Finding blood in your semen can be alarming and concerning. However, in most cases, it is not a serious health problem, a symptom, or a bigger underlying health issue. In many cases, it can be resolved without treatment. However, it is best to consult a medical professional to help rule out certain risks or diseases.
The condition of having blood mixed with your semen is medically known as hematospermia or hemospermia. It can make the semen appear brownish-red or red in color.
Although the presence of blood in semen is not normal, it is reasonably common. The condition can affect men of all ages. However, hematospermia is more often observed among men between the ages of 30 and 40 years.
There are several possible causes of the blood mixing with semen. These include:
While hematospermia can often be benign and self-limiting, there are situations where seeking medical attention is advisable.
For men 40 and over, chances are higher that blood in the semen needs evaluation and treatment. This is especially true for men who:
Your primary care doctor or a urologist may perform a physical exam, blood tests, urine tests, or imaging tests to diagnose the cause of blood in your semen and rule out certain conditions.
If you’re under age 40 and see blood in your semen, it will more than likely resolve even without treatment. However, it is still a good idea to make an appointment with a medical professional to rule out any underlying medical conditions or STIs.
Hematospermia is rarely a cause for much concern in itself. However, seeing blood in semen can still be alarming. Moreover, it can be a symptom for other health issues like infections.
As such, it is important to see a physician or specialist to determine the exact cause and rule out any serious underlying medical conditions.
With prompt action, proper evaluation, and treatment, most cases of hematospermia can be resolved, putting your mind at ease and ensuring your long-term health and well-being.
Discover the Best Age to Start Gender Reaffirmation With HRT and take a step closer to your authentic self. Hormones are essential for both developing and maintaining characteristics related to gender. At HEALOR ™ transgender care clinic in Las Vegas, our compassionate team is pleased to offer hormone replacement therapy (HRT) to help patients of all needs and backgrounds begin their gender reaffirmation journey. During this time, board-certified physician Dr. Raj Singh believes it's important that you feel fully informed and prepared.
One common question people have about gender reassignment is when to start HRT. Some people say the best age to start is as early as 16, while others make the decision later in life. Because there are no set guidelines, the decision should be made with careful consideration of what would work best for you. If you want to know the pros and cons of HRT, call our Las Vegas, NV clinic for a discussion.
Hormone replacement therapy is the process of changing the hormone levels in your body. During treatment, estrogen or testosterone can be administered through injections, pills, or topically. This is performed for transgender individuals who would like to transition their physical appearance, so it better aligns with their gender identity.
For example, estrogen can be used for more feminine characteristics, like breast development, while testosterone is for more masculine traits like facial hair. In a gender reaffirmation consultation with the providers at HEALOR ™ transgender care clinic in Las Vegas, we can learn about your goals and create a personal treatment plan for hormone replacement. We're here to make your journey as smooth as possible.
Many of our patients want to learn the pros and cons of HRT at an early age. Here are some well-known benefits of hormone replacement in Las Vegas, NV:
There is some debate about what age to start hormone replacement therapy. Some people start at 16 because many medical professionals agree that the teenage years may be easier to transition through. By starting hormones during adolescence, transgender people can begin making immediate changes.
However, it's also normal for people to wait until later in life to begin their transition. If you aren't having difficulties with your assigned gender, then there's no need to rush into something that may be challenging or painful for you. At our clinic, we believe the best age is based on an individual's maturity and understanding of the process.
If you're still uncertain or hesitant about what age to start hormone replacement therapy, Dr. Singh and the trusted team at HEALOR ™ transgender care clinic in Las Vegas can answer your questions and guide you on the path to treatment. Whether we see you for an initial gender reaffirmation consultation or as a returning patient, our providers are here to support you. We're proud to have worked with many transgender people in their personal journeys.
You may wonder if there's a "best age" to start hormone replacement therapy. If you're considering transitioning, the best time to start hormones is on your timeline. If you want more information about the pros and cons of HRT from a board-certified physician, call Dr. Raj Singh for a hormone assessment in Las Vegas, NV. The compassionate staff at HEALOR™ transgender care clinic is ready to get started with you.
Thyroid antibodies are proteins the immune system produces to target and destroy cells in the thyroid gland. Antibodies are a normal part of the body's defense system. Still, in some cases, the immune system can produce antibodies that mistakenly attack healthy cells in the thyroid gland, leading to thyroid disease.
There are three main types of thyroid antibodies: thyroid peroxidase antibodies (TPO antibodies), thyroglobulin antibodies (TG antibodies), and thyroid-stimulating hormone receptor antibodies (TSH receptor antibodies). TPO antibodies and TG antibodies are commonly found in autoimmune thyroid diseases, such as Hashimoto's thyroiditis, while TSH receptor antibodies are associated with Graves' disease.
Thyroglobulin is a protein that is produced by the thyroid gland. It is a precursor to thyroid hormones regulating the body's metabolism. Thyroglobulin is produced by the thyroid follicular cells and secreted into the colloid, a space in the thyroid gland where thyroid hormone synthesis occurs.
Thyroglobulin is a large protein molecule containing many tyrosine residues, essential building blocks for synthesizing thyroid hormones. After thyroglobulin is produced and secreted into the colloid, it is then taken up by the follicular cells and broken down into smaller fragments. These fragments are then converted into thyroid hormones, including thyroxine (T4) and triiodothyronine (T3).
Thyroid peroxidase (TPO) is an enzyme that plays a critical role in the synthesis of thyroid hormones in the thyroid gland. TPO is located on the surface of thyroid follicular cells, which are the cells that produce and secrete thyroid hormones.
The main function of TPO is to catalyze the iodination and coupling of tyrosine residues on thyroglobulin, a protein that serves as a precursor to thyroid hormones. This process involves the incorporation of iodine atoms into tyrosine residues to form monoiodotyrosine (MIT) and diiodotyrosine (DIT), which then combine to form the thyroid hormones thyroxine (T4) and triiodothyronine (T3).
Thyroid peroxidase antibodies (TPO antibodies) are a type of antibody produced by the immune system that target thyroid peroxidase, an enzyme involved in the synthesis of thyroid hormones. TPO antibodies are commonly found in autoimmune thyroid disease, such as Hashimoto's thyroiditis, Graves' disease, and postpartum thyroiditis.
In Hashimoto's thyroiditis, TPO antibodies attack and damage the thyroid gland, leading to an underactive thyroid (hypothyroidism). In Graves' disease, TPO antibodies can also be present, but the primary target is the thyroid-stimulating hormone (TSH) receptor, leading to an overactive thyroid (hyperthyroidism).
TPO antibodies can be detected through a blood test, and their presence can help diagnose autoimmune thyroid disease. TPO antibody levels can also be used to monitor the progression of thyroid disease and assess treatment effectiveness. High levels of TPO antibodies indicate ongoing autoimmune activity and a greater risk of thyroid damage.
Normal thyroid peroxidase Antibody level:
The normal range for thyroid peroxidase antibody (TPO antibody) levels can vary slightly between different laboratories and methods used for testing. However, TPO antibody levels of less than 9 IU/mL are generally considered normal.
It's important to note that even if TPO antibody levels are within the normal range, it does not necessarily rule out the possibility of thyroid disease. Some people with autoimmune thyroid disease, such as Hashimoto's thyroiditis, may have normal TPO antibody levels.
In addition, TPO antibody levels can fluctuate over time, and a single test may not provide a complete picture of thyroid function. Your doctor may order additional tests, such as thyroid hormone levels, to help diagnose and monitor thyroid disease.
Thyrotropin, also known as thyroid-stimulating hormone (TSH), is a hormone produced by the pituitary gland in the brain. TSH plays a crucial role in regulating the production and release of thyroid hormones from the thyroid gland.
When thyroid hormone levels in the blood are low, the hypothalamus in the brain releases thyrotropin-releasing hormone (TRH), which signals the pituitary gland to produce and release TSH into the bloodstream. TSH then stimulates the thyroid gland to produce and release thyroid hormones, including thyroxine (T4) and triiodothyronine (T3).
Once thyroid hormone levels in the blood have reached a certain level, the hypothalamus and pituitary gland reduce their production of TRH and TSH, respectively, in a negative feedback loop that helps maintain proper levels of thyroid hormones in the body.
