"Gross data mismanagement" led to unreliable results that contradicted 30+ years of medical literature, producing a media frenzy that misled consumers and compromised public health

Three professional medical societies and a highly distinguished international group of over 130 scientists and concerned physicians have petitioned the Journal of the American Medical Association to retract the article that precipitated recent concerns regarding cardiovascular risks with testosterone therapy. In a letter addressed to the editor-in-chief of JAMA, Dr. Howard Bauchner, the group cites "gross data mismanagement," rendering the article "no longer credible." The article by Rebecca Vigen and colleagues was published in the November 13, 2013 issue of JAMA, entitled "Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels."

Nelson Vergel asks for change in testosterone guidelines after another negative study

A new study published last week and a previous one from the Veterans Administration Hospital System (see below post) show what happens when older men are given testosterone replacement without managing potential blood level increases of factors that can affect their health.

Testosterone replacement can increase red blood cell (and hematocrit which is the total red cell volume) and estradiol production, two important factors for men's health when present in normal levels (red blood cells carry oxygen and estradiol maintains healthy bones, cognitive function and sex drive). However, due to genetic, age or other factors some men can have excessive production of both. High hematocrit and estradiol are more common in older men on testosterone since testosterone related aromatization and erythrocytosis are worse in that population. In excess, both variables have been linked to cardiovascular risks in older men. Not a single one of studies reporting higher cardiovascular risks in men on testosterone have managed either important factor.

Tri-Amino is an injectable amino acid combination which contains three nitric oxide producing agents; L-Arginine, L-Citrulline, and L-Ornithine.  Together these ingredients potentiate blood flow by increasing nitric oxide.  Congestive heart failure, heart disease, peripheral vascular disease, migraines and other diseases may be improved by supplementation with L-arginine to increase Nitric Oxide.  

Arginine is a chemical precursor to nitric oxide (a blood vessel-widening agent called a vasodilator). Early evidence suggests that arginine may help treat medical conditions that improve with increased vasodilation. These conditions include chest pain, atherosclerosis (clogged arteries), heart disease or failure, erectile dysfunction, intermittent claudication/peripheral vascular disease, and vascular headaches.  L-arginine is converted in the body into a chemical called nitric oxide. Nitric oxide causes blood vessels to open wider for improved blood flow. L-arginine also stimulates the release of growth hormone, insulin, and other substances in the body.

SAN FRANCISCO -- Men with chronic pain and opioid-induced androgen deficiency may find some pain relief with testosterone replacement therapy, a small trial suggested.

Although 14 weeks of testosterone did not affect the men's perception of their pain, which was the primary endpoint, the treatment significantly improved objective responses to painful stimuli in a laboratory setting, according to Shehzad Basaria, MD, of Brigham and Women's Hospital in Boston.

At the Endocrine Society meeting here, where Basaria presented the results, he said that the lack of clinical benefit accompanied by changes in objective responses is consistent with prior studies.

Being able to detect the beginning stages of hair loss by understanding its causes can be important for successful prevention or intervention. Unfortunately hair loss can affect people at any point in their life, sometimes beginning in their 20s. According to the Mayo Clinic, the most common cause of hair loss is a hereditary condition called male pattern baldness and female pattern baldness. The genetic predisposition causes the person to be more sensitive to specific sex hormones which trigger hair loss. The sensitivity to hormones cases the hair follicles to shrink which leads to thinning hair and eventual loss of hair. The medical term for this type of hair loss is called “androgenetic alopecia”. Androgen is a generic term for certain sex-hormones, testosterone being the most well-known. Another hormone related cause of hair loss can result from thyroid disorder.

Defy Medical consulted our pharmacy consultant to develop MIC-Lipo capsules based on our observation of current weight-loss protocols which include MIC-Lipo injections. MIC is short for Methionine, Inositol, and Choline. These three nutrients together are called “lipotropic”. Lipotropic nutrients play an important role in the breakdown and metabolism of fat in the body. These compounds enhance the liver and gallbladders role by decreasing fat deposits and speeding up metabolism of fat and its removal. Lipotropic nutrients are also used to maintain a healthy liver. Medical clinics which specialize in lipotropic nutrients can create a specific formula, also known as MIC Combo, which has proven to be an effective aid in total fat loss. Methionine, Inositol, and Choline are the three ingredients which form MIC. MIC is the foundational ingredient within our MIC-Lipo Capsules. MIC-Lipo has been shown to significantly assist patients in fat loss that are eating a low calorie diet.

