Just need to talk it out

[XtheUndead (imported)]

I have some of the issues that others here know. My libido is overactive, sometimes unbearably so: four jerkoffs in a row to get to an uneasy sleep, then twice in the morning, is the worst I have had it; sometimes I precum in my shorts for no particular reason in the middle of the day; and this is getting worse with time (I am entering my fifties, would have expected the fires to be less intense than in my twenties). My sex life with other people has never been satisfactory: my lifelong devotion belongs to a straight guy from college, who cannot love me back and finds it awkward to remain a friend; this never changes, I can't get past it and love someone else. I have anger outbursts that hurt those around me; I thought that was getting better with time but recent events showed otherwise. And I have testicular pain: in my youth I got recurrent inguinal hernia with hydrocele complications; that has eased with time but they still hurt whenever I'm overheated.

It is better without pants. When I'm naked for a couple hours, I get calm, no erections, no masturbatory urges. I hang out at a social-nudist resort ("family" not "swinger" type) where there are the usual mixture of people there to "be naked", "see naked", or "be seen naked"; I'm just there to "be" naked, not that I don't like looking at a cute butt as well as anyone, not that I mind if someone of either gender checks me out, but I'm happiest if I have the place mostly to myself and I can just walk around with sun and wind on my skin. I never wear clothes in the apartment. I generally take my pants off to drive; I don't think anyone can see, anyhow I've never been stopped, while when I drive with pants I get hot and hurting, and the road rage sets in, and I get tickets. But I feel bound to get in trouble.

Am I a "candidate"? Really, no. The thought crosses my mind, but often the thought is horrifying, rather than attracting, or even titillating; I skimmed some of Bboy's story collection, found it juvenile, not that I would judge anybody who finds that the right kind of jerk-off material, but that's not me. I am interested rather in the true stories, and am particularly grateful to Phil for his long thread giving a look into the realities. I am already subject to bouts of depression; anything that pushes my mood down might kill me. I already have feeble upper-body strength and badly-healed bone fractures. I heal poorly in general and pick up infections easily. All these are, in med-speak, "strong contra-indications". And I would want my penis taken off at the same time, couldn't stand the thought of going in for a "procedure" more than once (unlike the fantasists, the "procedure" is what I would rather skip past), and nobody will actually do that (well, hardly anybody, but I wouldn't consider having it done with "Dueling Banjos" playing in the background) for somebody who has no feminine identification. I am a little jealous of someone like Erica Ann, who has a destination to go toward, rather than just something to run away.

I would consider "total nullo" if it didn't have side effects. But I guess I would really want it to be on-and-off LOL like in the "Detachable Penis" song: sometimes sexuality is precious to me, even if mostly it has become a burden; I just need to be able to put it on the shelf for a while. But the world doesn't work that way. So OK, I'll continue as a male: then I just need to find a place to live (and work, hmmm...) where I never need to wear clothes again, and I need for my beloved to realize he wants to bring me off every night and every morning-- what? you're going to tell me the world doesn't work that way either?

I've had a couple therapists, could never quite get open about some of this. It just feels good to unburden myself. Thanks for being here.

[mrt (imported)]

I don't know how good this advice is *I'm not a doctor!

Having spoken to a couple of men who had insane high hormone levels and sound like an echo of you - have you considered talking to a GP and having your hormone levels checked? One of the gents who had these types of problems had a tumor that was giving him huge spikes in testosterone.

Is it possible that your condition is medical not mental? Or some combo? I've only had low Testosterone although during my initial HRT stuff with injectables I had a bit higher dose that made me a bit more goofy then usual. Low Testosterone was no fun. Asexuality comes with a lot of baggage in my case and frankly in healthy amounts I like sex. But 5 times a day? Sheesh... I can "get" why thats a problem.

Find a good doctor that you can talk to openly. You don't have to be embaressed they really HAVE heard it all. If you go in and report your symtoms of Hyper sex drive / rage etc and ask for a hormone panel (Thyroid as well as the Testosterone, Estrodiol and the LH etc that drive those) I think the doctor will be very matter of fact.

Frankly I think the idea of total emasculation only sounds good because your having so much trouble with your drive being out of control. I suspect that getting it under wraps in some average level that idea will seem very un-fun.

*But thats just me!

Hang in there!

