Patients of Dr. Mariano

[jon671]

I am waiting for a bunch of labs to come back. I'm working with a doc to try and get insurance to cover treatment. Well it's been a long road and I'm suffering from depression, anxiety and all the other lovely symptoms of low t. However lately the depression and anxiety has gotten worse. The depression is not the "I hate my life type", but "I am sick of my health and this anxiety is becoming unbearable" type. :kabong:I want t and hcg does he prescribe this? I tested low 3 times. Anyway since he specializes in psychiatry and endocrinology I figured he will probably be able to help me. Plus it is much more economical to see him instead of Crisler. I tried emailing him, but no reply yet. My doc would rather send me somewhere else. I may end up paying out of pocket. Does he treat online or over phone after initial visit?

 

[steve999]

Try to mellow out. Having long term health issues is unpleasant, but most of our issues respond reasonably well to treatment. It can just take some time to get things sorted out.

Dr. M. will prescribe testosterone cypionate, HCG, or a combination thereof where applicable. At least he did for me.

You might want to re-check the economics of Dr. M. vs. Dr. C. Dr. M will run you at least $250 for each in-person visit or telephone appointment and probably $500 for the first long evaluation visit. He does not accept insurance, so this might be out-of-pocket for you. I think Dr. C is substantially cheaper for telephone appointments, but you would need to see him in person first, which probably involves flying somewhere for you. I've actually considered seeing Dr. C as a second opinion to Dr. M but have not yet done so.

E-mail with Dr. M is strictly limited to scheduling appointments. I would suggest calling, although you will almost never reach his admin in-person. I think Dr. M. is quite knowledgeable, but he could really stand to staff up in terms of office administration.

 

[The Matrix]

Try to mellow out. Having long term health issues is unpleasant, but most of our issues respond reasonably well to treatment. It can just take some time to get things sorted out.

Dr. M. will prescribe testosterone cypionate, HCG, or a combination thereof where applicable. At least he did for me.

You might want to re-check the economics of Dr. M. vs. Dr. C. Dr. M will run you at least $250 for each in-person visit or telephone appointment and probably $500 for the first long evaluation visit. He does not accept insurance, so this might be out-of-pocket for you. I think Dr. C is substantially cheaper for telephone appointments, but you would need to see him in person first, which probably involves flying somewhere for you. I've actually considered seeing Dr. C as a second opinion to Dr. M but have not yet done so.

E-mail with Dr. M is strictly limited to scheduling appointments. I would suggest calling, although you will almost never reach his admin in-person. I think Dr. M. is quite knowledgeable, but he could really stand to staff up in terms of office administration.

You can also come to see Dr O as well if you are in the northeastern USA, but if you are in mid west go see DR C. and if the west coast see DR M
People have said many good things about all three, but if its the psychological end of things then DR M would be the one. Some time balance hormones are not the only answer to the equation and need more intervention from another specialist. Dr O and I work to heal the person as a whole from inside out by balancing lifestyle, nutrition, and also now we are focusing heavy on the gut and detoxifcation which alot of dr's are missing this crucial point in todays society. We are always at semnars learning more and more about other areas which will affect the hormonal axis. BEst of luck in your search what ever route you may take all 3 are good.

 

[mikeyboyeee]

Why have you not addressed your sleep apnea yet which is probably the root cause of 90% of your issues?

 

[The Matrix]

Why have you not addressed your sleep apnea yet which is probably the root cause of 90% of your issues?

If his CBC are high sleep apnea, and hemochromatosis be first to be ruled out.
EVen severe cases of hypothyroid can have elevated CBC as well.

 

[mikeyboyeee]

In an old post, he was compalining of bad sleep apnea, so it only makes sense that a lot of his other issues (low test, etc) could be directly related to that (like we think mine are).

 

[JanSz]

Why have you not addressed your sleep apnea yet which is probably the root cause of 90% of your issues?

I see that you eating what dr M (in Fair Lawn NJ) is dishing out.
Describe your experience in more details.

EDIT,
sorry, you have already provided some details,
I did not read the whole thread when I wrote this post.
.
.

 

[JanSz]

dr Mariano is not only an expert but willing to share details of his pov.
Plus, when he writes his opinion it is in unambiguous terms, for dummies (like me).
This is rare.

With all that said, I noted that dr Mariano would

#1---work on adrenals/thyroid first, providing that TotalTestosterone>600.

#2---His emphasis when fixing thyroid is to provide plenty of T4 and other support, I guess supplementing with Cytomel(T3) would be last on his list

#3---when reviewing testosterone levels he is going by TotalTestosterone and would rather spend time at finding a reasons of why in range TT is not translating into desirable BioAvailableTestosterone levels (BAT).
In my view it is a noble goal, not sure about success rate.

#4---He is psychiatrist first, each case is mental/physical, if he can't fix it, it is probably hopeless.

...........

 

[mikeyboyeee]

So it's a good idea to start pumping yourself with tons of **** prior to fixing a MAJOR affliction which can affect all of your hormones, inuslin, etc?

I am eating what a Dr. tells me because what he says makes sense?

