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Clomiphene Low-Testosterone Andropause Treatment


Written by Dr. Welsh, Published on 07 August 2014

Clomiphene Low-T Andropause Treatment

Low-T is a medical condition that affects men of all ages. Age-Related Testosterone Deficiency begins to become an issue for many men as young as thirty years of age, and remains problematic all throughout the lifespan. Testosterone Replacement Therapy has long been used as a useful means to restore Testosterone Concentrations and foster improved health, but there are other options available to patients.

What Are the Symptoms of Low-T

Low-T affects male health in a wide variety of ways. When most people think about Testosterone Deficiency, they think about Erectile Dysfunction and Low Libido. These are indeed two of the most prominent and noticeable symptoms, but Low-T impact the entire body in a variety of ways. The following are some of the symptoms of Testosterone Deficiency that men might experience:

  • Weight Gain

  • Loss of Muscle Mass

  • Osteopenia

  • Anemia

  • Muscle Pain

  • Fatigue

  • Loss of Quality of Life

  • Depression

  • Anxiety

  • Increased Susceptibility to Prostate Cancer

  • Enhanced Risk of Alzheimer's Disease and other Neurological Disorders

  • General Increase in Mortality Risk

Now, sexual health is important, but it's clear that Andropause impacts far more than simply sexual health. It can literally take years off of your life.

Primary Vs. Secondary Testosterone Deficiency

You may not realize it, but there are multiple forms of Testosterone Deficiency, based upon the source of the deficiency. Primary Hypogonadism refers to Low-T which is caused by medical issues which suppress the ability of the testes to provide Testosterone to the body. This can be caused by testicular cancer, testicular removal, mumps, genetic disorders, or other medical issues which impact the testes.

Because these forms of Low-T are caused directly by Testicular Malfunction, the only effective form of Testosterone Restoration is directly via Bio-Identical Testosterone Treatment. The body effectively loses its ability to produce Testosterone in the case of Primary Testosterone Deficiency.

On the other hand, Adult-Onset Testosterone Deficiency is not caused by issues with the testes, but with issues with signaling from the Pituitary and Hypothalamus. The testes retain their ability to produce all of the Testosterone that the body needs, they are just under-active due to a lack of stimulation.

Lifestyle Choices Can Make Andropause More Severe

Andropause is exacerbated by conditions related to lifestyle which further suppress Testosterone signaling. The following are some examples of physiological circumstances which suppress the body's ability to meet its own needs for Testosterone:

  • Lack of Sleep

  • Diabetes

  • Steroid Abuse

  • Excess Iron

  • Brain Injuries

  • Anxiety

  • Depression

  • Certain Medicines

The most common form of treatment today for all forms of Low-T, including Age-Related Hypogonadism, is Bio-Identical. There are a variety of effective forms of Bio-Identical Low-T Treatment, including Testosterone Injections, Patches, Pellets, Gels, and Creams.

Side-Effects of Testosterone Restoration

Each of these forms of treatment have their own particular advantages and disadvantages amongst themselves, but all are generally effective. Of course, Testosterone Therapy in general comes with its own unified list of side-effects, including:

  • Increased Red Blood Cell Count

  • Reduced Fertility

  • Gynecomastia

  • Shrinkage of the Testicles

Some of these side-effects can be treated effectively. For example, increased RBC can be mitigated by blood donation, and the risk of gynecomastia can be controlled through the use of Arimadex, an estrogen blocking medication. But what options are available for patients that want to benefit from Testosterone Therapy while also preserving and retaining their fertility?

Bio-Identical Testosterone Fine For Men that Don't Want Kids

For older patients that have no interest in bearing children, Testosterone Replacement meet their needs effectively, but for younger men in their thirties and forties that are suffering from issues related to Low-T, but are also looking to have children in the near future, Testosterone is simply not an option, unless they freeze sperm before initiating therapy.

Clomiphene Helps Men That Want Children Experience Testosterone Restoration

Luckily, men that want children don't have to avoid Testosterone Restoration, because HCG and Clomiphene Citrate have both been shown to be highly effective at providing the same great benefits as Testosterone Therapy with Injections, Patches, Etc., while also preserving fertility.