[XtheUndead (imported)]

Thanks. As between "medical" and "mental" I expect it's a combination. But it's not a "huge spike", it's a gradual escalation of a lifelong condition. I've always been this way, just not this bad. Actually I'm feeling better the last couple days because the "Al Gore weather" (80-ish in October is unheard-of in Michigan) suddenly broke to a more typical chilly drizzle, and the teeth-grinding pain I was getting little shots of went away, too. Now I just have to look forward to my annual winter SAD.

You are right that I should be seeing a doctor. I've been broke and uninsured for a decade, and completely got out of the habit of even seeing a G.P. for checkups, but I'm making a little more money lately and ought to start taking better care of myself.

[plix (imported)]

XtheUndead,

Hi and welcome

I hear stories all the time about these 20 year-old guys who want their nuts cut off tomorrow because they jerk off twice a day and believe that is "overactive." In your case, though, if everything is indeed as you describe, I can see how you would call your libido overactive.

I would suspect that T levels in the normal range for someone your age cannot cause a libido like the one you describe - either your T levels are high for your age (or even higher than normal for any age), or you have something else going on. Either way, getting into a good doctor would definitely be a good idea. Not all doctors are good or should even have medical licenses, and it can take time to find the right one for you, but it is definitely worth it. Unfortunately sometimes the rule of you get what you pay for applies. If you can scrounge up the cash for a better doctor, you likely will not be displeased

I had my balls off at 20 (now 22), and while I don't regret it in the slightest (that actually changes from time to time - I have phases where I regret it more than the slightest), there are things about it that I am not especially fond of. I was one of those 20 year-olds I told you about in the sense that I believed my libido was very overactive and I would be much happier without any. I was right in that I liked the decrease, but wrong in that I would be happy without any. I am now doing some experimentation with hormones to hopefully get a degree of libido back that I feel comfortable with.

I would not seriously consider having your balls off until you have done as much research as you can into all of the effects it brings AND you have confirmed your issues are not caused by something that can be fixed. Having them cut off is a lot more than just loss of libido, which I am sure you know since it appears you are doing your research But there is always more to do, and more stories to hear, both good and bad. And if you do decide to remove them, always do chemical castration first

I know of people who have had them cut off and then went on T because they just wanted more control over their T levels. That can probably be done if you wanted to, but keep in mind that not all respond to replacement T in the same way - for some it doesn't work at all. It would not be fun to have them gone forever and then find out synthetic T doesn't work for you. My own response to it was rather poor.

I am here if you have any more questions or if you want to talk, and so is everyone else at the EA. Don't hesitate to find out as much as you can. DO hesitate to act quickly before exploring all of your options

[IbPervert (imported)]

XtheUndead,

Hi and welcome

I hear stories all the time about these 20 year-old guys who want their nuts cut off tomorrow because they jerk off twice a day and believe that is "overactive." In your case, though, if everything is indeed as you describe, I can see how you would call your libido overactive.

Reminds me of a movie about an all boys Catholic school. All the boys are lined up to go into the confessional and one boy starts asking everyone else what they are going to confess too...finally one of the boys says, "I masturbate eight times a day!" The reply came back, "you tell him that and they will cut your nuts off!"

[Danya (imported)]

Hi Xtheundead,

I've got to say I'm very impressed with the responses by MrT and plix. I'm 55 and sometimes I think I've got an overactive libido because I masturbate once a day. I don't get much out of it. I have considered castration for many years, for a number of reasons I won't go into here, but it doesn't really sound like it would be a good solution for you. I agree, see a doctor and give a really clear explanation of what you're going through. Not only have doctors heard everything, if they're good they should keep up on the literature. They have an understanding of the complexity of the human body and how out of balance systems can be bad news. You need to be sure nothing serious is going on and even though you've had this problem for years there may still be an underlying physical cause that needs to be addressed. And by the age of 50, there are standard tests you should have anyway, guy. Some to establish baseline levels. Unfortunately, cancer risk goes up as we age. It's generally recommended that by age 50 or so you should have a colonoscopry. Colon cancer is easily treated if caught early. Get your PSA level checked for your prostate health. Sorry, I didn't mean to go on like this! I'm not a physician but you need to take control of your health. See what can be done to help you cope better. If you can possibly afford it, see a doctor. Not having insurance sucks and there shouldn't happen in the US or anywhere else.

