What To Try Next - Long Post Warning

[locked5x5]

A Very Long Post - But hopefully my story and information will help others and possibly educated myself further as well.

First of all let me just say how thankful I am that a site like this exists. I have been lurking for a bit but would really appreciate any feedback on my situation and potential next steps.

So my story begins when I began to notice my ED problem about 20 months ago. It was not too bad and I attributed it to my age (49 at the time) along with my ample weight (6'1" 295 at the time) and the fact i have been married for 20 years. Getting an erection was easy but the firmness waned so approximately 12 months ago I got on a low dose of sildenifil and things were good for while.

However all that changed one morning the second day of June of this year when I woke to shortness of breath which would later that week be diagnosed as a 95% LAD arterial blockage (the widowmaker as they call it). Despite being scared to near death, my procedure went very well receiving only a single stent. My cardiologist said no heart attack evidence, the location was ideal (straight and not curved), no other problems or disease and that he believes it was caused by continued inflammation in that area.

I received the stent along with with a blood thinner, a statin and BP meds and I thought all would be well. However, at a follow up less than a week later, my GP diagnosed me as pre-diabetic (thanks redbull and nos) and I was put on a newer drug called Farxiga... yes 2020 is a year for the ages!

Needless to say that I did not take any of this lightly and immediately got started on my journey to become as healthy as possible... not only to stay alive but to get back my "manhood performance". Flash forward to 1 month ago which was 3 months after this health crisis and i had lost a total of 65 pounds (230) now avoid all sugar/fructose and most carbs (Keto) along with several stretches of water only fasting (three separate 3 day fasts and using the one meal a day method most other days).

The weight loss, activity level and my overall health were amazing with one exception... the ED is still a problem and the sildenifil and even taldalifil were now about 90-95 percent ineffective. It was at this point (one month ago) that I decided to stop the statins and BP completely. Due to the weight loss my BP was consistently in the 115/70 range so doctor was OK with dropping. He advised against dropping the statin use but I wanted my vigor back and i did not eat much anyway so I am taking Niacin as a precaution

Now we are post 1 month since dropping all meds except the blood thinner (2 more months of that but told it can only help not cause ED) and the Farixga (also told has no impact on ED). I have lost another 12 pounds (218) and as a bigger guy anyway (220 in college) I feel I am about as fit as I am getting weight wise (if you squint you can make out 4 of my 6 abs).

Yet still my ED persists and typical drugs are still mostly ineffective. I am now on a daily regiment of over optional 40 supplements (many gleaned on these forums) including niacin, D, high dose C, K, ALA, EDTA, CoQ10, NAD+, B complex, Omega 3, pine bark, citrulline, arginine, DHEA, serrapeptase, high dose garlic, milk thistle, Proline, benfotamine and resveratrol which have helped a bit but nowhere near where i need to be. I get the very random night stiffness but its not significant save for about 2 times where i was rock hard, which made me hopeful but then nothing moving forward (odd...)

So I turn to others for IMNAD advice on how to tackle this further. I do not want to get injections or an implant as I feel my ED was new enough that whatever damage I caused with my poor health may be reversed in time and diligence.

My belief is that one of two things have happened (but very open to other ideas):

A) (Pre) Diabetic ED caused by high blood sugar. I think this is the least likely culprit because everything i read says it takes years of high blood sugar to "destroy" the endotheal nerve cells of the penis. I am taking daily 1000mg ALA (alpha lipoic acid) daily to treat this however.

B) Clogged penile artery ED. This has been my primary focus since - by my logic - if the largest heart atery in my body can get inflammed/clogged then surely so can the much smaller ateries of the penis.

So focusing on the latter, I have many questions.

- I have read that going full on "whole food vegan" and avoiding meat will clear these arteries. But that would expose me to more carbs/sugar/fructose which I want to stay away from. Anyone have experiences here?

- I have read about ultra long water only fasts clearing up arteries the absolute fastest (which makes sense). As stated I have done three separate 3 day fasts but I have read about 5, 10 and even 30 day fasts that kick in a process called Autophagy that works to clear arteries. Again any experiences?

- Finally with me coming off the meds 1 month ago, I believed that any med induced ED would be out of my system and that at least the viagra would work. Am I being impatient? Any experiences on the typical reversal process if you are "doing everything right"?

Again, I want to thank this site for existing and thank any responding members in advance for your feedback!

[dtwarren1942]

In addition to peripheral neuropathy in the penis, high blood sugar can also cause autonomic neuropathy which affects involuntary body functions, including sexual response. However as you mentioned, you believe you have not been pre diabetic for that long, but it is a possibility. You have taken the right steps to reverse both neuropathies. Hopefully, your healthy practices will begin to improve your ED.

You might want to visit an urologist and discuss Trimix injections.

[locked5x5]

In addition to peripheral neuropathy in the penis, high blood sugar can also cause autonomic neuropathy which affects involuntary body functions, including sexual response. However as you mentioned, you believe you have not been pre diabetic for that long, but it is a possibility. You have taken the right steps to reverse both neuropathies. Hopefully, your healthy practices will begin to improve your ED.

You might want to visit an urologist and discuss Trimix injections.

Thank you for the feedback!

I believe (but may be wrong) that the ALA I take and avoiding all sugars like the plague are the right steps to address any diabetic nueropathy.

I am not ready for injections as I plan to give this a full 12 months of other options before even considering that.

I am interested in Avanafil and Valdanafil as potential new meds.