One of our favorite vendors of high quality nutritional supplements now produces a protein supplement. This delicious protein power now available in natural chocolate is an excellent supplement for elimination diets. With all essential vitamins and minerals, Metabolic Detox Complete meets nutritional needs during detoxification. We have also found it to have sufficient amounts of protein to help build muscle when used as a protein supplement.

Metabolic Detox Complete provides hypoallergenic pea, rice, and hemp proteins, as well as vitamins, minerals, amino-acids, and other nutrients to support detoxification and muscle support.

An excellent protein supplement for comprehensive detoxification programs and elimination diets, Metabolic Detox Complete provides a well-rounded macro- and micronutrient base. It contains a hypoallergenic blend of pea, rice and hemp proteins, beneficial medium chain triglycerides, and omega 3 fatty acids. Metabolic Detox Complete also includes a balanced combination of vitamins, minerals, essential amino acids and other beneficial nutrient cofactors to simplify and support both detoxification and the support of muscle tissue.


1.05KG (21 SERVINGS)


Available in both natural Vanilla and Chocolate


As a protein supplement used along with either a detoxification diet or a strenuous exercise program


wheat, gluten, egg, dairy, soy protein, corn protein, yeast, nuts, artificial sweeteners, colors, or preservatives.


  • Elimination Diets
  • Detoxification
  • Allergies
  • Leaky Gut Syndrome
  • Chronic Fatigue

Information for Athletes

  • Each serving Contains 21g of protein with 1000mg L-Glutamine
  • Each serving contains ingredients which maintain liver health and metabolic function.  These ingredients include N-Acetylcysteine, Silymarin, MIC, in a ration designed to detoxify the liver
  • Each serving contains Medium Chain Triglycerides and Omega-3 fatty acids
  • Hemp protein is plant-based, but it nonetheless contains all eight essential amino acids. Along with protein, hemp powders usually have fiber, omega 3 and omega 6 fatty acids, and other vitamins and minerals naturally found in the plant. Most brands have between 13 to 15 g of protein in 2 tablespoons. Hemp protein provides ample calories and other beneficial nutrients, along with protein
  • Both hemp and whey protein are great sources of the branched-chain amino acids. These proteins are of particular interest if you are trying to build muscle and support continuous training. Branched-chain amino acids are stored in your muscle tissue and serve as immediate fuel for heavy exercise. Along with some carbohydrate, branched-chain amino acids are arguably the most important ingredients in an exercise recovery drink. 
  • Hemp Protein can be purchased in powered form from most health food stores if you are interested in purchasing it by itself.  We have spoken to competitive athletes who have used both whey and hemp (separately) and all of them found hemp to be superior for use in protein shakes due to its high fiber, high amino acid absorption, and soluability. 
  • We suggest adding 5g-10g of pure L-Glutamine post training and 1cc-3cc Tri-Amino prior to a strenuous or competitive event. 

25% Discount when purchased at Defy Medical

These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.

Diindolylmethane (DIM) is a stable indole found in cruciferous vegetables which promotes a beneficial estrogen metabolism in both women and men.  Post-menopausal women that take hormone replacement therapy can improve their estrogen metabolism with DIM. Among the other benefits DIM gives women is a lower chance of weight gain and maintain uterine, cervical breast health while decre asing the chances of cancer.

Supplementing your diet with DIM specifically promotes beneficial estrogen metabolism and helps restore a healthy hormonal balance.

An open label study of DIM in overweight men and women showed it promoted more efficient weight loss and more active fat metabolism.

Metabolic Detox is a product designed to support the liver in detoxification processes. We combine the classic liver botanical Silymarin with antioxidants N-Acetyl Cysteine (NAC), Alpha Lipoic Acid and Selenium.

Medical providers at Defy Medical suggest Metabolic Detox when liver enzymes are elevated.  Elevated liver enzymes may be a sign of a more serious medical problem and can lead to liver damage.  As our medical team continues to monitor each patient’s blood work we have found that Metabolic Detox plays an important role in restoring liver health.  Of course, in addition to the detoxification provided by Metabolic Detox, we must identify and treat the cause. 

Defy Medical offers Adrenal Tea Capsules which are formulated at a specialty pharmacy which focuses on natural compounds, herbs, and nutritional formulas. Each batch is tested for quality and potency under the same standards as pharmaceutical medications. This formula is made by a pharmacy exclusively for medical doctors who focus on fatigue, stress, and adrenal function.