In fact, Clomiphene and HCG not only preserve Fertility, they actually enhance fertility, because they supplement the mechanisms which lead to the production of Testosterone, which also lead to the healthy production of sperm.

How Does Clomiphene Work?

When a man's body is working properly, the hypothalamus sends signals to the pituitary to produce a Testosterone Precursor Hormone known as Luteinizing Hormone. This hormone is released in the blood, where it circulates down to the testes and activates the production of Testosterone.

Some of the produced Testosterone is then converted into Estrogen. Like women need a little Testosterone, men need a little Estrogen, and Estrogen actually acts as a negative feedback mechanism to the production of Testosterone, circulating back to the brain, encouraging the pituitary to halt Luteinizing Hormone Production.

Interference with this signaling is actually one of the ways that lifestyle inhibits Testosterone Production. Body fat has the ability to convert Testosterone into Estrogen, and the more body fat a patient harbors, the larger the strain on his Testosterone Balance.

Clomiphene helps to encourage the increased production of Testosterone by inhibiting the negative feedback mechanism caused by Estrogen. Clomiphene Citrate reduces the influence of Estrogen upon the hypothalamus and pituitary, encouraging the body to produce more Luteinizing Hormone.

Because Estrogen signaling to the brain is reduced, it keeps the pituitary happily churning out enough Luteinizing Hormone to meet the needs of the body.

How do HCG and Clomiphene differ?

Whereas Clomiphene increases the body's production of Luteinizing Hormone, HCG imitates the function of Luteinizing Hormone in the body, encouraging the production of both sperm and Testosterone.

Bio-Identical Testosterone Replacement Therapy, on the other hand, increases Testosterone by directly replacing the body's own Low-T Production. This causes the body to produce more Estrogen and other Negative Feedback Mechanisms, which slows down the body's release of Luteinizing Hormone, eventually to the point where the patient is ultimately infertile. Luckily, this is temporary, and will relieve itself given enough time without Treatment, but this still poses a direct problem for younger patients of child-bearing age.

How Does Bio-Identical Testosterone Interfere with Testicular Function?

With standard Low-T Treatment, the pituitary and the hypothalamus receive signals from the body that Testosterone Levels are normalized, and take this to mean that the testes are producing ample Testosterone for the body. When it receives these signals, the hypothalamus tells the pituitary to stop making Luteinizing Hormone, which in turn both suppresses the production of Testosterone by the testes and prevents the manufacture of sperm as well.

This is the biological mechanism by which Testosterone Therapy leads to reduced fertility and the shrinkage of the testicles. Because the testes are no longer active, they go into a state of dormancy, which can also cause the testes to recede.

How do HCG and Clomiphene Preserve Testicular Function?

Human Chorionic Gonadotropin and Clomiphene Citrate both have the ability to simultaneously increase Testosterone Levels while also sustaining the normal function of the testes. In fact, HCG is very commonly used as a mechanism to return the testicles to normal function after Testosterone Therapy has been completed. HCG is commonly used in a process known as cycling.

Many men that do not produce enough Testosterone can benefit greatly from short-term use of Clomiphene, especially those that have other factors suppressing their Testosterone Production. Under these circumstances, treatment usually lasts from three to six months. Men with Age-Related Low-T caused by Andropause, however, require long-term therapy to keep their Testosterone Levels at a healthy concentration.

Because Clomiphene increases Testosterone Production naturally, in a way which is in congruence with the natural hormonal cascade of the body, Low-T Treatment with Clomiphene has a significantly lower risk of side effects as compared to Bio-Identical Testosterone Treatment. Clomiphene also does not carry the same potential for Testosterone Abuse, because the patient cannot easily receive more Testosterone than they actually need.

Clomiphene was originally thought to only be effective for the treatment of Testosterone Deficiency and Infertility in younger male patients, but over the course of the last decades, a growing body of evidence has shown that Testosterone Restoration with Clomiphene is a highly effective method of treatment for men that are suffering from Andropause that are 30, 40, 50, and beyond.

