Type of Specialist to See for Hormonal
Hello- I listened to “the role of testosterone in males and females…” podcast, I am a female, age 45 with apparently normal levels of estradiol. I know my primary care provider knows next to nothing about hormones and how they may affect various QoL measurements. When I asked to test my hormones, she only ordered estradiol. Nothing else. So my question is, who/what type of specialty provider would I want to see who would have a high level of expertise into hormone replacement (beyond use just for menopause/treating “hot flashes which I don’t have). An endocrinologist? Gynecologist? Im just looking to be pointed in the general right direction. Thank you.
Testosterone Levels by age
In podcast #291 you talk about a T level of 381 being low at 50 years old. Yet there was a lot of discussion around basically is one showing any symptoms of low T....i.e. is it really a problem. What would be the expected level at 50 ? And for that matter for 30, 40, 50, 60, 70 etc. In otherwords what are the markers you use to guide discussion on TRT in males in your practice?
Adverse effect of lp(a) increase vs. LDL decrease after statin therapy
There are several papers (see the link below for one) that describe a significant increase in lp(a) levels in patients treated with statins to lower overall cholesterol. As both the podcast as also several studies report that lp(a) is a significant risk factor, I am wondering what Peter's opinion is on this. Sotirios Tsimikas, Philip L S M Gordts, Chelsea Nora, Calvin Yeang, Joseph L Witztum, Statin therapy increases lipoprotein(a) levels, European Heart Journal, Volume 41, Issue 24, 21 June 2020, Pages 2275–2284, https://doi.org/10.1093/eurheartj/ehz310
Low Dose Naltrexone
What are your thoughts about using LDN for an autoimmune inflammation response. I recently, had two retinal detachment surgeries 5/23 and 8/23…The later with a Scleral Buckle to hold the retina. I have since, in the last 6 months develped orbital muscle inflammation. I do not want to treat systemically with pulse steriod IV or the other suggested IV drug infusions. All blood tests for any other reason for the inflammation have been negative. Would love if you can weigh in understanding that you do not have all the information,
Coronary artery calcification from very vigorous exercise
What do you make of recent research concluding that very vigorous exercise can cause coronary artery calcification? I am 53 and was recently found I have a calcification score 114 which is 87%tile and an estimated arterial age of 74. I tend to want to push myself with running and extreme exercise. How should I think about this, eg with a muscular build BMI seems inaccurate for me, is coronary calcification score in the same status as a generally applicable risk factor but not for practitioners of very vigorous exercise? Or should I just commit to moderation in exercise?