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  • Testosterone and GH treatment?

     

    QUESTION:

    I am 32 and qualify for testosterone therapy based on my free test levels (7.5) and my regular test is around 530. I did the Low-T quiz and got a score of 39 (it said a score of 27 and higher has been defined as suggestive of androgen deficiency).

    Wondering if it is worth it for me to get treatment. I don't want to be on it for the rest of my life. Also I don't want the receding hairline, mood swings, or gyno that can come from test therapy. Is there a way to be treated in which I won't have those side effects?

    One of my goals is increased bone prominence and structure on my brow ridge and jawline. Is testosterone for me, or should I be looking at GH, or something else?


    ANSWER:

    It is great that your doctor checked your free testosterone level, as it is the free testosterone fraction that is active.

    Whether you need to be on testosterone for the rest of your life depends; obese men may not need to be on testosterone indefinitely as fat loss may revert the testosterone deficiency. Also, if your testosterone deficiency is related to stress, it may be temporary. However, if you are stress-free and relatively lean, you may need to be on TRT indefinitely.

    Side effects like receding hair line, mood swings and gyno are primarily an issue when testosterone is taken in supra-physiological amounts. The goal with TRT is to reach a therapeutic testosterone level (within the normal range) in order to improve symptoms of testosterone deficiency; achieving higher testosterone levels within the normal range is unlikely to cause gyno or mood swings, but may still happen in some men (especially hair loss) even when things are balanced well. Injectable testosterone results in less conversion of testosterone to DHT, and thus reduces likelihood of hair loss.

    If you want to preserve fertility, combining TRT with HCG, or using clomid is recommended. Since you are only 32, you may want to try clomid first. For more on clomid, see our article: TRT and Fertility – how to get the best of both worlds - Clomid and HCG - part 2

    Your interest in accentuating your jawline is a cosmetic issue; losing body fat (testosterone induces fat loss) will make facial feature more prominent.

    When it comes to GH (Growth Hormone), it is strictly regulated by the federal government and you must have clinically diagnosed growth hormone deficiency. The diagnosis is made by a GH challenge test. For more info on that, see our article: How Is GH Deficiency Diagnosed?

    Without a diagnosis of growth hormone deficiency you cannot legally be prescribed growth hormone.

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.

    Yours in health and wellness, Dr. John J. Pierce, DO.

  • HCG and clomid for restarting HPA axis?

     

    QUESTION:

    I read your article about HCG and clomid; do you think that after a year and a half of being on testosterone cypionate I can bring back my natural testosterone levels with HCG and clomid?

    ANSWER:

    As outlined in our article " TRT and Fertility – how to get the best of both worlds - Clomid and HCG - part 2” research supports the efficacy of both HCG and clomid in “restarting” the HPG axis (Hypothalamic-Pituitary-Gonadal).

    However, the dosages of each, and duration of HCG and/or clomid treatment needed to bring back a man’s natural (endogenous) testosterone levels varies widely between individuals. There is no one-size-fits all. The greater the dose of testosterone you have been taking, and the longer the duration, the harder it will be to kick-start your HPG axis. Therefore it is important that you go to a doctor who knows how to deal with the consequences of the testosterone use.

    After you get your endogenous testosterone levels back, if you do another testosterone cycle and are concerned about fertility, you may want to consider taking the testosterone together with HCG, as the HCG will help maintain intra-testicular testosterone and spermatogenesis during the cycle, which gets suppressed when testosterone is taken alone.1,2

    References:

    1. Coviello AD, Matsumoto AM, Bremner WJ, et al. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J. Clin. Endocrinol. Metab. 2005;90(5):2595-2602.

    2. Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J. Urol. 2013;189(2):647-650.


    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.

    Yours in health and wellness, Dr. John J. Pierce, DO.

  • What level should I expect my testosterone level to end up at if I seek testosterone treatment at your clinic?

     

    QUESTION:
    About a year ago, I had blood work done that showed my total testosterone to be at 308 ng/dL. I know that the normal range for testosterone is about 300 - 1000. What level should I expect my testosterone to end up at if I seek testosterone treatment at your clinic?


