You do this a lot. It is an attempt to limit the evidence someone can use to prove their point. Like you are some sort of authority on what counts as evidence.
The criteria you put forward is absurd. There likely isn’t a study on men on TRT in the context of high hematocrit leading to high BP. You know this, so you use those as your qualifiers to what you will accept, but I am not playing that game.
It is known that TRT can increase hematocrit. Do you dispute that? I am willing to link something for this if you don’t buy it.
It is known that high hematocrit can lead to high BP. Do you dispute that? I can link here too if you don’t buy it.
@Carma / yeti308 whatever other handles you have. I see we cant make any headway just like we could not a few years ago in that other thread enackers started on E2 benefits. If you are who I think you are it is unreal how you operate in such bad faith.
Your response to what i posted above continues to reinforce that debating you is futile.
I posted two interventional studies above that directly contradicts your claim on E2.
I posted two studies (one case report and one database study) that directly contradict your claim above on elevated Hct from TRT and cardiac adverse events. Now the study from June 2022 has already been “debunked”? And now you change the goalpost to RCT studies when you know there are none?
Still waiting for those examples of libel in the other thread.
ReWatched a movie recently employing your debate strategy…
Where are you going with this? Do healthy people need TRT? Begs the question what should a medical provider do when he gives an unhealthy person TRT? The primary concern with elevated Hct from TRT has always been and continues to be with the patient that has compromised cardiovascular system / hematochromatosis / endothelial dysfunction and vasodilation limitations. We aint really worried about healthy 18 yr olds on TRT now are we?
Think about your comments and take them to their logical conclusion. While a small segment of total TRT population someone should still be looking out for them.
Good point. Aldosterone / RAAS mediated water retention and hct elevation for a person with compromised cardiovascular system. Nothing to see here move along according to @Carma.
Since you like anecdotes and personal stories so much heres one for you carma.
Have a friend who is internist. Has put a number of men on TRT. Very careful with obese older dudes as has experience with strokes / high BP / and DVT in some of these patients. Amazing with all the patients you have treated you have never seen any of this. It is like your practice is the Lake Wobegon of the TRT universe. Congrats.
Maybe you should make yourself aware of the literature giving testosterone to morbidly obese man. In fact the worst grades of obesity were given testosterone. You would be amazed at the results they got and the fact that none of them had heart attacks strokes blood clots. There is a plethora of literature out there treating men with severe obesity with testosterone without any major adverse cardiac events. Amazing tare load that despite thousands of studies being done including men that have coronayy artery disease, angina, heart failure, previous heart attacks, morbid obesity that there hasn’t been any study in all of these men showing any major adverse cardiac events. I finally come to the conclusion that you absolutely know have no idea what you’re talking about because you have limited knowledge of the actual clinical medical literature. You just cherry pick studies to try to continue your confirmational bias. What are you actually missing here? We have given it to severely compromised patients when I when I say we I’m talking about the medical establishment. I have given testosterone to most severely compromised and it caused no harm… in any randomized control trial.
Obviously you can’t do it but I’m gonna ask you one more time. Please provide a study where men were given testosterones even if they had already had a pre-existing heart attack or had congestive heart failure etc. where it caused a major adverse cardiac event. You can’t provide one because there aren’t any and it’s not because it hasn’t been used in thousands of studies it’s because it hasn’t caused any harm. You really don’t know what you don’t know do you?
Try reading what i already posted first. Too much to ask?
Maybe the BP monitor was wrong or he had white coat syndrome?
A 60-year-old man with a medical history of depression, seasonal allergies, remote appendectomy and cholecystectomy presented to the emergency department with a sudden headache. Upon examination, his blood pressure was elevated (190/112 mm Hg) and he had erythrocytosis (hemoglobin 196 [normal 130–180] g/L and hematocrit 58% [normal 40%–54%]). Results for a complete blood cell count that was obtained six months before the patient’s visit to the emergency department were normal (hemoglobin 154 g/L and hematocrit 46%). Our patient was discharged from the emergency department with a prescription for amlodipine (5 mg once daily) for management of his hypertension. After follow-up with his family physician, he was referred to our general hematology clinic for evaluation of erythrocytosis.
Tareload, the case reports and database studies that you try to report are about a step above toilet paper. How about some real studies which are called randomized controlled studies or perspective studies. You have nothing and you never will because it’s been used for 85 years and hasn’t caused any harm because it’s not harmful. Look man I can provide you with several observational studies that show the harm with testosterone and each of those studies have been completely debunked by the entire medical community. Only poorly designed and highly flawed observational studies have shown harm and no randomized control trial has. So keep posting your highly flawed poorly design studies that medical societies have completely discussed and debunked. Morgentaler and others have written entire papers about the studies that you keep wanting to present and about how flawed they are.