What Makes Clomiphene such a good choice for men with Low-T Caused by Andropause?

Let us quickly break down the benefits of Clomiphene:

  • Clomiphene produces fewer side effects than Bio-Identical Low-T Therapy.

  • Clomiphene is available in generic form, and can be obtained for a very reasonable price.

  • Clomiphene can be taken orally, bypassing the need for Testosterone Patches, Creams, and Injections.

  • Clomiphene restores Testosterone Production to normal levels without risk of overdose, infertility, or testicular shrinkage.

  • With Clomiphene, it is possible to encourage your body to produce its own natural Testosterone.

Why Isn't Clomiphene More Commonly Prescribed?

Although Clomiphene is a highly effective alternative to Testosterone, it is very under-utilized in today's pharmaceutical climate. There are a number of reasons for this:

  • Because Clomiphene is generic, pharmaceutical manufacturers don't advertise the product heavily, which leads to a reduced level of awareness.

  • Medical professionals are also victims of these issues of awareness. In spite of the fact that Clomiphene is clinically shown to increase Testosterone Production effectively for men with Andropause, the majority of physicians are not fully cognizant of the safety profile and the effectiveness of the treatment.

  • Another reason for this reduced awareness is that Clomifene is not approved by the Food and Drug Administration for Male Testosterone Deficiency. There is research that proves the effectiveness of the treatment, it simply hasn't been fully evaluated by the FDA.

This is because Clomid, the brand name form of Clomiphene Citrate, was originally designed to treat women with fertility issues. In the female body, Luteinizing Hormone plays an important role in the normal menstrual cycle, whereas in men it encourages healthy sperm and Testosterone production. As a result, most physicians are aware of the FDA-Approved usage of Clomiphene, and are under the false impression that Clomiphene is only effective as a treatment for women.

HCG vs Clomiphene

Human Chorionic Gonadotropin is more commonly used than Clomiphene as a treatment for Adult-Onset Hypogonadism and Andropause, because of the increased level of awareness and the older research profile. But for men that can benefit from either treatment, Clomiphene is the better option for most patients because it is much cheaper than HCG, and it is also easier to administer. To date, HCG can only be prescribed via injection, whereas Clomiphene can be effectively used orally.

Side-Effects and Issues Related to the Use of Clomiphene Citrate

Clomiphene does indeed have a safety and side-effect profile that is better than Bio-Identical Testosterone Therapy, but there are some risks to consider, as there are with any other form of Hormone Therapy, or medical treatment in general:

Pyrospermia – Among older patients taking Clomiphene Citrate, patients can experience an increased concentration of white blood cells in the semen. To date, there is no evidence that this causes any health issues, and this increase in WBC Count is not the result of infection.

Changes in Vision – There is a very low risk that eyesight issues can occur as a result of the use of Clomiphene. These side-effects are not permanent, and are fully reversed upon the suspension of treatment.

Clomiphene is a Synthetic Drug – Unlike other forms of Hormone Restoration such as HGH Injections and Testosterone Therapy, Clomiphene is not naturally reproduced by the human body. Bio-Identical Hormones are naturally occurring, they are simply created in a laboratory environment. This means that there is a potential risk for side-effects to be uncovered in the future, because Clomiphene could have some unintended function outside of its intended uses because of its unique and abiological structure.

On the other hand, Clomiphene has been prescribed and tested on male patients for over forty years, and the above risks are the only ones that have become manifest.

Some men may not respond to Clomiphene for Andropause – Because Clomiphene encourages the youthful production of Testosterone via the Hypothalamus and the Pituitary, men with Primary Testosterone Deficiency will not respond effectively to Clomiphene. There are also other factors of the endocrine system which can lead to inhibited effectiveness.

Is Clomiphene Citrate Right For You?

For many patients, Clomiphene is an incredibly viable form of Testosterone Restoration, and may even be the ideal form of treatment. It can be used for patients that need Testosterone Therapy for a brief period of time, as well as for patients that suffer from chronic Low-T resulting from Andropause and Age-Related Hypogonadism.

