Manhood Matters Podcast
Conversations around challenges dominating a man's journey through life. These topics are explored by real, everyday friends, with a lot of experience... And we have the occasional expert guest.
Manhood Matters Podcast
Your Body's Warning Signs: Understanding Testosterone Decline
Testosterone deficiency remains one of the most misunderstood health issues affecting men today. Despite impacting millions of men over 30, myths and misconceptions continue to prevent many from seeking help for symptoms that dramatically affect their quality of life.
In this revealing conversation with nurse practitioner Minal Patel from Game Day Men's Health, we explore the reality of testosterone replacement therapy (TRT) beyond the stigma and misinformation. Minal expertly explains how testosterone naturally declines with age and various lifestyle factors, leading to symptoms many men simply attribute to "getting older" – persistent fatigue, depression, weight gain despite exercise, decreased libido, and cognitive challenges.
The discussion clarifies crucial distinctions between medically supervised hormone optimization and performance enhancement, addressing common fears head-on. We learn that proper testosterone therapy isn't about becoming superhuman but rather restoring optimal function for your body's individual needs. Minal details the comprehensive monitoring process that ensures safety, the various treatment options available, and why lifestyle factors like exercise remain essential components of successful therapy.
Perhaps most importantly, this episode challenges the masculine identity issues that often prevent men from addressing hormone health. As Jabari and I share our personal experiences and hesitations, the conversation opens a judgment-free space for men to consider whether their symptoms might have a treatable underlying cause.
Whether you're currently experiencing symptoms of low testosterone or simply want to understand this critical aspect of men's health, this episode provides the medically-sound information needed to make informed decisions about your wellbeing. Don't miss this opportunity to learn how addressing hormone health could help you reclaim your energy, motivation, and zest for life.
Forward this episode to the men in your life who might benefit from this conversation – the information shared could be life-changing. And remember, if you're experiencing symptoms, consult with a qualified healthcare provider who specializes in hormone health.
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I'm trying to decipher what you mean by sex stimulation goes down.
Speaker 1:No. So there's these salinizing hormone and then, like follicular stimulating hormones those actually they're in your pituitary gland but they stimulate your testes.
Speaker 3:Generally? Does it have any side effect on your sexual performance or your ability to get or maintain an erection?
Speaker 1:So being on testosterone therapy can actually help that, if it's you know if it's a symptom. Yo, we're around buddy, you know decrease in sex drive or not being able to have like your corrections. It can definitely help when you're getting on the testosterone.
Speaker 3:So the side effect would be more in terms of you trying to Thanks for joining us. Before we go into today's episode, we have a special disclaimer. Because of the nature of the topic, we do need to let you know that we are not licensed professionals and cannot give medical advice. We have an expert guest on today's episode, but she is not your expert guest. Therefore, please consult your own doctor if you have any questions or concerns regarding your health. Now, before we go into today's episode, we need a huge favor. If you have gotten any value from this, forward the episode or any of your favorite episodes to a friend and ask them to give us a review.
Speaker 3:That is how other people find us, that's how they find the show and that is essentially how we grow. How other people find us, that's how they find the show and that is essentially how we grow. Seriously, right now, do it before you forget. It takes just a few seconds In today's conversation. Man, this is one you don't want to miss. If you're a man over 30, you'll need to pay very close attention to what's coming up. Ladies, if you have a man in your life who is over 30, make sure he listens to this conversation. What is testosterone? How does it impact us as men? How would we know if we're deficient? What can we do about it? And is testosterone replacement therapy safe? Is it for you?
Speaker 3:On today's show we have returning champ and co-host Jabari Pride, and we meet up with nurse practitioner Minal Patel. She is a clinic director at Game Day Men's Health in Alpharetta, georgia, and as a licensed professional, she offers a ton of insight. Welcome to Manhood Matters. Let's get to it. Welcome back, bro. Yeah, it's been a while. Yeah, it has been a while. I feel like you don't love me or something. Yeah, no, I've had so many other guests.
Speaker 2:Oh, so they're better than me.
Speaker 3:I'm just saying you know people, you're busy, so it is what it is. And today we have on the show someone that I've been trying to get on this show for my God I want to say months now it feels like it's been well. She's extremely busy, and with good reason. We have nurse practitioner Minal Patel, who is a clinic director at Game Day Men's Health. Thank you so much for being here with us.
Speaker 1:No problem. Thank you for having me.
Speaker 3:This stems from what's been going on with me for the past I'm going to say a couple of years to where I was feeling lethargic, no energy feeling I don't want to put a label on it, but I kind of feel like depressed is the right word, and I say that loosely because, again, it hasn't been clinically diagnosed as such, but I kind of feel like I could use a boost of something energy help with whatever. And I wanted to rule out one thing, because I was having a conversation with a friend and he mentioned that he said your testosterone was probably low and the man in me kind of attacked right back what you mean, you know what do you mean?
Speaker 3:because that's the thing that makes you a man. So the first thing that I heard was oh, you're a whole woman now. Um, so I didn't like that. Yeah, decided to look into it, decided to check into it and I think there's a stigma. I think there's a misunderstanding that we all have, especially as men, especially if we're that type of alpha male who just feels whatever that means, right, whatever that really means. But we feel like there's something associated where there's a shame, and I didn't want to admit that. I felt like, no, I'm just as good as you, 20 year olds. I could run circles around these guys. I'm just as strong.
Speaker 1:So maybe we'll start out by going over very simple basics and explain what it is and how it worked and how it impacts us as men. Yeah, so testosterone, it's obviously it's a sex hormone. Men have a lot of it. I mean females have testosterone as well, but in smaller quantities, where it used to be the highest, like in your early late teens to like early 20s. From there it does gradually start to decline. Most people it could be like a slow, gradual decline. Others it could be a sudden drop, just due to like their lifestyle habits, you know, like genetics, due to drinking a lot of alcohol, due to gaining a lot of weight, sometimes having some kind of medical condition like, let's say, diabetes or sleep apnea. All of that can also cause you to have lower testosterone levels.