Measuring TSH levels in the blood is a standard test to assess thyroid function. High levels of TSH indicate an underactive thyroid (hypothyroidism), while low levels of TSH indicate an overactive thyroid (hyperthyroidism). Treating thyroid dysfunction typically involves medication to replace or regulate thyroid hormones, such as levothyroxine for hypothyroidism or antithyroid drugs for hyperthyroidism.
Thyrotropin receptor antibodies (TRAbs) are a type of antibody produced by the immune system that targets the thyrotropin receptor located on the surface of thyroid cells. TRAbs are primarily associated with Graves' autoimmune disease, which leads to an overactive thyroid (hyperthyroidism).
In Graves' disease, TRAbs stimulate the thyrotropin receptor, leading to increased production of thyroid hormones by the thyroid gland. This results in symptoms such as weight loss, heat intolerance, tremors, and palpitations. TRAbs can also be present in other autoimmune thyroid diseases, such as postpartum thyroiditis and Hashimoto's thyroiditis.
Measurement of TRAb levels in the blood can be used to diagnose Graves' disease and to monitor the progression of the condition. High levels of TRAbs indicate ongoing autoimmune activity and a greater risk of thyroid dysfunction. Treatment for Graves' disease typically involves medication to regulate thyroid hormones, such as antithyroid drugs or beta-blockers, and in some cases, radioiodine therapy or thyroid surgery may be necessary.
It's worth noting that TRAbs differ from thyroid peroxidase antibodies (TPO antibodies) and thyroglobulin antibodies (TG antibodies), which are other types of antibodies produced by the immune system that target proteins in the thyroid gland.
Thyroid antibodies are not considered normal, as their presence usually indicates an underlying autoimmune thyroid disease or other thyroid disorder. However, it's important to note that some people with thyroid disease may not have detectable levels of thyroid antibodies, and autoimmune conditions cause not all thyroid disorders.
Lowering thyroid antibodies can be challenging, as the underlying cause of the antibodies is often a chronic autoimmune condition. However, some steps may help to reduce thyroid antibody levels:
In some cases, thyroid antibodies can go away, but this depends on the underlying cause of the antibodies.
In cases where the antibodies result from a temporary condition, such as postpartum thyroiditis or medication-induced thyroiditis, the antibodies may go away as the underlying condition resolves.
However, in cases of autoimmune thyroid disease, such as Hashimoto's thyroiditis or Graves' disease, the antibodies are caused by a chronic autoimmune condition that persists over time. While treating these conditions can help manage symptoms and reduce antibody levels, the underlying autoimmune process may not completely disappear.
In some cases, treatment for autoimmune thyroid disease can lead to a decrease in antibody levels, but this does not necessarily mean that the antibodies have gone completely. Regular monitoring of antibody levels and thyroid function is essential for managing thyroid disease and assessing the effectiveness of treatment.
Still have questions about elevated thyroid antibody level. Schedule an appointment with our thyroid experts in Las Vegas.
Discover What Is Semaglutide and How Does It Promote Weight Loss. Weight loss is a common goal for many individuals, but traditional methods such as exercise and dieting are not always enjoyable or effective. In some cases, alternative approaches are necessary. Semaglutide is one such option that has gained attention for its potential to promote weight loss. But what exactly is semaglutide, and how does it work?
Semaglutide belongs to a class of medications called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Originally developed to treat type 2 diabetes, experts have also found that semaglutide significantly impacts weight loss. It is a synthetic form of a naturally occurring hormone called glucagon-like peptide-1 (GLP-1), released by the intestines after eating. GLP-1 is crucial in regulating blood sugar levels, insulin secretion, and appetite.
Semaglutide is typically administered through subcutaneous injections, where a small needle delivers the medication just below the skin. The injection can be self-administered once a week. Following the prescribed dosage and administration instructions a healthcare professional provides is essential.
Semaglutide promotes weight loss through various mechanisms. Here are three of the most significant effects as it relates to weight management:
Firstly, it works by activating GLP-1 receptors in the brain, which helps to reduce appetite and increase the feeling of fullness. It leads to a decreased caloric intake and an overall reduction in body weight.
Additionally, semaglutide slows down the movement of food through the stomach, which increases the time it takes for the stomach to empty. This delay in gastric emptying helps to regulate the release of sugar into the bloodstream, preventing sharp spikes in blood sugar levels and promoting better glucose control.
Moreover, experts have found semaglutide to increase energy expenditure, or the number of calories the body burns at rest. Increased energy expenditure and decreased caloric intake lead to burning fat, helping individuals achieve their weight loss goals.
Semaglutide is an FDA-approved medication for weight loss. It has been associated with improvements in many other parameters, reducing blood pressure, improving blood sugar control, and decreasing the risk of developing type 2 diabetes.
These benefits make semaglutide a potentially valuable option for individuals who are overweight or have obesity-related health conditions. People using this medication can expect to experience the following:
Semaglutide suppresses the appetite, reducing cravings and hunger. It helps reduce caloric intake and may help individuals stick to their diet and exercise plan.
Semaglutide can cause an average weight loss of two to four pounds weekly. This benefit is due to its appetite suppression effects and ability to slow gastric emptying and increase energy expenditure. Weight loss can be observed after four weeks of treatment, but it can take several months to reach the maximum effect. Adults can lose about 15.9 kilograms after 68 weeks.
The medication improves insulin resistance, which is vital for individuals with pre-diabetes or at risk of developing type 2 diabetes. It helps regulate the release of sugar into the bloodstream and can help reduce high blood glucose levels.
Semaglutide can boost energy levels, making participating in physical activity and exercise easier. As a result, individuals may feel less fatigued and more motivated to stay active.
The combination of increased energy expenditure and calorie restriction may lead to fat burning, allowing individuals to reach their weight loss goals.
As an FDA-approved medication, semaglutide has been proven to be generally safe and well-tolerated in clinical trials. Semaglutide is available in various dosage forms, including tablets and injections, and users must adhere to the instructions for proper use and administration. However, like any medication, it may have side effects and risks, which should be considered and discussed with a healthcare professional.
Semaglutide is primarily approved for individuals with a body mass index (BMI) of 30 or higher or those with a BMI of 27 or higher with obesity-related health conditions. It is important to note that semaglutide should be part of a comprehensive weight management plan, including healthy eating, regular physical activity, and behavior changes.
Before taking the medication, the care team must know about any of the following conditions:
It is also crucial to inform the care team about insulin and other medications for diabetes. Semaglutide is not suitable for everyone and should be taken only with the guidance of a healthcare professional. Experts must thoroughly review the individual’s medical history to ensure it is safe to take semaglutide.
As mentioned earlier, semaglutide is generally safe and well-tolerated in clinical trials. However, like any medication, it may have side effects. Commonly reported side effects include the following:
The first few doses of semaglutide may cause temporary dizziness. Individuals with this side effect are advised not to drive or operate machinery until they can safely do so.
Some individuals may experience fatigue after taking semaglutide. If this occurs, one must get plenty of rest and take the medication when they can sleep or rest.
Some people may also experience nausea, vomiting, diarrhea, or constipation. It may help to take the medication with food and drink plenty of fluids to reduce the risk of these side effects.
Headaches are another common side effect of semaglutide. Taking ibuprofen or paracetamol may help reduce the discomfort.
Some people may experience a feeling of fullness or bloating. Drinking plenty of fluids and eating smaller, more frequent meals may help reduce these symptoms.
Reporting any side effects experienced while taking semaglutide to the healthcare provider is essential. Suppose the side effects become too severe or are causing significant distress. In this case, the healthcare provider may need to adjust the dose or switch to another medication.
Other side effects that one must immediately report to the care team include the following:
Awareness of potential drug interactions when taking semaglutide can help reduce the risk of serious complications. Individuals must inform the healthcare provider about all medications they’re taking, including prescription, over-the-counter drugs, vitamins, and herbal supplements.
Before considering semaglutide or any other weight loss medication, it is best to consult a healthcare professional who can evaluate your specific situation and determine if it is a suitable option for you. They will assess your medical history, current health conditions, and potential risks and benefits associated with semaglutide use.
While semaglutide shows promise as an effective weight loss medication, it is essential to approach weight management holistically. A balanced diet, regular exercise, and healthy lifestyle choices remain crucial for long-term weight management and well-being. By working closely with healthcare professionals and implementing a comprehensive plan, individuals can optimize their weight loss journey and improve their health.
Today will be discussing the topic of Diabetic neuropathy treatments or diabetic nerve disease
As the incidence of diabetes and prediabetes is increasing diabetic neuropathy is becoming an increasing problem.