Of course, like any form of Hormone Therapy, Clomiphene should only be used as prescribed by a licensed and board-certified medical professional. If you are interested in Clomiphene, or any other form of Hormone Replacement Therapy, we encourage you to contact our clinic for more information.


How Is Sleep Apnea Diagnosed and Treated


Written by Dr. Welsh, Published on 27 July 2014

How Is Sleep Apnea Identified and How Is It Treated?

Because Sleep Apnea cannot be diagnosed in the context of a routine medical visit, it requires a certain protocol to be effectively diagnosed. An effective way to establish to one's physician that you may be suffering from sleep apnea is to keep a sleep diary for fourteen days leading up to your appointment. You can use this diary as evidence that your sleeping habits are being disrupted, which may prompt your physician to set you up with an appointment with a sleep specialist.

Also, be open with your doctor about your energy levels and how your sleeping issues impact your quality of life. It's also important to share your personal and family medical history in order to provide further evidence of your deficiency.

Sleep Apnea Physical

Further evidence of sleep apnea can be evaluated via physical examination. Your doctor can look into your throat, nose and mouth in order to identify the presence of tissue which may impede the ability to breath easily during the night. For example, many adult Sleep Apnea patients have a soft palate or uvula which is larger than normal and restricts airways during sleep.

If your physician considers you a potential sleep apnea sufferer, he or she will likely recommend that you visit a sleep specialist. There are a number of tests that can accurately diagnose sleep apnea, but these tests require you to have an opportunity to be monitored sleeping comfortably.

Polysomnogram for Sleep Apnea Diagnosis

The most frequently used test for sleep apnea is known as a Polysomnogram. This test uses various diagnostic devices in order to evaluate blood pressure, heart rate, eye movement, and brain activity during sleep. This test also measures other factors, including the rise and fall of your chest, snoring, and the rate at which air flows in and out of your nose, as well as oxygen levels in your blood stream.

As you can imagine, this test is fairly elaborate, so it generally requires that you visit a specifically designed sleep laboratory or sleep center. There is no pain involved with the procedure, and it's no different than a normal night's sleep, except of course, you will be fitted with a number of sensors attached to your finger, limbs, chest, face, and scalp.

These devices will help your sleep specialist provide you with an informed diagnosis with regard to your sleep apnea, which will help him or her provide you with the most effective form of treatment to meet your needs.

CPAP Sleep Apnea Treatment

The most effective method to treat Sleep Apnea is known as a CPAP, or Continuous Positive Airway Pressure device. This works exactly how it sounds. It enhances air flow through your nose and throat, widening your airway and helping you sleep more soundly through the night. The elaborate testing during your sleep study will help your physician properly calibrate the CPAP to meet the needs of your body at rest.

There are also tests which can be administered at your home to provide diagnostic data regarding your sleeping pattern. The most commonly used device is known as a Home-Based Portable Monitor. Of course, this device will not provide the same depth of results as a Polysomnogram, but it can provide valuable data at a cheaper cost. In particular, the home monitor measures the rise and fall of the chest, heart rate, air circulation, and blood-oxygen levels. Often, this test is used as a preliminary examination for patients, in order to see if they actually need a sleep study.

What Are Sleep Apnea Treatment Options

There are a number of options available to sleep apnea patients, dependent upon the severity and source of their apnea. These options include breathing devices, mouthpieces, changes in lifestyle, and surgery. Obstructive sleep apnea is generally not treated with medication

What Are the Goals of Sleep Apnea Treatment?

  • Reduce Fatigue

  • Stop Snoring

  • Make It Easier to Breath During Sleep

Because sleep apnea is commonly associated with other conditions such as hypertension and obesity, Sleep Apnea treatment is often combined with other forms of treatment in order to relieve these other related medical conditions.

It is important to treat sleep apnea, because in doing so, you can reduce the risk of a variety of related medical conditions, especially those related to the heart and cardiovascular system, including stroke and heart attack.

The treatment that will work best for you depends both on your medical condition and your personal preferences, and your sleep specialist will help you pick the ideal treatment option to meet your needs.