Best wishes,

Todd

[XtheUndead (imported)]

I did have detailed blood work done, back a dozen years or so ago. Things might have changed, but I tend to doubt it has changed much: all hormones were within normal ranges, which somewhat disappointed me because I really wanted an answer for such things as, why was I still getting puberty-level acne when I was pushing 40? (that, at least, has eased though not gone away). Apparently what I have is "androgen hypersensitivity", an abundance of biochemical receptors that makes a little go a long way; unfortunately, while there is a fair amount of literature on androgen insensitivity (presents early, as some degree of intersex despite normal XY chromosomes), there is little about the other direction.

Of course, although I am educated and a good researcher, I am not a doctor and don't really know w-t-f I am talking about (not that I am always convinced doctors do either). I am the kind of imaginative hypochondriac (comes from a chronically sickly childhood) that doctors find a nightmare to deal with: once, getting ready for bed, I saw a dark purple spot with blotchy margins on my chest; rapidly diagnosed aggressive melanoma; weighed the pros and cons of spending months in miserable chemo for a low-percentage prognosis; decided I'd rather accept that I was dying and max out my credit cards travelling around; and was working on who to give away all my stuff to before I looked at my shirt and found that a Bic pen had burst. (OK, I'm exaggerating this story.. but only a little.)

I was referred for the bloodwork by my second psychiatrist. The first, Sandy, put me on Prozac for my depression, which was terrible because it gave me boners that would neither shoot off nor go down, then switched it to Paxil which worked better. Raul continued the Paxil and added Welbutrin, the combo working better on the depression than either alone: and when I was unemployed, broke, and uninsured, he kept seeing me for $35 a session (effectively $0 but he knew I would feel better about it if it wasn't $0) and gave me both the meds out of the samples the salesmen leave-- great guy, so I know there are good doctors out there.

But I still fear that if I tell a doctor about the testicular pain (and the lack of mention here about any good therapy for it tends to confirm the fear), that he will just tell me "Live with it, or cut them off", and if I tell him I would rather have all or nothing, he will say "What, are you nuts?"

[Danya (imported)]

I've been on antidepressants of different sorts since I was assaulted and nearly killed in 1984. So I've had first hand experience with the effects of most. Just as a brief aside, I'm now using EMSAM, a 'patch system' (read expensive)as the manufacturer calls it. I put it on my arm. It's in the old type Monoamine Oxidase Inhibitor antidepressant class which fell out of favor due to very strict dietary restrictions. But these often worked for people where other drugs failed. The lowest dose of the patch doesn't require dietary restrictions because the med bypasses the digestive system to go directly into the blood. Sorry, this is getting longer than I intended. The stuff's really expensive, like $500 for a 30 day supply and my copay on this is $155. I don't know if I can afford to stay on it but it has worked wonders for me and hasn't had the lousy sexual side effects of SSRI's. There was a reason I started down this off-track topic and that's to say there are always new treatments being developed not only for depression but for other things. In fact, I could give another example of how my persistent asthma has finally been brought under control with two new drugs released this year. But I've already digressed too much. There may be one or more physicians on this site but, if so, I don't believe we've heard from them. I still recommend you see a doctor. Your stating that you went a number of years ago for blood work does not guarantee that the results will be pretty similar now. And so what if they are? You don't know what the current thinking is on what may be going on for you. It seems to me that, at worse, by seeing a doctor you will spend some money and not get any answers. At least you would have tried. You could still get an updated physical. Maybe you'd even find a better outcome than you have in the past. I know it can be a pain in the ass going to see a doctor and I'm kind of sick of them myself! I guess I just see that, in my case, two medical problems that I thought were not solvable have been greatly improved. Sounds like you're really worn out by years of struggle and I can relate. I just think there might be more hope out there for you than you're able to imagine right now. Seems like it could be worth a try.

[Danya (imported)]

I need to learn when I've written enough I just remembered that there are a number of posts on this site from men with overactive sex drives, whether by their own estimation or a partner's. Some of these men have taken androgen-blockers to help. You might find you could partially lower your testosterone and get some relief. I wish you the best.

