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  1. #31
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    Quote Originally Posted by Mark Rippetoe View Post
    Amazing! Test levels vary diurnally! Who would have known this without Hurling's always-valuable take on the situation? And that means that the average test level is the value we must consider!! I think I speak for the rest of the board when I say that we don't ever want your Test levels above the average between borderline low and "normal" for a geezer, because a man of your experience, wisdom, and masculine capacity -- both as a Law Enforcement Officer and a Martial Artist -- would undoubtedly make the rest of us look like fools, not to mention the existential danger posed to DB 24/7/365. We can already just barely imagine the existential danger you once posed to nogoodnick criminals during back-alley takedowns on your way home from Gung Fu/Wing Chung/Hopkido classes during which you masterfully contributed by teaching 80-year-olds to safely fall, with your testosterone levels just above average for a man in his 20s, 30s, or even 40s or 50s.

    Gentlemen, try for a few seconds to envision Mark E. Hurling striding the earth with his test level at 745, and then tell me if you want that as even a remote possibility. Why, NO ONE would ever be able to get testosterone again, because the Medical Community would see the example of Mark E. Hurling, striding the earth, bringing shame and yet simultaneously reassurance to all other men, and tell us that if This Man is the average man, then the average between borderline low and "normal" for a geezer is plenty good enough for us all.
    Once again, witty and gracious, as has become your wont in your dotage.

    You seem to have ignored my opening sentence to make your point however:

    If someone has a poor quality of physical life and some aspects of mental depression or sluggishness and they think TRT is the answer, why not?
    Kind of like the selective journalism of a CNN. Carry on.

  2. #32
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    JF Sully - thanks for you contribution. I’m wondering if you see that your use of “Depression” and “Low T” consistently as condition ICD codes is part of the problem Rip and others are pointing out?

    Being depressed a while after a beloved dog dies doesn’t meet the condition criteria for Depression. Having all the other symptoms of lowT but a “normal” blood test doesn’t meet the condition criteria for hypogonadism, so no treatment even if TRT fixes the symptoms. I suggest we call it “LowT” if TRT works instead (since that’s what laypeople assume). The AMA can call the thing that requires a particular blood test value “Clinical Hypogonadism“.

  3. #33
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    Quote Originally Posted by Mark Rippetoe View Post
    Amazing! Test levels vary diurnally! Who would have known this without Hurling's always-valuable take on the situation? And that means that the average test level is the value we must consider!! I think I speak for the rest of the board when I say that we don't ever want your Test levels above the average between borderline low and "normal" for a geezer, because a man of your experience, wisdom, and masculine capacity -- both as a Law Enforcement Officer and a Martial Artist -- would undoubtedly make the rest of us look like fools, not to mention the existential danger posed to DB 24/7/365. We can already just barely imagine the existential danger you once posed to nogoodnick criminals during back-alley takedowns on your way home from Gung Fu/Wing Chung/Hopkido classes during which you masterfully contributed by teaching 80-year-olds to safely fall, with your testosterone levels just above average for a man in his 20s, 30s, or even 40s or 50s.

    Gentlemen, try for a few seconds to envision Mark E. Hurling striding the earth with his test level at 745, and then tell me if you want that as even a remote possibility. Why, NO ONE would ever be able to get testosterone again, because the Medical Community would see the example of Mark E. Hurling, striding the earth, bringing shame and yet simultaneously reassurance to all other men, and tell us that if This Man is the average man, then the average between borderline low and "normal" for a geezer is plenty good enough for us all.
    Holy shit, lol.

  4. #34
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    When I say biological depression I mean endogenous depression, the tyoe that doesn't get better with time, life changes, therapy and is marked by anaergia and ahedonia.

  5. #35
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    Your question makes no sense. If test is his problem a simple blood test can show us. If he has psychotic depression, it isn't something TRT will cure, if you think it never has been tried you have no idea what you are talking about. Sure, mild cases of depression should not be treated with medication as first line, but psychotic depression doesn't sound like something "mild" for me. And your worry about antidepressans mostly apply to SSRIs, which to be honest are shit drugs. They've been developed as anxiolitcs and latter marketed as antidepressans, suposedly "safer" than older ones like TCAs and MAOIs. They have low efficacy. The MAOI Parnate is the most effective antidepressant know to man for biological, endogenous, depression, and it has one of the best side effect profiles, after a few months basically almost all side effects disappear. I don't know how bad the guy who post is feeling right know, but if his fucked up in the head, he knows. Biological depression isn't sadness or caused by life events, it's marked by ahedonia and aenergia without external factors, people who have it are like diabetics who need insulim. Do me a favor Rip, read this piece and contact Dr. Ken Gillman, world renowned specialist on serotonin syndrome, on skype and have a chat with him, tell your idea of testosterone as a treatment. You are two old fellas, so at least you will have a good time. Sorry, but you are not the only one who knows your shit.

    https://psychotropical.com/patient-s...rmers-shotgun/

  6. #36
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    Which seems easier to diagnose? One who requires a simple blood test or other who needs a experienced professional? Just do the godamn blood test then, it is easy. Psychotic depression doesn't sound like something low T would cause.