    ANSWER:
    When it comes to "normal ranges" (aka reference ranges) it is important to remember that these vary for every assay and laboratory. Thus, if you do a blood draw and send it off to two different labs, you may likely get two different readings, despite it coming from the same blood draw. Therefore, when comparing and monitoring treatment response, it is important to stick with the same laboratory.

    Regarding your question "What level should I expect my testosterone to end up at if I seek treatment at your clinic?" the first thing to point out is that there is no single target testosterone level or threshold that is universally optimal for every man. There are large inter-individual differences in androgen sensitivity, which means that two men can have the same testosterone level, but one man may suffer from hypogonadal signs/symptoms while the other man may be perfectly fine.

    At Ageless Forever, in contrast to regular doctors, I put every patient through rigorous blood work testing and a physical checkup to check not just your testosterone levels, but also other hormones and metabolic parameters. Then I tailor the testosterone dose individually to each patient based on his complete clinical picture, and follow up regularly and adjust the dose based on the patient's response.

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.

    Yours in health and wellness, Dr. John J. Pierce, DO.

  • Does Saw Palmetto work for lowering DHT levels and reducing hair loss?

    QUESTION:
    I'm 56 and have been on Axiron (underarm testosterone preparation) for two years. I'm getting back hair and a slightly receding hairline. Would saw palmetto or DIM help?

    ANSWER:
    DIM modulates estrogen metabolism (as we described in a previous FAQ), and thus is not relevant for hair loss, which is an androgen relates issue.

    The effectiveness (or lack thereof) of Saw Palmetto, aka Serenoa repens, in reducing DHT levels in the blood and/or inside tissues, and in inhibiting DHT related side effects like androgenic alopecia (aka male pattern hair thinning or male pattern balding), is unclear at the present time.

    DHT is primarily responsible for prostate growth [1] and androgenic alopecia.[2, 3] DHT drives the follicular transformation in androgenic alopecia. The enzyme 5alpha-reductase causes a substantial increase in the local (or follicular) transformation of testosterone to DHT.[4] Scalp skin DHT in turn causes gradual miniaturization of hair follicles, i.e. progressive thinning of hair.[5]

    Test tube studies have shown that Saw Palmetto inhibits 5 alpha-reductase activity (and thus conversion of testosterone to DHT) in human foreskin fibroblasts [6] and human benign prostate hyperplasia cells [7], and it may also inhibit receptor binding of androgens in human foreskin fibroblasts.[6] However, extrapolating results from test tube cell cultures to humans has to be done cautiously.

    Despite the test tube studies showing that Saw Palmetto can inhibit 5-alpha-reductase, there is only one study that have investigated whether Saw Palmetto has any effect on androgenic alopecia; this small study found improvements in 6 of 10 subjects who had taken 1 softgel containing 200mg saw palmetto extract, twice daily for 5 months.[8] This single small study, while promising, does not give enough evidence that that saw palmetto can prevent or stop hair loss or baldness from progressing, or cause hair regrowth. Most clinical research on Saw Palmetto has focused on BPH (benign prostatic hyperplasia), where some benefits have been seen (although this is still inconclusive).[9, 10] It should be noted that part of the potential therapeutic benefit of Saw Palmetto on the prostate may be non-hormonal.[9]

    Even though there is little evidence to support its efficacy in preventing hair loss [11], Saw Palmetto is a relatively safe supplement and you may want to give it a try. A recent study concluded that supplementing with up 960 mg daily of a saw palmetto extract (which is 3 times the recommended daily dose) for 18 months is safe.[12] The best way to find out if a supplement works, is to try it (without making any other changes to your regimen).

    You may want to have your blood levels of DHT (and testosterone as well) checked before your start supplementing with Saw Palmetto. However, remember that circulating levels of DHT do not accurately reflect intra-tissue levels of DHT.


    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.

    Yours in health and wellness, Dr. John J. Pierce, DO.


