Desmosterol elevation may be beneficial, reconsider Clomiphene for Low T?
Hi Peter, fellow physician and new member here, congratulations on your book and the impact you are making in peoples lives. You book is not only extremely empowering for individuals, but hopefully can also be a call to arms for medicine to move toward your 3.0 vision. After 30 years of practice I shared much of your disillusionment with the traditional practice of medicine, kudos to you for seeing it so early in your career. OK, now for my question about Clomiphene: In spite of the Triparanol experience, there is recent research that suggests that some elevation of Desmosterol may be beneficial through its activation of Liver X Receptors (LXR's). As you have stated, new drugs for ASVD need to prove that they effect EVENTS rather than just lab numbers. It seems that you removed Clomiphene from your toolbox because of possible ASCVD risk, based on a lab value rather than more solid evidence such as a documented increase in events. If the effect of Clomiphene induced elevation of Desmosterol is uncertain at best, do you think it is unreasonable to consider its use for age related low T? Would your opinion change for a 40 yo VS a 65 yo? For people with low vs high ASCVD risk? Thank you in advance for your time.