. Going with a qualified therapist is probably the best way to learn these kinds of techniques. They can determine what thought processes and behaviors are interfering and help you to neutralize them with simple techniques.
11-19-2008, 12:48 PM
LH is released in pulses and you hit a low point. Your TT is not great and your FT is ok. Doc will not see that as a problem.
You appear to be overweight. That can increase E2. E2 represses the HPTA and also has direct negative effects on libido and sexual performance.
E2 causes BPH.... what are your PSA numbers and trends?
What is your serum glucose?
Hypothyroidism and hypogonadism have many symptoms in common, including libido and ED. Test TSH, T4, free T4, free T3.
Age? Build? Fat deposit patterns?
11-19-2008, 05:47 PM
I have been battling this change in my life for the past year and half and it truly is a struggle .... I am on my 4th urologist .... GAWD ....
11-19-2008, 06:37 PM
11-20-2008, 04:22 AM
[QUOTE=KSman;1658964]LH is released in pulses and you hit a low point. Your TT is not great and your FT is ok. Doc will not see that as a problem. i see a problem with my low TT even if doctor doesnt. I will be pushing for higher T. I need a lot more tests done as I was ignorant of how much testing I need done and so at the mercy of the doctors before I discovered this board. That will change now. I run the testing starting next month. Thats why I cant provide all the figs at the moment
You appear to be overweight. That can increase E2. E2 represses the HPTA and also has direct negative effects on libido and sexual performance. Lol at overweight...I am 79 - 80kg. Thats not bad for 181cm tall. Another 2 cm and I would be 6 foot. I notice sportsman in Australia (Australian Rules Football or Footballers) who are same height are about same weight as me. Did you read the "176 as kilo's? Its American in pounds. I think I converted it correct as pounds arent used here in Australia. If you see me, you will see I am perfect build. Slim and hard stomach, reasonable chest and arms. Strong muscular legs and behind. I was always a stronger build below the navel for some reason. Must be genetic. Generations of footballers
11-20-2008, 04:37 AM
I do notice one trend that is not auguring well for my T levels. After my varicocele operation, I expected all the hair down below to grow back quick. Two months later and the shaved nether region hair is only 1 cm long. I shaved the hair on my temples too and it barely grows back. I shave only once every two days. To me this is a sign of something not right. Some stupid Urologist who was later struck off for incompetence (not an easy thing to do in Australia where incompetence seems to lend itself to being a specialists or GP) once said that "Are you still shaving?" I said yes....to which he replied "Then you dont have a T issue"
Lol. What a dope he was. I reminded him I used to shave twice a day when all was well. Not once every two days. He had no answer. Just another specialist polishing an executive suite chair while raking in easy money by not lifting a finger to help me get a lift period.
11-20-2008, 04:40 AM
11-20-2008, 04:45 AM
Thats nonsense as I used to get erections just thinking about Judge Judy in a low cut floral one piece on the shore of lake superior with large dark sunglasses on.
11-20-2008, 11:01 AM
I am trying to make you feel better, since psychogenic ED is relatively easy to fix with well-proven techniques. Many regular guys get it, it does not mean they are crazy, and there is no shame in it. Since you do have morning wood, there is a good possibility that that may be the case. But you should definitely first have a competent urologist examine your hormones and check if the penile nerves and vasculature are OK. You may have to insist on this or shop around, since a lot of them won't want to bother - they just want to give you meds and get you off their back if they are like typical doctors here in the U.S. Having said this, there is no shame in using meds in the meantime if it will help get your confidence back.
It is definitely possible that the bout of antidepressant use could have started you worrying about getting your wood back. Once a guy has become fixated on what his penis is doing it is very difficult to have a normal erection, which causes a vicious cycle that can perpetuate itself for a long time unless addressed.
Just so you know, once I started having problems, I also started spending a lot of time worrying about chemistry and other (in my case nonexistent) possible physical problems (which I thought could be due to taking Propecia/Dutasteride - without problems - until last year). Without a doubt these worries made the ED much worse. I would think things like "OK, my DHT has normalized now, so let's see if I get good wood," or "This is the best porn in the world, my hormones are fine, so why the **** is it not happening yet?". Of course, it is normal to think like this, but these are precisely the thoughts that are guaranteed to turn off the erection. In my case, these kind of thoughts were the problem, and counseling was very useful in bypassing them.
On a different note, I also had a varicocele when I was sixteen. It was promptly operated, and I didn't have any problems until about 4 years ago, when I started having pain again. My GP misdiagnosed it as epididymitis and put me on Cipro for two months while I was waiting, in a lot of pain, to see a urologist (yeah, the lovely waiting times of the wonderful U.S. health care system - the waiting time on the previous occasion was three days in South Africa). Of course the unnecessary antibiotics played absolute havoc on my system for many months afterwards, and I am still waiting for an apology for the misdiagnosis. The urologist diagnosed it as a recurrence of the varicocele, and said he could operate but it would probably go away by itself, which in fact it did soon after. I found exercise helpful, especially leg curls for some reason. Fortunately it did not negatively affect my testosterone.