[Leebert]

I've went through the same thing. ED has been a struggle every since. I only weighed 190 . My stent is in the front part of the heart and there's still one in the back side at 35% blocked. Pills came rt to a halt when that happened! Didn't work no more. Went to bi mix and worked just ok, that failed also.havent had a usable hard on since! Watch the diet, but still don't help. I was on thinners as well for a yr and bruising from a tiny little bump anywhere, so I told doc I wanted off them before I went to injections and weened myself off them as you can't stop cold turkey with thinners. This ED thing messes with your head and my marriage of 45 yrs. We're holding on yet, but she wants vaginal sex and I can't do yet! I hope you figure out soon, it's been a disappointing journey for us so far, I'm at the point of giving up!

[tomas1]

I know it's easy for me to say, but I found when none of the pills worked at all, I had to step up to injections. I really had great success with them and they worked for around 5 years. I did have to keep increasing the strength of them until they Stopped working. At least they can buy you time unless your diet and exercise regimens work. I don't know why I'm skeptical; I guess because none of that helped me. Good luck on your journey.

[Gt1956]

I personally have doubts that lifestyle changes will help with ED. Especially after it has hit you.
Let's talk about blood glucose for a minute. My local urologist that I plan on using for my implant has done several informational videos on YouTube for Boston Scientific or AMS. I forget which at the moment. He cautions about the danger of diabetic damage.
I teetered on the edge of a diabetic diagnosis for many years. I hoovered just under the fasting blood glucose level for that diagnosis. After watching numerous videos on ED & diabetes I now believe that is the main cause of my ED. Despite having my glucose very well under control, A1C of 6.5. My lipids are good. My blood pressure is lower than when I was in my 20's. BMI could be better, I'm at 30. There has been absolutely no change in my ED.
The damage from high glucose has been done & that damage is non reversible. Good news is that there is a very easy way to track your glucose levels. WalMart has their own brand of diabetic supplies that are cheap. Other chain stores have a similar house brand. Buy a meter, some test strips & a finger lancer. This is something that you can do without involving a doctor. Should cost less than $40 for all of it.

[Gt1956]

Locked5x5, while avoiding sugars is a good idea. Carbs is what seems to be the big diabetic problem. I would suggest that you try my suggestion of getting some simple blood glucose monitoring equipment. That will show your progress on your glucose levels. Then you can try cutting back on carbs & see which makes the biggest change in you glucose levels. I think that you'll be very surprised at the results.

[Simbarn]

Congratulations on turning your life around with all these changes you have made! I was a PT in my younger years, so I know how difficult this can be for some people.
How are your nocturnal erections?
If it were me I would consider the chronic (daily dosing) of low dose Cialis; 5mgs. I have posted quite a a lot about this in the past, so read some of my previous posts as I don't have the time to go into it again here.
There are many studies on how this works in a different way to on demand dosing.
With all your health issues there will be some damage in the erectile tissues. Endothelial damage and smooth muscle deterioration and possible partial blockage in the cavernosal arteries that feed the corpus cavernosum. This all results in CVOD. Low dose PDE5 inhibitor therapy has been shown to help reverse some of this damage.
It is imperative to get the nocturnals working again regularly. The daily Cialis will help this. This is a long term treatment. Years, not months.
Speak to your doctor and check if you can take the tadalafil daily with regard to your heart and blood pressure. It will also lower blood pressure on a constant basis too. So this needs to be assessed by your doctor first.

[locked5x5]

I personally have doubts that lifestyle changes will help with ED. Especially after it has hit you.
Let's talk about blood glucose for a minute. My local urologist that I plan on using for my implant has done several informational videos on YouTube for Boston Scientific or AMS. I forget which at the moment. He cautions about the danger of diabetic damage.
I teetered on the edge of a diabetic diagnosis for many years. I hoovered just under the fasting blood glucose level for that diagnosis. After watching numerous videos on ED & diabetes I now believe that is the main cause of my ED. Despite having my glucose very well under control, A1C of 6.5. My lipids are good. My blood pressure is lower than when I was in my 20's. BMI could be better, I'm at 30. There has been absolutely no change in my ED.
The damage from high glucose has been done & that damage is non reversible. Good news is that there is a very easy way to track your glucose levels. WalMart has their own brand of diabetic supplies that are cheap. Other chain stores have a similar house brand. Buy a meter, some test strips & a finger lancer. This is something that you can do without involving a doctor. Should cost less than $40 for all of it.

I currently switched from the strips to a glucose monitor which is a FAR better and more convenient way to track my levels. My fasting numbers are usually in the <95 range which is good but not great, I would like to get down in the 70s. I have been following Dr. Jason Fung who is certain diabetes can be completely revsersed.

Now I know that does not mean the glucose damage of the nerves and endothial has not already started and that is why I take high dose ALA every day. I "feel" like I am making progress - albeit very slowly.

I have added D-Apartic Acid and Tribulus to my daily supplement cocktail and I am just convinced that I will post back in here in 2021 with 100lbs weight loss and a near to fully cured ED. Maybe wishful thinking but IF it can be done naturally, I will do it.

Good luck everyone and thank you for all the great feedback!

[locked5x5]

Locked5x5, while avoiding sugars is a good idea. Carbs is what seems to be the big diabetic problem. I would suggest that you try my suggestion of getting some simple blood glucose monitoring equipment. That will show your progress on your glucose levels. Then you can try cutting back on carbs & see which makes the biggest change in you glucose levels. I think that you'll be very surprised at the results.

Oh I avoid carbs as well... I just avoid sugars like they were bleach!

It is impossible to avoid all carbs but I am on a near KETO diet for 4 months now (less than 20g a day) plus lots of fasting.