QUESTION: 1. Some of my male patients have original T values around 180-400, and are of all ages, what are the long term outcomes of treatment? Can they get off the T eventually and have their bodies start producing naturally, or once they are on it are they on it for good? Some of my young guys (20-30s) I would like to see get off the T regime. Is that realistic?”

ANSWER: The most common cause for low T in young men in the research is toxicity with chemicals (even from personal care products). Next most common is chronic illness. If the toxicity goes away and they stop the offending products and detox they can have their T rise. Also if it is from chronic illness you need to Rx T until they are better including infections gone and their Thyroid and adrenals rebound – then I regularly can get them off T (may take 1-3 years).

QUESTION 2. If I add anastrazole, where does the Testosterone go? Does the body just metabolize it as testosterone? Do you think its safe for them to be taking both Anastrazole and Propecia?

ANSWER 2: Safe is relative. Usually it is but watch for side effects. And yes, most is eliminated via normal (non DHT) hepatic pathways

QUESTION 3: Treating ED, and what would you say are the main contributing factors to ED in terms of most common cause? (I know diabetes, arterioslerosis, trauma, medications, depression, lack of interest in parterns). I am wondering about how estrogen, and progesterone play a role.

ANSWER 3: The usual things you mention are the most common. The effects of estrogen antagonizing T is a huge issue. Total estrogens should be checked along with T in all ED and low T cases. Progesterone is less an issue really.

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