• Would using (injecting) testosterone bother/effect my Crohn`s disease?

  Answer:  / As far as testosterone goes I have not seen any issues/interactions with Crohns disease. Human Growth Hormone has been shown to improve Crohns disease. JJP /

• hi doc is there any way i could boost my testosterone levels what should i take

  Answer:  There are multiple ways to boost testosterone levels. I have not seen much success in the way of supplements. You should first have your levels checked to see if you need your testosterone level improved. JJP 8/23/08

• doc my penis glans are quite red if i have sexual activities with a women will i get hiv or aids beacuse my penis glans are red and i am using canesten cream

  Answer:  If you use a condom you will decrease the likelyhood of contractiing a STD. Practice safe sex protocols and you will be less likely to contract a STD. JJP 8/13/08

• hi doc can you tell me how to boost testosterone levels which are required for sperm production should i take more protein

  Answer:  It all depends on what your current level of testosterone is. More protein intake will not increase your testosterone level. JJP 8/13/08

• hi doc there this smoothie which is manily 400g strawberries 225g cherries and 1 tsp of flaxseeds they say it gets the blood flowing to all the right places and puts your little soliders on high alert and it even boost testosterone

  Answer:  Thanks for the information. Sounds like it will boost the blood sugar as well. JJP 8/10/08

• hi doc i have got this problem that when i ejcualte no semen or sperm comes out what nutrition should i start to take and do you think my testicles have stopped working

  Answer:  I suggest you find a urologist. JJP 8/07/08

• hi doc do you know anything about speman tablets which increases sperm count do they actually work

  Answer:  Never heard of it. JJP 8/04/08

• hi doc can you tell me if all of the sperm is made from protein and how much protein does your body need to keep producing thick white sperm

  Answer:  No its not all made from protein. The daily requirement for protein is about 1 gram per kilogram of body weight. JJP 08/02/08

• i doc i have this bad feeling that my testciles are not producing sperm anymore shoud i see my gp and what blood test will he do i am at the age of 22 what medication will he give

  Answer:  You should see a urologist. JJP 7/31/08

• hi doc can you tell me how to treat premature ejaculation which means cum qucikly

  Answer:  Unfortunately there is no 100% effective treatment. Viagra has been shown to be helpful with PE. JJP 07/27/08

• Dr. Garcia, Hope you are fine. I am 42, laid in the sun for years, (haven`t been is sun in last 10 years), Sometimes I don`t see the outside for weeks. However, I am just now showing sundamage, fine lines around the eyes, and around near mouth (the part where some people get parentheses), I don`t have parentheses, just the starting of crepe paper looking skin on the cheek next to the mouth, a couple of brown spots. This is my regimine: Cleanse with foaming cleanser, tone with NON Alcohol toner, Obagi Vitamin C, Obagi Elastiderm (love it), moisturizer, Glominerals face primer, Obagi healthy skin sunblock, then apply makeup. At night, Cleanse, tone, Neostrata 15 %, and Obagi Elastiderm. What can I add or change that would work better for my skin?

  Answer:  Retin-A is a must for the crinkles, start at 0.05% at night and progress to 0.1% twice daily under all the rest. All the best. JG 7.27.08

• hi doc can you tell me how sildenafil citrate treats ED and how it helps to achieve an erection

  Answer:  It is a vasodialator. It helps blood flow everywhere especially in the area of concern. JJP 07/27/08

• say doc can you tell me what the size of the penis in flaccid and erect state is 7inches above average

  Answer:  Please ask a urologist your question concerning penis size. JJP 7/24/08

• hi doc i just wanted to know if there is a way to increase penis size what would you say do penis enlargement tablets work and secondly what size does you need to be in order to have intercourse with a female what average size needed

  Answer:  I do not think there is any good alternative to increase penis size. There are no pills that have been proven to work, regardless of the advertising hype. There are surgical techniques, but they have serious risks associated with them. As far as what size one needs to be to please a woman, it depends on the woman. JJP 7/21/08

• Hi! Im a 25 year old male. I recently had my testosterone checked since I have been feeling really tired for the last couple of years. My results came back and my Test levels were pretty low (314) for my age my doctor said. He has recomended TRT. I am open to it, but my dr does not seem to be very well educated in this area and it seems at times that I have more knowledge than him from my internet research. My concern is that I had gyno surgery and I do not want the gyno to return from low T levels, not high T levels converting to estrogen. What do you suggest? Should I be taking nolvadex along with the injections? Is this something you offer? What kind of costs are associated with it if choose to go thru your practice and not of my doctors?

