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Dr Adi
Dr Adi, Professor
Category: Endocrinology
Satisfied Customers: 284
Experience:  Director of the Pediatric Diabetes Clinics at UCSF.
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Would be grateful for you opinion on my situation which I

Customer Question

Would be grateful for you opinion on my situation which I have written about and what way to proceed as l say at the end I'm not a doctor and I'm not trying to be a doctor I'm just suggesting this form of therapy to help me or can use offer an alternative form of therapy to help me sort out my ill health as at the moment I do not have Any quality of life and I've got remarried to a younger woman Who loves me very much I love her we have a young child and I feel down the line this is going to affect my relationship and Marriage and I don't want to lose my wife i met her first when she came to America to study at university and we become good friends but we always had feelings for each other and then a good couple off you years later she was transferred to my home country and when I'll be home I will go and see her and eventually we knew our feelings for each other where So Strong we got married she's French basque and I am Irish and she has been move to Paris with her job so now i live between New York and Paris and I'm afraid I will lose her due to my illness and I have other children and their suffering not financially or physically but since I Lost one of my daughters it has changed me and I need to get my health back on track to keep it all together thank you. ***** been having problems with chronic fatigue lack of libido erectile dysfunction problems ejaculating too early my semen levels we're very low when I would ejaculate (ie not much semen) and loss of appetite and would have to get medication to stimulate my appetite to start working again and severe pain at times. I do live in America but the problem is I'm back home in Ireland at the moment due to ill health in my family and I'll be here for a good few months so while I was here i decided two get blood test done privately the test would be sent to me to see the figures and what the problem was from the test as GP here in Ireland are not too forward to let you see the results the just tell you and at times if they look like they wear kind of in normal range they just say you were ok but that is not the fact the results would show that you're levels were not right but that's due to not many men would go to the GP with this problem because of their manhood and they wouldn't even think of it in Ireland and that's why Some doctors wouldn't have the experience with this problem with men and hormone imbalance as my previous doctor was killed in a car crash he would have had the knowledge to treat this condition and this guy took over his practice and he is not very helpful in a lot of situations I've come to think a lot of new doctors just want to do the basics and prescribe you medication that causes more of a problem then help so the first test I got done not too sure if you've heard about this one is Homocystein is an amino acid produced in a Gene but a mutation in the Gene can happen and you start producing excessive amounts of the amino acid homocysteine in the body which causes especially chronic fatigue but I do know the treatment to to get for the first test and where it's prescribed it comes from England and is actually quite simple medication as it's only and excessive use of certain B complex vitamins to put this right but I'm talking well over the recommended daily allowance but it works and the second test I got done was my testosterone so here are the figures after two tests and I like your opinion in what I'm going to ask you.
Homocystein levels in my body from test
Homocystein value. Interpretation levels
Less than 10. Optimum level
10 to 15. At risk.
16 to 20. High risk
Over 20. Very high risk
My value was 18 so I'm in the high risk level
Now my testosterone figures where
Your Free Androgen Index test result has been returned as LOW
Your results
Normal range
24 - 104
Your Testosterone test result has been returned as NORMAL
Your results
13.70 nmol/L
Normal range
7.6 - 31.4 nmol/L
Your Sex Hormone Binding Globulin test result has been returned as HIGH
Your results
91.00 nmol/L
Normal range
19 - 83 nmol/L
Now to try and correct my Testosterone levers and get them back in sync I was going to use
Treatment with Clomid (clomiphene 25 mg or 50 mg tablet daily)
And to stop and inhibit if my Testosterone levers start to go up and start the correction process to prevent as it is going up converting in to too much oestrogen I was going to take
an aromatase inhibitor such as anastrazole (also called Arimidex).
I know when Clomid is prescribed two men with similar problems in America it is off script equals off label
But the problem here in Ireland as a lot of GPS have not dealt with this problem because of what I said above there is a assumption is no way would I prescribe Clomid to male with low levels testosterone to correct the problem it's only on script to be prescribed two females with infertility problems and getting pregnant I'm not too sure but I have got other medications describe to me that were off script equals off label in Ireland I did ask my pharmacist as I know him well and he said I can't see a problem it's not licensed for males but you can get it off script equals off label but the problem I have it's with this new Doctor is to just talking to him he kind of man when he get something in his mind there is no talking to him he seems to not listen to you he's the doctor which I know. but I am the person with the problem but when I explained the way I feel as I do know my body and I new there was something wrong and the tests have come back with problems. and I'm sitting here contemplating to go in and ask him about the medication and I am actually feeling very sick and feeling very hi anxiety and nervousness about thinking of going in to see him about the medication and the only reason I know about this subject is when I first went to university I was studying to graduate in the Medical Profession but I changed my mind and went to different path which I do not regret as I became very successful in what I studied instead of the Medical Profession but I've always keep up the Date as much as I could with the advances in medicine. I hope what I have written and give me your opinion on the subject p.s. I would not like to take HCG as in Reading about it while you're taking it can cause suppression of your own production and Lower your levels and I've read and heard bad things about the side effects. I've been told bodybuilders do use the medications I have mentioned to start up there on production off
testosterone they call it a PCT pre cycle therapy as I have done and still do bodybuilding from a very young age I am now 45 years of age so I've been at it about 30 years but I was lucky I was blessed with good genetics and I gain muscle fairly easily and in no way did I ever take anabolic steroids as they call it in the bodybuilding world AAS and then PCT and why I never took steroids two was because I didn't want to cause problems with my fertility semen production and testosterone levels and anyway back in the day when I started there was no such thing as (PCT ) I know it's come a long way but still I would not take them back then guys were taking them like Candy after only starting a couple of months in the bodybuilding world of training where I was at it a good few years and was still bigger then these guys who took the anabolic steroids did not appeal to me at all oh yes I wanted to be Arnold Schwarzenegger he was my hero but I did take a lot out of Arnold philosophy in the way is mental and physical strength have made him to succeed in anything he ever put his mind to and I use that in my career as well.
So anyway I would like your opinion on what I have written or is there another way to go about two sort this problem out I am not a doctor and I'm not trying to be a doctor and I'm not trying to tell you your job but I'm only giving an explanation of what I was thinking but as I said the problem is getting the medication prescribed here in Ireland and I'm at a loss on what way to proceed I will be extremely grateful if you would reply to my message with your opinion and what way to proceed to sort out this problem this problem started when my 20 year old daughter was murderer in the Canary Islands off Spain a couple of years ago I do think about it every day but I am strong oh I miss my daughter so much all the time but I do know I can't bring her back I am very spiritual person and I believe she's in a better place now as this world has gone mad when you look at the news and see what's happening I can't figure it out people are suffering everywhere due to politics money and oil and politics thank you.
Kind regards
Submitted: 6 months ago.
Category: Endocrinology
Expert:  Dr. David replied 6 months ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 6 months ago.