Speaker 3:So overall, then, there's an expected decline, is what you're saying. There could be a rapid decline due to a medical condition, but there is an expected decline due to age.
Speaker 1:Yes. So, as you age, your levels can start decreasing.
Speaker 3:Can or will, Just naturally Will they like. For sure it sounds like.
Speaker 1:So let's say somebody is in their 50s but they are following a good lifestyle, meaning they are following a good, balanced diet, they are exercising daily. Then their levels may be higher compared to someone that is not doing that at their age.
Speaker 2:I feel like you've described everything. That should say that my levels are in the toilet right now. Yours, yeah, why? As far as what do you mean? Poor diet, gained weight 46 next month. I feel tired all the time, but I also have a nine, seven and five year old and I probably get anywhere from four to six hours of sleep at night.
Speaker 3:It's like could it be low?
Speaker 2:T. Could it be three kids, Like I don't know.
Speaker 3:That was my thing too. I wanted to eliminate the testosterone thing. I was like I needed to get it tested because I wanted to at least eliminate that and just say, well, let's take that out of the equation, right? Whatever else is wrong with me has to be something mental or something with work or whatever else, and maybe I'm overworked, I'm stressed, but I wanted to eliminate that one thing If there is something I can do about it, and it seemed like it was the easiest thing to handle.
Speaker 2:I was about to say that it's like you're looking for the quickest fix.
Speaker 3:Yeah, well, I'm looking at the thing that if there are three things I have to fix, if I can fix one, can I fix this one thing that I'm deficient in? What should we look for to feel that, okay, it's time to get it checked?
Speaker 1:Right. So if you've been experiencing a lot of like low energy, fatigue, mood changes, especially like depression, if you've been noticing that you're exercising but not able to lose the weight, you're exercising, you know, four or five days out of the week, but still not losing the weight, notice any changes in your sex drive. Notice changes in like loss of um early morning erections so all the things that men don't want to admit right, that's pretty much yeah, are there physical things?
Speaker 1:yeah, yeah, morning erection like just like looking in the mirror, looking like, oh yeah like so, like weight gain in the midsection, sometimes weight gain in like the chest area and the hips, dry skin, especially on, like your face, hands interesting.
Speaker 1:So then once that's noticed and we're not in our 20s, we should definitely get that checked yeah, it doesn't hurt to get it checked just to kind of rule out that aspect of it, right, cause I mean, obviously fatigue is like a really broad term. It could be caused due to a lot of different things, right, but getting that testosterone level checked you could kind of get an idea of if it's contributing to that fatigue that you're having.
Speaker 2:So is there a base level of testosterone where a man should be?
Speaker 1:I'm sure there's like some type of range. Yeah, so it's a pretty broad range, typically anywhere from like 300 to 1100 even, but obviously, like an optimal level varies based on the person. But if you're having symptoms related to low testosterone, we aim for your total testosterone level to be at least above 550. Low testosterone.
Speaker 2:We aim for your total testosterone level to be at least above 550. So it's possible to be like a 1200,.
Speaker 1:But you're tired, you're experiencing all the symptoms of someone who has low T. I mean you could be at a 1200 range. Now our cutoff is at at least if you're 599 or higher than obviously you're at a therapeutic level. So if you're in 1200, that's a pretty therapeutic level, or actually even higher.
Speaker 2:But is it? Is it the inverse the higher the number you need testosterone, the lower number you don't, or is it?
Speaker 3:No, no, no, the lower the number. You need testosterone. Got it Okay? Yeah, okay, cause I remember when I got tested, I think I was somewhere in the 300s, right. What's interesting is I got tested at a different facility where my doctor felt, based on everything else, well, you don't really need it. So he wasn't going to prescribe anything, and I'm not sure why that was because I still felt the same. I was listening to another podcast where the guy who's a doctor on the show he was saying sometimes, like a 900 for me might be low, whereas for you it's good enough, a 900 for me might be low, whereas for you it's good enough, because, again, different people, different body types, different lifestyles, et cetera, different genetics. So what he would look at, he would look at just what's the normal range, regardless of how I felt. He felt like, oh you don't need it.
Speaker 2:Do you think he just gave you the eye test Like, ah, he looks like he works out, he's good, he's not fat yeah.
Speaker 3:That was a little bit of that it was a little bit of like I'm not really listening to everything else you're saying in terms of how you feel you look fine. Whatever's wrong with you is probably in your head. Go see somebody else. He just wants some steroids, yeah.
Speaker 4:But yeah, I'm not here to get you stronger or whatever, and I still felt the same way.
Speaker 3:I felt so when I came here, went away, I was thinking I guess he's right, but weeks later I was still feeling horrible.
Speaker 2:Yeah.
Speaker 3:And I wanted to eliminate that. I didn't even have the energy, as you know, to go to the gym. Yeah, I didn't want to, just a zero drive to even get up and just go to the gym. But I thought I needed help and I came here and I got my levels tested and it was a different story. So when a different facility says you're at 300, you're 47 years old, you're fine, that's the way it should be, because according to your age, that's where you should be anyway. Do they have a point in saying, well, it should decline. So why should we mess with nature?
Speaker 2:And can you also explain what TRT stands for and what it means?
