On anabolic minds some people are saying that some men tried TRT but got no effect out of it because of adrenal or thyroid issues. Apparently Dr. Marianco from the mesorx forums is good at treating this sort of thing.
Here’s a link to a post made by a good friend of mine (and yours) galapagos.
http://anabolicminds.com/forum/male-anti-aging/74627-hpta-restoration-does.html
I too have heard time after time that Dr. Marianco is “good at treating these issues”.
I have heard it from a person who know a person who mentioned it about a person etc, like Chinese whispers. I have also seen Dr. Marianco write articles purporting to be good at helping to help those that have complex endocrine issues.
However!
I have not heard of a single person that has been helped first hand, not one.
I think what we are looking at here is very good self promotion and Chinese whispers but not actually hearing first hand from anyone being helped or hearing of any of his success first hand in the world of endocrinology.
I have also heard this theory that testosterone issues and hypogondism cannot be treated unless thyroid or adrenal issues are treated first. This to me seems to be another series of Chinese whispers.
There is no significant evidence whatsoever that states that their is a hierarchy of hormones and that the thyroid or adrenals should be treated prior to hypogonadism.
Also in most cases, there is little to no evidence that such people have any thyroid or adrenal disorder to start with. In fact very often it is claimed that people have such disorders on the flimsiest of evidence.
If someone has an adrenal or thyroid disorder of course it should be diagnosed and treated and it should be done so via proper methodology and accurate assays and not saliva tests which are ludicrously inaccurate and often incorrectly point to such disorders. The thyroid and adrenals should be tested where symptoms and clinical presentation indicate that such testing is worthwhile, just as with hypogonadism and any given condition diagnosed should be treated in the correct manner.
To this point there is a mountain of evidence that shows the link between lowered androgen status and finasteride. Finasteride is a known anti androgen and it was used to chemically castrate men who had prostrate cancer. We often see lowered testosterone, LH, free testosterone levels post finasteride use and we often see increased levels of estradiol and SHBG. So we know that the connection, the cause and effect that can occur in terms of finasteride and hypogonadism.
For all the theories there is little to no proven evidence of a link between finasteride and adrenal or thyroid disorders/dysfunction.
If such evidence comes to light we should be open to it and take it into account. We should not dismiss possible links between finasteride and endocrine disorders if they are evidenced. However we should not be attaching weight to un-evidenced or poorly evidenced links between finasteride and these or other conditions.
I have read of the most ludicrous pseudo-medicine and pseudo-endocrinology that has been put forth by Dr Marianco. It all sounded like an extremely complicated labyrinth of effects that were quite plausible in the most bizarre way to the layman. Of course none of anything he had to say was in the slightest way evidenced or based in relaity. It was garbled nonsense that people have latched onto in hope and desperation as much as anything else.
You know what? Dr. John Crisler whom you respect would not agree with you. Dr. Crisler regards Dr. Marianco as a knowledgable and respectable man. Take a look at this post on anabolic minds where Dr. Crisler makes a post himself verifying this fact.
http://anabolicminds.com/forum/male-anti-aging/52566-free-testosterone-measure.html
Well shock horror but;
Whilst I respect the fact that Dr Crisler has helped many men with hypogonadism and related issues and whilst I recommend people seeing him as well as other quality doctors on this basis…
I also think that Dr Crisler is a shameless self promoter. I also know that he could get into an argument with himself if left on his own in a room for 24 hours. I am also aware of the fact that he has a very colorful record/past when it comes to arguing with website owners on the internet…and I am also aware of his less than professional record when dealing very poorly with some people who have seen him.
FAR too many people seem to think that Dr Crisler is the be all and the end all of experts when it comes to the treatment of hypogoandism.
I am here to tell you that is not the case and burst that bubble!!!
Dr Crisler is one good doctor who’s self promotion exceeds his ability to such a degree that people seem to always be talking about him as though he was the only doctor who understand or has ever treated hypogonadism or related issues. People talk about Dr Crilser as though he is THE top doctor in the world who treats these conditions, which he isn’t.
Dr Crisler is no where near as qualified or as experienced as Dr Eugene Shippen who doesn’t endlessly promote himself in the same way and who doesn’t come with the same issues. Even there though Dr Shippen is one doctor in a world of doctors treating these conditions….
I recommend Dr Crisler to certain people, because he can and has helped people, but he is just one doctor and he also has his issues.
Now, Just because Dr Crisler speaks, I do not sit in awe at his sainted words (sarcasm).