Todd

[mrt (imported)]

I can't tell you what to do but Orchialgia (Chronic teste pain) is a condition that should be checked out. I've had that and was cured with a Bilateral Orchiectomy. This may seem radical but I did try the other options such as pain meds, injections etc. If your nuts are in pain there probably is a problem. If your having roid rage symptoms and hypersexuality? Again there is probably a problem. Please consider seeing at least one GP and getting labs done if nothing else. And ASK for the results and get back to us with them. I don't think we have any Doctors here but we know what is "wrong" and what is normal in some cases anyway. And some of these labs say "Everything is normal" which is insane.

I would not tell you that orchiectomy is the solution. A lot of other things ought to be tried first but if all else fails? Its an option to consider.

But I still fear that if I tell a doctor about the testicular pain (and the lack of mention here about any good therapy for it tends to confirm the fear), that he will just tell me "Live with it, or cut them off", and if I tell him I would rather have all or nothing, he will say "What, are you nuts?"

[XtheUndead (imported)]

Well, one definite symptom of my hormonal/emotional/whatever-it-is condition is that I tend to act on rash impulses (you might say I go off half-cocked!) and that is a big part of why I am here, to get talked down. You guys are great.

In that regard, one poster who worried me a lot as I rummaged around here was Johnny_60016 who said he was going to get cut this October, wanting it for the experience although he knew perfectly well he would want his penis back immediately. Do you guys know if he's a fantasizer who would never follow through or if he's had something done to himself? Either way, is he OK?

[kristoff]

Well, one definite symptom of my hormonal/emotional/whatever-it-is condition is that I tend to act on rash impulses (you might say I go off half-cocked!) and that is a big part of why I am here, to get talked down. You guys are great.

In that regard, one poster who worried me a lot as I rummaged around here was Johnny_60016 who said he was going to get cut this October, wanting it for the experience although he knew perfectly well he would want his penis back immediately. Do you guys know if he's a fantasizer who would never follow through or if he's had something done to himself? Either way, is he OK?

Keep in mind that the VERY large majority here are strictly fantasizers. Of those that believe they are serious, most will not or cannot, for whatever reason, carry through. A Scientific Wild Assed Guess (principle of SWAG), based on data generated by the survey study conducted here 2 years ago, and recently published, would suggest that about 5% of folks here are actually nullo or eunuch, 90% being the eunuch variety. That would include voluntary as well as involuntary. Jesus may be able to give more accurate figures. I would doubt Johnny_60016 actually did anything - though I could eaily be wrong.

[XtheUndead (imported)]

Jesus may be able to give more accurate figures.

Or his Dad, maybe

Yeah, I would have guessed he was strictly a fantasizer, but I thought I would ask in case someone knew something.

My case is about the same. I'm angered that I have a fresh zit on my forehead, even though it's a little one: I'm 51 not 15 And I'm depressed that my left nut has been achy most of the day; a friend said I was looking very tired, and that worries me because I usually don't let anything show. I don't think anybody in my life knows any of this (it's such a relief to have a place to talk where my only worry about fitting it is that I might be too close to "normal" for some people's tastes!)

Please consider seeing at least one GP and getting labs done if nothing else. And ASK for the results and get back to us with them. I don't think we have any Doctors here but we know what is "wrong" and what is normal in some cases anyway. And some of these labs say "Everything is normal" which is insane.

Yes, I am definitely going to find a doctor. And I promise to get back to you, MrT, you are a gentleman and a scholar.

[XtheUndead (imported)]

I had my balls off at 20 (now 22), and while I don't regret it in the slightest (that actually changes from time to time - I have phases where I regret it more than the slightest), there are things about it that I am not especially fond of.

Plix, you make me a little sad. You really didn't have enough time to know what it was you were giving up. Me, I've had my fun, all I can stand and then some.

[twaddler (imported)]

"

Me, I've had my fun, all I can stand and then some.

"

Lack of testicle(s) or testosterone != funlessness.

[plix (imported)]

Plix, you make me a little sad. You really didn't have enough time to know what it was you were giving up. Me, I've had my fun, all I can stand and then some.

I probably did miss out on quite a bit by giving them up so early, but there were a lot of reasons, including some gender issues I had at the time. In that situation the sooner they are gone, the better - the T really masculinizes you over the years. Not having them can be a lot of fun too though

[DonFL (imported)]

normal for WHAT is the question, Mine were normal, for a bull in rut, 3900ng/dl. if your normal for a 16yo and are 45 or so, tha isnt normal. Yes, im one of the rare true hyper-androgisim patients, im me if you want to know more.