For patients with mild sleep apnea, the best form of treatment may simply be a mouthpiece, combined with changes in lifestyle. On the other hand, patients that experience more severe sleep apnea will likely be most effectively treated with a CPAP or with surgery.

In some cases, your issues with daytime fatigue may come from sources other than Sleep Apnea, and if your Apnea Therapy isn't providing you the results you need, it's likely that you aren't allowing yourself adequate rest. You need seven to eight hours to become fully rested, and some patients actually need more.

If the combination of sleep and medical treatment aren't effective, you and your sleep specialist will have to explore other potential options.

Adopting Healthier Habits to Encourage Better Sleep

For patients that only have light sleep apnea, you may actually recover from your condition simply by altering your habits and lifestyle in order to improve your sleep.

  • If you suffer from a stuffy nose due to allergies or other conditions, use medications or nasal sprays to improve your condition

  • Make the effort to sleep on your side. Obstructive Sleep Apnea is most commonly an issue when a patient sleeps on his or her back. There are shirts and pillows that can inhibit back-sleeping and help alter your habits.

  • If you are overweight, make the effort to lose the weight and reach a healthier weight. Soft tissue can inhibit airways, making it harder to breath during sleep.

  • Don't take medications that cause you to become sleepy, and limit your use of alcohol, entirely if necessary. Depressants cause your airway to become more restricted because the muscles relax.

  • If you are a tobacco user, stop smoking.

  • For some patients, a simple device known as an oral appliance can mitigate the effects of sleep apnea. It can also be used for snorers.

In regard to mouthpieces, you can actually visit an orthodontist or dentist, that can built you a mouthpiece designed specifically for your mouth to increase airflow. This mouthpiece will open your mouth very slightly, preventing your tongue and your jaw from getting in the way of your breathing.

Breathing Devices for Sleep Apnea

For patients that have more troublesome sleep apnea, there are medical devices that promote airflow by actively circulating air, keeping the airway open. The most prescribed treatment for more severe sleep apnea is the CPAP. There are two types of CPAP. The most common device utilizes a mask which covers your nose and mouth, but some devices just introduce airflow through the nose. This product provides a slow and steady stream which delivers air to the throat. In doing so it makes it easier to breath.

It's important to recognize that snoring and sleep apnea are related but not identical health conditions. Just because you are no longer snoring doesn't mean that you no longer need your CPAP or have been cured of your condition. Sleep Apnea is chronic and moderate to severe sleep apnea will return if you suspend treatment.

Under most circumstances, a professional will visit your home in order to prepare the CPAP for use, dependent upon the recommendation of your physician. It's also important to recognize that your condition may change over time, and this might necessitate changing the settings on your CPAP periodically to improve air flow. Of course, this should only be done by your sleep doctor.

Some people experience side-effects as a result of using a CPAP. Most common side effects include headache, dry mouth, skin irritation, and stuffy or dry nasal passages. Also, if the CPAP isn't programmed correctly, it can lead to stomach discomfort and bloating.

For the most part, these side-effects can be easily treated, helping you to get the most out of your CPAP device. It's important to be open with your sleep doctor and the tech that comes to your home to make sure that your CPAP treatment is optimal.

For patients that experience issues with runny or dry nasal passages, there are ways to increase the moisture content of the air to improve response. Also, you may benefit from choosing a mask that fits your face more securely.

Most patients that use CPAP find that the device improves their sleep quality and their energy levels and are satisfied with the treatment.

Sleep Apnea Surgery

In major cases of Sleep Apnea, the patient may benefit most from surgery. The form of surgery required depends on the specific cause of Obstructive Sleep Apnea. In general, the goal of Sleep Apnea Surgery is simply to open airways more securely. This can be done by removing, stiffening, or shrinking soft tissue in the throat and mouth, and can also be accomplished by adjusting the jaws to increase airflow.

Soft tissue surgery can be done either as an outpatient procedure or at a hospital. If the goal is simply to shrink soft tissue, it may simply require an injection or other form of treatment, rather than surgery. If the goal is to increase the thickness of the tissue, the surgeon may make a small incision and place a bit or sterile, hard plastic into the tissue.

