My Visit with HAN and Dr. Overbeck

[engival]

Nik are you going to use Testosterone ?

 

[hardasnails1973]

Nik are you going to use Testosterone ?

only as last resort..
giving DHEA TD 4 weeks then dedcide from there
If not then goto clomid see if he responds ..Things done in baby steps.

 

[engival]

HOw you feel about SUBLINGUAL dhea for better e2 control?

 

[Ignitionnet]

Probably an odd question but that's what every decent diagnostician should do when there are no clear diagnostic tests which offer an obvious course of treatment, so where does your input come into the co-consultations? I fail to see where someone whose expertise is around nutrition and whose beliefs appear to emphasise the role of the digestive system in the endocrine system comes into a course of treatment involving treating hypogonadism with hormones and performing diagnostic tests to check the endocrine system for response. This would appear to me to be pretty standard endocrinology, ignoring the specifics of what the treatment actually is, which appears to be seeing a low number and endogenously raising it, and dealing purely in general terms.

Could you clarify this point for the interested?

Just reposting my question, not the first time I've posted questions a couple of times but hey I'm persistent and interested, be interesting to know the dynamics here

 

[nickatnite]

Today marks 3 weeks into the TD 50mg DHEA cream. Energy still pretty stable. However, I noticed the past week that my appetite has diminished a little. I'm usually only hungry about twice per day. I've also been having some joint pain here and there. As far as weight goes I'm still about the same, trying to be more active but haven't noticed much of a difference. My stomach feels like its getting more bloated/larger. My chest is kind of puffy but nothing alarming. When I say puffy I mean my nipples don't stick out much. Every now and then I get a shooting pain in my lower back kind of where my kidneys/adrenals would be. That could just be from me carrying on all this excess weight though. I do notice when I press on the area above my fat humps it seems sensitive. I'm not sure if this means anything. But anyway nothing much else to report. Going to still go at this. If any one has any recommendations or criticism I'd love to hear it regardless. Thinking about doing some nutrient testing to see if theres some vitamin/mineral I'm missing that's throwing everything off. I don't know if one thing could actually do all this but who knows. Well, until next time...

 

[nickatnite]

Just weighed myself. Lost about 2 1/2 pounds since the start of the DHEA cream 3 weeks ago.

I want to thank Dr. O & HAN for again being there whenever I have a question!

 

[hardasnails1973]

Nick due to your past history of cancer lets check 2/16 pathway as sometimes estrogen domainace can be not just estrodial but other esrogen metabolites as well that can bind to the receptors. When I stop DIM on DHEA I get bad estrogen symptoms even though my wood is perfectly fine. I would be concerned with altered methylation which need to be taken into consideration as well.. Glad you lost weight. so we are making progess less check T levels and e2 levels dhea urine then LH then if all not imporves impliment cllomid challege to see if you are able to start up. Again with in one month we will knowt then 7 days of clomid to see if you can restart. I muscle test you on saturaday to see where everything is at and need to make adjusments.

 

[Ignitionnet]

Nick due to your past history of cancer lets check 2/16 pathway as sometimes estrogen domainace can be not just estrodial but other esrogen metabolites as well that can bind to the receptors. When I stop DIM on DHEA I get bad estrogen symptoms even though my wood is perfectly fine. I would be concerned with altered methylation which need to be taken into consideration as well.. Glad you lost weight. so we are making progess less check T levels and e2 levels dhea urine then LH then if all not imporves impliment cllomid challege to see if you are able to start up. Again with in one month we will knowt then 7 days of clomid to see if you can restart. I muscle test you on saturaday to see where everything is at and need to make adjusments.

This post really feels in a huge way like it was done for the benefit of the Meso audience rather than the patient. Seems a bit odd for a care giver to be discussing a client's case like this.

 

[hardasnails1973]

This post really feels in a huge way like it was done for the benefit of the Meso audience rather than the patient.

