asih.net said:
It is revealing of you to draw conclusions, make assumptions, and speculate on the material facts of the proceeding. Is prejudgment one of your stronger characteristics? After admitting that you simply don't have the desire to review the website and dig through all kinds of twisted logic and meaningless drivel immaterial to the presented complaint. Sir, the statement is oxymoronic. Logic is not based upon speculation, guess, and emotive urges. But your emotions take control when without any basis (your words, not mine) you exclaim, I wonder why the Texas Medical Board didn't turn over their files to enforcement authorities for prosecution of what seems to me to be felonious conduct under Federal law. How do you explain the fact that you did not read any of the website except the first page! Your conclusions were based upon noting more than raw emotions without any reasoning. I am sorry if the topic of AAS is a sensitive one for you. After the website returns tomorrow try a light read. If you really want to be dumbfounded and frightened read the sections on the Board experts.
The website belongs to me, alone. I designed, built, and wrote each and every word. Please excuse the lack of complexity, etc. in the site. I only have a very basic understanding of web construction. But it is rather strange who is responsible that "right off the bat was the following LARGE posting on the front page of the indicated web site..." These are Findings of Facts by the Board. I can understand not reading in detail since there are over 5,000+ pages. But had you I think you would have been very surprised
Your post is right that other forms of hypogonadism must be ruled out before embarking on the protocol. However, the post is clearly intended for those for those individuals using AAS. Your statement, The use of multiple drug approaches to effect HPTA restart in hypogonadal situations generated by AAS usage actually has a long history. Numerous doctor have used various combinations in that regard, so this is no big deal, is very far from what is fact. The medical literature contains very little with respect to treatment for anabolic steroid induced hypogonadism (ASIH). In fact, I would venture to guess that the total number of cites is less than 10!
The protocol works well with older males as well. But, again you are correct in implying their is a attenuation or blunting of the HPTA response with aging. I differ with strongly thought that HPTA normalization is "meaningless" if it returns the person to low normal T levels and they are symptomatic. This is a critical factor and concept and the primary reason surrounding TRT in Andropause or PADAM. While there are many studies showing significant morbidity with hypogonadism there are none in individuals with low-normal T. Depending on your view of ASIH this becomes important to the male who is electively on TRT (decreased libido, energy, etc.). Should this person need to stop TRT for any hypothetical reason) he will have the ability to stop and normalize the HPTA and thereby avoid those known morbidities associated with hypogonadism. But this may be dependent upon how long/dose/etc. He is on the TRT before stopping. See the Catch-22 a clinician places themselves - without a treatment to normalize the HPTA it may now not be possible to stop TRT! A basic tenet of medical care is to ensure a patient's autonomy - the result of the preceding actions has possibly eliminated his autonomy.
In your post you stated that it might still be necessary after HPTA normalization for the patient to be on TRT. The use of the term anabolic steroids in this proceeding included testosterone. Another reason to try and read some of the material is related to your post that after treatment the patient's T/LH level may fall. Correct!!! This comes to the regulation of the HPTA. Other considerations are clinical factors but disregard them to simplify argument. What factors need to be considered for HPTA regulation? I will let you answer this, if you wish, because this is at the heart of some of the individual's treatment and possibly lead to some introspection for your comments.
Lastly, and this will be most embarrassing for you but please accept it and make peace so an exchange of important issues may take place. The paper you cite is not from Australia or England but Houston!!! Yes, the paper is mine. I do appreciate you placing many of my quotes in your post. Is it possible for you to reconcile the individual from the website you did not read with the author of the paper you cite? I think so. Lets talk about issues of relevance and importance. For me it is important to understand your reactions. Why? The topic of AAS are so heavily politicized that it is imperative that an effort is made to bring this topic back to the realm of medicine so individuals are treated properly.
I hope this clarifies some of your issues. By no measure do I mean to raise your ire. I have tried to clear away those points where no exchange is possible and discuss those that have substance and mutual understanding.
Peace.
Mike
Note: If you would like a copy of the article let me know. No problem.
Sorry.
