The Berman Method
The Berman Method
Episode #187: Low T Signs and Remedies
Healthcare should work for you, not against you. Yet many patients find themselves trapped in a system designed to prioritize profits over healing. In this eye-opening episode, Dr. Jake and Jenni Berman, PA-C tackle the frustrating reality of dealing with health insurance companies that seem determined to deny claims by any means necessary.
We share our surprising discovery about our own dentist, who provides exceptional service without accepting any insurance - proving that sometimes the best care comes from providers who operate outside the traditional system. This revelation highlights how the healthcare landscape has shifted, requiring patients to become smarter consumers who seek quality rather than simply following insurance networks.
The conversation then turns to the growing epidemic of low testosterone affecting men in their 30s and 40s - far younger than previous generations experienced. While testosterone replacement clinics offer quick fixes, we explore why hormone levels are declining in the first place: blood sugar instability, cortisol imbalance, environmental toxins, and nutritional deficiencies. Rather than jumping straight to hormone replacement (with its potential side effects like increased prostate cancer risk), we outline a comprehensive approach to restoring hormonal balance naturally.
Ready to take control of your health? We break down the specific protein requirements for optimal hormone function - men need 5-6 ounces three times daily plus 3 ounces between meals, while women need 4-5 ounces three times daily plus 2-3 ounces between meals. This episode equips you with practical knowledge to address root causes rather than simply managing symptoms. Because when you're dealing with David against Goliath, sometimes you need to step outside the system to find real healing.
This is the Berman Method podcast, featuring Dr Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy.
Speaker 2:We are rolling, rolling, rolling, rolling on the Berman Method podcast, treating problems and not symptoms. David, going against Goliath, where the corporate medical system does not have your best interests in mind, Big Pharma, the health insurance companies they are going to choose profits over patient outcomes every time, because a patient cured is a customer lost. It is that simple, dr Jake Berman, here with my beautiful co-host.
Speaker 1:Jenny Berman, physician assistant and.
Speaker 2:Walker, ryan Bermanator.
Speaker 1:He's just hanging out here. Definitely more alert Hanging out in my lap.
Speaker 2:Way more alert. Got his little paw onesie on Paws all over him. So cute oh my goodness, you're just so cute.
Speaker 1:And he's going to be five months. Well, he is is five months by the time this is being released.
Speaker 2:Look at that smile, oh my goodness, smiling with his whole head, his whole face, I mean his whole face does smile.
Speaker 1:People comment on that all the time. If you're wondering, he still has blue eyes they are still blue, very blue, really blue.
Speaker 2:Yeah, holy cow so recessive gene going strong right now if it wasn't for those ears, I would thank you as the mailman's.
Speaker 1:Those are definitely my ears, though he has your ears and your nose.
Speaker 2:Yes, he wasn't three minutes old and the first thing you said is oh my gosh, he's got your ears and your nose. Yes, he wasn't three minutes old and the first thing you said is oh my gosh, he's got your ears. I did say that.
Speaker 1:Since I was actually coherent during this delivery, I got to see them when they were born. You see him when he was born and yes, I said he has your ears before I even held him.
Speaker 2:Yeah.
Speaker 1:But that's OK, they're cute, but that's okay, they're cute.
Speaker 2:Of course they're cute, they're mine, what do you think about that?
Speaker 1:you're cute, you turned out all right I turned out all right all right yes, here we go, david against Goliath.
Speaker 2:It is getting more and more clear that the health insurance company's number one job is to deny I mean, we talked about it last episode and probably a few of the past episodes the amount or the frequency of which we're getting irate customers. Not us personally, not us personally. The health insurance companies are getting more irate customers. It's increasing the frequency because there's so many more people that are being smarter about their health care and they're choosing to go to out-of-network providers and pay in cash to get the health care that they want instead of what they have to get for somebody that is in network. So going to an in-network provider that may not be qualified or the expert that they're looking for and then trying to submit for out-of-network reimbursement on their own and 100% of the time it's a headache.
Speaker 2:100% of the time it's a denial. You put the period in the wrong place. There's a headache. It's a headache. 100% of the time it's a denial. You put the period in the wrong place. There's a smudge on your signature here. It's just. They find the craziest things to deny and I cannot tell you so. I've been doing this for 10 years. Right, I haven't taken insurance for 10 years. And of course, there's the people that want to submit for out-of-network reimbursement. So I'll give you a super bill to submit for out-of-network reimbursement and historically it's been just a couple of headaches Over the past six months it has been 100% headache, just a tenfold increase on what they're denying and it's erroneous. It's not even true.