There is alot of crucial information in here that may help other people and to give may be a new way to look at things. One thing does not work for every one so things have to be modified and this thread is just one of the many ways one can try to benefit from different approaches out side the main stream practice. HRT unforntately is triall and error and using general principles to get a desired outcome. Some may get there faster then others, but end result is the same to make them not better but well.

 

[Millard]

There is alot of crucial information in here that may help other people and to give may be a new way to look at things. One thing does not work for every one so things have to be modified and this thread is just one of the many ways one can try to benefit from different approaches out side the main stream practice. HRT unforntately is triall and error and using general principles to get a desired outcome. Some may get there faster then others, but end result is the same to make them not better but well.

You have blurred the lines between providing information and discussing/treating a client openly on the forum. You've essentially opened your door during an office visit and invited hundreds if not thousands of people to observe and interact with you both. Even if your client (and Dr. Overbeck too) has released you from confidentiality and given you permission to do this, let's avoid providing very specific medical advice to very specific (your own) clients in an open forum.

The information can be conveyed effectively to the meso community in other ways that don't open up questions of medical ethics/confidentiality.

 

[hardasnails1973]

You have blurred the lines between providing information and discussing/treating a client openly on the forum. You've essentially opened your door during an office visit and invited hundreds if not thousands of people to observe and interact with you both. Even if your client (and Dr. Overbeck too) has released you from confidentiality and given you permission to do this, let's avoid providing very specific medical advice to very specific (your own) clients in an open forum.

The information can be conveyed effectively to the meso community in other ways that don't open up questions of medical ethics/confidentiality.

Our main purpose is to help people and to provide the logic behind reasoning the direction we are taking, but the wording will be change from now on to emphasize informational only.

 

[m_ob]

Our main purpose is to help people and to provide the logic behind reasoning the direction we are taking, but the wording will be change from now on to emphasize informational only.

....

 

[Ignitionnet]

The unfortunate thing is that if the Clomiphene restart works it would suggest that if Mike Scally's HPTA restart program had been followed straight away this patient would be fine already.

Regarding the diagnosis of insulin resistance, was a rapid IV glucose tolerance test or fasting then 2 hour plasma glucose loaded bloods done?

Be interesting to know how this came about. I really don't care who's right or wrong here but the whole approach to treating this man appears to be quite scatter shot. I'm struggling a bit to understand the diagnostic path here and if it's a case of throwing drugs at the issue and seeing what happens I'm not sure if this is really appropriate to the patient's welfare given cited, documented and evidenced diagnostic paths and treatments that aren't being followed. Is this 'blazing a new path' and throwing out the rule book or using patients as experimentation subjects? Probably a fine and blurry line.

Given how well understood many of these processes are and knowledge of endocrinology I do agree the approach of testing response to certain treatments is a valid one, however I would have thought it only valid after running out of experience from other doctors who have followed these courses. Medical journals, etc, are there for a reason, to learn from the diagnostic experiences of others so that they don't have to be repeated but you can instead skip straight to what worked in the end, surely?

Everyone is different, sure, but if there's a minimal risk treatment that works in the vast majority of cases and doesn't have cited long-term issues (unlike DHEA supplementation in men appears to going by cited studies here) why not JFDI?

 

[CubbieBlue]

The unfortunate thing is that if the Clomiphene restart works it would suggest that if Mike Scally's HPTA restart program had been followed straight away this patient would be fine already.

Regarding the diagnosis of insulin resistance, was a rapid IV glucose tolerance test or fasting then 2 hour plasma glucose loaded bloods done?

Be interesting to know how this came about. I really don't care who's right or wrong here but the whole approach to treating this man appears to be quite scatter shot. I'm struggling a bit to understand the diagnostic path here and if it's a case of throwing drugs at the issue and seeing what happens I'm not sure if this is really appropriate to the patient's welfare given cited, documented and evidenced diagnostic paths and treatments that aren't being followed. Is this 'blazing a new path' and throwing out the rule book or using patients as experimentation subjects? Probably a fine and blurry line.

