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Am I messing up my hormonal status with supplementation ??

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 Posted 9/23/2012 12:42:34 PM
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Tom. (9/23/2012)
from THIS LINK it talks about other causes:

...High PVRs can be caused by bladder outlet obstruction (BBO), bladder hypocontractility or acontractility or, in rare cases, a large bladder diverticulum. BOO can stem from prostatic enlargement, poor sphincter relaxation (dyssynergia), urethral or meatal blockage, or less common causes, such as a bladder stone. Poor bladder contractility can result from neurogenic, myogenic, psychogenic, or pharmacologic causes."

For some men finasteride has its own set of side effects, mood disorders (depression, aggression), and erectile dysfunction.

do you think there may be some interactions going on with all the supplements you're taking?


Thank you. My urologist also mentioned the other tests indicated in the article to check bladder compliance and I will see with him in a couple of months for re-test.

With regard to supplementation, it is the full point of this thread. I am even more cautions now with hormones supplementation (e.g. I stopped the DHEA). To answer your question I do not think so but might give a full break to everything which directly or indirectly might affect hormonal status prior to re-test.
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 Posted 10/12/2012 8:12:15 PM
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Albedo, check the side effects of finasteride before you say yes to that!
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 Posted 10/20/2012 6:08:42 AM
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David D (10/13/2012)
Albedo, check the side effects of finasteride before you say yes to that!


Thank you David D. I know about this. On the other side surgery and possibly complications down-there are also scaring. As I will report later, other urologists recommend both an alpha-blocker and a 5-alpha reductase prior to other tests and surgery. Possibly and hopefully side effects might disappear once treatment is stopped while complications after surgery, if something goes wrong, might be penalizing for life.


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 Posted 10/20/2012 6:40:01 AM
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Just for an update, prior to additional visits scheduled in Nov/Dec, focusing on the huge post void residual (PVR), now that the PSA "normalized":

For an additional opinion I visited a very good friend of mine also urologist. He performed an ultrasound scan of bladder prior and post voiding, measurement of flow peak/pattern between the two and an DRE.

From about 1.5L pre-voiding (he asked to retain till the visit and I could do that for about 3-4 hours) I could only void 50% to about 0.7L post-void ! He said, considering the historics, I might be suffering of a chronic retention and even the top dose of tamsulosin (2x0.4mg/d) does not seem to help.

However, and here is something positively new, the somewhat discordant fact is that, despite the (huge) PVR, the voiding pattern and peak is reasonable (he was expecting much worse) and looks typical of BPH, the latter is from my own studies when looking at profiles such as BPH, stenosis etc .. Peak was not that bad and despite pattern irregularities and of course a longer than ideal time to void, he found it not terrible.

The bad news is that he said that even after a TURP it is not sure the condition of a bladder lacking tone could be solved. This is scaring !! He mentioned training but I felt he was a bit skeptic. I really cannot see me doing a TURP and yet get to use a catheter to urinate after all !!

He typically would recommend tamsulosin + finasteride for 6 months after which, if no effect, TURP would be the gold standard. I questioned about the other methods but was skeptic. He said greenlaser has the potential to replace long term the TURP.

Bottom line I am not fully convinced of TURP and its potential complications such as incontinence. Any experience here?

Btw I have shown him the LEF prostate formulation and he encouraged the usage as cancer prevention and prostate protection; he said LEF packed a lot of good stuff in there :-)

I will return to my current urologist in a couple of months possibly for cystoscopy and/or urodynamics test to check bladder function and obstruction, the latter being the most likely cause of PVR also based on the paper linked above from Tom (thanks).

Final comment guys! I apologize I am no longer posting as before but still looking at your interesting posts. Simply lacking the energy to research and focusing a lot on my own stuff. I hope I can return as soon as possible.

Thank you a lot for your help!


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 Posted 10/27/2012 11:27:17 AM
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Transpower (2/6/2012)
...  My estradiol was 66.7 pg/nL, out of the range of 7.6-42.6. ...




I'm surprised at this range. I've just looked at the AMA's SI conversion site (since my lab reports are all in SI units)

http://www.amamanualofstyle.com/oso/public/jama/si_conversion_table_2.html

, and see that their reference  range for Estradiol 3  is  5 to 40 ng/mL But I've seen much larger discrepancies between labs. For instance, my lab lists reference range for Estradiol as  0-146 pmol/L, which according to the AMA conversion app equals 0-42ng/mL.