  Answer:  First I think there are better alternatives than TRT for a young man such as yourself. I have patients with Testosterone levels of 1200-1400 with out giving them any testosterone supplementation. I think helping the body produce testosterone is better than just supplementing it at a young age. As far as estrogen goes, it depends. First we would have to ascertain your current level of estrogen and what level you make when Testosterone is balanced. If it is high and/or you have symptomology then we treat with an aromatase inhibitor not an estrogen receptor blocker, like nolvadex. Please feel free to contact our office if you have further interest to find out more. (702)838-1994. Thank you. JJP 07/21/08

• hi doc i just went to a website herballoveshop.com and they are saying that frequent masterbation everyday kills erections and testicular functions resulting in no more pserm being produced just watery semen because your a doctor can you tell me of the effcts masterbating everyday will have

  Answer:  Please see a Urologist with your concerns. JJP 7/14/08

• hi doc i just wanted to know if a male masterbates for several years does it cause any problems such as problems getting sexually aroused physically or visually and if so does viagra help

  Answer:  It should not. JJP 7/13/08

• hi doc i have got red skin on my glans of my penis i have tryed canesten which my doctor told me to take but that didnt treat it it all red which cream should i use and should i avoid using soap

  Answer:  I think you need to see a dermatologist in person for a diagnosis and treatment plan, sorry. JG 7.7.08

• hi doc does doing excessive masterbation everyday damage your penis penile veins and does it kill off sperm meaning less amounts which are watery there is this doc called dr nk lin who says it does the above and also lowers testtosterone levels please help

  Answer:  The act of masturbation does not cause any problems, which I am aware of. I have not heard of any clinical studies to confirm what you have been told. The male body will produce sperm at a particular rate. It is true that the more one ejaculates the less sperm will be released. This is due to decreased time for the sperm to be produced. As far as damaging the penis, I suppose it is possible if one is over zealous.

• hi doc i have got these dark blue purplish veins in my inner foreskin see them when i pull my foreskin down what are these veins are they a sign of damaged penile veins i did used to masterbate a lot say 3-4 times a day could that have caused these veins to appear in my inner foreskin alot of men dont have veins like the ones i metioned on their inner foreskin please help

  Answer:  It sounds normal. If you are that concerned go see your doctor. JJP 6/10/08

• doctor i see thses blue veins when ever i pull my foreskin down {retract it down} thses veins are purplish color and i wnated to know is this a sign of damaged valves in the penis what can i do about them ps i heard a doctor n.k lin that it is caused by frequent overmasterbation what do you say please help

  Answer: 

• What is the `best practice` for reducing frontal fat on the male chest and stomach. My BMI is 28.4 and I am a 55yrs who engages in daily aerobic exercise regimen. HH 03/05/2008

  Answer:  There is no such thing as natural spot reduction. As you lose weight it comes off evenly all over the body. You may increase the size and tone of the muscles in the problem areas for a better look. Liposuction may also be of benefit. JJP 3/07/08

• Hi Doctor, I have a follow up to the post I made earlier. My fiance who is 45 with diabetes had his testosterone checked due to no sex drive and no energy. The doctor ordered 1 shot of 100mg per month to see if he can raise it up to 500, which he was tested at 305 (complete testosterone). He was feeling great, full of energy, still no sex drive however. After 6 days, he crashed. He even left work early because he was just plain tired. He went back to the doctor that night, but saw another doctor. This one believes in super aggressive measures. He gave him another shot of 100mg and prescribed the testim gel due to insurance not covering the shot. Again, he feels great. He even felt a little desire but could not maintain an erection. The desire lasted maybe 2 minutes. At least it`s a start. My question to you is, how long does it usually take for the sex drive to come back. He`s on testim 50mg per day. Is it possible, because of his diabetes that he will need to take cialis or viagra to maintain an erection. And the testim just makes him want to have sex. Or should the testim be enough for both? Sorry for the long winded post.