Given how well understood many of these processes are and knowledge of endocrinology I do agree the approach of testing response to certain treatments is a valid one, however I would have thought it only valid after running out of experience from other doctors who have followed these courses. Medical journals, etc, are there for a reason, to learn from the diagnostic experiences of others so that they don't have to be repeated but you can instead skip straight to what worked in the end, surely?

Everyone is different, sure, but if there's a minimal risk treatment that works in the vast majority of cases and doesn't have cited long-term issues (unlike DHEA supplementation in men appears to going by cited studies here) why not JFDI?

Well I think he called it "hidden" insulin resistance, which I'm fairly certain is a made up diagnosis.

 

[hardasnails1973]

Yes and they already have. I know several guys using the same thing and having simiilar results as well. Dr John has an excellent presentation on why TD is better then oral DHEA. Ok if DHEA is low so give him oral DHEA so why not try TD DHEA instead since it can potentally convert into androgenic hormones with in the body. Dr. John atleast has the balls to try new things and if people get results and the logic is there what is work with that? By giving TD DHEA it by passes first pass of liver and is less likely to convert to estrogen. Oral has a highly likely abilty to convert to estrodial. Since getting off dhea my e2 has stabilize while being on TD dhea it has help my sleep, body composition, and even out my moods tremendusly, and as further testing shows may even be a cheap way to increase gh out put for people. So the evidence is there Dr john had the balls to bring it to attention of Dr's with open mind.

 

[CenDS]

Well I think he called it "hidden" insulin resistance, which I'm fairly certain is a made up diagnosis.

it is. Most insulin resistance in the USA is from leptin resistance which is a hypothalamic receptor problem that exogenous steroids can dramatically alter both for the good and bad depending upon who is tinkering. Type one DM is a different animal altogether and one needs not to mix terms or confuse the lay public.

 

[CenDS]

You have blurred the lines between providing information and discussing/treating a client openly on the forum. You've essentially opened your door during an office visit and invited hundreds if not thousands of people to observe and interact with you both. Even if your client (and Dr. Overbeck too) has released you from confidentiality and given you permission to do this, let's avoid providing very specific medical advice to very specific (your own) clients in an open forum.

The information can be conveyed effectively to the meso community in other ways that don't open up questions of medical ethics/confidentiality.

completely agree and that is why I get so many copied sheets from this forum............this is the kind of posting that really is dangerous in the wrong hands..........thank god some of my patients bring this crap to me before acting like their own doc.

I would hope that their would be some responsible person here to point out this huge loophole.

 

[CubbieBlue]

it is. Most insulin resistance in the USA is from leptin resistance which is a hypothalamic receptor problem that exogenous steroids can dramatically alter both for the good and bad depending upon who is tinkering. Type one DM is a different animal altogether and one needs not to mix terms or confuse the lay public.

Thanks for the clarification.

 

[nickatnite]

it is. Most insulin resistance in the USA is from leptin resistance which is a hypothalamic receptor problem that exogenous steroids can dramatically alter both for the good and bad depending upon who is tinkering. Type one DM is a different animal altogether and one needs not to mix terms or confuse the lay public.

Do tests exist for leptin resistance?

 

[m_ob]

it is. Most insulin resistance in the USA is from leptin resistance which is a hypothalamic receptor problem that exogenous steroids can dramatically alter both for the good and bad depending upon who is tinkering. Type one DM is a different animal altogether and one needs not to mix terms or confuse the lay public.

In March 2010, researchers reported that mice with type 1 diabetes treated with leptin alone or in conjunction with insulin did better (blood sugar didn't fluctuate as much, cholesterol levels went down and they didn't form as much body fat) than mice with type 1 diabetes treated with insulin alone, raising the prospect of a new treatment for diabetes.