Speaker 1:Yeah, so a lot of primary care doctors. If you're getting like your testosterone check, they go by that big broad range which is considered normal. Sometimes it may not go off of like oh, you're having symptoms of low T and you're in this range, you need testosterone. Sometimes they don't go off of that. They go off of like that normal range. That's probably what happened with you Versus here at Game Day. We specialize in testosterone replacement therapy so we look at your levels but we also look at your symptoms and go off of, like I said, if you're below that five 50 range, you're having symptoms and, yes, you probably you do need testosterone replacement to help with that. But to answer your question, trt stands for like testosterone replacement therapy and it's a medical treatment aimed at raising those testosterone levels in men that have low testosterone.
Speaker 1:It's a condition Sometimes it's also referred to like hypogonadism and it comes in like different forms. You could do an injection form, you could do an oral form, you could do creams, gels. Most people tend to go with the injection form because it goes directly into your muscle and typically you can take it once or twice a week or more, but typically it's once or twice a week. There's also like a pellet form. Those are little tiny testosterone tablets that they make a little incision in your skin. Put it in the fat part of your skin and they gradually release testosterone. It's more of a long term can last up to like three to four months.
Speaker 2:Okay, okay, okay. Well, it does sound like earlier. The example you were giving was almost like if he was the doctor to talk about his diet and the doctor was like yeah, so looking at your BMI, you're obese. And you look at him, you're like well, clearly, I think I'm obese on the BMI scale because I'm six feet 200 pounds, so I'm overweight, but I'm not obese. So what you do is you really look at what's specifically going on with that individual to then make a determination like okay, yeah, I know this general scale says that you're okay, but you're not okay, right, Okay, what is free testosterone versus not free testosterone?
Speaker 1:Because I think when they check for like the total testosterone?
Speaker 3:right. What is free versus total?
Speaker 1:Yeah, so free testosterone is basically what's readily available for your body to utilize, and the total testosterone is in your body as a whole right, so the free.
Speaker 3:Free is what matters, then so, yes, free definitely matters.
Speaker 1:So, like my guys that are having symptoms and, let's say, their total testosterone is above the limit, like at a therapeutic level, then we can check their free testosterone level. If it is low, then we can consider putting them on testosterone as well.
Speaker 3:Gotcha, I think that maybe that's what a lot of doctors are checking for your regular PCP. They're seeing that your overall testosterone level is high enough, but you can't use that for what we need it for as men. Correct me if I'm wrong. The free testosterone is what we need in order for us to feel the energy you know, not be foggy, and you definitely look into that to make sure it's not just a blanket. Hey, you're fine, go home.
Speaker 1:Yeah, definitely Stop crying.
Speaker 2:How have you been feeling the last three months?
Speaker 3:Admittedly, first month made zero difference. Maybe the first six weeks it made zero difference and I was coming here all the time, but the reason was because I was just sitting on my ass.
Speaker 1:Still, I still wasn't getting in the gym.
Speaker 3:And I realized that later because, you know, I even came in, I saw Manala here and she asked me the same question. I was just like oh, it makes no difference. She's like are you going to the gym? I was like no, she's like you gotta need to. So what happens if you just take it kind of like what I was doing, cause I feel much better now, but when initially I was taking it and hoping that it was going to be like a magic pill?
Speaker 1:Obviously it's not. I mean, you definitely, yes, you will take the testosterone, but we want you to utilize it. You know, to reach that best version of yourself, you have to be eating a well-balanced diet. You have to exercise, at least you know, three to four or five days in a week.
Speaker 3:Not twice like Jabari, not two days. I knew you were going to say something. Four times a week, go ahead.
Speaker 1:If you're not exercising, then obviously the testosterone can just sit there and cause other effects, right? We want you to utilize it as best as you can. Lose weight, start building more of that lean muscle mass, burning that fat, uplifting your mood. I mean exercising itself releases those good endorphins right.
Speaker 3:When you say utilizing it, just so we're clear, it means that you need to do all the other things that go along with that and this kind of gives you can we call it a boost to kind of help you get there.
Speaker 1:Right. I mean, sometimes I kind of explain it like as a almost like a supplement. Let's say you were low in like B12, which is causing, like the low energy. Obviously we recommend taking B12 to boost that up. So same thing with this. Yes, testosterone will help raise your levels up, but you also, in conjunction, need to modify your lifestyle. It's not a magic pill. If you just take it. You're not just going to become Mike Tyson.
Speaker 3:It's not like Popeye and spinach.
Speaker 1:Right.
Speaker 3:That'd be great. That's what I thought it was at first. I was like I'm going to take this and feel awesome, and that did not happen.
Speaker 2:Because if you don't use it, then your estrogen levels will also climb to match your testosterone levels, which means you'll still have some physical changes.
Speaker 1:So a taken testosterone, I mean it definitely needs to be medically monitored. That's why we're here. There's certain levels in your blood that we need to be checked periodically Because if they're not checked then obviously you're going to get some side effects right. So number one is your hemoglobin count, or your red blood cell count. We keep an eye on that. Sometimes when you take testosterone, it actually increases your red blood cell production, which is a good thing if somebody's anemic. But if you take testosterone, there's a chance that that red blood cell count will go up and if it gets too high, then your blood will get too thick. It can start affecting your blood pressure, bleeding, all of that Other things we monitor is Well.
Speaker 3:how do you handle that Like, if that happens?
Speaker 1:If your hemoglobin levels are up, we obviously hold off on the testosterone until it comes back down, or we can also have you donate blood. That's an easier fix because it will help it come down and then you can stay on the dose that's working for you. Sometimes we may have to go down on your dose based on how your body's reacting.
Speaker 2:Would it make sense to do a blood thinner, maybe ibuprofen or something?
Speaker 1:Not ibuprofen, maybe like a baby aspirin or a fish oil Aspirin. Yeah, grape seed oil capsules.
Speaker 3:Or you can just donate a pipe and be done with it and get paid.