If the goal of the surgery is strictly tissue removal, this form of treatment will only be provided at a hospital, and you will require anesthesia. After treatment, there is a chance that you will experience pain of the throat for seven to fourteen days. Finally, pediatric patients may benefit from tonsil removal, which is a common and standard surgery.


What is Sleep Apnea and How Does It Impact Health


Written by Dr. Welsh, Published on 27 July 2014

What Is Sleep Apnea?

Sleep Apnea is a relatively common medical condition which is characterized by shallow breathing or pauses in breathing during sleep. Different patients experience this condition for different reasons, and also to different severity. Some patients only stop breathing for a few seconds, while other may stop breathing for a few minutes, and actually shock themselves awake with a choking or snorting response which leads them to gasp for air. In extreme cases, breathing may stop thirty times in an hour, or even more.

For most patients, Sleep Apnea is a chronic condition which has a devastating effect upon sleep quality. This is because changes in breathing pattern alter sleeping patterns as well. In order to get a good night's sleep, we need to spend a certain length of time in deep sleep, and sleep apnea causes patients to experience reduced sleep quality, owing to reduced time spent in deep sleep.

Because sleep apnea inhibits sleep quality, one of the most common symptoms is daytime fatigue and exhaustion, because the body never recovers its sleep debt, no matter how long that the patient remains asleep.

Why Is Sleep Apnea Bad?

Sleep Apnea is a major problem, not only for its impact on sleep quality, but because it is one of the most commonly undiagnosed disorders, because it occurs as one sleeps, and many patients don't even realize they suffer from the condition. There is also no way to diagnose sleep apnea via blood testing, and the condition cannot be diagnosed through a normal doctor's appointment. Often, it is not the patient that recognizes his or her sleep apnea, but a sleeping partner, member of the family, or roommate.

Although Sleep Apnea has many causes, most patients with this condition suffer from obstructive sleep apnea. In the case of this obstructive sleep apnea, airways shrink or temporarily close during sleep, which leads to pauses in breathing, or breathing which is too shallow to meet the needs of the sleeping patient.

Snoring Most Common Symptom of Sleep Apnea

Because of this blockage, one of the most recognizable symptoms of sleep apnea is heavy snoring. Because the airway is partially blocked, the air reacts with flaps in the nose and throat, making the signature sound. This condition can occur to anyone, but patients that are obese or overweight are most likely to experience the condition.

A minority of sleep apnea patients suffer from central sleep apnea. This is a sleep-breathing disorder caused by miscalibrated signaling from the brain. The part of the brain which is in control of breathing malfunctions during sleep, leading to pauses in breathing. Most commonly, this condition is a symptom of other conditions, or the use of particular medications. These patients also rarely experience snoring.

What Are Common Risks Associated with Sleep Apnea?

  • Elevated Risk of Wrecks and Workplace Accidents resulting from exhaustion

  • Abnormal Heartbeat

  • Human Growth Hormone Deficiency

  • Testosterone Deficiency

  • Elevated Risk of Heart Failure and Cardiovascular Disease

  • Elevated Risk of Diabetes, Obesity, Stroke, Heart Attack, and Hypertension

  • Elevated Cortisol Level

What Are the Causes of Sleep Apnea?

The reason why Sleep Apnea can't be diagnosed in a normal doctor's visit is because breathing works differently while we are awake. For example, the throat muscles remain firm, leaving the airway unimpeded from the nose and mouth to the lungs. After you fall asleep, the muscles become more relaxed, which shrinks the airway. Also, while we are awake, we can consciously regulate breathing to an extent, whereas, while we sleep, the brain self-regulates breathing.

There are a number of physiological issues that can lead to Obstructive Sleep Apnea:

  • Aging increases the risk of sleep apnea, as the subconscious brain sometimes weakens its signal to keep throat muscles tight

  • Some patients have bone structures in the neck and head which naturally restrict airways

  • Obesity can cause sleep apnea, because soft tissue puts pressure on the windpipe during sleep, leading to trouble breathing during sleep

  • Abnormally large tonsils and tongue

  • Muscles of the tongue and throat relax too much, obstructing the opening of the throat

What is the Direct Physiological Effect of Sleep Apnea?

