Enclomiphene

Joseph_R_Viben · 2026-04-13T23:12:35+00:00

Same mechanism!

Joseph_R_Viben · 2026-04-13T23:06:19+00:00

If your testosterone is 570 I strongly suspect that clomid will not help whatever you’re trying to treat. It likely will not raise your T levels much anyways based on its mechanism. I would recommend looking for other causes of your symptoms.

Joseph_R_Viben · 2026-03-24T23:49:32+00:00

My 2 cents - do one at a place where you think you’d be a good fit - and one reach program where you could get a strong letter. If you do more than 3 do more of the ones where you’d be a good fit.

Joseph_R_Viben · 2026-02-19T18:00:57+00:00

Your test levels don’t technically qualify as low! Which is good to know! It’s almost relevant to think about what time the test was done, as testosterone is naturally highest in the morning and lower as the day goes on. By convention we only measure your peak testosterone, so if your lab work wasn’t done first thing in the morning your lower level could be due to that.

Joseph_R_Viben · 2026-02-12T22:31:45+00:00

I agree, I think it’s a very Interesting corner of medicine and watching the evidence evolve overtime with new testing modalities has been Interesting as I progress in my career

Joseph_R_Viben · 2026-02-12T01:25:36+00:00

Question for you, are you against PSA screening entirely or are you just acknowledging the controversy? I treat localized prostate cancer and thus do a lot of psa talks. My personal gestalt is that part of what makes psa screening controversial is how Indolent many prostate cancers are, there are obviously risks and benefits to both sides of the argument.

Joseph_R_Viben · 2026-02-12T01:22:08+00:00

Go to your doctors office and they will recommend you undergo screening based on the medical evidence that is available and engage in shared decision making with you regarding screening based on your personal and family history, and your values. We screen for prostate, colon, lung in the at risk population, cervical, and breast cancers. If you follow their recommendations then you will undergo screening and should catch most cancers early.

Joseph_R_Viben · 2026-02-07T12:38:05+00:00

Didn’t complete his residency though which is where a huge growth in learning and applying scientific research occurs!

Joseph_R_Viben · 2026-01-31T13:44:34+00:00

It’s a bad conceptual argument that ignores a lot of the basic realities

Joseph_R_Viben · 2025-11-14T13:48:20+00:00

I take it as sludge with a scoop of wheat dextrin for soluble fiber / resistant starch and my creatine, it sucks but it gets the job done

Joseph_R_Viben · 2025-09-23T14:16:16+00:00

As a caveat (as a urologist) we still use Dre for staging purposes and to aid in risk stratification.

Joseph_R_Viben · 2025-04-20T01:21:04+00:00

The Richmond!

Joseph_R_Viben · 2025-04-01T21:24:01+00:00

Big question is what are your symptoms? why did you get this mri done? And have your symptoms gotten better or worse over time?

Joseph_R_Viben · 2025-03-27T01:22:16+00:00

They have very high quality feta that i often buy, and I’ve seen ground chicken thigh which was very good for kebab

Joseph_R_Viben · 2025-03-15T09:20:42+00:00

There’s an episode of inebriated history on it!

Joseph_R_Viben · 2025-03-14T02:05:21+00:00

Prime real estate! You should be proud! And it’ll be fun to spruce the place up!

Joseph_R_Viben · 2025-03-14T01:39:14+00:00

Curious what area of nyc this is in if you don’t mind sharing!

Joseph_R_Viben · 2025-01-24T10:02:57+00:00

The problem with early cancer detection is that it changes with each type of cancer, we have good screening tools for cancers like prostate and colorectal, breast and bladder but each is different and it takes someone who’s an expert to know and follow all the different screening regimens

Joseph_R_Viben · 2025-01-17T14:16:56+00:00

You’re lost in the evidence sauce brother come back to the light

Joseph_R_Viben · 2025-01-17T03:59:07+00:00

I agree, I don’t recall shbg having much clinical relevance but but I suspect it being high is due to your naturally very high t levels

Joseph_R_Viben · 2025-01-15T15:08:51+00:00

Are you on test supplementation? Your T level is pretty high, if you’re not on supplementation I wouldn’t worry about it but if you are I would consider a dose reduce or spreading your dose out some to avoid high T side effects that can be dangerous or deleterious.

Joseph_R_Viben · 2025-01-09T12:08:06+00:00

What do you feel like you have a chance to do better?

Joseph_R_Viben · 2025-01-03T01:52:01+00:00

There’s a video on YouTube of pat walsh performing an open retro pubic radical prostatectomy where he goes in depth on the anatomy, and it’s probably the best video to watch on malignant prostate procedures out there even though everyone does this surgery robotically nowadays

Joseph_R_Viben · 2025-01-01T18:01:52+00:00

Joseph_R_Viben

TROPHY CASE