I did have detailed blood work done, back a dozen years or so ago. Things might have changed, but I tend to doubt it has changed much: all hormones were within normal ranges, which somewhat disappointed me because I really wanted an answer for such things as, why was I still getting puberty-level acne when I was pushing 40? (that, at least, has eased though not gone away). Apparently what I have is "androgen hypersensitivity", an abundance of biochemical receptors that makes a little go a long way; unfortunately, while there is a fair amount of literature on androgen insensitivity (presents early, as some degree of intersex despite normal XY chromosomes), there is little about the other direction.

Of course, although I am educated and a good researcher, I am not a doctor and don't really know w-t-f I am talking about (not that I am always convinced doctors do either). I am the kind of imaginative hypochondriac (comes from a chronically sickly childhood) that doctors find a nightmare to deal with: once, getting ready for bed, I saw a dark purple spot with blotchy margins on my chest; rapidly diagnosed aggressive melanoma; weighed the pros and cons of spending months in miserable chemo for a low-percentage prognosis; decided I'd rather accept that I was dying and max out my credit cards travelling around; and was working on who to give away all my stuff to before I looked at my shirt and found that a Bic pen had burst. (OK, I'm exaggerating this story.. but only a little.)

I was referred for the bloodwork by my second psychiatrist. The first, Sandy, put me on Prozac for my depression, which was terrible because it gave me boners that would neither shoot off nor go down, then switched it to Paxil which worked better. Raul continued the Paxil and added Welbutrin, the combo working better on the depression than either alone: and when I was unemployed, broke, and uninsured, he kept seeing me for $35 a session (effectively $0 but he knew I would feel better about it if it wasn't $0) and gave me both the meds out of the samples the salesmen leave-- great guy, so I know there are good doctors out there.

But I still fear that if I tell a doctor about the testicular pain (and the lack of mention here about any good therapy for it tends to confirm the fear), that he will just tell me "Live with it, or cut them off", and if I tell him I would rather have all or nothing, he will say "What, are you nuts?"

cutting them off isnt so bad, you get to be 100% in control of your own hormones. i feel better than ever in my life.

[kristoff]

"

Me,

I've had my fun, all I can stand and then some.

"

Lack of testicle(s) or testosterone != funlessness.

That is rather self-limiting. Get out of your pants, and back into your head, and be a bit creative. Just think, what can you do with a door knob, for example?....

[XtheUndead (imported)]

Lack o

f testicle(s) or testosterone !=

funlessness.

Sorry, didn't mean it that way.

Mine were normal, for a bull in rut, 3900ng/dl. if your normal for a 16yo and are 45 or so, tha isnt normal. Yes, im one of the rare true hyp

er-androgisim patients, im me if you want to know more.

My problem is that while I have some of the symptoms of hyper-androgen, I didn't actually have overly high levels, at least last I checked. So I don't really know what is going on with me, but somehow doubt it is purely psychosomatic.

Anyhow, as people keep telling me, I have to get to an MD for testing. I think I will go back to Raul first and tell him what's been happening to me these past few years (I was never to get as deep with him about sexual frustrations as with Sandy, probably because Sandy was female, but now that I've dumped it out once, I think it will be easier to say it out loud). I don't know how to go about finding a doctor who takes uninsured patients, but Raul will be able to give me a referral, so that seems like the best strategy.

[mrt (imported)]

I probably did miss out on quite a bit by giving them up so early, but there were a lot of reasons, including some gender issues I had at the time. In that situation the sooner they are gone, the better - the T really masculinizes you over the years. Not having them can be a lot of fun too though

For those that think I'm one dimension Mr T all about testosterone all the time? Surprise! I agree with Plix. If your are serious about gender and transition the earlier you act the better. Maybe (better) is not the right word. More easily the transition is made? More complete?

I don't know that I can ever really say that male HRT is the "same" as getting it from your testicles. Or that a male using Estrogen will be the same as a women with working Ovaries but... I don't see why not? In my case I don't know how long mine were not doing the job right but I do feel great now and I think that once you get on a good dose and stay there for a few months (Regardless of the type male/female) your going to feel better.

I think one problem is that it doesn't work overnight. In my case it didn't even work in a week or two. "Some" stuff felt better in 3 days but it took me months to get rolling right. And I think that if you levels are going up/down and crazy lows or highs? Your going to be miserable...