    References:

    1. Steers, W.D., 5alpha-reductase activity in the prostate. Urology, 2001. 58(6 Suppl 1): p. 17-24; discussion 24.
    2. Piraccini, B.M. and A. Alessandrini, Androgenetic alopecia. G Ital Dermatol Venereol, 2014. 149(1): p. 15-24.
    3. Kaliyadan, F., A. Nambiar, and S. Vijayaraghavan, Androgenetic alopecia: an update. Indian J Dermatol Venereol Leprol, 2013. 79(5): p. 613-25.
    4. Hoffmann, R., Male androgenetic alopecia. Clin Exp Dermatol, 2002. 27(5): p. 373-82.
    5. Ellis, J.A., R. Sinclair, and S.B. Harrap, Androgenetic alopecia: pathogenesis and potential for therapy. Expert Rev Mol Med, 2002. 4(22): p. 1-11.
    6. Sultan, C., et al., Inhibition of androgen metabolism and binding by a liposterolic extract of "Serenoa repens B" in human foreskin fibroblasts. J Steroid Biochem, 1984. 20(1): p. 515-9.
    7. Weisser, H., et al., Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate, 1996. 28(5): p. 300-6.
    8. Prager, N., et al., A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med, 2002. 8(2): p. 143-52.
    9. Marks, L.S., et al., Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol, 2000. 163(5): p. 1451-6.
    10. Tacklind, J., et al., Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev, 2012. 12: p. CD001423.
    11. Murugusundram, S., Serenoa Repens: Does It have Any Role in the Management of Androgenetic Alopecia? J Cutan Aesthet Surg, 2009. 2(1): p. 31-2.
    12. Avins, A.L., et al., Safety and toxicity of saw palmetto in the CAMUS trial. J Urol, 2013. 189(4): p. 1415-20.

  • Are there any OTC (Over The Counter) aromatase inhibitors that you would recommend?

     

    Answer:  There are several OTC compounds that are claimed to have an aromatase inhibiting, a.k.a. anti-estrogen, effect. Aromatase is the enzyme that converts testosterone to estrogen (or more precisely estradiol), and therefore, inhibiting aromatase activity will reduce estrogen levels.

    The most well-known OTC compounds with purported aromatase inhibiting effect are zinc and chrysin. However, research supporting the anti-aromatase efficacy of either zinc or chrysin is scant. Zinc is more effective in elevating low testosterone levels than it is in inhibiting conversion of testosterone to estrogen (if it does at all). Chrysin (a flavone phytochemical, i.e. a biologically active compound found in plants), while having good anti-aromatase activity in test tube experiments [1-3], does not seem to be effective in humans [4] because of poor bio-availability after oral ingestion.[5, 6]

    Other compounds with aromatase inhibiting effect are apigenin and hesperetin [3], as well as coumarins.[7] They seem to hold more promise as aromatase inhibiting agents than either zinc or chrysin.

    When discussing aromatase inhibitors it is important to remember that inhibiting aromatase, and thus estrogen production, is only one part of the story. Modulation of estrogen receptor signaling [8] and estrogen metabolism [9] are also important factors to consider. For certain outcomes, especially cancers, this may actually be more important than circulating estrogen levels in the blood (which does not reflect overall estrogenic activity).

    Compounds derived from cruciferous vegetables, especially indole-3-carbinol (I3C) and its breakdown product diindolylmethane (DIM) [10, 11] beneficially impact estrogen metabolism in a way that results in less “bad” estrogenic 16alpha-hydroxyestrone (16α-OHE1) and more “good” 2-hydroxyestrone (2-OHE1).

    Supplementation with I3C [12] or DIM [13] increases 2-hydroxylation of estrogen and production of 2-hydroxyestrone, which lowers the 2/16 estrogen metabolite ratio, and thereby reduces risk of both breast cancer [14, 15] and prostate cancer.[16, 17] I3C, and especially DIM, are naturally occurring compounds currently in the spotlight for their cancer protective effects, partly mediated by their beneficial impact on estrogen metabolism and signaling.[18, 19] Remember, the best natural way to reduce the activity of aromatase and conversion of testosterone to estrogen, is to shed excess body fat. The expression and activity of aromatase is directly proportional to the amount of body fat. This explains why many obese men who start testosterone therapy will experience a reduction in estrogen levels after a while, as testosterone treatment results in significant fat loss.