Speaker 1:Right, I didn't get paid what they give you donation right, so you don't get paid yeah, no, I got a t-shirt.
Speaker 3:You need to get paid. Yeah, I got a t-shirt. Um what?
Speaker 2:and a cookie, some grape juice. They didn't give you any food, snack, something else oh, t-shirts and a what which?
Speaker 3:which clinic is that? Um yeah, um no, they didn't give me a t-shirt. That was pretty. That was it. That was my first time to ever donating blood in my life, because I don't like needles, so I was like I'm not gonna get stuck voluntarily, I don't have to. That happened to me as well. Um, so it was elevated and just it just come down.
Speaker 1:So and there's obviously like if you're not drinking enough water, if you're dehydrated, that can also make it go up. If you're, let's say, eating a lot of red meats, that can also make it go up because the iron content. So usually we say kind of do red meat in moderation, do more of your lean meats, and then there's like certain conditions that can also make it go up. So like if you have like uncontrolled sleep apnea, obviously then that can make it go up. If sleep apnea is there, we'll tell you to go get a sleep study done. Or if you are not using your CPAP, then we tell you to use it, so it's controlled.
Speaker 3:Gotcha. So what I'm hearing is one of the most important things you can do. In fact, the only way you should do it is to go see a medical professional like yourself so that other things could be monitored, because I think that some of the stigmas and things that are negative that people are hearing is bad. Things happen to people when they start buying it in the back of the gym, you know, in the alley and you know they just take more and more and more Because, again, if you take something, you start to feel the positive results from it. You're going to want more. It just becomes almost addictive, not in a medical way, but it makes you want more of it because that feeling is good of like I'm getting stronger, et cetera. But what you're doing is not to give anyone anything to make them Superman. You're just bringing them back to normal levels, am I correct?
Speaker 1:Yes, so normal levels for that person.
Speaker 3:For that person, right, so it's not even normal. It's like you.
Speaker 1:You're not gonna make me a 20 year old right you should have said last time the gym was trying to get you to, I guess, the best version of yourself, so like a healthier version of yourself okay right, because low testosterone obviously can lead to a lot of medical issues if not treated well. So, like the, you can gain weight that can lead to diabetes, high blood pressure, high cholesterol levels, which can lead to diabetes, high blood pressure, high cholesterol levels, which can lead to other things like stroke, heart attack. All of that, so we don't want you to have that Right.
Speaker 3:So low testosterone can lead to that. You alluded to bringing you back to the best version of yourself, and you measure that based on what is it that you look for? Is it just the physicality of a person? What else?
Speaker 1:Also how you're feeling, how your symptoms are improving. Typically your total testosterone levels as well. We want to make sure they're coming to a good optimal range. On average most people, we try to get you in that 800, 900 range but you know, let's say you are more sedentary, not working out as much. Sometimes you may be happier in that 600, 700 range versus someone that's vigorously working out. They may be happier a little bit above 900 because they're burning off more of that testosterone or utilizing more of that testosterone.
Speaker 3:Yeah, I'm definitely using it now.
Speaker 2:Yeah.
Speaker 3:Right, cause we've been in the gym, we're going and we're going hard. So, yeah, thanks, yeah.
Speaker 4:Yeah, you're welcome.
Speaker 3:Definitely might need to get that tested again, see if I need more. When I hear it, the way I kind of feel about it is I think of it like someone who is deficient in something else, like a diabetic. You're not just pumping someone full of insulin just for the hell of it, you're only doing it because they were deficient in this particular thing. Is that a good comparison?
Speaker 1:It's different from you being a diabetic and getting insulin right. Your levels were low. We're helping it come back up to a good optimal range, so all those symptoms that you were having can be alleviated.
Speaker 3:Okay, that makes sense. Initially your reflex reaction was I would never do that. But then you say, well, I'll never say never, and you kind of left it open.
Speaker 2:So I was an athlete High school and college and post-college I'll never say never and you kind of left it open. So I was an athlete high school and college and post-college I ran track. So with track the testing is very stringent, like if your caffeine levels are too high, you could get banned for like four years or eight years, which is could pretty much destroy your career Right. So pretty much college and post-collegiately. If I had a headache, I wasn't taking any medicine. If I wasn't feeling well, I'd sleep it off Like I didn't want to put anything into my system that could be disqualified.
Speaker 2:Exactly so. That fear was always in me and, like there are people that were how do I politely say this Were performing much better than they should have been due to things that they were doing extracurricularly Right.
Speaker 2:So then there's that stigma, so they were taking some performance enhancing drugs oh, 100%, okay, back in the 2000s it was HGH, you know. Before that, steroids were big. Right, after HGH, trt became a thing, but then it had to be monitored correctly. Right, there were people I'm sure they had a doctor that could help them be above the levels that they should have been. Right, so there's always a stigma of you don't want to be caught doing anything. So the best way to not get caught doing anything is just to not do it.
Speaker 2:So for me it's always been like when we were talking about it, I was like, oh, I could never do it. It's because it was always. If I do it, even though I'm not competing now, it's still that those are the people that did that and I don't want to be one of those people because I did it the right way. You know, maybe I don't finish first, but I'm finishing clean with a good conscience. Right, that's always been in the back of my head where it's like maybe you know, I do get my levels tested and then you're like, you're at a 200 Jabari, like kids are not, like your levels are way too low. And it would still be tough for me, cause I'm like, ah, I feel like I'm cheating, even though I don't have any meets coming up. I'm never going to run again. I'm 46. I'd blow both my hamstrings out if I try to run down the track, but it's just that. That's stigma.
Speaker 3:Yeah, for me, and I'm I'm not the norm, I'm nowhere. This Cheating to what? Cheating for what?