The main issue with diabetic neuropathy is a loss of sensory function, so patients have limited ability to perceive certain sensations such as temperature, vibration and pressure. Patients may also notice unsteadiness especially with eyes closed
Diabetic neuropathy is a chronic debilitating disease that causes symptoms such as numbness and weakness from damage to nerve fibers. Over time patients may also experience symptoms of symptoms of pain from abnormal and damaged nerve fibers. Symptoms tend to be common in the toes and feet and often get worse at night
The important question is why does this happen. So let us take a look at the underlying pathophysiology
Our body is constantly repairing our damaged nerves, in patients with diabetic neuropathy the damage is happening at a much accelerated rate and our body is not able to keep up. So if you have diabetic neuropathy that generally means that you have an imbalance between nerve damage and nerve repair. As seen in this image, Nerve fibers are surrounded by schwann cells. These cells have their own microcirculation and have a high metabolic requirement.
In patients with uncontrolled diabetes, the tissues are over saturated with abundant amounts of glucose, this extra glucose gets converted to a molecule called acetyl coenzyme A. This molecule later gets converted to acylcarnitines.
It is these acylcarnitines that are thought to be toxic to Schwann cells and may be responsible for the symptoms of diabetic neuropathy. So in simple terms not only that these nerve cells are starving, and at the same time they also are surrounded by these toxic molecules which leads to significant and often irreversible damage to nerve fibers
Once a diagnosis of diabetes is established it may take several years for diabetic neuropathy to develop. In certain individuals if they have high risk factors the symptoms may appear much sooner.
Let's look at some of the Risk factors for developing diabetic neuropathy
of course this is the big one, if your blood glucose is out of control the disease may progress much rapidly. We also know that when blood glucose is brought under control at a rapid rate by using insulin therapy, the neuropathy can worsen initially and may cause significant pain and discomfort. This particular condition is from inflammation caused by rapid changes in glucose levels and is called treatment induced neuropathy or insulin neuritis.
BMI is directly related to diabetic neuropathy, this is thought to be secondary to insulin resistance caused by obesity, Hypercholesterolemia: especially low HDL levels correlate with increased risk of neuropathy.
Uncontrolled high blood pressure can cause further spasm and damage to the neural microcirculation and may restrict blood flow to the nerve fibers and schwann cells
let’s us dive into some of the potential treatment and preventative options
There are several medications that can be used to improve the symptoms of pain
Several antidepressant such as duloxetine, amitriptyline can reduce pain
Duloxetine is typically started at 30 mg a day and must be taken on a full stomach to reduce nausea
Gabapentin and pregabalin ( Lyrica) are also extremely effective in reducing pain.
if your already overweight I do not recommend pregabalin as this can cause significant weight gain
Other medications can be capsaicin cream or lidocaine patch
Some studies have mentioned acupuncture as an effective therapy however data is lacking.
Let us look at Nonprescription based approach:
Strict control of blood glucose is essentially important to prevent and improve diabetic neuropathy. It is possible that once the treatment for diabetes is started, the neuropathy may worsen like we discussed before. This condition however is rare and is called insulin neuritis or treatment induced neuropathy.
B12 deficiency is common in patients with diabetic neuropathy, sometimes this deficiency can be made worse by starting a patient on metformin.
So if you are taking metformin, its a really good idea to take B12 or B complex supplementation.
This is one of my favorite injections to improve nerve pain this is a powerful antioxidant can reduce inflammation in the nerves, Monthly injections are typically required
another powerful antioxidant to reduce inflammation in the nerve fibers
Resets cellular metabolism and provides rapid source of energy at the cellular level
So that was a brief overview of diabetic neuropathy, will be discussing diabetic autonomic dysfunction in another video
Here is what I recommend to help improve your diabetic neuropathy
Control your diabetes
Reduce insulin resistance: this can be accomplished by healthy lifestyle, losing weight and nutritional supplementation. Avoid excessive amounts of insulin as this can make insulin resistance worse
Lose weight
Stop smoking
Improve your HDL levels by taking omega-3 twice a day
Alpha lipoic acid injections
Glutathione injections
NAD injections.
B12 or B complex supplementation
Medical estrogen is a first-choice hormone for people needing estrogen hormone replacement therapy (HRT). One positive aspect of estrogen is that there are many ways to receive it. Each method has pros and cons, but the variety means that every patient can find a best-fit for their body.
Keep reading to learn about the many different ways estrogen can be administered, and what makes each one special.
Estrogen can be used to treat estrogen deficiencies in transfeminine and cisgender people. In cisgender patients, estrogen is often used to treat the symptoms of menopause. Menopause causes a natural decline in estrogen production, and HRT can address some of the undesirable physical and mental changes that come with it.
Estrogen can be administered as the primary sex hormone to transfeminine patients. Here, it is the center of a feminizing hormone therapy regimen that can include anti-androgens, progesterone, and other medications. In transfeminine people, estrogen is feminizing – changing the body from masculine to feminine – before its maintenance function kicks in to sustain these changes.
is the simplest type. The hormone is prescribed as pills in milligram doses and taken as instructed by a clinician. Adjusting the dose is as simple as adding or removing pills from the daily routine. Oral estrogen is commonly prescribed for its convenience and wide availability.
Many people start and end their HRT journey right here, but some seek out alternatives. Oral estrogen is very good at supplementing natural production, but some transfeminine people find that it doesn’t produce ideal results.
are sticky patches applied to the skin that release medication over several days to a week. Doses can be quickly adjusted by adding or removing patches. Transdermal patches are good for maintenance therapy in cisgender women, and are convenient and easy to remember.
Although convenient, the effectiveness of transdermal patches can also vary between people due to different absorption rates due to skin composition and age.
can deliver estrogen into the body for steady absorption. One injected dose of estrogen can provide enough hormones for a week (or longer!), and it absorbs smoothly. The injection can be delivered by patients (after instruction) or clinicians. There are a range of injection sites offering different degrees of inconvenience, as well as a choice between subcutaneous (under the skin) or intramuscular (into the muscle) injections. Injections are a first-choice for many transfeminine patients who want a potent, consistent source of estrogen.
The challenges related to injections are often related to access and anxiety. Injected estrogen is not always widely available, and patients must contend with their fear of needles to use this method.
are one of the newest innovations in estrogen delivery. The pellets are inserted via a small incision. This is an outpatient process using local anasthetic. Once in place, the pellet begins dissolving and releases estrogen over the next 4-5 months. Estrogen pellets offer an effective and stable source of hormones that requires minimal input after insertion.
Although effective, the subdermal route requires a trained clinician to implants after depletion. Dose adjustments can be difficult due to the implant’s long-acting nature. Availability can also vary from state to state.
arrives as a cream, spray, or gel and is applied to the skin. Like transdermal patches, topical estrogen is absorbed through the skin and into the bloodstream for effect. Topical estrogen is normally applied daily and is a low-hassle way of supplementing the body’s estrogen demands.
As with transdermal patches, topical estrogen absorbs differently in different people. Users should also take care to not wash the area after application, as this may remove the estrogen before it has fully absorbed.
can be dispensed as a cream, suppository, or ring. No matter the form, they are applied to the vaginal area or inserted into the vaginal canal. This administration route is often used to treat menopausal symptoms like vaginal dryness. Usage intervals vary from days to months (in the case of insertable rings), and this method is great for targeted treatment to the vaginal area.
Vaginal administration is generally not prescribed to trans women, who may lack vaginas or would benefit more from a whole-body dose over a targeted, local dose. However, it is excellent for treating the vaginal symptoms of menopause.
Hormone replacements aren’t a one-shot medication for a single illness, but a treatment regimen that can last for the remainder of a person’s life. It’s important to find the medication and administration route that fits each patient best, so that their treatment is as pleasant as possible.
Even if the variety is a bit confusing at first, your clinician will be available to walk you through the pros and cons of each option and how it can fit. There’s a good pick for anyone who needs it, no matter their lifestyle, medical, or budgetary needs.
Note: This article was reviewed by Dr. Raj Singh prior to publication.
Wondering if DHEA improve systemic lupus erythematosus (SLE) symptoms. SLE stands for Systemic Lupus Erythematosus, a chronic autoimmune disease that can affect various body parts, including the skin, joints, kidneys, heart, lungs, and brain.