Speaker 1:I had a patient get declined because denied, because I gave too many diagnosis codes, Like what Too many? What, yeah? And I was like they're like they want one and I'm like, well, one's not going to get very much covered. Like I put multiple because this is what you're experiencing and this is what we're treating you for, so this is what they should cover. But then if there's too many, then there's too many reasons that they should cover it.
Speaker 2:Yes, and at the end of the day you got to look at health insurance, just like you look at your car insurance. You would never, ever ask your car insurance to reimburse you for an oil change. You're not going to ask your car insurance to reimburse you for new tires, new brakes or tire rotation or a maintenance on your AC. You're not going to ask your car insurance to pay for your detail. So get your car detailed. You know I want to wax my car. Do you think that State Farm will reimburse or Progressive will reimburse for detailing my car?
Speaker 1:Right, we don't ask for reimbursement for massages. Yeah, so why is your treatment of your gut or your shoulder any different?
Speaker 2:Yeah, it's just a paradigm change because historically, that's what, what it's the way it was. I mean this is so outdated though. I mean it really started changing back in the nineties. Here we are, almost 30 years later, and people are still trying to grasp on to the old way of doing or having healthcare services, and it's just it's changing. Hopefully we're preaching to the choir here. Hopefully, if you're listening to us regularly, you get it by now and you're making the right decisions.
Speaker 1:And if you're not getting answers you need to find, most of the time, an out-of-network provider to help you find the answers. And I'm living this right now with a client who unfortunately has been not well for five years and has been seeing tons of different providers over the last five years, including a rheumatologist, a neurologist, and my first set of blood tests I did on him I found started finding answers right away and had to do more testing. I had to do more blood testing and called him right away and said you know, I think we need to further investigate this, but it was a blood test that I did that no one's done on him in five years. Like, why did it take five years for that blood test to get done, to start finding some answers?
Speaker 2:Speaking of finding answers. So I think we've mentioned a few times over the past couple of years on this podcast our dentist, that we go to Park Dentistry. It's right across the street from our office and about four years ago it was right around.
Speaker 2:COVID, I wasn't happy with the dentist that I was going to. I wasn't unhappy, I just wasn't happy with it. So I'm going you know what? Why don't I shift my mindset and find somebody that might provide a better service, a better product and pay money out of my pocket? Because me too, you know I was guilty of this. I was only going to a dentist that accepted the dental plan that we had and I, just I was like I got to do it. I've got to practice what I preach.
Speaker 2:So the first thing I had to do is I go on Google and I Google dentists and there's two dentists in the downtown area that are so far ahead of the competition on Google reviews that it's not even close. I mean, it's 1,000 or 2,000, something crazy like 1,000 to 2,000 five-star reviews, and there's two of them. And then the other 75 dentists in the area have five reviews or 10 reviews, less than 50 reviews, and I'm going holy cow. What are these places doing differently? One of those places was right across the street from me Park Dentistry. So I went to them and the experience that I had walking in the door was just insane. I didn't even tell them that I had insurance, because I just wanted to pay out of pocket. I wanted to see what the service was and I've been going there ever since. Jenny and I have been going there ever since and paying $150 to $300 every single time we go. I go at least three times a year, if not four times a year.
Speaker 1:I go four times a year, yep.
Speaker 2:And it wasn't until last week when I went there again and I overheard one of the other admins saying that we're out of network with everybody, all insurances. And I said how long have you been at a network with all insurances? And the lady I was talking to she goes probably three or four years now. And I'm going this is insane, absolutely insane. I had no idea, no idea that they didn't take any insurance at all.
Speaker 1:I didn't either.
Speaker 2:But the product, the service, the employees, everybody is so happy. When you walk in there, they call me by my name. When I walk through the front door, the place is clean, it smells good. The actual product itself is great. I mean, everybody is just happy. And this place is big, it's not small, and people are willing and able to pay out of network prices to go to this place because it's a better product, right right, and they're not pushy at all, which is the other nice thing.
Speaker 1:And you would expect, as an out of network clinic and everybody's paying cash, that they would be pushing you to do all these crazy things and procedures and composites and things like that. And they're not even pushy. They're like this is what we see. You make the choice. It's really nice.
Speaker 2:Love it. I absolutely love it. So you got to get smarter, you got to spend your money on where you think you're going to get the best product, and you got to do your research. It's that simple.
Speaker 1:So do we want to talk about what we were planning to talk about?
Speaker 2:Yeah, one of our good buddies requested that we talk about low T because it's a popular topic in the news, not the news, sorry, on commercials. You see it everywhere, where these med spa clinics are popping up left and right, all around town and virtually for low testosterone, especially for males.