  Answer: 

• My fiance is 45 years old. He suffers from fatigue all day. Absolutely no sex drive whatsoever. He has prescriptions for both cialis and viagra, however, when he has taken a pill in the past, it worked as far as getting an erection, but he never feels like even popping the pill to begin with, and if I should bring it up, I am pressuring him and doesn`t feel like talking about it because it`s frustrating. I understand it`s frustrating, but if we never talked about it, nothing would get done. Recently he went to his primary care doctor and she did a total testosterone test and it came back at a level of 305. She gave him a prescription of a shot of 100mg once a month with hopes of rising the level to 500. I was wondering if 305, even though in the normal range is considered low normal, would that be the reason he never has the desire for sex? And how soon will he start to feel the added testosterone via a shot. If he does obtain a 500 range, will his sex drive come back? Thank you for your help.

  Answer:  I`m happy you have raised this issue. Yes, his testosterone is low. The numbers just give a baseline. It doesn`t matter what his level is (within reason), if he has symptoms of low testosterone as you have described then his level is low for his body. For his primary to suggest that a level of 500 should fix this is absurd. It may or may not depending on what level his body needs. Also, the free testosterone is the most important aspect of the equation. 100 mg of testosterone a month is a very low dose. It is not even considered the minimal standard of care by endocrinologists. This low dose may suppress him more than he already is. Testosterone Cypionate has a half life of 6 days. This is the usual form of replacement. That means that in 6 days only half of the original dose is available (about 50mg, 6 more days half of that (25mg) and so on. You see at the end of the month there is only approximately 3 mg available. There is more to this story, but one can see the issues at a basic level. This is why it is important to see someone who has been trained in the field of (anti-ageing, age management medicines or functional endocrinology) These are all terms for the same thing. Physicians with this level of understanding can and will treat effectively and appropriately, so you and your husband do not have to go on suffering. JJP 2/24/08

• Hi Dr Garcia A little while back you had suggested trying progesterone USB Cream for very oily skin. I am a Male, age 40. I did a little more research and wondered if you knew anything about a product called Spironolactone, with the trade name, Aldactone. This is supposed to be a DHT blocker. I have a website about it, but didnt want to post until I heard your response. A quote from the site is: As we noted, it has a structure similar enough to testosterone to bind to the testosterone receptor. However, instead of activating it as androgens do, it antagonizes the receptor, acting as an antiandrogen. Dihydrotestosterone, the 5-alpha reduced metabolite of testosterone, is believed to play a major role in androgenic alopecia, or male pattern baldness. By blocking the binding of DHT to androgen receptors in the scalp, spironolactone may help prevent or treat AA. Would this product, in your opinion, work as well as the progesterone cream? thank you! Rick

  Answer:  it is worth a try, just need to get a prescription and start at a a low dose to avoid any sexual side effects. JG 2.16.08

• For about the last year I have been losing my hair-it is very thin and very dry. It has always been thick until now. The loss is all around the top and sides of my head (actually extremely thin all over) and the hair is almost gone on the top above my forehead. It is very drastic. I am 65 years old, had a Hysterectomy 10 years ago and have been taking Bio-Identical Hormones,plus Testosterone rub on gel for 2 years. Could the testosterone cream cause such a drastic loss of hair? The dermatologist I went to said to use Rogaine for men, which has had no effect. Thank you. H.W.2-11-08

  Answer:  Yes the testosterone can have an effect on your hair loss. Testosterone is converted to dihydrotestosterone (DHT) to a greater or lesser extent based on your genetics. If testosterone is used transdermally it converts to DHT much more. DHT is partially responsible for male pattern baldness. We have had success in treating the problem in women by using scalp-med. Check out the web page at www.scalpmed.com JJP 2/11/08