In people with SLE, the immune system becomes overactive and attacks healthy tissues and organs, leading to inflammation and tissue damage. This can cause many symptoms, including fever, fatigue, joint pain and stiffness, skin rashes, hair loss, chest pain, shortness of breath, and neurological problems.
DHEA stands for Dehydroepiandrosterone, a hormone produced by the adrenal glands. It is a precursor to the sex hormones estrogen and testosterone, meaning the body can convert DHEA into these hormones.
DHEA levels in the body peak in early adulthood and then decline with age. Some studies suggest that low DHEA levels may be associated with systemic lupus erythematosus (SLE), and DHEA could be a potential treatment for improving some of the lupus symptoms.
Studies have shown that DHEA levels can be decreased in people with lupus, particularly those with active disease. This is thought to be due to the chronic inflammation and immune dysregulation characteristic of lupus.
Low DHEA levels in people with lupus have been associated with various health problems, including depression, cognitive impairment, and bone loss. Some studies have suggested that supplementing with DHEA may help improve these symptoms, although more research is needed to fully understand the effects of DHEA supplementation in people with lupus.
There is some evidence to suggest that DHEA supplementation may suppress the synthesis of interleukin 10 (IL-10) in women with systemic lupus erythematosus (SLE). IL-10 is an anti-inflammatory cytokine that helps regulate the immune response, and low levels of IL-10 have been associated with increased disease activity and organ damage in SLE.
Another study found that in women with lupus, those who took oral prasterone (DHEA) at a dosage of 200 mg once daily could reduce their prednisone dosage to 7.5 mg/day or less for a sustained period of time while still maintaining stabilization or a reduction of disease activity. This was compared to women who took a placebo. The results showed that a significantly greater proportion of patients treated with prasterone were able to achieve this goal.
Systemic corticosteroid administration, such as prednisone, can affect DHEA levels in the body. Corticosteroids can suppress the adrenal gland's production of DHEA, leading to lower DHEA levels.
FDA has granted orphan drug status to DHEA for the prevention of loss of bone mineral density in SLE patients taking glucocorticoids. FDA is requesting additional Phase III trial data for the treatment of SLE and the prevention of loss of bone mineral density. Discuss with your primary care physican if you have additional questions regarding DHEA effectiveness in lupus patients.
Rapid ejaculation is a common sexual dysfunction that occurs when a man reaches orgasm and ejaculates too quickly during sexual activity, often before he or his partner is satisfied.
The duration of sexual intercourse before ejaculation varies widely, but on average, premature ejaculation is defined as ejaculation that occurs within one minute of penetration. However, the definition of premature ejaculation can vary depending on the individual and their partner's preferences and expectations.
Premature ejaculation (PE) is a common sexual dysfunction that affects many men worldwide. Studies suggest that approximately 1 in 3 men or 20-30% of men experience premature ejaculation at some point in their lives. However, the prevalence of PE varies widely among different populations and age groups.
It is also important to note that the definition of premature ejaculation can vary among individuals and healthcare professionals. Some definitions consider premature ejaculation as ejaculating within two minutes of penetration, while others consider it as ejaculating before the individual wishes to do so.
Ejaculation is the process by which semen is released from the male reproductive system during sexual activity. It is a complex process that involves several organs and physiological mechanisms.
During sexual arousal, the brain sends signals to the reproductive organs, which stimulate the production of semen in the testicles. The semen then travels through the vas deferens, a tube that connects the testicles to the urethra, which is the tube that carries urine and semen out of the body. When a man reaches the point of orgasm, the muscles in the pelvic area contract, forcing the semen out of the urethra and out of the body. This process is typically accompanied by a pleasurable sensation known as ejaculation.
It's important to note that ejaculation and orgasm are not the same things, although they often occur together. Ejaculation refers specifically to the release of semen, while orgasm refers to the intense physical and emotional pleasure that typically accompanies ejaculation.
Postorgasmic illness syndrome (POIS) is a rare and poorly understood medical condition in which people experience a range of physical, cognitive, and emotional symptoms following sexual activity, particularly orgasm that can significantly affect the quality of life and can cause significant emotional distress. Most men have such extreme fatigue post-ejaculation that they start to avoid sexual activity completely.
Read the Detailed blog on How to treat symptoms of post-orgasmic illness syndrome [POIS].
Acquired premature ejaculation refers to a condition where a person who previously had normal ejaculation control begins to experience a persistent and recurrent pattern of ejaculating too quickly, often with minimal sexual stimulation or before they desire to.
Lifelong premature ejaculation (LPE) is a type of PE that is present from the first sexual experience and continues throughout a man's life. It is also sometimes referred to as primary premature ejaculation.
The exact cause of premature ejaculation is not fully understood, but it is thought to be a combination of psychological and biological factors.
Psychological factors:
Biological factors:
Medical Factors:
Although Erectile dysfunction and premature ejaculation can often co-exist, Premature ejaculation and erectile dysfunction are two different sexual health conditions that can affect men, and they involve different aspects of sexual function.
Premature ejaculation is a condition in which a man reaches orgasm and ejaculates too quickly during sexual activity, often before he or his partner has had the opportunity to achieve sexual satisfaction. Premature ejaculation is typically defined as ejaculation that occurs within one minute of penetration.
On the other hand, erectile dysfunction is a condition in which a man has difficulty achieving or maintaining an erection that is firm enough for sexual intercourse. Erectile dysfunction can be caused by a range of physical or psychological factors, and it can affect a man's ability to engage in sexual activity.
This is a clinical diagnosis based on history and a physical examination. There is no single diagnostic test. Healthcare providers at HEALOR will typically ask about sexual histories such as How long they have been experiencing PE, the frequency of PE episodes, and any other related factors. They may also ask about the patient's mental health, stress levels, and relationship dynamics.
Our healthcare provider may also perform a physical exam to check for any underlying medical conditions that could be contributing to the patient's PE. This may include a genital exam to check for abnormalities, such as infection or inflammation, and to rule out any structural issues that could be causing the problem.
There are several medical treatment options available for premature ejaculation, including:
Yes, there are some ways to treat premature ejaculation at home. Here are some techniques you can try:
There is no clear scientific evidence that circumcision directly helps with premature ejaculation. Some studies suggest that circumcision may reduce sensitivity in the penis and thus potentially help delay ejaculation, but this effect is not universal and may not be significant enough to make a noticeable difference for most men. Additionally, circumcision is a surgical procedure that carries its own risks and potential complications, so it should not be undertaken lightly or without a clear medical indication.
Botulinum neurotoxin injection is a treatment that is used to temporarily paralyze muscles by blocking the release of acetylcholine, a neurotransmitter that signals muscle contractions. While Botox injections have been used for a variety of medical and cosmetic purposes, there is limited evidence to suggest that it is an effective treatment for premature ejaculation.
Some animal and human studies have shown that injection of botulinum neurotoxin into bulbospongiosus muscle delays ejaculation and could be a potential treatment option however, these studies have been small and not replicated Therefore, Botox injection is not currently considered a standard treatment for premature ejaculation. Additionally, Botox injections are not without potential risks and side effects, including pain, swelling, and temporary weakness or paralysis of nearby muscles.
The outlook or prognosis for premature ejaculation is generally good, as there are several effective treatment options available that can help men overcome this condition. With appropriate treatment, most men can learn to control their ejaculation and enjoy longer-lasting sexual experiences.
The success of treatment may depend on the underlying cause of premature ejaculation. For example, if psychological factors such as anxiety or stress are contributing to the problem, counseling or therapy may be necessary to address these issues. On the other hand, if the condition is caused by physical factors such as inflammation or infection, treatment may focus on addressing these underlying health issues.
Overall, the prognosis for premature ejaculation is positive, and many men are able to overcome this condition with the help of their healthcare providers and appropriate treatment. It's important to talk to a healthcare provider about any concerns related to premature ejaculation and to work together to develop an individualized treatment plan.
Plaquex IV therapy is a type of therapy that involves the intravenous administration of phosphatidylcholine. Phosphatidylcholine is a naturally occurring substance found in cell membranes throughout the body, and it has been shown to have several health benefits.
Phosphatidylcholine is a type of phospholipid molecule that is a major component of cell membranes in living organisms. The choline molecule is important for many functions in the body, including the formation of acetylcholine, a neurotransmitter involved in memory and muscle control. Phosphatidylcholine is found in many foods, including egg yolks, soybeans, sunflower seeds, and peanuts, and can also be synthesized in the body from other phospholipids. Phosphatidylcholine can be synthesized in various tissues of the body, including the liver, the lungs, and the brain. Very low-density lipoproteins (VLDL) produced by the liver contain a large amount of circulating Phosphatidylcholine.