    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.  

    Yours in health and wellness, Dr. John J. Pierce, DO. 


    References:

    1. Kao, Y.C., et al., Molecular basis of the inhibition of human aromatase (estrogen synthetase) by flavone and isoflavone phytoestrogens: A site-directed mutagenesis study. Environ Health Perspect, 1998. 106(2): p. 85-92.
    2. Kellis, J.T., Jr. and L.E. Vickery, Inhibition of human estrogen synthetase (aromatase) by flavones. Science, 1984. 225(4666): p. 1032-4.
    3. Jeong, H.J., et al., Inhibition of aromatase activity by flavonoids. Arch Pharm Res, 1999. 22(3): p. 309-12.
    4. Gambelunghe, C., et al., Effects of chrysin on urinary testosterone levels in human males. J Med Food, 2003. 6(4): p. 387-90.
    5. Saarinen, N., et al., No evidence for the in vivo activity of aromatase-inhibiting flavonoids. J Steroid Biochem Mol Biol, 2001. 78(3): p. 231-9.
    6. Walle, T., et al., Disposition and metabolism of the flavonoid chrysin in normal volunteers. Br J Clin Pharmacol, 2001. 51(2): p. 143-6.
    7. Hong, Y. and S. Chen, Aromatase inhibitors: structural features and biochemical characterization. Ann N Y Acad Sci, 2006. 1089: p. 237-51.
    8. Firestone, G.L. and S.N. Sundar, Minireview: modulation of hormone receptor signaling by dietary anticancer indoles. Mol Endocrinol, 2009. 23(12): p. 1940-7.
    9. Lord, R.S., B. Bongiovanni, and J.A. Bralley, Estrogen metabolism and the diet-cancer connection: rationale for assessing the ratio of urinary hydroxylated estrogen metabolites. Altern Med Rev, 2002. 7(2): p. 112-29.
    10. Bradlow, H.L., Review. Indole-3-carbinol as a chemoprotective agent in breast and prostate cancer. In Vivo, 2008. 22(4): p. 441-5.
    11. Wang, T.T., et al., Estrogen receptor alpha as a target for indole-3-carbinol. J Nutr Biochem, 2006. 17(10): p. 659-64.
    12. Reed, G.A., et al., A phase I study of indole-3-carbinol in women: tolerability and effects. Cancer Epidemiol Biomarkers Prev, 2005. 14(8): p. 1953-60.
    13. Dalessandri, K.M., et al., Pilot study: effect of 3,3'-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Cancer, 2004. 50(2): p. 161-7.
    14. Fuhrman, B.J., et al., Estrogen metabolism and risk of breast cancer in postmenopausal women. J Natl Cancer Inst, 2012. 104(4): p. 326-39.
    15. Dallal, C.M., et al., Estrogen metabolism and breast cancer risk among postmenopausal women: a case-cohort study within B~FIT. Carcinogenesis, 2014. 35(2): p. 346-55.
    16. Barba, M., et al., Urinary estrogen metabolites and prostate cancer: a case-control study and meta-analysis. J Exp Clin Cancer Res, 2009. 28: p. 135.
    17. Muti, P., et al., Urinary estrogen metabolites and prostate cancer: a case-control study in the United States. Cancer Causes Control, 2002. 13(10): p. 947-55.
    18. Maruthanila, V.L., J. Poornima, and S. Mirunalini, Attenuation of Carcinogenesis and the Mechanism Underlying by the Influence of Indole-3-carbinol and Its Metabolite 3,3'-Diindolylmethane: A Therapeutic Marvel. Adv Pharmacol Sci, 2014. 2014: p. 832161.
    19. Zhang, W.W., Z. Feng, and S.A. Narod, Multiple therapeutic and preventive effects of 3,3'-diindolylmethane on cancers including prostate cancer and high grade prostatic intraepithelial neoplasia. J Biomed Res, 2014. 28(5): p. 339-48.