All this makes comparing notes rather difficult.


outlier@hushmail.com

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 Posted 10/27/2012 12:21:12 PM
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This discussion is of great interest to me, both because I have had greatly fluctuating PSAs over the past decade, resulting in two negative biopsies, and because greenlight laser pvp has been recommended to me as my best chance of avoiding perpetual bacterial prostatitis due to constriction.

Albedo's PSAs seem rather insignificant in comparisons to fluctuations over less than a year between 4, 20, and 6, and I'm afraid that orthodox urologists are inclined to hugely underrate the effect of prostate inflammation on PSAs.

UTIs suggest the possibility of bacterial prostatitis. So if a biopsy is ordered, one should make sure that a tissue culture is also ordered. Unfortunately for me, both my urologists failed to do this, and as the labs they use seem to have no other method of testing for infections of the prostate,  "bacterial prostatitis" remains only a "working hypothesis" more than a decade later, adding insult to injury...


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 Posted 11/6/2012 11:11:54 AM
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I took DHEA off and on for around two years, 50mg at a time about 3 or 4 times a week, and I'm now having heart issues. EKG and Ultrasound tests have revealed heart damage with no other explanation as to how I got it? I am healthy, low cholesterol, low blood pressure, non-smoker, no drugs, no history of heart disease. I've been in shape all my life, never even more than 10 lbs overweight. Don't use drugs.

Borderline left ventricular hypertrophy and moderate left atrial enlargement. I can no longer exercise, and am off caffeine. 

There are other studies you can google that report "rare" cases of individuals experiencing erratic heart beats who were taking DHEA. There may be other contributing factors such as stress. Even so, I would caution against taking it.

Take it at your own risk. 

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 Posted 12/24/2012 1:05:51 AM
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I have done a cystoscopy and the urodynamic (pressure-flow) tests (both invasive and non-invasive). Finally not a big deal. Results: obstructive to the cystoscopy, even with relatively small prostate, while partially obstructive to the urodynamic test with hypercompliant bladder and very large residual. Bladder detrusor muscle has typical configuration of trabeculations but is better than what can be thought.  I am told flow is not too bad and the partially obstructive result of the pressure-flow study indicates some good chances of recovery after surgery, at least partial, of the bladder compliance. Need to do something quite rapidly though not to make it worse.

Scheduled for B-TURP in January (Bipolar TURP).

Wish me good luck guys and in meantime my very best Season's Greetings to all hoping to be back full energy to this Forum soon.

PS
For those interested please refer to the European Association of Urology 2012 document:
http://www.uroweb.org/gls/pdf/12_Male_LUTS_LR.pdf
or the equivalent guidelines from the AUA, e.g.
http://www.auanet.org/content/clinical-practice-guidelines/clinical-guidelines.cfm?sub=bph
and references therein.


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 Posted 12/25/2012 3:08:14 AM
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The radiofrequency and microwave therapies look promising....
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 Posted 12/25/2012 5:56:05 AM
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Transpower (12/25/2012)
The radiofrequency and microwave therapies look promising....


Agree. However, wrt to TUMT:

"... The review found that TUMT was somewhat less effective than transurethral resection of the prostate (TURP) in reducing LUTS...."

"... Similarly, a pooled analysis of three studies (two RCTs and one open label) of ProstaLund Feedback TUMT (PLFT) with 12-month follow-up showed that the responder rate was 85.3% in the PLFT group and 85.9% in the TURP group (4)...."

"... Low-energy TUMT has disappointing results for durability. Several studies have reported a re-treatment rate after low-energy TUMT as high as 84.4% after 5 years (11-14), while other studies have reported re-treatment rates of 19.8-29.3% after high-energy TUMT, though with a lower mean follow-up of 30-60 months (15-18)...."

and wrt TUNA:

"... However, TURP produced greater symptom improvement and a better QoL than TUNA™, as well as a significant improvement in Qmax after TUNA™ (Table 19). More detailed comparisons between TUNA™ and TURP can be found in some very high-quality and comprehensive, systematic reviews and meta-analyses (12,13)...."

"... Even short term (12 months), up to 20% of patients treated with TUNA™ need to be re-treated with TURP (1). A recent French report described a failure rate (incorporating re-treatment) of up to 50% over a 20-month period (17)..."

http://www.uroweb.org/gls/pdf/12_Male_LUTS_LR.pdf
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