Phosphatidylcholine is an essential phospholipid that plays an important role in the structure and function of cell membranes. Low levels of phosphatidylcholine have been associated with a number of diseases and conditions, including:
It should be noted that while low levels of phosphatidylcholine have been linked to these diseases and conditions, more research is needed to fully understand the underlying mechanisms and potential therapeutic uses of phosphatidylcholine.
Plaquex® IV therapy is a medical treatment that involves intravenous injections of phosphatidylcholine, a type of phospholipid that is found in high concentrations in cell membranes. The therapy has been proposed to have several potential benefits, including:
However, it's worth noting that some of these proposed benefits are still being studied and may not be supported by conclusive evidence. As with any medical treatment, it's important to consult with a qualified healthcare provider to determine if Plaquex® IV therapy is appropriate for your individual health needs.
While PC is generally considered safe for most people when taken in recommended doses, there are some potential side effects that you should be aware of:
It is important to talk to your doctor before taking any new supplements or medications, especially if you have any pre-existing medical conditions or are taking any prescription medications.
Plaquex® is a medication that is administered intravenously (IV) to treat various conditions such as atherosclerosis, high cholesterol, and other cardiovascular disorders. The following is a general description of how the Plaquex® IV infusion is given:
Plaquex® IV infusion should only be mixed with D5 water dextrose 5 %, even in diabetic patients. Plaquex® should never be mixed with normal saline as will cause saponification or formation of soap in the iv bag
This should always be stored in the refrigerator and never in the freezer. Ideally should be taken out of the refrigerator about an hour before dilution with D5 water.
It's important to note that the Plaquex® IV infusion may be administered differently depending on the patient's condition and the healthcare provider's preferences. Therefore, it's essential to follow the specific instructions provided by the healthcare professional administering the medication.
At HEALOR ™, our primary care doctors are experts in administering many different types of IV therapy and IV nutrition in Las Vegas
Have you ever received Plaquex IV Therapy? Please Leave a comment, and share your experience.
Can you believe it? Oral testosterone is a thing now.
In the past, when a client asked me about oral testosterone, my answer was that we could not take Oral testosterone due to the risk of toxicity to the liver. I am pleased that oral testosterone options are available now with the recent approval by the FDA of testosterone undecanoate with brand names such as kyzatrex, Jatenzo, Tlando.
The symptoms of low testosterone in men can include:
Testosterone undecanoate is a synthetic form of testosterone, a male sex hormone, used for testosterone replacement therapy (TRT) in men with low testosterone levels. It is a long-acting injectable form of testosterone that is slowly released into the bloodstream over several weeks, and recently, the FDA has approved an oral capsule form.
Unlike other forms of testosterone, such as testosterone cypionate or testosterone enanthate, which require frequent injections, testosterone undecanoate is injected less frequently, typically every 10-14 weeks. This can make it a more convenient option for men who require TRT. The oral form is taken daily to twice daily.
Oral testosterone, such as methyltestosterone, has been available for several years; however, this form of testosterone was not recommended due to the increased risk of liver toxicity, jaundice, and risk of liver cancer and so it was rarely prescribed by doctors.
The newer version of oral testosterone therapy, such as Testosterone undecanoate, bypasses the liver. It is absorbed directly through lymphatic channels in the small bowel instead of the portal vein, thus avoiding the liver toxicity effect.
| Name/available dose (mg) | Dose Range | Common Side Effects |
| Kyzatrex :100,150, 200 | 100- 400 mg twice daily | High BP |
| Jatenzo : 158, 198, 237 | 158 to 396 mg twice daily | Nausea, Diarrhea, |
| Tlando : 112 | 225 mg twice daily | Raised prolactin, headache |
- No injection site pain or muscle scarring.
- Excellent for individuals with needle phobia.
- Testosterone elevation is much more physiological.
- Dosing can be easily adjusted.
- Easy Storage.
- Testosterone levels return to baseline quickly after stopping the medication if testosterone reversal is desired due to Secondary polycythemia or other complications of testosterone therapy.
- Possibly reduced hair loss (alopecia).
- Higher free testosterone concentration, possibly due to lower SHBG levels.
- No risk of dermatitis as is with topical testosterone.
- No risk of transfer to partner.
- Levels are much more predictable.
- Much higher levels can be achieved.
- No surgical procedure
- No risk of scarring.
- No recovery time.
Additional:
- maybe an effective therapy for a rare genetic condition, 5α‐reductase deficiency (micropenis, ambiguous genitalia)
- Expensive when compared to other forms of TRT.
- Must be taken with food for ideal absorption.
- Must be taken twice daily to maintain adequate levels of testosterone.
- Significant variation in testosterone levels among different individuals.
- Individuals accustomed to maintaining a high therapeutic level of Testosterone may not see significant improvement in symptoms.
- Nausea, diarrhea, and headache are common side effects of oral testosterone.
- No data on whether this can be used in females.
In summary, testosterone therapy can have excellent results in the quality of life of men suffering from andropause. Oral testosterone therapy is a welcome addition to testosterone replacement medication.
Do you or your partner suffer from symptoms of low testosterone? Looking to get life back on track? Testosterone replacement therapy can help restore balance and keep levels where they need to be for better overall health. Our team at HEALOR can help!
I am often asked what we can expect in terms of breast development after starting estrogen therapy by a many of of my transgender patients. This is an area of very limited research and I will do our best to shed some light on this topic
Normal breast development: breast development is a complicated process that starts at birth in biological females and then accelerates during puberty.
There are 5 stages of breast development in biological females and transgender women. The timeline of breast development in transgender woman can vary significantly depending upon the age, dose and duration of feminizing hormone therapy with estrogen. There can also be variation depending upon the type of estrogen modality used such as oral estradiol versus topical, estradiol injection or estradiol pellets.
| Stages | Timeline | Changes |
| Stage I | 3-6 months | Tip of the nipple is raised |
| Stage II | 6-12 months | Breast buds appear, both the breast and the nipple gets enlarged. A dark circle develops around the nipple which is called areola. |
| Stage III | 12-16 months | Further enlargement of the breast tissue |
| Stage IV | 2-3 years | Elevation of the nipple and the breast and increase in size of areola |
| Stage V | Transgender women are unlikely to achieve this stage. Surgical breast implants are required if a larger breast size is desired. |
Transgender women MTF Transition Pictures
We are sincerely thankful to our patients for allowing us to use their transition pictures to help guide others in their journey.
Progesterone therapy is recommended for transgender patients to decrease the negative side effects of estrogen. In my personal opinion, Progesterone supplementation does not significantly change the development of breast tissue.
Testosterone suppression with anti androgen such as spironolactone, bicalutamide, finasteride or additional medications are required to augment breast development. Elevated testosterone levels have a negative effect on breast tissue development and ideally should be maintained below 100 ng per dL.
have questions about gender affirming hormone therapy? Schedule a consultation with our transgender care doctors in Las Vegas.
Dr. Raj Singh MD, FACP, FASN
Starting transgender hormone therapy can be overwhelming, but it doesn't have to be. Get your questions answered with this list of the top 9 transgender hormone therapy FAQ.
At HEALOR™, we have treated hundreds of patients with gender dysphoria and based on our experience we have compiled a list of the most commonly asked questions when it comes to Feminizing or masculinizing hormone therapy.
As most hormone therapies can have irreversible effects both physically and mentally, we at healor, require a letter or statement from the patient's psychiatrist or counselor before Feminizing or masculinizing hormone therapy can begin. This is in compliance with Nevada state law. Regulations and laws vary across different states and we encourage you to discuss this with your medical provider.
In female to male transition, you can expect enlargement of the clitoris, deepening of the voice, increase in facial and body hair, irregular menstrual cycles followed by complete cessation of the menstrual period, and a decrease in the percentage of body fat. In male to female transition, you can expect a decrease in testicular size, decreased erections, an increase in percentage body fat, and some growth of breast tissue.
Testosterone therapy can increase the production of sebum which makes the skin to be more oily which can result in the development of acne and flare-up of acne.
Scalp Hair loss is very variable, as the sensitivity of hair follicles to dihydrotestosterone or DHT may vary. Patients who are on higher doses of testosterone will experience male pattern baldness. We at healor, will prescribe customized formulations containing finasteride to block DHT conversion, which protects scalp hair from damage. we do not recommend oral finasteride due to the risk of irreversible sexual dysfunction.