Also his protocol for treating hypogonadism is more shameless self promotion, in that use of HCG pre-dates Dr Crisler and was being used prior and in and around the time that he used it with TRT. That is not to knock what he has said on the matter. The use of HCG in combination with TRT is something that works well for a good deal of men, so I do not knock such treatments. Likewise the use of arimidex, pre-dates Dr Crisler. His protocol is just a re-hashed word document that has no significant publication or anything beyond what many doctors have been doing. Great hype for him though.
So yes Dr Crisler gets recommended as does Dr Shippen because they are two doctors that have helped people…but that does not mean to say that Dr Crisler is some;
“special one”
Who people should fete……
Now I use my own intellect, my own knowledge and I use my own eyes and having looked at all the hypogonadal websites in the US for a number of years I can say that all this talk about Dr Dr. Marianco and his theories and helping people is just shameless advertisement.
He has not helped anyone with these conditions that I know of. He had not helped anyone on the hypo2 forum. I have not seen a deluge of people come forward and say wow Dr. Marianco has helped me find answers and treatments etc.
I do not hear anything truly great about Dr. Marianco apart from that coming from Dr. Marianco or Dr Crisler. I am sure you can dig up certain names from websites where he frequents who will say otherwise (are they real or invented?), but I do not know of anyone in mainstream circles/sites he has helped. And I see zero evidence for his absurdly complex theories that just happen to indicate that he is the man to go and see and get help from…no bibliography, no linked sources to evidence anything he has had to say. When questioned about his theories he has either never commented and diappeared or he has gone into the most blurred and vague language that has again no evidence.
Also I am aware of Dr Crisler and Dr. Marianco having related business interests;
Draw your own conclusions on that one.
I will continue to recommend any doctor that I think can help any member of this site, I will continue to recommend anyone who I think can improve the health of anyone here- that is what comes first.
But I do not have to agree with many of the things that such doctors get up to, I do not have to like them personally and I do not have to take their shamless self promotions and act like it is scripture.
If anyone and I mean anyone comes up with any groundbreaking information on hypogonadism or the treatment of finasteride that indicates adrenal or thyroid related issues…anything that is proven with a high standard of medical evidence then I will welcome it with open arms.
If anyone can prove and help anyone with these conditions then I will welcome what they have to say and what they offer irrespective of my personal feelings.
Until things are proven and whilst people act in controversial ways and shamelessly say things which are unproven and make wild claims, I am going to put my point across and explain my reservations.
This is my first post of this nature in the open forum having been put on the spot…
P.S
You can agree with what I have written, be informed by what I have written, question what I have written etc etc.
But you have my feelings in any event.
I will not critisize any doctor on the “medical” treatment of individuals where I can possibly avoid it. I would only do that if serious problems came to light. This post is NOT a critisism of the medical practice of anyone, rather a critical comment on business issues related to the practices of the mentioned doctors based on my opinions and what I have seen, read and been told by other hypogonadal patients.
I hope to not have to speak any further on such negative matters and this is my last post in this thread.
I like this post, it needed to be said and needed to be said by some1 without a hidden agenda yet who still have the knowledge u do. I guess it was u who needed to say it 
Good 1.
By the way id just like to say that i have thyriod issues, and t-gel work wonders for me. Im hyperthyriod, but docs dont think thyroid condition is bad enough to treat. On a side note, ive been feeling better and better lately without any meds at all. I have even gotten back to my old job, bike messenger… however when i know i want to be horny, i take a pack of gel, sometimes i even have a healthy libido au natural. Maybe this isent a good long time solution but for now i have a normal life and feel weel again so im not changing it untill i need too.
The only thing i changed in my life is that i actually do stuff again, so i cant offer u any magic product or similar.
Ill keep letting u know how it goes and i do still read here, just not as frequently as b4.
Best of luck / Björn
Good for you. I wanna try some Androgel or similar (TRT). I have heard it can help prostate recover maybe???
ANyway, how long have you been taking it, and is it a regular thing (i.e. everyday) and also are you worried about any long term side effects with it?
So you say you are almost feeling normal again.
Thats great.
Tell me also, do you feel prostate symptoms at all??
Peace,
B
TRT will not help with prostate issues if you have elevated E2 or SHBG.
In fact it can exacerbate prostate issue by increasing E2.
So TRT is good if SHBG is not high and E2 not too high and if E2 is kept in check if it becomes to high…
So TRT can help, with “can” being the operative word as it depends upon the above and on the cause of the prostate problem being a hormonal one.
Well, the prostate issue… ?? I don’t know what exactly it is caused by, but it seems like it is definitely prostatitis, no question. However, I’m thinking maybe it was caused by something such as hormonal change… caused by finasteride.