 

  • I've read that more frequent injections of testosterone propionate may be preferable to testosterone cypionate. Do you offer both options? Also, I travel all the time and would like to be able to self-administer injections. Is that possible?

     

    Answer: If one injects more frequently, the side chain on the testosterone molecule does not matter. Propionate by its nature is very hard on a lot of people causing extreme injection site soreness and flu like symptoms. For those reasons I do not recommend it for my patients. I have gotten phenomenal results with low dose every other day administration on testosterone cypionate. We do allow our patients to be in control of their own medication administration. If a problem of overuse presents its self, then we deal with that on an individual basis. I am happy to say that rarely happens. 

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic.  

    Yours in health and wellness, Dr. John J. Pierce, DO. 

  

  • Question on the 6 year testosterone replacement study in your news blog: They administered 1000 mg at the start, and then again at 6 weeks? Why would they administer so much at the start when the half life is like 7 days or so? Wouldn't the subjects start feeling hypogonadal again after a couple weeks which would last until the next shot or pellet? I wonder why they wouldn’t have administered like 150-200 mg each week, so after 6 weeks, the subject would still be at 1000 mg total administered?

     

    Answer: 

    The 6 yr study http://www.agelessforever.net/anti-aging-news-blog/effects-of-6-year-long-term-testosterone-replacement-therapy-trt-in-patients-with-diabesity used testosterone undecanoate, which is a long-acting ester of injectable testosterone. 

     

    Every different ester of injectable testosterone has a different pharmacokinetic profile, i.e. different half-life in the blood. Therefore, different testosterone esters require different dosages and injection regimens. 

     

    Administration of 150-200 mg/wk is a typical dosing regimen for testosterone cypionate, which is a shorter acting ester of injectable testosterone.

     

    Likewise, different testosterone formulations (injectable vs gel vs pellet) will display different pharmacokinetic profiles. 

     

    Bottom line is that when interpreting studies, the important factor to look at is the baseline testosterone level and final testosterone level achieved, and the elevation above baseline, not so much the dosage. Two men may require different dosages to achieve the same final target testosterone level due to for ex. differences in body fat mass etc).

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO. 

  • I'm interested in the CoolSculpting procedure; if the fat cells are frozen and eventually killed, what are the future repercussions to the general health? Does it act like a radiation, are other organs affected by the freezing temperatures?

     

    Answer: When the fat cells freeze during the CoolSculpting procedure, they undergo a process called apoptosis (programmed cell death). This is a natural process. Any cell that freezes undergoes the same process. This technology is designed to target just the fat cells. The skin, blood vessels, nerves, muscle and underlying organs are not affected. The fat that is liberated from the dead cell is used as a fuel by the body. This is evidenced by post procedure studies that proved cholesterol levels are not raised. There is no radiation involved in the process. The fat bulge of concern is pulled in between two cooling plates with suction. These cooling plates are designed to maintain a temperature cold enough to just freeze the fat cells (adipose tissue) and not damage any other tissues. If they get too cold the machine will turn off, as a safety precaution.

     

    The CoolSculpting device is FDA approved for the treatment and was developed by Harvard University Scientist. It has proven to be very safe and there have been no long term complications. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

 

 

 

 

 

  • I believe I am having symptoms of low testosterone. I asked my doctor about it and she dismissed it and said I am too young to have low testosterone. I was wondering what the process was, and how much a consultation would be?

     

     

     

    Answer: First off I would like to know just how old you are. Second, there is no age restriction on low testosterone. There are medical conditions that may go unnoticed for years that cause low T. Injuries to the head causing concussion or loss of consciousness can also be related to low T. The most important aspect is what symptoms are you having and do they point towards low T or another issue all together? We correlate your symptoms and your blood work to determine what condition(s) you may have. We have many different ways of treating a low T condition outside of just simply starting testosterone therapy. I hope that answers your question sufficiently. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

     

     

 

 

 

 

 

 

 

  • I am a Canadian male who’s very interested in starting GH therapy. I was wondering if you take on Canadian patients? And how one would go about getting treatment? Or if you know any MDs in Canada who specialize in this area?