Patient’s on masculinizing hormone therapy can expect complete cessation of the menstrual cycle in 6 months.
Deepening of voice on masculinizing hormone therapy generally takes about 6-12 months and is irreversible.
Growth of Breasts varies on the age of the client, estrogen levels, and appropriate use of androgen blockers for best results. Among Anti Androgen drugs, Bicalutamide tends to have the most effect on breast growth, however, this medication can cause liver enzyme elevation and must not be used in individuals with liver problems The development of breast tissue is variable, typically results are seen in about 3 months and breast tissue growth may continue for up to 2 years. Many patients are happy with the results, however, some may require surgical breast augmentation. Read this blog titled " Breast growth with Estrogen Therapy in transgender patients" for more details on this topic.
Patients can experience male pattern baldness, the development of acne, increase in red blood cell production which can raise hemoglobin levels and cause secondary polycythemia. Secondary polycythemia can increase the risk of heart disease and stroke. Some other risks include the development of osteopenia and osteoporosis, the elevation of cholesterol and liver enzymes.
Patients can experience More blood clots, the elevation of liver enzymes, elevation of lipids especially triglycerides and breast cancer.
I hope this was helpful in improving your understanding of hormone therapy.
Erectile dysfunction is the inability to achieve and maintain an erection of sufficient rigidity for sexual intercourse. This condition can lead to a diminished sense of satisfactory sexual relations and personal well-being. Over time, it can even affect one's quality of life. Even though ED is a common condition affecting young and older people, men of all ages should know that ED can be treated and managed.
Many treatment options are available, and the proper treatment depends on several things. This article will help you understand the various treatment options available. Before getting there, it is essential to know what causes ED.
Adequate blood flow is required to achieve and maintain an erection. Cardiovascular problems cause the heart to malfunction, leading to insufficient blood circulation around the body. Conditions such as high cholesterol and atherosclerosis impede blood flow causing insufficient supply to the penile region. In addition to this, obesity causes a reduction in the testosterone levels present in your body, leading to erectile dysfunction. Furthermore, nerve damage, sometimes caused by excessive masturbation, will cause you to have reduced sensitivity levels, directly correlating to the inability to get arousal.
Stress and anxiety contribute to the release of stress hormones. Cortisol is one of the most abundant hormones released and causes vascular constriction. Blood flow becomes sparse, and as a result, you will be unable to achieve an erection. Depression, on the other hand, affects the functioning of your body as a whole. It is known that depression can inhibit the hormone testosterone, causing this to be lowered. As a result, vessel constriction is triggered, and blood flow is inhibited.
Certain medications, such as antidepressants, affect hormonal production. This is especially true of SSRIs. Sexual problems are known to occur after long-term use of these medications. The association between depression and sexual disorders is sustained for at least two years after discontinuation of the antidepressants; caution can minimize this effect.
ED can cause you to live a lesser quality of life and can make it difficult to have relationships, family, and friends. Many ED patients experience depression and anxiety due to their condition, and they often cannot believe that they will recover from it. This cannot be further from the truth. There are many remedies for getting rid of erectile dysfunction, thus bringing you back to the lifestyle you enjoyed before your condition. ED is not a death sentence, and it is essential to give yourself confidence in the treatment options highlighted here and to follow the recommendations made by your doctor.
Lifestyle change is amongst the most important and effective treatments for ED. It is also a relatively simple process as long-term effects are attributed to the alterations in lifestyle. Exercise is critical in lifestyle change treatment as patients are instructed to participate in cardiovascular exercises, weight training, and muscle-building activity. These increase testosterone levels, thus enhancing blood flow to your penile region. Kegel exercises target the pelvic floor muscles by tightening them, thus improving erectile function.
Another lifestyle improvement you can adopt is to eat healthily. You are what you eat, and the foods you eat impact your overall health. Fatty, processed foods are undesirable as they will lead to obesity, which will, in turn, lower testosterone in your body. It would be wise to include vegetables, fruits, and lean protein in your diet as these are high in nutrients and low in fat, contributing toward a healthier body.
Smoking and alcohol consumption are lifestyle choices that will impact your overall health. It is crucial to drastically reduce your smoking and alcohol intake as they both contribute to impotence. Smoking narrows blood vessels through the action of nicotine which is a vasoconstrictor. Finally, getting enough sleep will lead to improved hormone production, thus helping combat erectile dysfunction.
Acupuncture is a traditional mode of treatment that involves the insertion of thin needles into specific body parts. This mode of treatment works by stimulating the release of hormones such as testosterone and neurotransmitters as well, consequently enhancing blood flow. In addition, acupuncture reduces the level of stress in your body which is a vital aspect of improving sexual function. Natural supplements also serve to improve overall blood circulation in the body. L-arginine is an amino acid in dairy, meats, and legumes. L-arginine helps increase nitric oxide levels, thus promoting the relaxation of blood vessels and improving blood flow. Panax ginseng is a supplement extracted from the root of Asian ginseng. It is a herb that has been used for centuries as a treatment for erectile dysfunction. Ginseng is rich in nutrients and has been shown to enhance testosterone production, thereby counteracting ED.
Viagra is a well-known remedy for ED. It belongs to a class of medications called phosphodiesterase inhibitors. These medications cause the blood vessels to relax in preparation for sexual intercourse. They achieve this by inhibiting the breakdown of cGMP, a molecule that assists a man in achieving and retaining an erection. In addition, these medications promote the production of nitric oxide, a vasodilating agent. Medications like Viagra and Tadalafil are generally very safe to use, and they will improve your sexual health. However, this should not be misconstrued to mean that they are risk-free. Always consult your doctor before you start on any medications, especially when it comes to performance-enhancing drugs.
Furthermore, using these drugs recreationally could lead to an interaction with other drugs and medical conditions, thus producing adverse side effects. Additionally, careless usage can lead to psychological dependence, which harms your sexual health. For these reasons, you should always use performance-enhancing drugs while under the observation of a healthcare professional.
There are multiple devices designed to help men who have erectile dysfunction. These include vacuum erection devices and rings. Vacuum erection devices use suction to draw blood into your penile tissues, thereby generating an erection. In many cases, the erection can be sustained by placing a ring at the base of your penis. A vacuum erection device typically requires a plastic cylinder and a pump to create suction.
Implantable devices provide mechanical support for an erection. Penile implants are a popular type of implantable device that performs this function. Penile implants are fitted surgically into the penis of a man and come in two types, inflatable and non-inflatable penile implants. An inflatable penile implant consists of cylinders surgically implanted into your penis and a pump implanted into your scrotum. When the need for an erection arises, you can initiate the pump to fill the cylinders with saline, causing your penis to be firm. A non-inflatable penis implant is made of two rods implanted into your penis. When you want to achieve an erection, you can manually adjust the position of your penis. An erectile dysfunction doctor in Las Vegas can advise you on which implantable device is best for you.
Las Vegas is home to some of the very best ED doctors. An ED doctor in Las Vegas will ask to consult you first to understand your plight and then assess you further through a physical examination to establish the nature of your problem. Las Vegas ED is home to unparalleled resources and expertise, all aimed at helping you regain full sexual function. An erectile dysfunction doctor in Las Vegas at HEALOR can find you the best solution from treatment options tailored to you. Bearing this in mind, you must take actionable steps to secure a healthy future. So, a good question would be to ask, "How do I find an erectile dysfunction center near me?"
The answer to this is relatively simple. All you have to do is look up entrusted professionals, and as soon as you make that phone call, you will be on course to achieving a better life.
Bicalutamide is an anti-androgen drug which means that it blocks the effect of androgenic hormones such as testosterone and DHT. The important thing to understand is that bicalutamide does not lower testosterone levels, it simply blocks the effect of testosterone on tissues. In many cases, Testosterone levels initially increase after starting this medication however, that is nothing to be concerned about. Testosterone levels start declining over time, this change happens much more rapidly if you're also taking estrogen and progesterone in addition to bicalutamide
Bicalutamide is most commonly used for treating men with prostate cancer
Off-label uses:
Today primarily will be focusing on bicalutamide use in transgender females
Other anti-androgen medications often prescribed are spironolactone and cyproterone acetate. However, these drugs are much weaker than bicalutamide. Cyproterone is also not available in the US.