11-21-2008, 04:43 AM
11-21-2008, 10:02 AM
Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging.
Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G.
Agreed on the imbecility of most specialists. I've been having my own struggle with a serially misdiagnosed shoulder injury for the past six months. In my experience here they are mostly lazy and stupid, so heaven forbid they should try confirming their guesses by putting in some extra effort to run tests and obtain actual data until you are at the point of complete incapacitation. It's more important to get you in and out of there in five minutes, if you are so lucky, and god forbid you should detain them by asking questions.
11-21-2008, 12:18 PM
T levels in guys varies of course. But some guys have had and need higher levels of T than others. But how to judge what the body needs or what level of T stimulation it used to get? Changes in hair growth really do tell a story, the story. And that story is not tainted by concerns of depression or mental issues at all. Nails can have slow growth and be brittle. Skin can be thin and frail.
Note that with age related hormone decline, many men are seen to have less hair, or hair loss, on their lower legs. TRT also reverses that.
11-21-2008, 08:39 PM
11-21-2008, 08:40 PM
11-22-2008, 05:25 AM
I will be trying the following in combination soon regardless of all the dumbass specialists dragging their feet.
Stoked/ Sustain Alpha and Tribestan. Just wonder what those can do for me. So long as they dont stop the old sperm factory from doing its thing (coz the wife will spit me out if she cant have a baby. Most T promoting products seems to turn the sperm production off. But these products claim not to. I had the varicocele op in Sept 29 to improve the sperm quality and so far that is proving a worthwhile exercise (even if I had to go to Vietnam to get it done) Mind you...if she cant have regular sex on demand she will probably spit me out anyway. So no point not trying them).
11-22-2008, 06:56 PM
Currently your FreeT=~67 per attached chart.
You want to have your FreeT(160-300)
You can have erection even if your FreeT~100
At certain personal level of Test your erection depends heavily on
Estradiol(E2)(20-30)(ultrasensitive type of test)
DHT(better if around upper range)
your prolactin looks good
#1, do not use (Sustain Alpha and Tribestan and similar sh*it)
To be fertile you will need HCG and possibly also HMG
You will first try to raise your test using HCG.
You will have to use HCG even it does not raise your testosterone sufficiently (fertility reasons and to prevent testicular athropy).
If your DHT is low you want to raise it, best with transdermal testosterone.
Best would be to have good (or properly adjusted)
You may be forced to take better overal care latter, now
quick version, (6-8) months project, until she is fertilized.
Freshness and availability of HCG is lately unreliable.
Get supply of about 70000iu HCG in no more than 5000iu,
better get 2000 or 1500iu ampoules, so you are sure that you are always using fresh HCG.
The other two are liquid, liquid is much better, easier to adjust dose.
Make sure that you will have HMG available if need.
It is expensive, hopefully you will not need it.
If you know that your DHT is low, get some Androgel (in pumps).
If DHT is ok, you will need depo-testosterone 200mg/mL
Get two or three 10ml vials.
Get some DHEA pills, in USA they are over the counter, not sure about Australia.
Get about 50 pills of 20mg Cialis
Get 300 insuline syringes 31Ga 5/16" long needle 3/10cc (three boxes)
Get 6-8 scripts for testing:
FreeT(160-300) (300 better)
Estrodial (20-30) guided by nightly erections
Test blood every 4-5 weeks, make adjustments as need to get to your goals.
Use Cialis 2pills/week, better cut them in half and use the four halfs within a week.
Start with 1000iu HCG shots EOD (every other day)
Control your E2 using Liquidex EOD.
If you need more than 1.5grams/week Liquidex, reduce HCG dose.
Do not use less than 250iu/shot
Use insuline syringe to dispense Liquidex, cut out needle completely.
Add Androgel, smallest amount that raises your DHT only to desirable level.
Add T-shots on EOD schedule if you still need to raise your FreeT.
Use graph below to figure your FreeT.
If she is not pregnant within 6-8 months add 75iu HMG EOD schedule
If she is not pregnant within about a year, check if you have a sperm, if you do, check her.
Stop or reduce to the minimum any thing that is made of
potato, wheat, rice
drop hydrogynated fats, margarine etc.
drop anything that says high-fructose
Replace above with (eaten raw) (variety) green vegetables, better juce the vegetables, drink juice and eat about 1/3 of the fiber.
Add as many (variety) of nuts as you wish.