• Dear Dr Pierce, My husband suffers from BPH and is taking Flomax and Avodart, and has had a prostate biopsy as his PSA tests have varied from 9.9 to 13. No cancer was detected but he does have a high amount of precancerous cells so is monitoring it regularly. However he does have a testerone deficiency with normal estrogen levels, and suffering from many of the signs and symptoms of male menopause . He is considering testerone replacement using bio-identical testerone. In view of his BPH and prostate concerns would this course of testerone supplementation be advisable?From what I have read low testerone can be a cause for prostate cancer, so raising his testerone sounds like a good idea? Thank you. TF 02/04/08

  Answer:  This is a very controversial issue. Some physicians would and others would not. I think as long as his Urologist is comfortable with his diagnosis of BPH and no cancer then treatment may be started. It could however worsen the BPH. The Avodart also is adding to his male menopause symptoms as it blocks DHT everywhere. JJP 2/4/08

• Hi, I`m not exactly sure how to explain my fiance`s situation. He`s 45, he`s diabetic (under control) about 30lbs overweight. Basically he has no sex drive what so ever. He was tested about 1 year ago for testosterone and it was normal. The exercise he gets is walking around all day for his job. He also has trouble getting and maintaining an erection. The times he does feel in the mood is only for me to masturbate him. He says this is mostly a stress reliever than sexual. He told me 5 years ago, before he was diagnosed with diabetes, he had the sex drive of a teenager. I don`t know what to do. He has gone to doctor after doctor, and they can`t help him. They all tell him he`s too fat. I know men who are much larger than him and with diabetes that don`t seem to have problems. I would never cheat on him, it`s not my style. But whenever I talk to him, he shuts down and gets mad because he feels like less of a man. Can you reply to me personally please, I don`t want anyone else reading this. Thank you

  Answer:  I will speak as to the issue you have presented. If you would like a personal consultation you may contact our office at your convenience. I am not sure his testosterone level is appropriate for him. The normal range is 250 -1100. This is huge range. 4X the normal low is still normal. With his symptoms, although he fell in the range, I feel his levels are low. He should be seen by someone trained in the field of Age Management medicine. JJP 12/10/07

• I have contacted your office on three separate occasions with the intent of scheduling an appointment. Every time I have called I have received a different answer regarding the cost and what to expect on an initial visit regarding hormone replacment therapy. If possible, could you provide some information on the cost and what to expect on an initial visit for hormone replacment therapy? Thank you for your time.

  Answer:  Sorry for the confusion. I have recently become medical director of Ageless Forever, as such we are going through some changes to provide better more complete evaluations of our patients. This may explain some of the inconsistency. We apologize. There are a few plans to choose from at this time. You may come in with out lab work done to find out more about us. This will not be as specific to your individual needs, as they will have yet to be determined. We do allow for some lab work to be done by your physician (Everything, except the hormone profile). We also have an Executive program where everything will be handled by us. If you have any further questions please feel free to contact us at (702)838-1994. JJP 11/5/07

• I am 49 year old man from HK. I have been experiencing thinning hair 10 years ago. I have used a no. of hair growth products but the thinning problem is not stopping-largely receding hairline and gradual baldness of the crown. Indeed, it has got worse now. I made an appointment to visit Svenson Hair last week and they claim that there is still a glimmer of hope of keeping my hair and perhaps have some of the hair regrowth. The programme prescribed would take 6 months but the costs are simply prohibitive.I am also using a oprduct called Trichoderm from France ( for nearly 20 days now and they say it would take 30 days to see some positive effect. I saw Scalp Med ad and am wondering if this product would help. I am pretty frustrated and very much like to have your suggestions please. Irving

  Answer:  I think ScalpMed is worth a try before any of the others. It is sold at ScalpMed.com JG 10.17.07