Speaker 2:Exactly. I don't have a meet coming up, I'm never going to compete again.
Speaker 3:All right. So forget meets right, like again ex-athlete myself and all of that stuff. Again, my view on it is if I'm deficient in something like if it was just B12 or low in iron, I'm not taking iron pills because I'm not low in iron, so I don't need it, so I'm not going to have. Let me have extra iron so I could be extra strong. That's not a thing for me. But I'm deficient in this one thing that I need to bring me back to my normal levels, not above. Why do you call that cheating? To get you back to Jabari Right now you're like Jab. How do we get you back to Jabari? So you're like your whole self. You know what I mean. That's the way I would look at it. Why?
Speaker 2:do you look at it as cheating? Because if I were to take us back to when we were both 22, I know that we're not 22, right, but if we were both 22 again and we were lined up on the line and my levels were 1300 and your levels were 1100. And you looked over at me like damn it, that guy's bigger than me, stronger than me, that's not fair. I'm going to lose this race. But over the next two weeks I'm going to visit Manal and then, you know, I'm going to be able to compete with that person. Right? It's like well, it's not my fault that I'm genetically different than you. It's not my fault, I haven't. It's and with a ridiculous stride that he can do what he can do and no other human can do. It's not his fault that he has that genetic advantage. So why should you penalize me by giving you an equal advantage to me when you didn't have that in the first place? So good point.
Speaker 3:Bring me to your levels. Is cheating Correct? Bring me to what I need to be at is not cheating. Does that make sense? It does make sense. I'm not trying to become Usain Bolt because if I look at everything genetically, let's say I was able to just break down his anatomy and I was like everything that he's got I stick it into my little five, seven body.
Speaker 4:I would explode, it wouldn't make sense right.
Speaker 3:But if I'm looking at the exact clone copy of myself, like it's another version of myself, that is optimal. And then there's me, who's suboptimal. I'm missing all kinds of things. Maybe this version is not sleeping at all, maybe this version is having all kinds of other issues, and all I want to do is bring it back to that other version of myself, which is the best version of myself. Not to meet me, jabari, because, again to your point, when I think about that example, I'm standing next to you and you're at 1300, I'm at 1100. Forget those numbers. I'm looking at the fact that you're six feet and you're 4'11". Yeah, exactly.
Speaker 3:I'm looking at that you're six feet right and I'm in my best shape, but I have a natural disadvantage. There's a reason, like in your MMA days, a 200 pound guy is not fighting 130 pound guy you see what I'm trying to clear.
Speaker 2:Yeah, yeah so, when it comes down to performance, if it's strictly a performance like you're trying to elevate your levels to perform at your 20 year old self, for me it's still like, well, that's not normal, because a I'm 46. Could I get my levels back up to when I was 26? I'm sure you could get me there and I'm sure I'd look amazing. Right?
Speaker 3:Not necessarily, no no, she can't get you back there, because that's not normal.
Speaker 1:So this is that's when you were 20.
Speaker 2:Go ahead, manon. So what would be a normal number for a normal being a vague term right, but what would be a good number for a athletic 24 year?
Speaker 1:old. So, like I said, average total testosterone levels usually in that 800, 900 range. Actually, it's based off of you as well. Yeah, and how you're feeling after you start taking it, and usually it takes about a month to three months for you to reach a good optimal level. After you, you know, get on testosterone therapy.
Speaker 3:That makes sense. Yeah, you would never walk into a legit facility and say make me like I was when I was 20. They would laugh you out of the building if they're a legit organization.
Speaker 2:They say go to Mexico.
Speaker 3:Yeah, go somewhere else with that, because we can't do that for you. Yeah, right, but could I be the best 50 year old version of myself? Because there are 50 year olds who run circles around a bunch of 20 yearyear-olds because they're in phenomenal shape. We're part of that select few. I mean, how many 20-year-olds do we know that we can just like run around them in the gym? Could you be the best 46-year-old version of yourself right now, to where everything's kind of balanced.
Speaker 2:So, once again, if it's strictly for performance and what I mean by performance is like going to the gym playing sports with my friends I wouldn't want to do TRT to do that, because I feel like at the levels that I currently have, I can do that without the extra TRT. Now, if it's, do you want to wake up feeling refreshed? Do you want to not be tired all the time? That's something different. If TRT was a cure for that, then it's like I could care less. If I perform better, If I can get through my day without needing a nap, that'd be great, right, Because whether it's TRT or it's, I'm sure I have sleep apnea. My wife tells me, like I think you're dying. You just stopped breathing Something. I need to do something, obviously, because it's just not having three kids. There's definitely something going on and you get to figure it out. But I mean, if TRT is the answer, then TRT is the answer. If the CPAP machine is the answer, a CPAP machine is the answer, right.
Speaker 3:I think you're also using an additional word here. That's creating more of a misconception, even in your own head.
Speaker 4:What is?
Speaker 3:that you keep saying extra. No one's trying to give you extra. Well, it would be extra to my levels that I currently have. Still not extra right, because if you don't have what you should have, let's say nothing else, like your body was working perfectly. But what do you mean by should have? Because there's a certain amount that you should have to where you should be to perform at your level. But there are other things that again keep me honest that bring that number down, whether you don't get enough sleep, whether it's stress, whether it's so many other things that accelerate that decline to where, if you were sitting on an island and life was good and you were farming and you were just chilling and you exercised every day and you didn't have any stress and all your concerns, maybe your levels will be higher. But we live in a very stressful world.
Speaker 3:Both you and I are in cells and we run our own businesses and things are very, very stressful. We don't sleep, you have babies, so it's declining that. It's not giving you the time that you need to even get to the gym, so all of those things are taking that number and declining it even more rapidly.