I’m gonna keep waiting man because you can’t do it can you you literally cannot produce one single study where testosterone was given the man and caused a major adverse cardiac event. We are talking about randomized control trials you know the most powerful trials that we can do. Please stop posting studies that have been totally exposed for being flawed and worthless. Once again you’re catering to the forum community so why don’t you try to take your knowledge to a true medical community and see where that gets
How many 60 year old men enter the ER with headaches? How many six-year-old men enter the ER with heart attacks strokes and blood clots every day? How many men to enter the ER this way or on testosterone and how many are not on testosterone? So what you’re saying in this one individual that it had to be due to the hematocrit correct? Do you have any proof of that? What about the man that entered the ER with headaches that don’t have an elevated hematocrit? What is it then? You have no idea about clinical medicine. But I’ll tell you want let’s take your concern to heart and design some studies deceit if raising hematocrit will call 60 year old men to go to the ER with headaches.
Oh wait a minute once again it’s already been done over and over and over again. Men have been given testosterone and that will raise their hematocrit because it’s the most common side effect and guess what? The ERs are not full of these men. You still haven’t answered the fact that Dr. Ramasamy admitted that his paper add many limitations and that he did not feel raising hematocrit with testosterone causes harm. Once again week studies produce week results. But you can always use these weak Studies as question generating. When we do that we can see what happens when we actually perform a randomized control trial. When we do testosterones never caused harm and 85 years of use. Of course to you it might but I guess you’re gonna need 150 years of studies without harm for you to believe that it’s not harmful. You are ridiculous
You really don’t understand do you. We give estradiol to me and we chemically castrate them but it’s a better way to castrate them than ADT. When you give estradiol without testosterone to a man with normal testosterone levels you’re going to chemically castrate him. Of course you don’t understand physiology do you. Finklestein study shows the harms of aromatase inhibition. You really have no idea about clinical medicine none at all or how to actually interpret the medical literature and apply that to clinical settings
I can only hope one day to be as knowledgeable and graceful as you. Compared to you the rest of us are like 5th grade education equivalent, if even that.
Why be a big fish in an intellectually small pond? Do you take credit here for community service or some type of continuing education credits?
I will wait for the correction or retraction then instead of your hearsay or paraphrase. Thanks for hanging out with us simpletons Doc. Careful mentioning people by name on here? Remember your advice?
Thanks for the tip. Going and debating a whole army of 200 mg T to the scrotum twice daily practictioners. Sounds fun. Is that last statement supposed make me want to join or run? Jay sounds like a sitcom laugh track in the background of your podcasts. You guys make a good team.
Take it easy and hope you are right. Being so confident in your position with the variability of the human body rarely turns out well.
I guess here is a little preview of what awaits me over at WLM:
Lastly, I have found the most profound article on BHRT that I have ever seen or read. Finally, someone has published exactly what I have been teaching and preaching on thyroid administration for the last 20 years. In spite of the fact that it’s in the bible of endocrinology not to suppress TSH, endocrinologists, ENT surgeons, and psychiatrists suppress TSH with impunity, but you can’t. Regardless of this right of certain physicians to suppress TSH, a landmark study reviewed why and how we came to fear suppression of TSH. Unfortunately, all of the studies that showed harm of TSH suppression were from extrapolation from Grave’s disease which causes harmful effects due to an autoimmune disorder and not from elevated levels of thyroid hormone. Years of studies of suppressing TSH by endocrinologists, psychiatrists using high doses of T3 for depression, and ENT surgeons suppressing TSH for treatment of DTC, none showed any harm. We will review this study and recent other studies showing the benefits of thyroid optimization and lack of harm with TSH suppression. In fact, proper treatment involves TSH suppression. I could not sleep after reading this article and I’m sure that you will feel the same.
Tareload I will leave you at this since you obviously have no true education or knowledge in medicine. I think Ricky Gervais describes you perfectly “when you’re dead you don’t know your dead, its only painful to others. The same applies when you are stupid”.
You are no longer worth my time
Mmm what a gentleman and so graceful, we should all strive to be like this guy, enackers, and Danny. Where do I start? What E2 levels do I need to obtain? They are clear role models for what an alpha male who has his hormones in check should be like.
Figure 1: Bland-Altman plots of serum sexual hormones and MAPR at the tip of the penis. (a) Relationship between TT and MAPR. There was no significant correlation between TT and MAPR. (b) Relationship between CFT and MAPR. There was no significant correlation between CFT and MAPR. (c) E2 was negatively correlated with MAPR. (d) E2/TT was negatively correlated with MAPR. MAPR: maximal average penile rigidity; TT: total testosterone; CFT: calculated free testosterone; E2: estradiol; E2/TT: estradiol to total testosterone ratio.
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