• I have been taking 25mg of DHEA a day (I`m a 44 year old woman) I just read this off a medical sight:Basal serum levels of total testosterone, dehydroepiandosterone sulfate (DHEA, - S) and androstenedione (A4) were measured by radioimmunoassay in 100 patients of acne vulgaris, and in 100 age and sex matched acne free healthy subjects. In males with acne the mean serum testosterone levels were marginally and the DHEAS and A4A levels were significantly higher as compared to controls (p). Females with acne had significantly higher levels of testosterone (p<0.001), DHEA-S (p<0.001) and (p < 0.01) than controls. Our data suggest that increased adrenal androgen levels in plasma may be responsible for treatment resistant acne vulgarism. Could this be the reason I am suffering from bad breakout?

  Answer:  yes, You should not take DHEA without gettng blood levels checked first. JG 7.14.07

• Hi Dr. Garcia. It was so nice to meet with you yesterday. My question is about my husband who has been using Testosterone replacement for about 9 yrs, being monitered regularly by his PCP. We lost our health insurance, so we had to go to injections once a week of 1.5 cc. instead of the patch.I have noticed that he really has ups and downs with moods and Im wondering if there is other methods of delivery that he could be using that would not affect him as much. sg

  Answer:  well we use testosterone creams that avoid that or we can use testosterone pellets that will also take away the fluctuations. He is free to come see us about changing over if he would like. JG 6.7.07

• hi dr garcia, thanks. you had mentioned maybe i should change my birth control pill from mircette to something else because of my low levels. what would you recomend? I was taking Ovcon before Mircette and seemed to be ok, but my doctor thought because of my hair loss maybe Mircette would be better. Also I have low levels of Ferritin, Protein A/G Ratio and high levels of cortisol and ESR. What could cause those and can any of those or all cause hairloss and what is the treatment for them? thanks a lot. Didi

  Answer:  I think you nee\ed to discuss the other BCP options with your gynecologist. High cortisol is due to high stres and that can affect hair loss. JG 4.7.07

• Hi Dr Garcia, in my recent lab work my DHEA was very low, 0.3 ug/ml and my estradiol was very low 3.0 pg/ml and 0.72 ng/ml Progesterone. The blood was taken during the middle of the 2nd week of my Mircette pack. I sthat the mid follicular phase? Are above low levels ok as I have severe hair loss? Also, I started bleeding for 5 days the day after I took these tests. It was not time for me to have my period. Does this mean I need a different birth contro lpill? thanks

  Answer:  sounds like you need a different pill, all sounds like potential side effects of the pill, those levels are low for mid-follicular phase. JG 4.4.07

• Hello Dr. Garcia, you had recommended to me before to use Progesterone cream. Can I apply that while on BC pills or I should stop the pill? Also, how should it be applied and how much? I think I read it could lead to cancer or cause other problems if not applied correctly and in right amounts. Thanks

  Answer:  it cna be applied while on BCP. It does not lead to cancer and the amount should be determined with blood or saliva testing , I suggest application on the inner arm or forearm, in two daily doses. JG 3.23.07

• I received my blood work results back and they indicate a low testosterone level and my HGH and thyroid is borderline. I`m 45, could this be a sign of getting older or something more troublesome?

  Answer:  most common cause is the aging process. JG 2.22.07

• Hi dr. garcia, I have a question and I hope it makes sense! I recently had my testosterone and things tested because I have developed Hirsutism, and on the results they gave you a number range where if you fall within that range, the levels are considered normal. I wanted to know, let`s say before my symptoms my level was at a 2.5 (just example numbers) and now it`s at 6.5, but the healthy range is 1.5-10.5, so even though I fall within the healthy range, could I be having these symptoms because the level has raised from 2.5 to 6.5? Sorry if this is confusing, thank you though!!