Speaker 2:In my head because of the stigma that I've had for so long. I would rather do something else than do TRT.
Speaker 3:What's something else?
Speaker 2:CPAP machine right, go to bed earlier. Like we got home from the gym yesterday. I didn't go to bed till 2am, I think. My aura ring said I got four hours and 15 minutes of sleep and I was like, oh, not a bad night. Now, if I fix those things, I'm still tired, still can't get rid of, like, the weight around my stomach. Then it's like, all right, let me, uh, let me see what the TRT can do for me. Yeah, it's just hard for me to make that jump in my head because I was, I had to be, so negative towards any type of performance enhancing drug Not not that you know you guys are, not that you're peddling PEDs out of your clinic, but that's, that's what it was for me for such a long period of my life?
Speaker 1:Is it that again with yeah, right, but if you modify your lifestyle and you're still having these symptoms and definitely come in and get those levels checked, come in for the consult where we could, you know, kind of go over your health history in more detail and come up with a plan would you consider trt or is it considered a performance enhancing drug? Are you talking more like uh, anabolic steroids?
Speaker 3:well, yeah, in the context that he's using it in, because, again, it does enhance your performance.
Speaker 2:And I'll give you a real world example. So in MMA specifically, there were some fighters that were great when they were in their 20s. They looked amazing. I'm not going to call anybody out because it's going to live on forever. They got older, they got to their 30s and they physically didn't pass the same eye test right, they got softer then trt um in their 30s yeah, okay, um, they weren't built like superman.
Speaker 2:They were still had muscles, but they just weren't like. You could see every single striation in their abs, right. Then trt was made legal in the ufc and then those 35, 36, 37 year olds look like they were 21, 22, 23 year olds. I'm sure some of them were taking advantage and going above where they needed to be. Right, there was some abuse. They were allowed to do that for a few years and then they said, all right, this is getting out of control. So they made it illegal again. And then those 30, now 36, 37, 38 year olds look like 36, 37, olds and they were getting knocked out I can guarantee you, I'm not there, I'm not in their world, I can 100 guarantee you.
Speaker 3:and I hate that brett's not here because he would have been able to attest to this. Yeah, they weren't going to a doctor to just get him back to normal range. No, these guys were truly enhancing their performance because they know I'm gonna go fight you, I'm going to go in the ring with you, I'm going to push it to the human limits because I'm about to get knocked out if I don't. So that's different. So I think in that world you're absolutely right, it exists in that world, and there's a big difference between that and the normal world that we live in, so it was labeled as a PED because it did enhance their performance.
Speaker 1:So, sorry the example, like anabolic steroids is one of them and where these athletes use these animal extrudes to improve their performance, improve their muscle mass, but they are using it at such a high level where it can cause a lot of harm in the longterm versus TRT. You are taking it for low T levels and you're getting it monitored. It's not like nobody is monitoring. A medical professional is monitoring it.
Speaker 1:So, if there's any harm being done, then we can adjust your dosing, we can stop you all of that. But versus anabolic steroids, people are just taking it.
Speaker 3:With one goal. The goal is to go fight that guy on Sunday here. I don't have a fight coming up, I just want to live, I want to be with my kids.
Speaker 2:But to go back to your question, TRT is a PED. Here's the problem with the term PED. Whenever you hear the term PED, you automatically think the worst possible thing. Right, but it's still technically enhancing your performance.
Speaker 3:So it's a vitamin, then in that case, right, because it's a drug.
Speaker 2:I don't think vitamins are more of a supplement. They're not technically a drug.
Speaker 3:I guess technically they're a drug it's testosterone that's made in your body from your testicles a drug it's?
Speaker 1:it's a sex hormone, right? The testosterone replacement that we especially like the injections. It's a synthetic form of testosterone but when you inject it in your body, your receptors they're not able to tell, tell it apart, right? So they think it is testosterone versus like. If you did like the pellets, those are bioidentical to the testosterone in your body but your body still reacts the same way to either one right.
Speaker 1:Look at it long term. These symptoms that you're having, like depression, let's say the sleep issues, let's say not being able to exercise, not being motivated that can lead to other things down the line and that is definitely going to affect your health right. I mean, major things are you don't want to end up with, like diabetes, cardiovascular disease, which causes even worse things like heart attacks, strokes, cancer, all of that being overweight have been known to seen with, like some cancers as well.
Speaker 1:So, if you start treating these symptoms now, if it's due to low testosterone, then obviously it's going to Decrease your risk of getting these cardiovascular diseases become diabetic. All of that.
Speaker 2:So I'm happy you brought that up. Long term, so is Steph supposed to take TRT for the rest of his life, because he's always going to be catching up right? It's a good question, yeah.
Speaker 1:So once you start, yes, it is a lifelong thing, but I mean, obviously you can stop it anytime you want. But just know, yes, you will go back to the levels that you're at possibly lower because you are aging as well.
Speaker 2:Right, so does your body. I'm sorry, I didn't mean to cut you off, but does your. Let's say he starts. Well, he started three months ago. Let's say he takes it for another 10, 15 years and now he's like you know what? I'm not going to the gym anymore. I'm fat and happy. I'm good.
Speaker 2:Right, I'm good, I'm not taking it anymore. Will his levels then drop further down than where he normally would have been, because his body is like well, we don't need to create what we've been creating, because we're getting it Right From outside of the body.
Speaker 1:Yes, so when you stop it, I mean it definitely takes a little while for your um, those sex hormones to start kicking back where you're making your own testosterone. But I mean there's other medications that we recommend sometimes, especially for guys that are younger or want to continue having kids. There's medications that you can take that keep stimulating those sex hormones. If you did decide to come off the testosterone, you won't feel that big dip when you stop it.