How do you keep E2 in check?
-btw, is E2, Estradiol?
And another question is:
-Hypo, I just had to fire my endo, simply because I feel its a waste of time trying to work with someone that won’t recognize fin as a problem, nor recognize any of my levels as “out of range” and “of concern” for treatment. … so I feel its time to move on.
Basically I think I need to find someone new, who can try to lower SHBG with Danazol, but I do not have insurance any longer. I wonder if this can be done easily, i.e. quickly and efficiently, like with one or at most, two appointments, since I will be paying out of pocket.
I am in … well you know where I am.
I would like to try this once and for all.
I want to get rid of these lingering prostate problems once and for all, and not just sit and wait, so I can be better after all.
I am almost there. But again, just want to try something just to see if it works any. I’m ready to try something such as Danazol, I’m not afraid. I mean whats the worst it can do to me?
Btw, I am still going back to the “Prostatitis Center” in Tucson for the full treatment in October to see if that does it. I will also be using it as a retreat of some sort to finish some much needed school work at the same time, so it will definately not be time wasted.
They do the full Feliciano methods for curing prostatitis. So hopefully there is not some hormonal pathway that then prevents full treatment, and full recovery.
I think it matters more if you are hypothyroid as opposed to hyperthyroid.
Regardless I think Dr. Marianco is a respectable guy. I personally know for a fact that I have adrenal issues. I feel better when I sleep more, and I feel worse when I skimp on it or am stressed out.
Lets not forget about the recovery stories of guys who’ve quite caffeine and slept more.
And you might be right because that is certainly possible, particularly given the use of finasteride.
Yes E2 is estradiol. How do you keep it in check?
Well, you and your endo or andrologist test for it and if it is high on or off TRT you lower it into a reasonable level with prescribed medication such as arimidex.
How do you know what a reasonable level is?
By testing to see what it is on arimidex and by evaluating symptomatic response.
E2 is not always the issue though.
SHBG could be.
In which cases you and your endo would know because you would test that at the same time as your other hormones and if high you could treat it with prescribed Danazol.
If the problem was just low testosterone and or DHT then TRT alone might work.
Sorry to hear of the problems you have encountered. Of course finasteride does cause problems, but as many of us know the problems are not widely know and very much misunderstood. I looked for your bloods in the forum but couldn’t spot them, so I don’t feel able to comment on them or say whether or not I think the endocrinologist is wrong or just drawing a blank. I am sure I have looked at your hormones in the past on the site but when looking at so many differing pathologies I like to see them again each time because I do not like to make errors and saying anything that is incorrect that could mislead someone. If you direct me to your bloods I can comment again on them.
Possibly…tough to say….but please if you can direct me again to the bloods and remind me of your location I can at least try to help…yes?
Bloods and location….let’s see if I can think of anything…
Just out of interest, can I ask you on what grounds do you think you have an adrenal issue. I am not being facetious, the question is a genuine one.
My blood results are at propeciahelp.com/forum/viewtopic.php?t=397
but I’ve had more recent ones which show high prolactin, but T is still at 600 or so. They f—ed up though and didn’t do SHBG again, nor free T or FSH or LH.
I was pissed, because now my insurance has run out.
I live in Boston.
But I just wish I could go get treatment easily. I.e. like with one, maybe two appointments tops… Or else just order some stuff over internet and at least try for a short period to see if results start showing.
Reasons I say I may have adrenal issues are the following:
I used to drink quite a bit of monster energy drink, I’ve also used a bit of the more powerful illegal stimulants from time to time
I’ve had and still pretty much have a shit sleeping schedule
I’ve made some decent progress since quitting caffeine and taking a supplement containing stuff like bovine adrenal extract, pantothenic acid
My libido goes back to shit after a night of late night drinking
I wake up tired and have bouts of exhaustion throughout the day.
I feel better if I can sustain a decent schedule and sleep well and whatnot.
Not only that but I feel there’s a good amount of correlation between the symptoms of adrenal fatigue like brain fog and exhaustion and whatnot, also the fact that even under good treatment and supplements it can take about 3 years to cure.
None of the above remotely constitutes evidence.
I mean nothing you have said even approaches weak evidence even.
As for poor sleeping, lowered libido, exhaustion…
Those symptoms could be put down to any number of conditions or even no condition at all.
You REQUIRE endocrine/ and possibly wider investigations to ascertain what the potential causes are for such symptoms.
It is nonsensical to just assume that you have a given condition with no evidence whatsoever.
You should want to establish the reality of your situation.