homosistein levels can be abnormal or elevated in patients who have abnormal B12 levels

you should get your B12 levels checked.

it seems you are taking lots of B12 vitamins which could be helping the problem.

there are blood tests to check for pericious anemia which can cause low B12 levels and severe fatigue

methylmalonic acid (MMA) levels is another blood test to check for pericious anemia.

you need your thyroid hormone levels checked.

I would fix your B12 levels first.

this could help drop your sex binding hormones and help your testosterone levels to be more normal.

Customer: replied 6 months ago.
No you don't understand I got my homocysteine levels checked and was recommended the medication to take to fix this problem have you read what I have written my Testosterone levels are not right and this is why I got in contact with you to ask your opinion about taking the medication or an alternative medication to sort this problem out it is nothing to do with my homocysteine in levels I asked you about the medication situation I was in no problem is my test levels or alternative medication to take I'm not happy with your answer you must have read my question probably
Expert:  Dr. David replied 6 months ago.

you most likely don't have a gene mutation causing homocysteine metabolism problems

but low B12 levels with pericious anemia can cause severe fatigue and low B12 levels.

you may be fixing that by taking B12 supplements.

but you should ask your doctor to see if you may have pericious anemia.

your liver making too much sex binding hormone can cause poor testosterone function.

you need more testing to find out the root of the problem.

Customer: replied 6 months ago.
I understand what you're saying but I'm not happy with this as this is not the question I asked how do I get a refund as I'm not satisfied to finish just this consultation with your doctor as I'm not satisfied sorry but that is not the question I asked as I said above I do know a bit about medical problems and not a doctor but I have a problem with my test levels and I just wished to get a refund how do I go about this
Customer: replied 6 months ago.
I had my B12 levels checked and they are at the correct level so that is not the answer I just wish to get a refund and stop this consultation Michael O'Connor
Customer: replied 6 months ago.
I got my thyroid checked and there is no problem there either it's just myTestosterone levels that out of problem so your first two suggestions of no help to me whatsoever I just wish a refund as you still don't seem to be answering the question I asked Michael O'Connor