Because sleep apnea obstructs breathing, the lungs don't absorb enough oxygen, which leads to oxygen deprivation. The reason why patients wake up abruptly is because, when oxygen levels in the blood drop below a certain concentration, it causes the brain to signal the sleeping patient to awake in order to restore oxygen flow. The body responds to this signal by suddenly tightening muscles in the mouth and throat.

Because the body isn't getting enough oxygen during sleep, this vastly increases the risk of cardiovascular issues, including arrhythmia, stroke, heart attack, and hypertension. It also triggers the release of fight-or-flight hormones such as cortisol, which can cause adrenal fatigue, as the body is producing an exceptionally high level of stress hormones. This also saps the body of resources necessary to produce sex hormones such as Testosterone and Estrogen, as well as Human Growth Hormone, which impedes health and wellness and can accelerate issues associated with aging.

Sleep Apnea also has a depressant effect upon metabolism, which causes the patient to be more likely to gain weight, and also increases the risk of diabetes. Often, patients with obesity actually suffer from the condition largely because of their underlying sleep apnea, which in turn causes sleep apnea to exacerbate.

What Individuals Are Most Likely to Experience Sleep Apnea?

  • Around 50% of patients with sleep apnea are overweight or obese

  • Both women and men experience sleep apnea, but men are at an elevated risk

  • Risk of sleep apnea increases with age

  • Heredity plays a role in sleep apnea

  • Some individuals have airway structures that naturally lead them to be predisposed to sleep apnea

  • Smokers are more likely to experience sleep apnea

What are the Symptoms of Sleep Apnea

The most noticeable symptom of sleep apnea is chronic snoring. Because airways are partially or completely blocked, this leads to loud snoring, and also may lead the patient to become shocked awake resulting from lack of oxygen.

The amplitude of snoring associated with sleep apnea is often dependent upon the manner in which the patient is laying. Generally, snoring is most obtrusive when sleeping on one's back, and is less of an issue when one sleeps on his or her side. This snoring may also not occur every night, and may be loudest with the patient is excessively fatigued and exhausted. Snoring associated with sleep apnea becomes worse over time for some patients.

Although snoring is one of the characteristic symptoms of sleep apnea, many patients suffer from the condition without experiencing sleepiness.

Another symptom of sleep apnea is daytime sleepiness. This fatigue can be so severe that it impacts one's ability to drive or work. Individuals with sleep apnea often find it very easy to fall asleep any time there is a lull in activity, without regard to how long that they slept the night before.

Other common symptoms related to sleep apnea include:

  • Sore throat upon waking

  • Dry mouth in the morning

  • Frequent need to urinate throughout the night

  • Personality issues, including mood swings, depression, and irritability

  • Issues with focus and concentration

  • AM Headaches

Pediatric sleep apnea patients often experience the following symptoms:

  • Irritability

  • Anger

  • Issues with academic performance

  • Tendency to breath through one's mouth


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If your doctor only prescribes testosterone by itself, you will probably have a rough ride. The tendency is for you to feel great the first couple months, while you increase testosterone levels, followed by a slow deterioration, once your estrogen creeps up.

High estrogen negates a lot of the positives from testosterone therapy, resulting in the same symptoms of low testosterone you had in the first place!

The solution is to add a drug called Arimidex. It's called an aromatase inhibitor, which essentially blocks the conversion of testosterone to estrogen. It has the effect of increasing testosterone levels, while keeping your estrogen low.

Once you have your testosterone and estrogen solved, it's time to stop the next inevitable decline? Shrinking testicles.

This is where HCG (human chorionic gonadotropin) comes in. It prevents both infertility and testicle shrinkage. Your testicles shrink because your body thinks it doesn't need to make testosterone anymore.

For some, small testicles may seem like just a cosmetic problem. But HGC does more than increase testicle size, it also increases adrenal function, which can have positive effects on well-being, libido, and energy.





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