  7. #37
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    Quote Originally Posted by AndreiDecker View Post
    Your question makes no sense. If test is his problem a simple blood test can show us.
    This assumes that test levels are always indicative of the patient's response to that level. And that is not the case. And people who are fucked in the head certainly as hell don't always know they are FITH. They rarely do. I know when I am out of my bailiwick, and I have deferred to JF here in the case of these severe cases accompanied by psychosis. If you want me to talk to Dr. Gillman, have him call me. My point is very simple: testosterone is a profoundly psychoactive endogenous hormone, and SSRIs and MOAIs are not endogenous compounds. As with thyroid deficiencies, it makes sense to bring the hormone level up to at least normal for the optimum biological age of 35 before adding pharmaceuticals that may not be necessary if optimum hormone levels are established, especially since the risk of acutely elevating test is very low, any negative effects can be quickly reversed, and the beneficial therapeutic effects manifest so quickly.

  8. #38
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    Quote Originally Posted by johnnys View Post
    JF Sully - thanks for you contribution. I’m wondering if you see that your use of “Depression” and “Low T” consistently as condition ICD codes is part of the problem Rip and others are pointing out?

    Being depressed a while after a beloved dog dies doesn’t meet the condition criteria for Depression. Having all the other symptoms of lowT but a “normal” blood test doesn’t meet the condition criteria for hypogonadism, so no treatment even if TRT fixes the symptoms. I suggest we call it “LowT” if TRT works instead (since that’s what laypeople assume). The AMA can call the thing that requires a particular blood test value “Clinical Hypogonadism“.
    No, I don't see that. What I see is that there is medical terminology on the one hand, and common usage of regular speech on the other, and that sometimes these overlap in misleading ways. This leads to all sorts of confusion, and I think it's important to clarify at times.

    Feeling low after your dog dies is not abnormal or a medical condition. If you want to say that you're depressed at that time, that's fine, but when someone else tells you that they are being treated for depression, you should not assume that they are experiencing what you went through over losing your dog. You would be surprised how many people make this mistake.

    So if your T isn't low, but taking testosterone makes you feel better, we should call it "LowT"? I would rather call it "subclinical hypogonadism," if I believed that your personal testosterone level (or maybe it's due to SHBG or something) led to symptoms that TRT helped, but you didn't meet accepted criteria for hypogonadism.

    We shouldn't name health conditions after treatments that seem to work. If that were the case, many people would be suffering from "LowCannabis" and we'd have to rename back pain to "hypoibuprofenemia." From careful observation of Rip on these boards and in his videos, I would actually diagnose him with "intermittent hypobourbonemia."

    Naming something in medicine doesn't dictate treatment (unless your doctor is a mindless drone, it happens), so it's better if the name communicates something useful. Doesn't always work, but we try.

  9. #39
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    If a person presents with a severe lung infection -- severe, as in elevated blood pressure, hacking cough, fever, inability to sleep -- is the proper procedure to take a sputum sample and wait until the test results come back before writing the antibiotic prescription, which could take 3 days depending on your jurisdiction, or to write the prescription right now based on the doctor's experience with these symptoms and what pathogen usually causes them, get some antibiotic into the patient immediately, and then let the patient's response to the drug serve as a diagnosis as well as a treatment, adjusting it later if necessary, thus potentially saving 3 days? Testosterone, like most commonly written antibiotics, has a very low potential for acute adverse effects. Thus, therefore, etc.

  10. #40
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    “ Feeling low after your dog dies is not abnormal or a medical condition.”

    That in and of itself is true. But it seems like you should know that one shouldn’t flippantly dismiss “feeling low” outright.

    What if you are not getting over it? What if you are just not shaking it like you KNOW you should be? Like, you unexpectedly don’t feel like you have the tools to cope, even though your daily life is fine...and you used to have those tools.

    What if you read that nightmare poem, ”The Rainbow Bridge????”

    I’m no doctor and I’ve never been clinically depressed. But after a major trauma (not my dog, but that will be worse) I was “severely situationally depressed.” I simply could not shake it for almost 4 years. I went to the edge but it was not for me. But in the words of the great David Lee Roth, I stood and looked down. I had no time to mess around.

    I functioned just fine, maintained my career (albeit not at the very top of my game, but successful) but I could not understand why the “me” I always was, was not the “me” I currently was. I was sad as hell and felt like I was in a tar pit.

    I finally went to a doc, got test checked a few times and I was far <200. Given my athletic background, my doc said, “how in the hell do you lift 4x per week?” (I hired Jim Steel a while back and still use his program).

    Long-winded point being, physically I was doing well. Mentally I was not.

    A clinical dose of test cyp., after about 6 weeks, changed my fucking life (yes n=1, but n=1 is all that matters to me.) It can’t be ignored. There’s no benefit physically (physique) at my dose (a mere standard 100mg/week), nor does there need to be, but holy mother of god did getting my levels in normal range allow me to be myself.

    For some men, this is the answer.

    Jfsully, please forgive me for this but I am not aware of your credentials. Please understand I am not asking in order to slag on them, I literally just don’t know.

    I find your posts valuable and interesting,

    Are you an endocrinologist? Psychiatrist? GP?

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