How Supplied: 

Adrenal Tea capsules costs $40 for 120 capsules.  Each capsule is made per order at a specialty pharmacy and will ship directly to you.  Adrenal Tea is only available at our pharmacy. 

How to Take : 

Take 2 capsules twice per day.  Preferably upon waking up and again after lunch. 


Improve energy, assist adrenal function, Reduce stress hormones, Treat Insomnia


Siberian Ginseng- adaptogen used to increase resistance to the stress reaction that occurs by improving the sensitivity of the HPA axis to cortisol. It is reported to have the ability to stimulate the immune and circulatory systems, regulate blood pressure, reduce inflammation, treat insomnia, and increase stamina.

Vitamin D-3

Vitamin D is the name given to a vitally important group of micro-nutrients. When activated, vitamin D becomes a potent steroid hormone by switching our genes on or off and instructing our cells where they are needed within the body. Vitamin D's effects are varied and profound. It has a similar structure to steroids such as testosterone, cholesterol, and cortisol (though vitamin D3 itself is a secosteroid). The term "vitamin D" refers to several different forms of this vitamin. Two forms are important in humans: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet-B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3, although humans should not rely on synthetic food fortification as a good source of Vitamin D3.

Glycine is one of the non-essential amino acids and is used to help create muscle tissue and convert glucose into energy. It is also essential to maintaining healthy central nervous and digestive systems, and has recently been shown to provide protection via antioxidants from some types of cancer.

Glycine is used in the body to help construct normal DNA and RNA strands—the genetic material needed for proper cellular function and formation. It helps prevent the breakdown of muscle by boosting the body’s levels of creatine, a compound that helps build muscle mass. High concentrations of  glycine are found not only in the muscles, but in the skin and other connective tissues as well. Almost 1/3 of collagen, which keeps the skin and connective tissue firm and flexible, is composed of glycine. (High amounts of Glycine are also found in gelatin, which is a form of denatured collagen). Without glycine the body would not be able to repair damaged tissues; the skin would become slack as it succumbed to UV rays, oxidation, and free radical damage, and wounds would never heal.

L-Glutamine- Glutamine is the most abundant amino acid in the bloodstream. It is most notable for its healing properties to the gastrointestinal tract and is helpful with ulcers, IBS, and gluten sensitivities.* Elevated cortisol levels from trauma (wounds, burns, surgeries) can deplete glutamine levels. In solution L-Glutamine is virtually tasteless. Glutamine is considered “anti-catabolic “which means it can help your body maintain muscle under stress or disease. Athletes use Glutamine for this purpose, to help muscles recover from exercise and to prevent the loss of muscle while dieting. Some people use glutamine for digestive system conditions such as stomach ulcers, ulcerative colitis, and Crohn’s disease.

Ever since human growth hormone (HGH) was first titled The Fountain of Youth, researchers have
studied the phenomenon that occurs when a hormonally deficient person is given physiological doses,
and seems to rapidly decrease in biological age.

It wasn't until 1997 that growth hormone deficiency was recognized as a clinical syndrome.
"Growth hormone deficiency is now formally recognized as a specific clinical syndrome, typified by
decreased muscle mass, increased body fat, decreased exercise capacity, osteopenia, abnormal lipid
profiles and diminished feeling of well being…"
(Inzucchi, Silvo; Hospital Practice, Jan. 15,1997).

We are all aware of the popularity Human Growth hormone has gained over the last few years.  Everyone from athletes to celebrities and now some of us ‘regular folk’ have enjoyed the tremendous benefits of this powerful hormone.  Human Growth Hormone is produced by the Pituitary Gland and is a very complex molecule. It promotes growth in children and plays an important role in adult metabolism. The body secretes the hormone, in decreasing amounts, throughout our lifetimes. The amount of HGH hormone in the body can be measured by levels of IGF-1 (Insulin Growth Factor). Growth hormone has a profound effect on all the cells of the body, more than any other hormone because it is THE cell generator. It is the "master hormone" controlling many organs and body functions and is directly responsible for stimulating tissue repair, cell replacement, brain functions, and enzyme function.

The most common forms of injectable testosterone include Testosterone Cypionate, Testosterone Propionate, and Testosterone Enanthate…or a 'blend' of some sort. I do not like testosterone "blends" do to irregular release patterns. Always remember that each of these forms is simply testosterone, the molecule remains unchanged, and the only difference is the "ester" which determines the half-life within the body. An 'ester' is basically a chain composed of Hydrogen, Carbon, and Oxygen atoms which are attached to the testosterone molecule which must be broken down creating a 'timed release" in the body once injected. Even though the testosterone molecule remains the same no matter the ester, each one can yield different results in patients.