I didn't dig through the web site because:
(A) YOU indicated that it was down for maintenance, and
(B) what pages I could access seem to argue everything but the facts of what the Texas Medical Board appeared to be viewing as the most serious charges...
And those appeared to be in regard to the administration of AAS in what they - as the decider of facts - felt to be non medical conditions.
I waded through a number of pages that went on and on with all kinds of legal descriptions and definitions and so forth and so on, pages that attacked the Board and their experts but didn't seem to come right out and ever say, "Hey, no, I never did that!". I also waded through pages that had links that didn't seem to go anywhere while other links worked. But I felt that i had "waded through" enouch to give me a picture of what was gonig on (or had gone on) here.
Also, please get your facts straight.
RE:
How do you explain the fact that you did not read any of the website except the first page!
I never said that I only read the ONLY the first page.
What I said was:
...without reviewing the whole site - which I simply don't have the desire to do...
I then shortly afterwards said:
...what I did notice, right off the bat, was the following LARGE posting on the front page of the indicated web site...
Note that this LARGE posting was a huge font size in bright bold red that YOU had positioned on the opening page!
Reading that whole segment / paragraph made it clear that I had obviously read more than only the first page!
Let's see, what did you call that?
Speculation?
Assumption?
Is prejudgment one of
your stronger characteristics?
As to your statement:
Lastly, and this will be most embarrassing for you but please accept it and make peace so an exchange of important issues may take place. The paper you cite is not from Australia or England but Houston!!! Yes, the paper is mine.
Why would I possibly be embarrassed? Please re-check the link that I provided: http://www.basskilleronline.com/hpta_reversal.html
The ONLY reference to Houston in that whole article was the following comment:
Laboratory testing was performed by Quest Diagnostics Inc., (Houston, TX) and SmithKline Beecham Clinical Laboratories, (Houston, TX).
As even NIH Hospital farms out much of their Hormone Testing to Mayo Clinic, this was pretty meaningless.
No where in this SPECIFIC online version of this study (obviously copied nad pasted by "basskilleronline") does it cite WHERE this particular study was done, or WHO it was done by or even the NAME of the study... and yet I'm supposed to be embarrassed for not knowing that?
Come on... you'll have to do better than that!
And the name Scally is also NOT located anywhere in that article... so again, how was I to "know" that it was yours? Not being an AAS-induced hypogonadal male, sorry, but it wasn't an article that I researched extensively to see who, when or where.... I noted that it was also cited - in the same incomplete form - on a number of BB / AAS related web sites and moved on... that one link of "basskilleronline" was the only one that I had bookmarked.
And as to whether or not there has been that much published medical literature on this topic, well, I simply don't know... but once again, that is NOT what I said... I spoke of doctors who USE such protocols... and there are a number of doctors who actually use this or similar protocols in treating AAS-induced hypogonadism. A review of the range of the various hypogonadal boards show similar treatments going on by a number of patients, under the supervision of doctors so they claim - and unless they are all using the same doctor... Like I said, I did NOT refer to publications in that area, what I referred to was therapies being used by doctors in that type of hypogonadism (Speculation and / or assumption on your part?)...
Anyway, I believe that a posting of this full article along with it's title, date, and authorship would be an excellent Thread for this site and would provide those with AAS-induced hypogonadism yet another therapeutical option. Additionally, this article is posted at numerous places across the Internet where it is just like basskilleronline - no authorship, nor title, nor date - so having it in it's full format on MESO would be a bonus for MESO... In fact, you ought to track down the various forms of its postings on the Internet and insist that they attribute authorship to yourself.
As to my "sensitivities" concerning AAS, I would propose that the opposite is true. I believe that it is you who has a "sensitivity" towards AAS... Possible a "light read" of applicable Federal statutes regarding the administration / prescription of AAS might be in order?
Now you may very well believe that your activities were not in violation of any such Federal laws, and that may very well be the case.
If that is what you feel to be the case, the I will offer some "professional advice" that could be of
tremendous advantage in your appeal process.