Speaker 3:Speaking of having kids, if you're 30, 35 years old, obviously I'm not having kids anymore. You don't need any more kids. Dude, I'm assuming you're done, yes, Cool. So you got your three, you're done. Yes, so, but for a 30 year old, 35 year old, maybe newly married or remarried? What are the risks and what's involved with someone who's definitely going to have more children?
Speaker 1:Right, I mean. So if you're actively trying to have kids, then we hold off on you getting on testosterone to begin with, but let's say, down the line a year later, two years later you did want to start trying. Two years later you did want to start trying. Yes, you could take testosterone, but we usually recommend getting on a medication called gonadalrelin which keeps those sex hormones stimulated, so your body's producing its own natural testosterone as well.
Speaker 3:Gotcha, gotcha.
Speaker 2:Why would it prevent you from having kids having the extra testosterone in your system?
Speaker 1:So when you are taking the testosterone it's like your body's like, okay, he has enough testosterone. So those sex hormones that usually stimulate those testes, they do take a break. So that's why someone that's young wants to continue having babies. We usually recommend doing the gonadalrelin to help keep those sex hormones stimulated and the sperm count up.
Speaker 2:It would be harder to get an erection. I'm trying to decipher what you mean by sex. Stimulation goes down.
Speaker 1:No. So there's um these solutinizing hormone and then like follicular stimulating hormones those actually they're in your pituitary gland, but they stimulate your testes to produce sperm and in turn, also build sperm as well.
Speaker 2:Got it, so your sperm count can go down.
Speaker 1:Yes, got it Sorry, I meant testosterone and make the sperm count go up.
Speaker 2:Okay.
Speaker 1:Late in the day.
Speaker 3:Generally? Does it have any side effect on your sexual performance or your ability to get or maintain an erection?
Speaker 1:So being on testosterone therapy can actually help that if it's a symptom. Yo, we're out, buddy, you know decrease in sex drive or not being able to have like your erections. It can definitely help when you're getting on the testosterone.
Speaker 3:So it's just really the side effect would be more in terms of you trying to have kids, and that's when you need to be watched by. And I like what you said a little while ago, because you said you would not even get them started If someone came to you and said I want to have kids.
Speaker 4:Right.
Speaker 3:And that's the point of coming to a medical professional as opposed to, you know, buying it from Joe at the gym, right.
Speaker 2:Yeah, I think that was one of the uh kind of like the those massive, massive body builds that are on all the jugs, their testicles shrink up because the body's just like we need to stop. Well, I don't know what all they were taking right, yeah, everything but the testosterone part.
Speaker 1:like I said, it can cause testicular shrinkage because it decreases your sperm count.
Speaker 3:I don't need sperm.
Speaker 2:You need to take more TRT so you don't have any more kids. I'm done.
Speaker 1:Now, obviously don't think of being on testosterone as like a birth control.
Speaker 2:It's the perfect male birth control Make me stronger and not have any more kids.
Speaker 3:That's actually a good point.
Speaker 1:You could still you know, get somebody pregnant. Don't think of it as a birth control but it can decrease.
Speaker 3:No, I had a hysterectomy, so I know Is that what it's called for me Vasectomy, you mean.
Speaker 2:Yeah, the hysterectomy, I knew it, I knew it. I knew it.
Speaker 4:Oh my God, I got snipped. I should just stick to that.
Speaker 1:I took all your ovaries out for a second.
Speaker 4:I took all the ovaries out.
Speaker 3:My ovaries are gone. I can't have babies. Man, oh my God. Thank God this isn't an educational show.
Speaker 4:We are leading them astray.
Speaker 3:A couple of other questions that we do have Once someone starts. You mentioned that they get results typically in about a month to three months before they start seeing results.
Speaker 1:Yeah, To get to a good optimal range. We've seen anywhere from a month to three months, sometimes longer if we are adjusting your dosing based off of the other lab work that we monitor.
Speaker 2:Gotcha, gotcha, but you have to be working out, though, to see results.
Speaker 1:I mean, obviously we do recommend that, yeah, because somebody came in to me a month in there.
Speaker 2:He was like, uh, hey, can we start going to the gym? I was like, ah, yeah, no, no, no, no, like we need to start now. I was like, yeah, I guess, man, I don't know why. He's like I'm on TRT.
Speaker 3:We got to have a long conversation after six weeks. Yeah, yeah, sure enough, I came in after six weeks and the question was how are you feeling? Just hear mumbling on, nothing, no difference really. And she's like are you going to gym?
Speaker 2:nah, just not doing anything he must have called me right after your conversation yes, he was like we need to go to the gym tomorrow.
Speaker 1:Yeah, yeah I was like find somebody that'll motivate you to go there. So you were him.
Speaker 3:So are there other risks for someone, obviously to be monitored and go into a professional clinician, and is there a point to where it's just like don't even bother, you're too old, you're 65 years old.
Speaker 1:Maybe you shouldn't even start at this point, because whatever you're feeling, you should be feeling I mean there's obviously some contraindications, like if you have prostate cancer or testicular cancer, if you have, like, severe kidney disease, severe liver disease, I mean if you have severe like heart failure or even uncontrolled sleep apnea, then obviously we don't recommend you being on testosterone therapy okay but as far as like you were talking like some side effects, or anything risks to watch out for.
Speaker 3:Someone who's just like if there is a side effect, I'm going to get it.
Speaker 1:Right, For example for me.
Speaker 3:I just like I've been blessed and really like healthy on my entire life. So if I got an antibiotic and they're like this might give you diarrhea, I will get it, because every drug has every effect that it could possibly have on me. It will have on me If I take one pill for a headache, I'm good. My wife may need three pills because she's like her resistance is a lot higher. So for someone like me, who's kind of like maybe more skeptical, was thinking are there any side effects and how will they impact me?