  Answer:  yes, some people are genetically sensitive to those issues at lower levels, one does not need to be outside of the normal range for those things to occur. JG 1.21.07

• Hi Dr. Garcia. I am currently on Ovcon 35 and 150mg/day Aldactone among other meds such as levoxyl. All my hormone levels are within normal range, but I have suffered from gradual hair loss for many years and the hair just gets thinner and thinner and the hair loss does not stop. I had noticed that the hair loss was less when my testosterone level was at the low of the range. In the last 3 months I have had severe hair loss 3 weeks out of the month and it practically stops for about a week when I have my menstrual cycle. My Dr. changed my B.C. pill to Mircette as he said my testosterone and DHEA has gone too low and too low causes hair loss also. The last lab I had done, in the middle of the 3rd week of the Ovcon pack showed my results as follows: DHEA 0.8 ug/ml, Testosterone 0.5 ng/ml and Progesterone 63.6 ng/ml. Do you have any input if this approach is good or I should reduce my Aldactone and keep the B.C. pill as Ovcon instead of switching to Mircette? Also, my Progesterone seemed too hig. Is that ok? Thanks Didi

  Answer:  It does not appear that your testosterone or progesterone are causing the hair loss, it might be you need a little more thyroid medicine. JG 1.12.07

• Good afternoon Dr Garcia and merry christmass to you and your family.I am wondering if you can tell me some information concerning normal FT and DHT, testosterone levels in men aged fifty to sixty years of age. Example a man 6ft tall 200lbs in weight and otherwise healthy. Thank you for your assistance. 12/26/2006, 3:15pm.

  Answer:  50-150 for the free and 25-75 for the DHT. Merry Christmas. JG 12.26.06

• Hello, could please tell what the normal levels of free Testosterone (FT) and the levels of DHT are for men who are in their middle to late 50`s in age?

  Answer:  varies by lab but about 50-150 for the free and 25-75 for the DHT. Merry Christmas. JG 12.26.06

• Hello, could please tell what the normal levels of free Testosterone (FT) and the levels of DHT are for men who are in their middle to late 50`s in age?

  Answer:  varies from lab to lab but about 50-150 for the free and about 25-75 for the DHT. Merry Christmas. JG 12.26.06

• Dr. Garcia, thank you for the info. on my husband`s testosterone. Just wanted to let you know that he is taking 1/2 cc twice a week and 1/2 cc of hcg 3 times a week. Does that seem like to much?

  Answer:  I think if he is doing all of that it is probably too much, either the testosterone or the hcg, not both. JG 11.17.06

• Dr. Garcia, my husband had his psi checked a year ago and it was .5 He has been taking testosterone shots twice a week for a few months. he just had his psi checked last week and it is 2.8. could this be because of the shots he is taking? should we be concerned? should he stop the shots?the doctor wants to do a biopsy.

  Answer:  he needs to stop the shots and then repeat the blood work in one month, if still elevated then I would proceed with the biopsy. I think twice per week on the testosterone is unusual. JG 11.16.06

• Hi doc, what are your thoughts on the product thats advertised on tv called enzypte male enhancement? It seems to me to be a waste of $$$.

  Answer:  I would agree, your wallet will get smaller though. JG 9.20.06

• I have a question. I recently took the morning after pill, Plan B. This pill contains the progesterin called levongestrol. I have since noticed hair loss after taking the one dose of the pill. Can the hormone levongestrol cause hair loss? I took the two pills about 2 weeks ago, so i was wondering if it could cause some hair loss? Can you tell me why this may have happened? Will this side effect not last very long? Since i am never going to take this medicine again. Please help

  Answer:  absolutley, yes it can, especially at that dose. The hair that was affected will most likely grow back but it might take a few months to regain the nomral hair density you had before. JG 9.17.06

• Dear Dr. Garcia, Is there a way to suppress DHT for men and women. Since it seems to be related to hair thinning and loss? Thank you.

  Answer:  Proscar or Propecia or Avodart. DHT is the culprit in hormonal hair loss, yes.JG 9.12.06

• Dr. Garcia, had my testosterone levels checked and came back at 401. I am 42 very active athlete and in very good shape. Also RBC count was 4.31 and hematocrit level 40.6. I'm wondering about the test result, any thoughts? . They RBC and the Hemo were on the low range. Should I be concernded???? I train about 300 miles on the bike weekly. L.A

  Answer:  well, they are low but I usually get a free testosterone and bioavailable to determine supplementation, along with a PSA, DHT and estrone level, then decide. JG 5.16.06

• Can the subcutaneous testosterone implant be helpful, in anyway, to a man suffering from ED (after prostate cancer surgery)and who is also diabetic?