Get EPA/DHA fats, specially those that emphasize DHA, (Flameout from testosteronenation)
11-23-2008, 10:38 AM
Originally Posted by JanSzLets stay on the board with this topic.Originally Posted by shyguava
Lets stay on just this one thread, easier to keep track.
Tribestan =(Tribulus Terrestris L.)
Sustain Alpha (7.5 oz) Manufactured by: Primordial Performance
That stuff is for show, just to give little edge to fully functional guys, so save your money.
It usually works if someone is missing only little bit,
your FreeT is hardly existing (FreeT=63).
I am telling you what may help you.
You should get about same advice as mine when you go and see a doctor.
Well, you would have to find a cross of TRT and fertility doctor.
Fertility doctors usually do not care if you have an erection, they will pull sperm out with needle.
Bottom line, it is your body, it is your decission of what you will do.
You said that you may loose your wife, I feel for you, this is best that I can offer.
There are other area of health that I have not addressed,
You should look into those soon.
If you wife would give you time it would be better if you look into them before you start with HCG, arimidex and testosterone supplementation project.
You will need good doctor,
but more important, he have to be willing to write you scripts for blood tests and at least some medicines that I mentioned.
Some medicines you can get over internet but I would be reluctant to do that with controled medicines.
So bottom line is a scripts for (frequent) blood tests, with out frequent blood tests do not even start, waste of time and energy.
11-23-2008, 12:46 PM
you might wanna check out if you have adrenal fatigue
if so hydrocortisone and dhea will help, as they have for me
my total testosterone rose 179 points by using HC/DHEA and free test doubled.. i had a surge in erectile function which proved to me that it wasn't all in my mind, and that i indeed had a hormonal problem
then i got soft again.. latest bloodtest show high estradiol.. lowering this will give me my wood back
i suggest you get with a good doc who treats adrenals first and then thyroid and testosterone.. treating in this order might naturally up your levels without the need for external testosterone
p.s. i also have varicocele as diagnosed by a urologist many years ago but this isn't the cause of my ED as tackling stress with the HC/DHEA has proven to be enough.. stress can be a major factor
p.s.2. for fertility i would skip on the cialis route i heard that taking these meds are not good for fertility, might wanna get some opinions on this one from some other guys on the board
11-23-2008, 01:04 PM
11-23-2008, 01:26 PM
11-23-2008, 01:59 PM
my doctor won't go above 30 mg dhea and 200 mg 7-keto-dhea
i don't know what that translates to in regular dhea, maybe 100 mg or so?
350 mg is crazy high i think, although ive seen BB-ers also use GRAMS of the stuff
anyway i was 8 on a scale to 12 so 30 mg is enough for me to raise it apparently
perhaps it's also difference in brand i don't know
11-23-2008, 04:06 PM
You are taking 30mg and your result is (ONLY) 8(12-30)
That is exactly my point, you have not enough DHEA.
Just get enough of these DHEA pills until your blood test read properly. You are abot 4x to low on DHEA may be much more, depends on range for 20yo and units.
DHEA is probably the cheapest supplement there is.
Another tack on the same subject.
I have been recently screwed on that.
It is about what range are you given on the blood test report.
I am 68yo.
I do my tests at Quest Diagnostics.
Quest Diagnostics: Test Menu
DHEA Sulfate mcg/dL
Adult Reference Ranges for DHEA Sulfate:
18-29 years: 110-510 mcg/dL
30-39 years: 110-370 mcg/dL
40-49 years: 45-345 mcg/dL
50-59 years: 25-240 mcg/dL
60-69 years: 25-95 mcg/dL
70-90 years: < or = 75 mcg/dL
So on my report I got that I am high on DHEAs, do not remember # but it was slightly higher than 95.
Damm, only latter I realised that I am actually very low on DHEAs.
Everyone needs number for a 20yo or higher.
Actually LEF.org recomends slightly higher range (500-640)
Dhea Restoration Therapy: Online References For Health Concerns
I do not want to say if you have to go only slightly above 30,
or possibly much much higher.
I do not know the units that you are using.
It looks like at least you have to quadrupple your current DHEA dose then test and see what it does for you.
11-23-2008, 04:14 PM
I already questioned my doc why he wanted to put me on DHEA. I said yeah i am at 8 already why do i need it? "Taking cortisol lowers dhea therefore you have to take along some dhea with it, also your urine values are low so that's why i want you to start on it". He gave me 30 mg dhea to start with. Then also 7-keto. Since i was already at 8, this amount of DHEA increased my levels to 12, meaning 50% higher than first. This is good and DHEA works for me.
Please tell me where i put in reference range 12-30 then i can check and edit that post. It's not correct reference range. 1-12 is.
11-23-2008, 04:59 PM
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