Bicalutamide also helps the aromatization of testosterone to estrogen which is why it is especially helpful for breast development when compared to other anti-androgen medications. Some small studies have shown better breast growth when compared to Aldactone and cyproterone. A possible mechanism is that Aldactone causes early maturation of the breast bud when compared with bicalutamide.
Comparison of anti-androgen effect of bicalutamide, Aldactone, and Cyproterone in transgender females.
Bicalutamide is known to cause a reduction in vitamin C levels and glutathione levels in animal studies. Taking glutathione and vitamin C may reduce the risk of liver toxicity however I have no data to support this strategy.
Half-life is 6 days so the drug stays in the body for several days so only twice a weekly dose is adequate. Compare that to spironolactone which has a half-life of only 2 hours
Do not use or use caution if you
Get a liver panel done 2-4 weeks after starting the medication. For any sign of liver failure such as jaundice, the medication must be immediately stopped.
Bicalutamide stays in the body for several days and has a half-life of 6 days which means half of the drug is broken down and removed by the body in 6 days. Twice a weekly dose of 50 mg is adequate. Higher doses increase the risk of liver toxicity and should be avoided
In summary, this is a very good medication for feminization therapy especially if high breast growth is strongly desired. Liver toxicity is a major concern and can be life-threatening so do not consume alcohol, and avoid hepatotoxic medications such as Tylenol.
![post-orgasmic illness syndrome [POIS]](https://healor.com/wp-content/uploads/2023/08/image-10-1024x663.jpeg)
When male sexual health is discussed mostly it is about men with erectile dysfunction, premature ejaculation, and delayed ejaculation. Postorgasmic illness syndrome (POIS) is a rare and poorly understood medical condition in which people experience a range of physical, cognitive, and emotional symptoms following sexual activity, particularly orgasm that can significantly affect the quality of life and can cause significant emotional distress. Most men have such extreme fatigue post-ejaculation that they start to avoid sexual activity completely.
The symptoms usually begin within minutes to hours after orgasm and can last for several days.
Symptoms of POIS can vary widely from person to person, but may include:
The exact cause of POIS is not known, but it is believed to be related to an allergic or autoimmune reaction to substances released during orgasm.
Although the syndrome has been reported in females after orgasm, primarily most of the data and case reports come from male patients.
This syndrome develops as a result of ejaculation and symptoms can appear after masturbation or after wet dreams.
Based on the available data, symptoms typically appear during the teenage years.
There is no single diagnostic test. This is a clinical diagnosis based on symptoms. At HEALOR™ we typically order tests that include a complete blood count, comprehensive metabolic panel, total and free testosterone levels, TSH to check thyroid, estrogen levels, sedimentation rate, and C-reactive protein to measure for inflammation.
Individuals suffering from this syndrome tend to have low to borderline low testosterone levels. There is a higher incidence of autoimmunity in testosterone deficiency possibly from the over-activation of T lymphocytes. It is possible that individuals who are predisposed to low testosterone levels may have a higher incidence of this syndrome. This is further supported by the fact that raising testosterone levels either by Testosterone replacement therapy or by using testosterone boosters such as Ashwagandha, Boron, Zinc, or adrenal support vitamins in these individuals tends to improve symptoms.
POIS is considered to be from a hypersensitivity reaction to semen and unfortunately, vasectomy does not help with the symptoms.
There is currently no known cure for POIS, but treatments may Include strategies to reduce allergy and inflammation.
Omalizumab is monoclonal antibody that is approved for use in allergic asthma, chronic rhinosinusitis, IgE mediated food allergies and works by lowering IgE and downregulates mast cells thereby reducing allergic response to the allergen. Since POIS is postulated to be an allergic disorder this has been tested in POIS and other allergy mediated disorders. The data is limited to case reports only and no controlled trials have been conducted. Omalizumab for POIS represents a new frontier in treatment options for POIS and should be explored further. Barriers to use are weekly injections, and cost of the drug $2000 -$3000/week.
We generally do not recommend testosterone therapy (TRT) in young males as it can cause infertility by causing testicular atrophy. If testosterone therapy is to be utilized we recommend adding clomiphene citrate to prevent testicular atrophy and preserve fertility.
Do you suffer from post-orgasmic illness syndrome (POIS)? Our primary care doctors in Las Vegas at HEALOR™ can help!
Chronic Fatigue The Hidden Epidemic
Do you struggle getting up in the morning? Do you crave sugar, coffee or other stimulants throughout the day? Are you exhausted towards the end of the day, yet are unable to sleep well at night? If the answers to any of the question is “yes” then you may be suffering from chronic fatigue.
Chronic Fatigue Syndrome (CFS) is a complex condition that is mainly characterized by the feeling of extreme fatigue without any underlying medical conditions. This fatigue can get worse with mental or physical activity but doesn’t get better with rest or sleep. It is also called Myalgic Encephalomyelitis (ME) or Systemic Exertion Intolerance Disease (SEID). Adrenal fatigue is becoming an important cause of undiagnosed chronic fatigue.
Chronic fatigue causes are relatively unknown, but there are many theories about the root cause. These theories range all the way from psychological stress to viral infections, but most experts believe that the main cause can be a combination of different factors. People with chronic fatigue may seem hypersensitive to normal activity and exercise as well. Some theories suggest that some people may be predisposed to the disorder which is then triggered by one or more of the following:
None of these chronic fatigue causes and triggers are conclusive, and there may be a number of different or combined factors that result in chronic fatigue.
There are some signs that you should look out for. These include:
Some factors increase the chances of developing chronic fatigue. These can include:
Chronic fatigue can develop into some complications that can further impact a person’s life in an adverse manner. These can include:
There is also no single medical condition that results in fatigue, which is why there are no real tests to confirm chronic fatigue. At HEALOR™, we may order a number of different tests including saliva hormone tests to rule out other problems with similar symptoms to chronic fatigue.
At HEALOR™, we rule out certain medical conditions or illnesses before they can diagnose you with chronic fatigue. These tests can include:
Chronic fatigue treatment depends on the possible conditional causing the fatigue
At HEALOR™, we may prescribe adrenal support multivitamins, adrenal extracts, bioflavonoids to improve the cortisol output which may reduce fatigue levels. Most patients do not crave coffee, sugar or other stimulants after 4-6 weeks of treatment.
When appropriate, we may order bio-identical hormone replacement therapy (BHRT) to optimize tissue hormone levels.
Chronic fatigue is a complex condition that often goes undiagnosed but can cause a lot of suffering on the patient’s part. It is important to recognize the symptoms of the problem so that you can seek some chronic fatigue treatment for the issue.
At HEALOR™, I have been able to help many patients with chronic fatigue over the past several years. I also travel frequently to teach and train other medical professionals in the art and science of chronic fatigue management. My years of experience has allowed me to formulate specific treatment protocols for adrenal fatigue, chronic fatigue, and hormone imbalances.
Today the topic of discussion is porn and its effects on health and relationships.
If you are not comfortable listening to discussions about sex and porn, then this would be a good time to watch a different video.
The reason behind making this video is that although porn is everywhere, its effects on health and relationships are not often discussed. Not only patient's but also doctors are uncomfortable discussing this topic although it has so many effects on overall health, and sexual function.
Sexual dysfunction is becoming more common and I am seeing erection and orgasm issues in men as young as 30. This was never such a big problem in younger individuals in the past, so there must be something going on. We all know that we have more exposure to environmental toxicity, pollution, stress and all these factors do play a role in sexual dysfunction. However, one of the biggest factors leading to sexual dysfunction nowadays is exposure to porn and this is often not discussed
In our sexual health clinic, I am seeing so many individuals with diminished sexual drive, delayed ejaculation, and orgasm issues. Lack of sexual pleasure and satisfaction are so prevalent in both men and women. For men, its mostly erectile issues during real sex and for woman it is primarily issues with orgasm. Learn more at HEALOR™
Can Transgender Hormone Transition Therapy Be Reversed?
At HEALOR™, we know how meaningful and exciting it is to move forward with gender transitioning and become the person you were always meant to be. Transgender hormone therapy is an integral part of gender dysphoria treatment, whether it takes place in the pre-surgical phase of the process or as a standalone approach. Double board-certified physician Dr. Raj Singh MD has advanced expertise in hormone replacement therapy (HRT) and has guided numerous patients in the Las Vegas, NV LGBTQ community throughout their gender reaffirmation journeys.