“The Hormone of Love”

Preparation: Nasal-Spray 50 units/ML; 5ML Vial

Oxytocin and Sex

  • Sex stimulates the release of Oxytocin in humans
  • It is a neurohormone responsible for initiating childbirth and is released during sexual orgasm
  • Research has shown in non-human mammals that Oxytocin plays a key role in the initiation of maternal behavior and the formation of adult pair bonds
  • Social stimuli may induce the release of Oxytocin making positive social interactions more rewarding
  • Studies show that people who maintained Oxytocin levels during negative emotions were less likely to report interpersonal problems

ExcelMale.com Debunks Misleading Testosterone Study

A restrospective study published this week on the Journal of American Medical Association concluded that testosterone may increase the risk of cardiovascular problems in men with a history of heart disease. This study performed at the Venteran’s Administration hospital sysmtem cautioned that men with pre-existing cardiovascular ailments who have low blood levels of testosterone (hypogonadism) might need to avoid testosterone replacement therapy (TRT) even if they need it to improve their lives.

Vitamin C shows promise as cancer therapy

Intravenous vitamin C – combined with conventional chemotherapy – can kill cancer cells, the University of Kansas Medical Center reported.

In a study of 27 patients newly diagnosed with stage 3 or stage 4 ovarian cancer, researchers found that patients who received a high-dose of intravenous vitamin C, along with conventional cancer therapy of paclitaxel or carboplatin, experienced fewer toxic effects from the chemotherapy drugs.

The media was again splattered with bad news about testosterone therapy this week. On Wednesday, Jan. 29, 2014, Finkle and colleagues published a study in the journalPlos One that exhibited an increased risk of heart attacks in testosterone users in the first 90 days of therapy, and the risk was higher in men who had had a history of cardiovascular disease. There are many problems with the data in this study and others like it that have lead to attention-grabbing headlines about how treatment of low testosterone levels may put men at undue risk. Similar to a November 2013JAMA study of testosterone risks that I reviewed in a prior post, this current study has multiple flaws that make its conclusions essentially meaningless. Neither study assessed testosterone levels of patients before and during therapy. There are other critical blood tests that should be done that were not being done during the treatment of the VA men or in the current study, including blood counts and estrogen levels. Higher red blood cell counts and higher estrogen levels are known issues that may occur in men given testosterone therapy. Without assessment of testosterone levels, red blood cell counts and estrogen levels prior to and during therapy, it is impossible to tell if a patient is a proper candidate for therapy and if they are tolerating the therapy well.

A published review of studies attempted to determine, from published studies, the time-course of the effects induced by testosterone replacement therapy from their first manifestation until maximum effects are attained.

This review found that:

  • Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, no further increments beyond. 
  • Changes in erections/ejaculations may require up to 6 months. 
  • Effects on quality of life manifest within 3-4 weeks, but maximum benefits take longer. 

Building on the work of the late John Myers, MD, the author has used an intravenous vitamin-and-mineral formula for the treatment of a wide range of clinical conditions. The modified "Myers' cocktail," which consists of magnesium, calcium, B vitamins, and vitamin C, has been found to be effective against acute asthma attacks, migraines, fatigue (including chronic fatigue syndrome), fibromyalgia, acute muscle spasm, upper respiratory tract infections, chronic sinusitis, seasonal allergic rhinitis, cardiovascular disease, and other disorders.

Two very different recent papers come to a similar conclusion: cyclical, physiologic hormone replacement therapy (HRT) may aid memory in postmenopausal women.

One paper found native progesterone, as it is in its natural state cycling the body, helps memory early post-menopause. The other paper found cyclic, physiologic, administered estrogen helps memory after induced menopause.

“Together these results point toward the importance of maintaining hypothalamic-pituitary-gonadal (reproductive system) hormone balance for optimal cognitive performance,” says Wisconsin Alzheimer’s Institute Research Director Craig Atwood, uninvolved in the studies.


A Safe Way To Increase Testosterone

Most of us are familiar with the functions of testosterone. Increased libido, mood regulation and feelings of well-being, increased muscle tissue, high bone density, and the prevention of unwanted body fat are just a few of testosterone's responsibilities. Not to mention peak mental acuity and the prevention of heart disease! It all starts deep inside the brain with the anterior pituitary gland, which is the trigger that releases lutenizing hormone (LH) into the blood. LH then stimulates the Leydig cells in the testicles to increase testosterone production.