I would strongly suggest that you take your practice records and set up an appointment with the Regional DEA Office for your area (Houston Division at 713-693-3000). Explain to them your situation and voluntarily submit COPIES of your practice records, specifically of the cases cited by the Texas Medical Board. To preserve confidentiality status, once you make the copies, go through and redact (mark out with a heavy black permanent marker) any references to names, addresses, dates of birth, social security numbers, etc. of each case. But be sure and include EACH and EVERY case that was reviewed and cited by the Texas Medical Board (use the same Initials Identification system that the TMB did for each case). If you get a clean bill of health from the DEA in that none of your actions violated any Federal law then you have a tremendous piece of advantage for your appeal process. There will be a similar State law through the Texas code of statutes. Find the primary enforcement agency for the State (not a local muniplaity or county enforcement agency which would carry little weight), but a State level agency. I would imagine that would be the Texas Department of Public Safety, Criminal Enforcement Division. Locate their Houston office number and follow the same process witrh them. Once again, getting a clean bill of health from the State's primary enforcement agency in that none of your actions violated any State law would then give you yet another tremendous piece of advantage for your appeal process!
As to:
By no measure do I mean to raise your ire. I have tried to clear away those points where no exchange is possible and discuss those that have substance and mutual understanding.
I have not had my ire raised even slightly. I believe that you jumped at some assumptions and conclusions and speculations based upon a quick scanning of my post rather than reading what I was actually saying (and then - humorously - proceeded to indict me for those same violations).
As you can see, I posted - even though not realizing that it was originally a study that you had done - what I felt to be a similar (and apparently successful) therapeutical process for the aid of AAS-induced hypogonadism, so I clearly do not have a bias against such individuals receiving treatment. My wife used to smoke and I would hate to see her denied treatment for some lung cancer or whatever down the road sometime because she was a "former smoker"... by the same token I would cast a biased eye towards a medical practitioner who then turned around and encouraged her to smoke or prescribed her tobacco!
But I will admit to a strong bias against AAS steroids (and I do not include Testosterone in reference range producing TRT amounts as falling within that realm). AAS steroids - with the exception of a narrow spectrum of medical uses (as far as I know) - are illegal in the USA. If they are legal in this other country or that other country, then usage of them within that context is their business and I would have to problem with discussions in that regard. I would disagree with that position and choose not to participate.
Anyway, my evidence of lack of ire is evidenced by the fact that I have provided a couple of options for you that would - IMHO - provide very strong benefits to your appeal process (and were probably things never even ever considered by your appeal attorneys).
Now should your appeal attorneys feel that this would be a BAD move in that legal violations did in fact occur, then forget that I brought it up!
Larry
P.S. As an "aging male" with hypogonadism and currently on TRT, I know that I personally (ME) would not want to go on an HPTA Reversal regimen that would ersult in my "normal levels" of around 180 Total Testosterone (range 260 - 1000) that existed PRIOR to starting TRT... I was absolutely miserable at those levels and had zero libido and complete ED... and that was where I was with NO hormone replacement therapy.... Even if a protocol such as you suggest DOUBLED my "normal production" via a "re-started" HPTA, jeez, that would mean that I now had around 360 Total T. Well, when my TRT regimen was initially started, I in fact DID have Total T in the range of about 375 - 380 for a couple of months... and I still felt like shit... So, for me personally, no thanks - I don't want to return to my previous "normal" levels of TRT or even twice my norma levels or even three times my previous normal levels (let's see, three times would put me at 540 Total T - still well below the recommended "upper quartile" that most antiaging doctors recommend).
P.S. #2 As to this following statement:
While there are many studies showing significant morbidity with hypogonadism there are none in individuals with low-normal T.
Yes, I would imagine that individuals with low-normal WOULD have a lower morbidity rate than those individuals with hypogonadism. But I would also imagine that individuals with optimal levels (upper quartile) of Total T, Free T, Bioavailable T would have even yet better morbidity rates. Nothing in my argument has favored that individuals should eliminate therapies and aim to remain hypogonadal, so where did that come from? My argument is that attaining an optimal level of T (as well as one's other hormones to the greatest extent possible) is the true route of the best possible Men's Health.