Before moving forward with this treatment, it is important to understand whether or not transgender hormone transition therapy can be reversed. Taking feminizing or masculinizing hormones will have a physiological and emotional impact, and we want to ensure you are fully aware of how this process will affect your body, health, and quality of life. Dr. Singh and our caring team are here to provide the information you need and will be with you every step of the way.
Transgender hormone replacement therapy is the administration of hormones to help patients acquire the physical characteristics of their true gender. Feminizing hormone therapy is administered to individuals who wish to transition from male to female (MTF) and involves taking estrogen, progesterone, and testosterone blockers such as Aldactone, bicalutamide, and cyproterone acetate.
Female-to-male (FTM) transition patients receive testosterone throughout the course of their hormone replacement therapy. Hormones may be taken via oral pills, injections, or absorbed through the skin via a transdermal patch or topical cream. Another novel approach we utilize is insertion of hormone pellets under the skin. Hormone pellets provide several months of treatment without the inconvenience of pills, or pain associated with injection therapy.
The effects of transgender HRT take place over time. While some are irreversible, many components of transgender hormone therapy for Las Vegas, NV patients can be reversed when the hormones are no longer administered. However, the extent to which a person might experience such effects is largely dependent upon the length of time the hormones have been taken, genetics, and other factors. During your consultation at HEALOR™ , Dr. Singh can talk with you about these effects and answer any questions you have.
Many of the physical characteristics that result from transgender HRT taken to block testosterone production in the body (in trans women) may diminish or be reversed when the hormones are no longer taken. Some of these include:
Understanding the full scope of how transgender hormone therapy will affect your body as it changes is important for all patients who are considering this option. Certain effects of transgender hormone therapy are long-term changes and, generally, are not reversible. These may entail:
Transitioning to your true gender is certainly a thrilling, life-changing decision. For more on the effects of transgender hormone therapy, contact HEALOR™ in Las Vegas, NV and schedule your visit today. Double board-certified physician Dr. Raj Singh and our team have advanced expertise in guiding trans men and trans women through the transition process and are excited to help you achieve your treatment goals.
Sweating is a natural bodily function that helps regulate our body temperature. However, for some individuals, the body produces an excessive amount of sweat, regardless of temperature or physical activity. This condition, known as hyperhidrosis, can be extremely uncomfortable and distressing for those affected.
Hyperhidrosis is more common than you might think. In fact, it's estimated that up to 5% of the population may suffer from this condition. If you're experiencing excessive sweating, know that you're not alone, and there are effective treatments available.
To diagnose hyperhidrosis, healthcare professionals look for specific criteria. Understanding these can help you determine if you should seek medical advice:
If you notice these signs, it's important to consult with a healthcare provider for a proper diagnosis and treatment plan.
Our bodies are covered in sweat glands that play a crucial role in maintaining our health. These glands help control body temperature, remove excess electrolytes, and eliminate excess fluids. The sweat glands are connected to our sympathetic nervous system, which controls many of our involuntary bodily functions.
In people with hyperhidrosis, the number and size of sweat glands are typically normal. However, these glands are overly sensitive to signals from the brain, resulting in the production of excessive amounts of sweat. This oversensitivity is what leads to the uncomfortable symptoms of hyperhidrosis.
It's worth noting that certain medications can also trigger excessive sweating. These may include:
If you're experiencing excessive sweating and are taking any medications, it's crucial to review your medication list with your doctor. In some cases, modifying or changing medications may help improve your symptoms.
Fortunately, there are several effective treatments available for hyperhidrosis. The right treatment for you will depend on the severity of your condition and your individual needs.
For mild to moderate hyperhidrosis, prescription antiperspirants can be highly effective. Products like Drysol or Xerac are available by prescription and can significantly reduce sweating. It's important to note that similar products available online or over-the-counter are often counterfeit and ineffective. Always consult with a healthcare provider to obtain genuine, prescription-strength antiperspirants.
A newer treatment option is Qbrexa, a topical medication containing 2.4% glycopyrronium. This treatment involves applying a pre-moistened cloth to the affected area (typically the underarms) once daily. The solution works by inhibiting neurotransmitters on the sweat glands, effectively reducing sweat production.
If antiperspirants and topical medications aren't providing sufficient relief, neurotoxin injections like Botox may be recommended. The typical dosage is 50 units in each armpit, administered through 10 to 20 injections spaced about 1 cm apart. Most patients notice a significant reduction in sweating within two weeks of treatment.
For those with more severe or persistent hyperhidrosis, there are additional treatment options available:
A recently approved treatment called Miradry uses microwave technology to destroy sweat glands in the underarm area. This non-invasive procedure typically requires 2-3 sessions for optimal results. While it's a more aggressive approach, it can provide long-lasting relief for those with severe underarm sweating.
This treatment is particularly effective for hyperhidrosis affecting the palms and soles of the feet. During an iontophoresis session, patients immerse their hands or feet in shallow trays filled with water. A small electrical current is then passed through the water for 15 to 40 minutes, depending on the device used. This treatment can significantly reduce sweating in these areas.
In some cases, oral medications like glycopyrrolate and oxybutynin may be prescribed to reduce sweating. However, these medications can have significant side effects and are generally not the first line of treatment when safer, more targeted therapies are available.
While seeking medical treatment is crucial, there are also steps you can take in your daily life to manage hyperhidrosis:
Remember, hyperhidrosis is a medical condition, not a hygiene issue. Don't let embarrassment prevent you from seeking help.
Hyperhidrosis can significantly impact your quality of life, affecting your confidence, social interactions, and even your career. However, with proper diagnosis and treatment, most people can find relief from their symptoms.
If you're struggling with excessive sweating, we encourage you to schedule a visit with your doctor. A healthcare professional can assess your symptoms, discuss these different treatment options, and work with you to develop a personalized treatment plan.
Living with hyperhidrosis can be challenging, but you don't have to face it alone. With the right support and treatment, you can manage your symptoms effectively and regain your confidence. Remember, seeking help is the first step towards finding relief and improving your quality of life.
So when referring to salt, we generally mean sodium chloride. Although, Often Used synonymously sodium is not salt as no chloride is attached to the sodium molecule. There are non-chloride versions of sodium, such as sodium bicarbonate, often referred to as baking soda and monosodium glutamate or MSG. Monosodium glutamate is an additive used as a flavor enhancer in processed foods, and its safety remains controversial.
As humans, we do not need much sodium to survive; however, most of us consume a very high sodium diet (3 grams of sodium per day), and the current guidelines recommend restricting sodium to less than 2.3 grams per day. Most of the sodium in our diet comes from processed food and eating out at restaurants.
So let us dive in and discuss different types of salts available in the market.
is highly refined and processed with anti-caking agents such as calcium silicate (Reduces moisture and clumps and keeps the salt freely flowing) and has other additives such as iodine. Most of the table comes from mining deep underground salt deposits and by evaporating seawater.
is derived after evaporating seawater from salt Lakes or ocean water. Sea salt is being promoted as much healthier than table salt; however, the sodium content in both sea salt and table salt is identical. Sea salt has some trace minerals like zinc, iron, and potassium which are beneficial. The problem is because of rising pollution in the oceans; the sea salts may contain high amounts of lead, arsenic, mercury, and other heavy metals.
is sourced from mines in Pakistan. The distinct pink color of the salt is because of the presence of iron oxide. Himalayan salt has some trace minerals such as iron manganese, zinc, calcium, and potassium, and its overall sodium content is lower when compared to table salt or sea salt. Because of this reduced sodium content and presence of trace minerals, the Himalayan salt gets marketed as a healthy alternative to regular salt. Himalayan salt has no added iodine, which may cause hypoactive thyroid in iodine-deficient individuals. There are no proven health benefits to using Himalayan salt, just like there is no benefit of using Himalayan salt lamps. Himalayan salt is also 20-30 times more expensive than regular salt, and it would be wise to spend that money on another good quality nutritional supplement.
is regular salt without the addition of anti-caking agents such as calcium silicate, so it tends to form clumps.
sourced initially from the Celtic sea, is also regular sea salt. These days most of the Celtic salt comes not from the french coast but from Guatemala and Hawaii.
In summary,
Limit salt intake, and although the ideal amount of salt consumption remains controversial, there is no scientific benefit to substituting table salt with pure sea salt, Himalayan salt or Celtic salt. With the consumption of unrefined sea salt, exposure to ocean pollutants such as lead, microplastic, and lack of iodine are real concerns.