Last week’s Journal of American Medical Association (JAMA) published a retrospective study that was performed at the Veteran’s Administration (VA) hospital system. While it has long been known that testosterone replacement therapy (TRT) improves sexual function, bone density lean body mass, and improves lipids, this study concluded that testosterone therapy may increase the risk of cardiovascular problems in men with a history of heart disease. It cautioned that men with pre-existing cardiovascular problems and testosterone deficiency should avoid TRT. Several problems with the VA study are obvious after reviewing its data. This press release reviews each of those deficiencies.

Life Extension claims flawed testosterone analysis published in the Journal of the American Medical Association (JAMA) spurs misleading media headlines. FORT LAUDERDALE, Fla., Nov. 12, 2013 /PRNewswire/ -- The recent study, "Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels" published Nov. 5 in the Journal of the American Medical Association (JAMA), is flawed and will discourage aging men from properly restoring their testosterone levels, according to a review by Life Extension scientific and medical staff affiliated with the Fort Lauderdale, Fla.-based longevity organization.

Many males over the age of 30 suffer from low testosterone, the primary male sex hormone related to overall male health. When within normal testosterone range, males display an increase in protein synthesis and lean muscle development as well as better overall physical and psychological health. Low testosterone levels have been found to correlate with physiological disorders ranging from Cardio Vascular Disease to Type II Diabetes. Men suffering from low testosterone have even been observed to exhibit psychological symptoms such as anxiety and depression. Males over the age of 30 who suffer from low testosterone are eligible for testosterone replacement therapy, commonly known as TRT. TRT is steadily becoming a standard in treatment for males exhibiting appropriate symptoms. Though much more research is needed, current data supports the use of TRT treatment in symptomatic males over 30 to improve overall male health.

Men with low testosterone levels after age 40 have a higher risk of death over a four-year period than those with normal levels of the hormone, a new study suggests. It's not clear, however, if the two are directly related, and researchers say that it's possible a third unknown factor is responsible for both low testosterone levels and increased mortality. The study, led by Molly Shores of the VA Puget Sound Health Care System and the University of Washington, Seattle, is detailed in the current issue of Archives of Internal Medicine.

Using Sermorelin for Growth Hormone Restoration Therapy

Defy Medical restores optimal levels of Human Growth Hormone using a more effective approach. Upon review of comprehensive blood work, our practitioners determine whether you would be a candidate for Growth Hormone (GH) restoration therapy. They can combine an effective dosage of Sermorelin (Growth Hormone Releasing Hormone) and Growth Hormone Secretagogues (GHS) like Ipamorelin, with other bio-identical hormones to potentially improve overall health and longevity.

Click here to read more

Defy’s medical team also utilizes injectable amino acids and peptides to help improve results:
“Supplemental parental or enteral Arginine has been shown to stimulate secretion of GH, insulin, and prolactin in humans. Several supplement studies have shown both Arginine and Ornithine to promote GH and insulin secretion with anabolic effects in postoperative patients….because Arginine potentiates the release of pituitary hormones (GH), it can be hypothesized that the beneficial effects of pharmacological doses of the amino acid on protein synthesis, wound healing, and immune function may be mediated via a pituitary messenger such as GH.” Amino Acids and Proteins for the Athlete by Dr Mauro DiPasquale.

SAN DIEGO – Testosterone replacement therapy is not associated with an increased risk of cancer or prostate cancer in men, based on results from a large study with a mean follow-up of nearly 9 years.

"We had hoped for these results," Dr. Michael L. Eisenberg said in an interview during a poster session at the annual meeting of the American Urological Association. "Certainly people are worried about testosterone in terms of prostate cancer development."

It is that time of year again where everyone seems to be getting sick.  The first thing many people do when they first experience the symptoms of infection is to visit their doctors to seek treatment with antibiotics.  Unfortunately, many of the illnesses that spread through communities are actually viral infections which cannot be treated with antibiotics.  In addition, antibiotic medications are so prevalently prescribed that the Center for Disease Control (CDC) has issued a warning against their overuse which has resulted in antibiotic resistant “superbugs”.  More than 2 million people get antibiotic-resistant infections each year, and at least 23,000 die because current drugs no longer stop their infections.