  Answer:  it depends on the cause of the ED and also the risk of prostate cancer recurrance has to be discussed with the testosterone. JG 3.17.06

• I'm curious about the post regarding testosterone and pubic hair. Where/when do apply it and how much? Thanks.

  Answer:  apply the testosterone cream to the inner arm or forearm. The dose varies depending on your blood work. JG 3.3.06

• Hi Dr. Garcia, I started testosterone cream about 3 weeks ago and it has helped increase the growth of my pubic hair. However, I notice the hair is still very thin. Will it eventually thicken or maybe not? Thank you.

  Answer:  it should but that wil take a few months to change. JG 3.2.06

• Hi Dr Garcia, I was recently prescribed testosterone cream as a hormone supplement. Will this help thicken my body skin at all? Also, I know it is rare considering the low dosage, but do you often see any negative side effects for women? Thank you.

  Answer:  It might depending on how old you are. I think as long as you keep your levels in a normal range you should do fine. JG 1.25.06

• Which of these might have less of a testosterone effect- norethindrone, norgestimate or levonorgestrel?

  Answer:  I am sorry but it varies from patient to patient becasue your body needs to metabolize the drug, they all can to a certain extent. JG 10.20.05

• Can androstene, or 1-AD, help instead of testosterone?

  Answer:  it is a reasonable product to use. I know the manufacturer claims no conversion to estrogen, but in clinical trials I have done I have seen some conversion. A short course certainly is worthwhile, but if one is going to do it longterm, I would suggest getting tested to see where your levels are before and during the supplemenmtation. JG 2.9.04

• dr.garcia,can you purchase testosterone hormone replacement online and if so where would be the best place? Also,is testing always done in every case before treatment is given.and how much is the cost per month for somthing like this.one more thing,in your opinion is hgh or testosterone replacement therapy more effective.

  Answer:  There are some pharmacies that have you fill out a form and then sell you testosteroen, but legally, a physician needs to see the patient in person for it to be done correctly. I do not use any of those pharmacies myself, as we use a compounding pharmacy which custom makes our testosteroen in the concentration we need for each individual patient. Testing should always be done before starting,and then repeated during the therapy to assure safety. As to HGH and testosterone, they do similar yet vastly different things. HGH is much more expensive and I feel it is best to optimize one's testosterone level before going onto HGH. The cost per month of testosterone will vary, but runs about $60, depending on the dose. HGH is significantly more expensive.

• I have recently heard that men with low testosterone levels may have problems with depression. Is this true as my husband is 61 and has severe depression and they can't seem to find the right medications for him to help him out and he was told years ago that he had very low testosterone levels. Do you think that these have anything to do with each other?

  Answer:  There are many men with low testosterone levels and depression who have been placed on antidepressants and when their testosterone is normalized, they can go off their antidepressants. I would suggest your husband getting tested again, but if he is on antidepresants he should not stop them cold turkey, then need to be slowly withdrawn once he is felling better

• I'm a 33yr old man and I'm strongly considering whether to get hgh or testosterone replacement. Due to my libido declining,hair thinning,skin wrinkling and forgetfulness which would be the best treatment for me?I do weight lift 3-4 times a wk.If you also include the general price of the both treatment,pls.Thank you for your time.

  Answer:  33 is somewhat young for all those problems. I think a good history and some blood tests would help figuring out the cause. If you are deficient in HGH and testosterone those can be prescribed when appropriate. The testosterone replacement runs about $65 per month and the HGH about $650/month, but one needs to see why at your age these are so problematic. I would suggest a full evaluatiuon to figure this out first and see if there are causes that can be eliminated and therefore avoid the medications.

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