30 Comments

Great invitees on the post!

Cheers to Vitamins and Surgeon.

Really refreshing to see the jungle grow this way.

Another win from BTB.

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Surgeon, thanks for the article. Vasectomized and reversed guy here. Fwiw I would never recommend anyone to get the procedure. Resulted in the most terrible chronic pain I've ever experienced. Reversal helped but not solved it, now back to like 75% of who I used to be. I firmly believe the stats on cases that go pear-shaped are way under-reported. The human body imho wasn't made to be messed with like this.

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I am sorry that the experience was so awful for you! I've not encountered such a difficult response but it is informative to know it can happen. Thank you for sharing so that the readers can take that into account when making their healthcare decisions.

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>Male Condom: Failure rate: 13%

Excuse me?

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The most common causes of failure are incorrect use (ie. wrong size or using multiple times) and breakage (increased risk with incorrect size and use with oil based lubricants). It is thought that if these human error factors could be eliminated the failure rate would be closer to 2% but it is difficult to eliminate these human errors in studies.

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Cool thanks! To be honest, 2% still sounds a lot to me haha.

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Great info on both.

There is a SaaS built in each your niches: customized stack builder that changes as needs change. If you vertically integrate from bloodwork to supplements = 💰

A cloud/tele health fertility clinic. Same as vitamins, own the experience from testing to treatment = 💰

Question for surgeon: if I get a vasectomy now (34), and freeze my sperm is that a good idea if I plan on having children in 5-10 years? Seems like best of both worlds.

Thank you both for insights!

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Freezing sperm is an option. Keep in mind it can be expensive, as can artificial insemination, so weigh that in your cost-benefit analysis. It is also important to consider if your future partner would be open to artificial insemination as some people are not. I think there are many methods to turn to before choosing to go under the knife. Surgery is not a risk-free endeavor. It would not be my choice if I were in your shoes. I know it sucks that there are so few options for men. If you want to reduce risk of unwanted pregnancy a combination of methods is a good idea. For example, condoms and having a partner on the pill. Hope this was helpful!

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Very good articles from both of you, thank you!

Vitamins, I’ve read that the FDA allows wide variations in what is listed on the supplements package vs what is actually there (15% I think). Where do you go to ensure you’re getting what you pay for as far as vitamin quality? Been looking at consumerlab but still assessing for reputable sources.

Appreciate it, thanks.

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You can search my Twitter timeline for “top brands” and I have a thread on the brands I consider to be highest quality.

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"But even multivitamins that are considered high quality, like Thorne, still cut corners by including low-quality ingredients like folic acid."

You should remove this. Folic acid deficiency leads to neural tube defects during pregnancy

Ironic you wrote this seeing that your post was paired with Surgeon's.

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I believe Rhino answered this question sufficiently, but I will reiterate that folic acid can be hugely problematic, while 5-MTHF folate is important for all kinds of things. I think you should think about your tone before posting next time.

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You don't like my tone because it's authoritative which it should be seeing I have 8+ years of medical training. I stand by what I said and no, this isn't medical advice.

When you see me commenting on things I know nothing about like crypto, feel free to slap me around

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Given your 8+ years of medical training and the abundance of research backing the downsides of synthetic folic acid, I don’t see how you can promote the use of folic acid, nor differentiate between folic acid and 5-MTHF. Nobody is saying folate is bad. But I too will stand behind what I said about folic acid.

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There are well known issues with folic acid. 5-MTHF is what you want rather than folic acid. Folate is important.

Be positive and constructive even when disagreeing.

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BowTiedWolf would you also recommend to avoid Ashwaganda on the precautionary principle due to evidence of hepatoxicity? See e.g.

DNA damage by Withanone as a potential cause of liver toxicity observed for herbal products of Withania somnifera (Ashwagandha) https://www.sciencedirect.com/science/article/pii/S2666027X21000074

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What is your purpose?

If using Ashwaganda for anxiety, why take the risk of hepatoxicity when there are other medications/supplements without this risk.

If using as a psychedelic (shaman ceremony, etc), then it is a matter of weighing up the risk of each psychedelic and rolling the dice

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>What is your purpose?

Flagging the risk of hepatoxicity for others, but as I'm not a doctor was hoping you'd comment on whether people ought to avoid it.

"why take the risk of hepatoxicity when there are other medications/supplements without this risk" seems to sum it up pretty well, thanks!

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Okay, understand

Macro view: I don't recommend/prescribe any supplements/medications that have the risk of organ damage (including ashwagandha).

Exception is life and death situation. I.E lithium for suicidal bipolar patient, etc

This is not medical advice

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Thanks to both.

Vitamin - thoughts on Animal Pak?

Surgeon - vasectomy has 1.5% failure...uh oh...?!?!?!?!?!

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The most common cause of reported failure in vasectomy is having sex too soon after the procedure. It takes about 12 weeks for the sperm that was stored beyond the portion that was cut to dissipate before it is effective as birth control.

The other potential cause of failure is the formation of a scar tissue tract between the cut ends of the vas deferens which allows sperm to travel through. This only occurs in about 2/1000 cases.

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read an article once that vit D dosages are completely wrong and that much higher dosages are fine. I've tried 25k-50k for a few months and was totally fine. They say you can enlarge your penis but only noticed a larger sack. Might be some truth in here ¯\_(ツ)_/¯ but if 100% true and effective vitD would've been sold out worldwide.

Ashwaganda makes me feel jittery and anxious.. could it be the quality?

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The Vitamins information is a winner - thanks for the helpful graphic with your recommended vitamin stack. Had you provided affiliate links to your recommended supplement provider, I would have bought several through those links (instead I went to Amazon and bought... but you have monetization opportunities!)

FYI, it should be noted that many of the contraceptive methods you provided would be considered by some people as abortions or abortifacients (drugs or devices like IUDs that kill an embryo after it has been created). That should be noted, because many Christians and others are opposed to contraceptives that cause the death of an embryo after it is created, even if they are ok with things like condoms that prevent insemination. Of course, Catholics and some others are opposed to all forms of contraception except natural family planning and abstinence, and they would argue that the science shows that when natural family planning is done correctly, it has a much lower failure rate than you suggest. https://www.usccb.org/issues-and-action/marriage-and-family/natural-family-planning/what-is-nfp/effectiveness

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Forget vitamins! Just eat like the LIVERKING!!

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Still keen for more insight on the 'you made it' phase (likely starting in late 30s/early 40s). The mental battle of shifting down a couple of gears has been brutal and lead to lots of anxiety that 'im falling behind' as the last 30 working years (ish) have been about the grind...i feel like I can't do any more hobbies...lol.

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Thanks for this, great insight.

In regards to hair health as a male, are there any specific vitamins that target this?

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Make sure your D, C, E, B complex levels are all in order. Berberine and resveratrol have shown some promise in hair regrowth.

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How can you seriously recommend a supplement stack WITHOUT talking about the dosage?

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Because I can’t spoon feed you everything in life. Your dosages will depend on your own goals, deficiencies, stressors, lifestyle, etc. You are welcome to follow along on my Twitter page where I talk about different dosages, or even ask nicely for advice in my DMs.

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