Excerpt from the book: Testosterone: A Man’s Guide

Most men find that their sexual desire increases after they start testosterone replacement. Sexual dreams and nighttime/morning erections may be more easily achievable, but in some cases testosterone alone does not make erections strong or lasting enough for successful intercourse. So, some men need some extra help to make sure that their improved sex drive matches an improved and hard erection.

Tri-Mix Penis Injections for Strong Erections

Trimix or Quadmix

These drugs are both available by prescription from compounding pharmacies. These are mixtures of prostaglandins and papaverine that increase blood flow and retention into the penis. Prostaglandins are mediators and have a variety of strong physiological effects, such as regulating the contraction and relaxation of smooth muscle tissue. Prostaglandins are not hormones and they are not produced at one discrete site, but rather in many places throughout the human body.

Men with Low Testosterone More Likely to Die

Men with low testosterone levels after age 40 have a higher risk of death over a four-year period than those with normal levels of the hormone, a new study suggests.

It's not clear, however, if the two are directly related, and researchers say that it's possible a third unknown factor is responsible for both low testosterone levels and increased mortality.

The study, led by Molly Shores of the VA Puget Sound Health Care System and the University of Washington, Seattle, is detailed in the current issue of Archives of Internal Medicine.

Erectile dysfunction may be tied to prolonged opioid use.

The Oregonian (5/16, Muldoon, 237K) reports, "A study published online today in the journal Spine indicates erectile dysfunction may be linked to prescription painkillers known as opioids." After examining data on some 11,327 men undergoing treatment for back pain, researchers found that "long-term opioid use increased by 50 percent the likelihood of also getting an ED prescription."

The Milwaukee Journal Sentinel (5/16, Fauber, 221K) "Pulse" blog reports, "Opioid use is known to lower testosterone levels." Patients "prescribed an opioid daily dose of more than 120 milligrams of morphine equivalent were 58% more likely to be getting an ED or testosterone drug."

Male Testosterone Levels Increase When Victorious in Competition Against Rivals, but Not Friends, MU Researchers Find

COLUMBIA, Mo. – Sporting events can bring a community together, such as when the Louisville Cardinals won the NCAA championship and University of Louisville campus was filled with camaraderie. They also can fuel bitter rivalries, such as the long-standing animosity between the St. Louis Cardinals and the Chicago Cubs. A University of Missouri study has found that testosterone levels during group competition are modulated depending on the relationships among the competitors and may be related to the formation of alliances in warfare.

Now that the warmer weather has come and summer time is right around the corner, the need for sun protection is at its peak. Daily sun exposure can wreak havoc on your skin and have a cumulative effect on its appearance. Whether you get outside once a day to walk your dog or you are a sun goddess bathing in tanning oils for hours on end, the sun is damaging your skin from the moment you step outside. Sun damage is the result of constant UV exposure and limited protection against it. Sun bathing, sunburns, tanning beds, and incorrect use of sunscreen all contribute to the risk of sun damage. Dull uneven tone, freckles, dark marks, age spots and Melasma from pregnancy are all examples of visible sun damage on your skin.

Growth hormone replacement therapy (GHRT) using recombinant human growth hormone (rhGH) has been embraced by many age management practitioners as one of the most effective methods for opposing somatic senescence currently available. However, its routine use has been controversial because few clinical studies have been performed to determine the potential risks of long-term therapy. Also, certain medical and legal issues have not been resolved causing some practitioners to restrict their use of the product.

A daily dose of 1500 mg L-citrulline [structural formula shown here] rids half of the men who have a mild erection problem of this complaint. Urologists at the University of Foggia draw this conclusion from a study in which 24 men with an average age of 56 participated.

High blood pressure, reduced insulin sensitivity and deteriorating cholesterol balance can all in the long term lead to a stiffening of the blood vessels in the male penis. As a result, the penis can lose its ability to have an erection. Doctors usually deal with this problem by prescribing phosphodiesterase type-5 inhibitors, such as sildenafil.

As we reported more than a year ago in our February 2010 LMR review -- Managing Erectile Dysfunction -- When Viagra Doesn’t  -- phosphodiasterase-5 (PDE-5) inhibitors, e.g., sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), are ineffective in 30-40% of men diagnosed with erectile dysfunction (ED).  Why? Because the PDE-5 inhibitors help restore erectile function by selectively blocking normal hydrolysis of cGMP, thus promoting cGMP accumulation and partially reversing deficiencies in the NO/cGMP pathway. The key word here is “partially” since insufficient production of NO precludes the formation of sufficient cGMP to enable benefit from a PDE-5 inhibitor.