     

     

     

    Answer: Yes I take patients from around the world as long as they can come to my office and physically see me. I’m not sure how the laws are in Canada for the dispensing of hGH, so I cannot speak to that point. To get a prescription for hGH one has to first be determined to have a growth hormone deficiency or a wasting syndrome (such as that typically seen in AIDS patients). This is generally determined by a history/physical and laboratory tests. I am not aware of any physicians in Canada that do this type of medicine. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

     

     

 

 

 

 

 

 

 

  • How does hGH work for fat loss? Is it because carbs will not be stored as fat? Is it advisable to not eat for at least two hours before injecting at bedtime?

     

     

     

    Answer: GH (a.k.a. hGH, human growth hormone) has been shown clinically to improve body composition primarily by decreasing body fat, especially around the belly, but also by increasing lean body mass. GH induces fat loss by increasing liberation of fat from fat stores (a process called lipolysis) and stimulating fat burning (fat oxidation). It also increases resting caloric expenditure (i.e. basal metabolic rate) and carbohydrate utilization (its effect on carbohydrate metabolism are more complex and less studies than its effects of fat metabolism). But GH doesn't directly inhibit conversion of carbs to fat. The mechanisms behind the effect of GH on energy expenditure may relate to increased glucose turnover protein synthesis or increased conversion of T4 to T3. You should not eat carbohydrates before injecting growth hormone in general. Because GH is a night time hormone, it should be taken at night. And if you’re concerned about fat loss you shouldn’t be eating carbs before bed anyway because doing so will interfere with fat metabolism. I hope that answers your question sufficiently. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

     

     

 

 

 

 

 

  • When a woman is estrogen dominant, is progesterone supplementation sufficient for skin benefits? Is it trough too much estrogen in relation to progesterone makes woman fat?

     

     

     

    Answer: Yes too much estrogen can increase body fat. Progesterone helps to balance the estrogen dominance. Estrogen dominance is too much estrogen and not enough progesterone, in simple terms. Also, a women can have too low testosterone levels, which will exacerbate estrogen dominance. At Ageless Forever, we therefore check all your hormones in women (as well as men), incuding testosterone.

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

     

     

 

 

 

 

 

 

 

 

 

 

 

  • I’m a bodybuilder and would like to further increase muscle size. I would like to work with a Doctor who will help me get to where I would like to be in terms of muscle mass, while keeping me healthy as well. Can you help me?

     

     

     

    Answer: I do have many bodybuilder patients. However, I do not prescribe them testosterone generally as they are on their own program. Meaning they are taking way too much of way too many things that are not medically indicated. I watch their blood work and try to keep their liver, kidney, heart/blood lipids healthy with supplementation. I also make sure they are not converting their testosterone to too much estrogen. When they come off I help them with Post Cycle therapy to get their endogenous (natural) testosterone production back to normal as quickly as possible. If that sounds like something along the lines of what you are looking for then please come in for a consultation. However, if you are looking for a physician to prescribe you anabolic steroids for the purpose of your bodybuilding endeavors, I suggest you look elsewhere. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.

     

     

     

 

 

 

 

 

 

 

 

 

  • Do you provide Testosterone Pellet Therapy? If so, do you find it to be the most beneficial delivery form of testosterone therapy? Thank you. I look forward to your response and hopefully becoming a patient.

     

     

     

     

     

    Answer: Yes, we do testosterone pellet therapy. It is my preferred method for many reasons. First it gives a more natural delivery of testosterone over a 3-5 month period of time. It is also less likely to have side effects of too much conversion to estradiol or dihydrotestosterone. We have not had much of a problem with infection, we only had a few patient's bodies reject 1 or 2 pellets. This usually occurs as a result of the pellet being placed too close to the incision site. Since then we have made some adjustments to our procedure and have almost eliminated the ejection complication. Hope that answers your question sufficiently. 

     

     

     

    If you have any further questions, please feel free to call our clinic 702-838-1994 and discuss it with one of our patient care coordinators. 

     

    Thank you for your interest in Ageless Forever Anti-Aging and Longevity Clinic. The Best In Health, Dr John J. Pierce, DO.