Speaker 1:And it's not surprising. It's not surprising, Definitely. In my opinion. More and more young males are having lower and lower testosterone levels in the recent past, so just in the last 15 years, men in their 30s and low 40s are getting low levels of testosterone, which isn't how it used to be. We didn't have this testosterone problem 20 and 30 years ago. Maybe we did and we just weren't testing it, but I don't think so. It was not as prevalent of an issue because our food was cleaner.
Speaker 2:Is that the reason why?
Speaker 1:That's a very big part of it. Just the pollution between our food and our environment is so much greater now that it definitely is impacting testosterone levels and all hormone levels across the board for males and females. There's a lot that goes into it, right. It's way more than just the pollution of the environment and of our food, but it's the implications of that, along with high stress levels, the amount of stress that people are under now versus what they were under 30 years ago, the amount of sugar that we're consuming, so what our blood sugar stability is like is playing a huge role as well. So there's a couple of primary reasons that hormone levels will shift and that males, specifically, will find lower levels of testosterone, females lower levels of progesterone, both males and females, higher levels of estrogen.
Speaker 1:And when I have an individual coming in with concerns of hormone imbalances telling me I think I just need to go on hormone replacement. I've tried everything that I can possibly think of. I'm sleeping terrible. My energy is really low. I don't have the recovery in the gym that I used to. My muscle mass is declining. My fat percentage is increasing. I'm not sleeping through the night. For females, they're having night sweats at night. Their mood is shifting, low libido these are all the symptoms that people are coming in with, saying I'm throwing in the towel, I just need to go on hormone replacement. And a lot of times I say okay, well, actually, every time I say, well, that might be true, but it also might not be true. Let's look a little bit deeper, specifically at blood testing that nobody's looked at yet. Yeah, your doctors are saying, okay, these are your symptoms, here's the pill or here's the cream or here's the patch, but we're not actually looking at the cause. Why are hormones decreasing when you're in your 30s, your 40s, your early 60s decreasing?
Speaker 2:when you're in your 30s, your 40s, your early 60s, what would be a couple of typical symptoms of a 30 to 40-year-old male with low teeth?
Speaker 1:Well, I just said a whole bunch of them, so not sleeping through the night, not being able to gain lean muscle mass, or finding that they're losing muscle mass, gaining fat mass, so they haven't changed their diet, they haven't changed their exercise and they're just gaining fat mass, as opposed to being able to see the recovery in the gym.
Speaker 1:Fatigue is a big one, just feeling not that you need to go take a nap, but just feeling lethargy lethargic throughout the day, not having that burst of energy that you're typically used to doing, not being able to do everything on your to-do list without just feeling exhausted, having brain fog. Brain fog's another one that a lot of men will complain about, where they just say I'm just not thinking as clearly, feeling more irritable so they're quick to snap and just irritable to people that they're not usually irritable around. Sometimes headaches waking up with a headache can be a sign, first thing in the morning, not feeling hungry in the morning. So if you have a low appetite in the morning and you're just not able to get in the amount of protein that you think you know is necessary to gain muscle mass is another symptom. And then think is you know is necessary to gain muscle mass is another symptom. And then libido, of course, is another one.
Speaker 2:Okay, so the first thing that we would do is what if I say that I've got one or two or five or all of those symptoms? What's the first thing that I would do?
Speaker 1:First and foremost, we have to check blood sugar control, blood sugar stability and cortisol levels. Those are two primary things that are going to go into hormone imbalances, specifically where our body is not excreting or balancing estrogen levels well. So in men, testosterone levels are driving down. Progesterone levels in females are driving down. We have to look at blood sugar control and cortisol levels. These are done via blood testing and saliva testing so we can actually see a 24-hour cortisol curve. What does your cortisol curve look like throughout the day? It naturally should rise first thing in the morning and then come down to its lowest point around midnight. So we need to look at the whole 24-hour curve and then also looking at different testing for blood sugar stability, and that does not just mean looking at your fasting blood sugar in the morning.
Speaker 2:Okay, is that where the CGM, the continuous glucose monitor, comes in?
Speaker 1:The CGM is a great tool. A fantastic tool to be able to look at your blood sugar 24 hours a day over a two-week, 14, 15-day period, so we can actually see how often is the blood sugar rising and falling. How often are you staying above 100 for your blood sugar, whereas we should be naturally below 100 throughout the day, besides the times that we're eating. So the CGN, the continuous glucose monitor, is a little sensor that goes underneath the skin and shows us what our blood sugar is doing 24 hours a day, super, super beneficial. We can see what is causing your blood sugar levels to elevate.
Speaker 1:Is it that you're not eating enough? You're not getting enough protein? You're getting too many simple carbs? You're eating foods that your body is sensitive to. Food sensitivities and allergies can make glucose levels spike. Is it stress? Stress will cause your glucose levels to rise. So definitely, the CGM is helpful. There are other baseline blood testing that we'll do in our office, including an A1C, an insulin, a triglyceride level. So there's different blood tests besides just your fasting blood sugar. That gives us a lot of information about blood sugar control and hormone balance.
