Mmmm I’m a primary care doctor and I wouldn’t worry about low T. It’s natural for it to go down with age and the data doesn’t really support TRT. A lot of guys are obsessed with their testifies, sex drive, etc. though so they ask for useless testing.

I’m not your doctor so take this all with a grain of salt since I can’t evaluate you through social media but how’s your mental health? Maybe you’re self medicating with masturbation. Probably best to follow up with your PCP.

McKenzie method for low back pain is a starting point. It’s stretching, maybe strengthening I can’t remember. Hip flexors, hamstrings, calves are usually tight and can cause back pain. The front and back of the legs have to be balanced or they’ll pull your pelvis out of neutral. Modern day sitting doesn’t do us any good, tightening all the posterior compartment muscles in the legs.

Core strengthening is important for good posture. Being aware of your overall posture is also really important too. Yoga is fantastic for stretching, posture, and strengthening.

Caveat: sometimes it’s structural and this stuff may only help somewhat but chronic pain is treated with multiple modalities. If this stuff doesn’t improve it significantly along with NSAIDs, follow up with your primary care doc.

How I know: I’m a physician who screwed up his back and had to figure all this out and now I teach my patients how to treat their back pain. I also use physical therapy liberally because it’s fucking awesome.

Oh they’re definitely not judged the same. There’s a reason DOs interested in the more sought after specialties rarely try for MD programs. When you have a bunch of alpha nerds who base their self worth on test scores and other stuff like that, you get arbitrary stratification. And I’ve seen good doctors fail STEP tests and shit doctors who graduated from Harvard. There’s always those situations when some happen to be good at the stuff a system deems worthwhile but suck at being a person and vice versa.

A lot of DOs go to Osteopathic medical schools because getting into MD schools is crazy competitive. It’s just another path to becoming a doctor that’s an option if you don’t get into a US MD school. The medicine curriculum is basically the same between the two. Though I’ve worked with a bunch of DOs who believe in osteopathy and practice it.

So I’m a physician and I support most things people do to import their health but I do try to make sure they’re fully informed. In terms of fasting, this cohort study found an adverse association between fasting and cardiovascular death. There are limitations to the study (self-reported diet, etc.) but it followed 20,000 people for 8yrs which is pretty good. Definitely need more study in this area, especially considering the complexity of human metabolism. Here’s are the highlights from the study but the full text is available at that link:

• People who followed a pattern of eating all of their food across less than 8 hours per day had a 91% higher risk of death due to cardiovascular disease.

• The increased risk of cardiovascular death was also seen in people living with heart disease or cancer.
• Among people with existing cardiovascular disease, an eating duration of no less than 8 but less than 10 hours per day was also associated with a 66% higher risk of death from heart disease or stroke.
• Time-restricted eating did not reduce the overall risk of death from any cause. An eating duration of more than 16 hours per day was associated with a lower risk of cancer mortality among people with cancer.

Ha, sounds like you might have delivered in rural areas like I did.

Amazon drivers (the ones in budget or Amazon cans, not flex in personal cars) do okish. I just quit workig for a third party company azon uses to shield them from liability and uni on ns because it’s miserable work but the pay was $22.50 is n rural upstate Northeast which isn’t too bad. The worload is crazy, it’s all rush rush rush, and they don’t care about you at all though.so fuck them and Amazon. The drivers would appre the tip, they’re gener hard working and decent people.

I’ve been using Autosync for years with good results first with Drive and Dropbox and now Pcloud. Supports a lot of different cloud services though not Proton which is why I haven’t started using that yet.

Autosync

Oh yeah, a lot of common causes need to be evaluated plus we need to assess if the person should be on blood thinners due to the risk for a clot in the heart that can travel to the brain. I’ve admitted quite a few patients for new onset Afib due to their underlying causes as we didn’t think they were good to go home. Admittedly most people would be fine and we can be too cautious due to legal liability and physician anxiety over bad outcomes but considering the possible consequences, it’s not a terrible thing to do that.