It makes sense for someone who is hypoxic during sleep(my oxygen went down to 60 by 1am) to start taking 50 pills a day, test (which I do currently take) HCG, Cortisol, Thyroid etc without 1st trying to address the underlying issue?

NOT addressing the issue and bandaiding the effects seems pretty stupid to me.

If curing the sleep apnea does not effect adrenals, test, thyroid etc, then it is time to start taking all that ****, but why start all that crap 1st?

What did it cost me to wait, 3-5 months out of a 65-85 year life span?

 

[jon671]

Try to mellow out. Having long term health issues is unpleasant, but most of our issues respond reasonably well to treatment. It can just take some time to get things sorted out.

Dr. M. will prescribe testosterone cypionate, HCG, or a combination thereof where applicable. At least he did for me.

You might want to re-check the economics of Dr. M. vs. Dr. C. Dr. M will run you at least $250 for each in-person visit or telephone appointment and probably $500 for the first long evaluation visit. He does not accept insurance, so this might be out-of-pocket for you. I think Dr. C is substantially cheaper for telephone appointments, but you would need to see him in person first, which probably involves flying somewhere for you. I've actually considered seeing Dr. C as a second opinion to Dr. M but have not yet done so.

E-mail with Dr. M is strictly limited to scheduling appointments. I would suggest calling, although you will almost never reach his admin in-person. I think Dr. M. is quite knowledgeable, but he could really stand to staff up in terms of office administration.

I understand Crisler might be cheaper, but the ticket or me to get to california alone is $1,200-1,300. I have a doctor that will treat me, but he doesn't feel comfortable with prescribing a regimen. He is my new gp and wants to work with someone who knows what they are doing. As a patient yourself can you give me an estimate of how much it costs you to see him or consult him over the phone or on the internet on average in a year?

 

[jon671]

You can also come to see Dr O as well if you are in the northeastern USA, but if you are in mid west go see DR C. and if the west coast see DR M
People have said many good things about all three, but if its the psychological end of things then DR M would be the one. Some time balance hormones are not the only answer to the equation and need more intervention from another specialist. Dr O and I work to heal the person as a whole from inside out by balancing lifestyle, nutrition, and also now we are focusing heavy on the gut and detoxifcation which alot of dr's are missing this crucial point in todays society. We are always at semnars learning more and more about other areas which will affect the hormonal axis. BEst of luck in your search what ever route you may take all 3 are good.

Thanks Matrix cost is the driving factor right now. If it wasn't I would take the Dr. O route. I do need to work on balancing lifestyle, nutrition, and gut and detoxifcation. From reading I have been doing and your advice and JanSz advice I am realize test is just apart of my problem. Like I said my sister has fibromayalgia and I went through the list of symptoms and I seem to have most. It makes sense though with my lifestyle.

 

[jon671]

Why have you not addressed your sleep apnea yet which is probably the root cause of 90% of your issues?

The times when I woke up gasping for air were after my last appointment and I see the doctor again on Tuesday with labs. I am gonna look at my the labs and discuss it with my gp.

 

[jon671]

In an old post, he was compalining of bad sleep apnea, so it only makes sense that a lot of his other issues (low test, etc) could be directly related to that (like we think mine are).

Where is you lh at? Mine was 3.something once and 6 the second time with the top of the range being 10 or 11 I forget. From what I have read though sleep apnea effects test by lowering lh. I know it is a problem and am going to push it. You said test makes it worse and your taking test right? I mean since you started test have you lost weight do you find it at all easier. I know it is mainly diet, but focus, drive, depression.....play parts I think. I mean did the test make you feel better?

 

[jon671]

dr Mariano is not only an expert but willing to share details of his pov.
Plus, when he writes his opinion it is in unambiguous terms, for dummies (like me).
This is rare.

With all that said, I noted that dr Mariano would

#1---work on adrenals/thyroid first, providing that TotalTestosterone>600.

#2---His emphasis when fixing thyroid is to provide plenty of T4 and other support, I guess supplementing with Cytomel(T3) would be last on his list

#3---when reviewing testosterone levels he is going by TotalTestosterone and would rather spend time at finding a reasons of why in range TT is not translating into desirable BioAvailableTestosterone levels (BAT).
In my view it is a noble goal, not sure about success rate.

#4---He is psychiatrist first, each case is mental/physical, if he can't fix it, it is probably hopeless.

...........

Thanks JanSz I think I want to go see him, but might be in like 6 months when I take vacation. I get those Labs next week :guilty:

 

[pmgamer18]

Yes to Dr. M he is the best of the best here is his info.
If you see him tell him pmgamer18 Phil said Hi.
=====================================
Romeo Mariano, M.D. (831) 375-6655 395 Del Monte Ctr #305 Monterey, CA 93940 262 Eldorado Street #100 physician, psychiatrist,Behavioral Neuroendocrinology and Immunology (831) 626-9094 fax.

 

[jon671]

Yes to Dr. M he is the best of the best here is his info.
If you see him tell him pmgamer18 Phil said Hi.
=====================================
Romeo Mariano, M.D. (831) 375-6655 395 Del Monte Ctr #305 Monterey, CA 93940 262 Eldorado Street #100 physician, psychiatrist,Behavioral Neuroendocrinology and Immunology (831) 626-9094 fax.

Thanks Phil