[mrt (imported)]

Sorry, didn't mean it that way.

My problem is that while I have some of the symptoms of hyper-androgen, I didn't actually have overly high levels, at least last I checked. So I don't really know what is going on with me, but somehow doubt it is purely psychosomatic.

Anyhow, as people keep telling me, I have to get to an MD for testing. I think I will go back to Raul first and tell him what's been happening to me these past few years (I was never to get as deep with him about sexual frustrations as with Sandy, probably because Sandy was female, but now that I've dumped it out once, I think it will be easier to say it out loud). I don't know how to go about finding a doctor who takes uninsured patients, but Raul will be able to give me a referral, so that seems like the best strategy.

I understand the issue with talking about "personal" stuff like sex, hormones etc with a doctor. I also (REALLY) get the idea that talking to a female MD about this is easier. I don't think there are that many that don't take "cash" for a visit. I would maybe call a few clinics nearby and ask to talk to the "triage" nurse. Explain over the phone your problem and ask if they have a female GP on staff that would be good to talk to. This solves the issue of going to a clinic and wasting a lot of time with the wrong Doc...

DO get it done. I'm a little scared that you have high levels caused by some issue that is not good.

[XtheUndead (imported)]

October 29, 2007

Cancer (6/22-7/22)

Try to be as expressive as you can today -- unleash your inner emotions and let the whole world know what you're feeling! Wearing your heart on your sleeve can make for a charming fashion accessory, especially when you want a certain someone to get to know the real you. Step out of your 'official' mode and get down to real feelings and honest interaction. Timid conversations will leave you yawning ... you need debate, vulnerability, and revelations today!

Hmmm... haven't I been chatty enough?

Decided to go straight to an internist (one I saw before, many years ago, and my Dad has seen since, for prostate problems and the like), since I would have to tell it all twice if I went back to the shrink first. But, "we're sorry, the office is closed until 1:30..." Don't they know the telephone weighs two tons and it takes me hours or days of agonizing before I can pick it up?

[XtheUndead (imported)]

Update: took a couple weeks to find a doctor who sees the uninsured at all, and is taking new patients, but I do have an appointment for a general physical. I'm afraid they're not really going to find anything about what was wrong with me: I am back to "normal" (until whenever the next time is), do it once or twice a day, no pains of late, even the pimples all clearing up.

[mrt (imported)]

Update: took a couple weeks to find a doctor who sees the uninsured at all, and is taking new patients, but I do have an appointment for a general physical. I'm afraid they're not really going to find anything about what was wrong with me: I am back to "normal" (until whenever the next time is), do it once or twice a day, no pains of late, even the pimples all clearing up.

I went in hoping the doctor would "guess" what was wrong with me. Even if your not currently having symptoms be smart and spell all your issues out. I would suggest you write down your problems and questions and print a copy and simply ask the doctor to go over them with you. It works great for us. The doctor will often make notes on the paper.

Should I use Vitamin D? YES 800 UNITS A DAY *Or whatever...

My Testes hurt like crazy then feel ok at times but mostly ache and keep me awake. *NEED TO DO THESE TESTS AND OR SEND YOU TO A URO.

You get the idea... This ways its not a guessing game...

If your answer to why are you here today is "I want a check up" thats ALL your going to get. Blood pressure, Heart, lungs a PSA, blood work and a DRE along with a Thyroid (maybe) and look over at your eyes, ears and so forth. If you don't tell her/him specific issues? Forget it.

Do NOT be afraid to open up to your GP. They really HAVE heard it all. And they are sworn to not tell others about your case. Not your wife, nor other doctors etc. Good luck!

[considering (imported)]

No competent medical person is going to tell you to "live with it or cut them off". That you can discuss it here suggests that you could find a "real" person with whom a discussion could be continued. I might suggest that you must be honest with anyone who is acting as your therapist or physician. In the past three years I have worked extensively with a Psychiatrist, my Physician and an Urologist preparing for nullo. Whatever eventually happens, and to me it's an all or nothing proposition, I and they will feel that no decisions were rashly made and that as many exigencies as could be found were considered. Rarely is it possible for anyone to make this sort of life-changing journey alone.

If it's been twelve years since you had a blood panel, it has been far too long. For that, how long has it been since you've had a total physical, top to bottom with all the invasive tests that might be necessary? This may help and, at all events, at forty you need a medical base line for the future.