Recent content by bigtbone

I typically see a decrease of around 3% for one unit in my patients. Lower, more frequent dosing helps. Many, possibly a majority, also have sleep hypoxia which compounds the problem. Sleep apnea is not a disease of obesity like many believe. It’s a disease of obstruction and muscle is more...

Agreed. I'm hearing you and your point is spot on. A gram per week is a run, not replacement. I've had several patients come to me from HRT clinics where their doses were 300-400mg+ per week. They never have any f/u bloodwork. Although they're always hesitant to have their dose lowered to normal...

There may have been a miscommunication but, to be clear, a hernia will not resolve on its own. I hope the Internist didn't tell you it might. It won't! What do you mean by "just above your stomach"? Above your belly button? Depends on the location as to what's been damage to allow a hernia...

I have found that some patients simply have elevated levels of aromatase as their baseline. People with increased bodyfat tend to have increased levels of aromatase. In such cases, even low doses of testosterone will lead to increase estradiol and estrone, even with testosterone levels in the...

There are walk-in labs in most cities where you can have blood work done without a prescription. Only downside is that your insurance company likely won't pay for it. Depending on your insurance, paying for the test yourself may be cheaper than paying for a visit to the doctor to get a...

I can't see any potential benefit by adding T4. Like others have said, T4 is in a form which is unusable by the body. It is slowly converted in the periphery by the body to T3, which is the usable form. We use T4 for thyroid replacement therapy in patients who are hypothyroid because it results...

I am a physician and very few of my colleagues know much about hypogonadism. Your levels are within normal range. However, the listed normal range is very wide (250 to 850) and 250 is NOT normal for someone your age. You should be in the 500s. Did you have your blood drawn in the early morning...

Sorry brother, but it's not likely. The study was very small (only 20 subjects)and was in a very select population: micropenis and idiopathic hypogonadal hypogonadism. Testosterone levels were essentially non-existent at <1. That's very different than maturing a little later than others. If your...

Anyone have the journal reference to this study? There is really no way to determine whether either a child or an adult is deficient due to the pulsitile nature of GH secretion. Even stimulatory testing with clonidine and arginine are very controversial. Most specialists do not even perform...

I'm a Medical Corps officer and a general physician. Thanks for your input guys. Three to four hours from now, I'll be inked! I think I'll switch it to my right arm, which has slightly less fullness and less deep cuts and separation than my left arm. That way the ink might distract from the...

This surgeon may be the best at what he does, but ask him yourself about my reply. I'm a physician myself. Not a surgeon, but I know what I'm talking about. Maybe he should share his "special skills" with the rest of the surgical community. Particularly so they can be utilized in the treatment...

33. Yes, been in the Navy 8 years now. Someone do me a favor here and enlighten me because I don't get it. What the hell is shocking or odd about the question? By Radar's response I'm guessing it is my choice of tattoo. Do the cool kids frown on anchors nowadays? And, if so, what about Marine...

It's not possible to remove the "total gland". The breast tissue is not just one big solid gland. It is tissue, made up of millions of cells. It is impossible for a surgeon to remove all the cells as they are not all visible with the naked eye. He might get most of it, but if you're prone to...

Couldn't decide which forum would be most appropriate for this question so sorry to those who wanna bitch about it. I have an appointment this saturday for my first and probably the only tattoo I will ever get, a US Navy anchor on my mid-upper arm to shoulder. Well, it just occured to me that...

1.5 month wait for a busy subspecialty like ortho is nothing. Compare that with 4-6 month wait with socialized medicine. Better yet, an orthopod in a socialized system wouldn't even see him for olecranon bursitis....period!