Speaker 2:Oh wow, it sounds like a lot.
Speaker 1:It's a stepwise process but you can't do it on your own and unfortunately, a lot of primary care doctors don't do it. When you go in and tell them, as a 42-year-old male, that you're just feeling fatigued all the time and you're gaining fat and you're burning muscle and you're not sleeping through the night, then they're going to say, okay, great, go to the urologist or go to this stop-in clinic and pick up your testosterone injections and good luck. The problem with it is we're not treating the problem. We're not treating the problem of you having what we call insulin resistance, which is actually what's driving testosterone down. We're not fixing the problem of you eventually becoming a pre-diabetic, and there's side effects of taking testosterone that a lot of clinics won't tell you.
Speaker 1:You, first and foremost, must get prostate exams to make sure that we're not increasing the risk of prostate cancer, as that is a side effect of testosterone replacement. But it can also thicken the blood, so it can cause iron levels and hemoglobin and hematocrit levels to go up, which can increase the risk of a heart attack or stroke. So if you already have a family history of cardiac disease, that would not be ideal. It can drive hormone levels other hormone levels down. It can affect your melatonin production, it can affect your magnesium. So there's definitely side effects to utilizing testosterone. Where we could, you know, focus on fixing the problem of blood sugar control and cortisol control, Okay, so step number one is get evaluated appropriately with blood testing and cortisol testing.
Speaker 2:Okay, so getting blood work, the appropriate blood work to check cortisol level and blood sugar level.
Speaker 1:Blood sugar stability, not just the blood sugar level.
Speaker 2:Okay, is that step one? Or is step one to do a test to see if testosterone is actually low or not?
Speaker 1:Well, I think we would do that simultaneous. You know, if you're going to have blood testing to check your testosterone levels simultaneously, we would look for the cause of low testosterone levels.
Speaker 2:Okay, so we're going to do it simultaneously. Yeah, good. So one needle prick and we got step number one done.
Speaker 1:And then step two would be making the appropriate dietary changes to control blood sugar and cortisol level, using the right amino acids and vitamin levels to control blood sugar and cortisol levels, and then, if it's necessary, to have the hormone replacement, to doing something like a precursor to testosterone tribulus or using actual hormone replacement therapy. If that's necessary, then we go that route. But we first want to find the problem. Let's fix the problem. Let's focus on the intake, the amount of protein that our body needs, the amount of fiber that our body needs for blood sugar and cortisol control.
Speaker 1:Most men are not getting enough protein and getting 12 ounces of protein at one sitting is not getting adequate protein for your body. Eating one or two meals a day with 10 to 12 ounces of protein at your meals is actually negatively affecting your body. So please don't do that. Focus on adequate protein. For females, four to five ounces for your meals breakfast, lunch and dinner, plus another two to three ounces between your meals. So for your morning snack and your afternoon snack. For men, we're looking at five to six ounces of protein at breakfast, lunch and dinner, plus another three ounces at your snack in between meals. So five times a day we're eating lean protein.
Speaker 2:Okay, good.
Speaker 1:That's the starting point.
Speaker 2:I like that. I really like that. We've got some clear objectives. So step number one is to get your blood test to see what the levels actually are. Step number two is to make the necessary changes, and for the vast majority of men and women, it's as simple not easy as simple as increasing quality protein uptake throughout the day.
Speaker 1:For sure Quality protein, and there's we could podcast on this again. Maybe we'll have part two next week, because there's a lot, you know. There's other things that will go into it besides the protein intake, when it comes to helping the body to regulate blood sugar, cortisol and testosterone production. So there's, you know, like I said, different vitamins, different amino acids, strength training regimens that need to be discussed. So there's more that goes into it. But rather than going to the one-stop shop of just getting the testosterone injections, let's fix a problem and not just treat the symptoms.
Speaker 2:Love it, Absolutely love it. Let's end on that note and make sure you like and subscribe, Share this episode with somebody that you think needs to listen to this and hear how simple not easy how simple it could be to make some significant changes.
Speaker 1:Ciao for now. It could be to make some significant changes. Ciao for now. Thank you for subscribing on your social media and podcast platforms to the Berman Method Dr Jake Berman with Berman Physical Therapy and Jenny Berman, physician Assistant with Berman Health and Wellness. You can find more information on our website wwwbermanptcom for physical therapy, bermanptcom forward slash wellness for the health and wellness. You can also find us on social media Facebook, instagram and on your podcast platform, so be sure to follow us, like us, subscribe to us and, if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.