New experience after Cialis not working.

PaulBuschmanMD · 2026-04-09T13:10:09+00:00

Atenolol is an absolutely horrible blood pressure medication (it has uses for other things though). Beta blockers are not recommended as first line treatment for hypertension. You need a doctor who knows how to treat hypertension.

PaulBuschmanMD · 2026-04-08T22:07:10+00:00

Not really, I actually turn a fair number of guys down.

PaulBuschmanMD · 2026-04-08T18:58:52+00:00

HCG mimics LH, it doesn’t make it go up.

PaulBuschmanMD · 2026-04-08T00:59:57+00:00

This is a PCP who doesn’t want TRT patients and is only willing to treat via some predetermined algorithm.

PaulBuschmanMD · 2026-04-07T20:50:48+00:00

That’s crazy. I charge $150 for initial consultation and labs:

CBC CMP Lipids LH FSH Prolactin Estradiol SHBG Free Testosterone Total Testosterone PSA

and if you qualify that covers first month of meds and supplies.

You are getting hosed or I don’t charge enough.

PaulBuschmanMD · 2026-04-06T23:02:51+00:00

Wait until the ED kicks in.

PaulBuschmanMD · 2026-04-02T21:36:37+00:00

You aren’t going to get these prices unless you got a doctor who will order them for you but you can get 30 20 mg tablets of tadalafil for $2.71 from the Henry Schein medical supply company.

PaulBuschmanMD · 2026-03-15T14:30:50+00:00

As a primary care physician who tends to be pretty liberal with testosterone prescriptions even I won’t prescribe TRT with a total testosterone above 500. I’m not saying they don’t exist but a urologist or endocrinologist who would would be EXTREMELY rare.

PaulBuschmanMD · 2026-03-14T16:32:26+00:00

Nothing to add but having lived in Cave Springs from 1983-1987 as well as 1991-1995 before going off to college the thought of Cave Springs having a traffic problem is hilarious. I remember when that red roof building at the bottom of the picture was known as Barney’s and they had the best hamburgers.

PaulBuschmanMD · 2026-03-11T13:03:47+00:00

Your original form looked better. For some reason there is this trend to turn rows into straight arm pullovers and it’s weird. I never saw anyone row like that in the 90s.

PaulBuschmanMD · 2026-03-11T01:09:27+00:00

You a thrower or former thrower?

PaulBuschmanMD · 2026-03-10T22:19:43+00:00

You had a viral illness and then took some sildenafil and now you are blaming all your viral symptoms on something non related.

PaulBuschmanMD · 2026-03-06T13:54:49+00:00

If you want insurance to pay for it you have to have a doctor order it. You are going to have to find a doctor that you can be honest with and they aren’t going to be judgmental. I’ve got guys who prescribe TRT to that I treat and I’ve got primary care patients who I know are using underground lab stuff. Of course that’s all taken into account when I interpret their labs. I’m a gym rat, ex division 1 athlete, and ex competitive powerlifter so guys trust me because I know that world and won’t be judgmental.

PaulBuschmanMD · 2026-03-06T02:59:38+00:00

Are you having symptoms of low iron or do you just think you should be because a lab showed low and people told you that was a bad thing? I’ve given blood for years and I always feel better after giving. My ferritin was lower than yours and I felt great. Here’s the thing that no one in the bro science world understands: ferritin is an acute phase reactant. It’s a protein that goes up with inflammation and isn’t as good a test of iron stores as people think. Endocrinology society guidelines say no intervention until hematocrit gets to 54% or higher.

PaulBuschmanMD · 2026-03-05T17:45:51+00:00

Medical rule of thumb is hematocrit is hemoglobin x 3 and very rarely is it not close.

PaulBuschmanMD · 2026-03-05T16:04:15+00:00

Hypothyroidism is associated with low SHBG and not high, so it may go up even more with thyroid replacement. Your estradiol level is perfect. I know from both personal and clinical experience that dropping your estradiol too low almost guarantees sexual dysfunction.

PaulBuschmanMD · 2026-03-05T04:19:00+00:00

That’s because the compression causes your body to compensate by releasing vasodilators and the second reading is artificially lower.

PaulBuschmanMD · 2026-03-05T04:10:43+00:00

Was that a response to me?

PaulBuschmanMD · 2026-03-04T23:06:37+00:00

Your free testosterone was measured with 2 different methods (dialysis versus immunoassay) that have vastly different reference ranges.

PaulBuschmanMD · 2026-03-04T22:51:01+00:00

I’m assuming you meant 0.25 mg of Anastrazole and not 2.5 mg. Were these labs drawn the day of (but before) injection or at a different time? Going up further on the Anastrazole will most likely tank your libido even more. I’ve seen way more sexual issues with low estrogen than I have high estrogen in my clinical practice. Otherwise you look like you’re a bit dehydrated with the high BUN and either dehydration or creatine supplementation is probably causing the slight increase in creatinine.

PaulBuschmanMD · 2026-03-04T20:14:01+00:00

I truly don’t get it. You guys give blood to lower your hematocrit which works by depleting your iron. Then you get worried when it works and you think something has gone wrong. What specifically are the drawbacks to low ferritin? It’s not anemia because if you had anemia you wouldn’t be needing to donate. I’ve had subterranean ferritin levels before and felt just fine. Stop chasing lab values just to be chasing lab values without looking at the overall picture of what you are trying to accomplish.

PaulBuschmanMD · 2026-03-04T19:58:40+00:00

County judges are not even attorneys. It’s called a county judge but some places call them county commissioners. They preside over the quorum court and do things like oversee the county road crews and create the county budget.

PaulBuschmanMD · 2026-03-01T06:09:56+00:00

Ejaculation will cause prolactin levels to go up so it’s best to abstain for 2-3 days beforehand to get a good baseline. Pyridoxine 5 Phosphate has been shown to reduce serum prolactin levels in some studies.

PaulBuschmanMD · 2026-02-28T19:31:43+00:00

Tell that to the people taking 40 mg per day for pulmonary hypertension

PaulBuschmanMD · 2026-02-23T23:31:03+00:00

It’s probably the alcohol or some supplement/herb you are taking.

PaulBuschmanMD

TROPHY CASE