Penile Implants

My thanks as well for the info, Doctor. I'm 52 and I've been on TRT for a year. My last bloodwork revealed a T level of 1,080 on a .4ml x2 weekly dose. My hematocrit is also elevated @ 53. My Doctor has requested that I give a double red blood donation quarterly to get it to <50. He said that he has never heard of actual problems with hematocrit above 50, but that he'd rather I try to keep it down through regular donations. Its good to know there is evidence out there disputing the persistent rumor that an elevated red count can lead to CV disease.

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Originally Posted by Will Still

My thanks as well for the info, Doctor. I'm 52 and I've been on TRT for a year. My last bloodwork revealed a T level of 1,080 on a .4ml x2 weekly dose. My hematocrit is also elevated @ 53. My Doctor has requested that I give a double red blood donation quarterly to get it to <50. He said that he has never heard of actual problems with hematocrit above 50, but that he'd rather I try to keep it down through regular donations. Its good to know there is evidence out there disputing the persistent rumor that an elevated red count can lead to CV disease.

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There is Zero evidence in the medical literature supporting phlebotomies in men on TRT. In decades of men having a secondary erythrocytosis it has never been shown to cause harm. We will discuss how medicine can get things wrong on the next podcast with Rick concerning prostate cancer. For decades men have been deprived of testosterone after being treated for prostate cancer unnecessarily. This deprivation of treatment was based on one physician's observation of one patient in the 1940s. We now know that man with active prostate cancer confined to the capsule as well as men who have been treated for prostate cancer can take testosterone with no worsening of the disease. Clinics have been phlebotomizing men for decades not based on any harm caused by TRT, but because they think that the secondary erythrocytosis you get from testosterone causes the same issues one would see in a person with polycythemia vera. It does not, as polycythemia vera causes an increase in red blood cells, white blood cells, and platelets and of course platelets clot. There is also a quantitative and qualitative change in red blood cells in people with polycythemia vera. So once again we get to the three myths, which are 1.) you must block Estradiol, 2.) that you have to donate blood because if you don’t there will be harm, and 3.) that it causes or worsens prostate cancer.

Very helpful, Keith. I look forward to the podcast.

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Originally Posted by J. Keith Nichols MD

As I teach all of my men there are three myths with regard to testosterone replacement therapy. The first myth is that you need to block estradiol. The second is that it causes or worsens prostate cancer. The third is that you have to donate blood while on testosterone replacement therapy.

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I've stopped taking estrogen blockers, increased my testosterone dose, and stopped donating blood. I've never felt better.

Psychological erection issues are real and I don't mean to discount them at all. But just in terms of erection strength, I get a benefit from a supplement called DIM. It's a substance found in broccoli and cauliflower. DIINDOLYLMETHANE: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews I started taking it because I was having trouble fully voiding my bladder, and I found it recommended for prostate health. It helped with that issue and also caused stronger erections as a nice side effect.