Speaker 1:Right. I mean that's the reason why we say to get it medically monitored right. There are certain levels that we have to check. If they're not right, yes, it could cause you to have some side effects, like if your blood gets too thick, that can affect your blood pressure, that can affect your bleeding, if your estrogen levels get too high, you can start getting like nipple sensitivity, gynecomastia or increase in breast tissue, mood swings, bloating, weight gain, decrease in your sex drive. There's like lesser known side effects, like acne. Sometimes people can have acne and that could depend on like what type. If you're on a super high dose or not, dosage adjustment needs to be made. Sometimes hair loss can occur as well. And another thing we monitor your prostate level as well because we want to make sure you don't have prostate cancer, because obviously, if you have prostate cancer, you cannot be taking testosterone therapy. That is why it has to be medically monitored to make sure we can manage any side effects that could be occurred.
Speaker 3:Gotcha, gotcha, while you're doing therapy, is there an age that you would just say no, I don't recommend you even starting 85. Yeah, 85, yeah, that's what. I'm saying If an otherwise healthy man and there are some dudes out there in the 70s, we see them in the gym. They're looking phenomenal Would you say there's a certain age that you would just say no. I don't think you should start at this point. Yeah, certain age that you would just say no.
Speaker 1:I don't think you should start at this point.
Speaker 3:Yeah, if you're like 85 and older, definitely, but if I'm, if I'm the sexy grandpa at 75.
Speaker 1:If you're having symptoms that are, you know, dramatic, then that coincide with having low testosterone. Then possibly dosages could be different for them versus someone that's in their forties.
Speaker 3:Okay, what does a visit to get everything started look like here at game day?
Speaker 1:Typically we'll schedule you with an appointment. There's some forms that we'll send you that you'll just fill out online, just like a basic intake form telling us about, like your health history, what you're interested in. That will save us time. So when you come in, our medical assistant will take you back, check your vitals, draw your blood and then, once we get your blood, we check your total testosterone level here in the clinic. Typically takes about 13 minutes after the blood spun and then, once we get that level, you'll get to see me or one of our other providers and we'll basically start your consult based on you know, symptoms, your history and then also your testosterone level.
Speaker 3:Do you find a lot of people come in and they're perfectly fine and you just go? Yeah, you just need to go Take your ass out because it's not testosterone.
Speaker 1:Yeah, so we get some that just want to know their levels.
Speaker 3:Okay, when they're perfectly good.
Speaker 1:Some that are also like at a therapeutic level where they may not need it. But there's alternatives, like I said, that we also offer, like vitamin therapies or even like peptide therapy, could be an alternative.
Speaker 2:Is this covered under medical insurance at all?
Speaker 1:no, it's not, is it?
Speaker 2:elective versus right.
Speaker 1:So a lot of insurance companies kind of go off of that normal range. If you are in that normal range, then they'll be like why should we cover it?
Speaker 2:Yeah, so if you're below the normal range, then it's possible that they could get it Possible.
Speaker 3:And by normal. They're looking at the overall. They're not looking at the free testosterone again, which, again, is what we need to focus on for what we're talking about here. Right, we are in Alpharetta, georgia, so for our Georgia listeners, how do they find you?
Speaker 1:I mean online. You can go to our website gamedaymenshealthcom, and there's obviously several locations in Georgia, but you'll see all the locations that are available. The initial consult is free. Once you sign up, we go over all the investment details. You know, there's gonna be a whole lot of dudes that go, oh, free consult.
Speaker 3:We do get that yeah.
Speaker 1:Well, that's what it gets them, you know, in the door. It gets them in the door, yeah.
Speaker 3:That's what got me in the door. I mean, it was a free consult. I was like, well, let me at least find out. Right, once I found out, I found that the experience here has been very transparent. It's been extremely helpful, educational. Every time, you guys well you specifically when we have a conversation, I always feel like you're teaching, and it's not just here I'm advising this, but I'm going to teach you everything that you need to know, which is very helpful to me, and I think that if more doctors and clinicians approached it that way, then we'd have, I guess, more people looking into it, because that's what's always been kind of a little daunting to me. I don't like doctors, I don't like going to them.
Speaker 3:I don't want to go, I feel like nothing's wrong with me and by the time I show up I'm like-.
Speaker 2:Everything's wrong.
Speaker 3:Everything's wrong I waited so long and it compounded into five other things that I could have prevented.
Speaker 1:Yeah, I mean it definitely helps to keep you well-informed, explain everything where you're able to understand it well, instead of using, like, medical jargon in there.
Speaker 3:I mean I will say for me right now, like again going to the gym with Jabari here, but my sons, they've joined us as well. So I don't know about you, but like for me, I feel like even when I don't want to go, I go for them. So then I'm like forced to go, and that's exciting and just to watch their own transformation. So I'm definitely utilizing it. Oh yeah, you know utilizing it, Cause we're going in the gym, we're going hard.
Speaker 2:We're going heavy. I was like how much did you do? I did 10 reps, Cool, and then he'll do 11.
Speaker 1:I'm like that's motivation. I told him to find someone that will motivate you.
Speaker 4:Oh we got it.
Speaker 1:Definitely.
Speaker 2:To competitive people.
Speaker 1:It's good that you're getting your sons to come with you as well, because, I mean, you're kind of, you know, being an idol for them to also start being a healthy version.
Speaker 3:Yeah, can't wait for them to be stronger than me.
Speaker 1:Not the case right now. It's not going to be able to lift you up. Exactly, exactly.
Speaker 3:Exactly. Thank you so much for the conversation, the education you know just Dispelling some myths and rumors.
Speaker 1:Yeah, thank you for having me.
Speaker 4:And definitely let's get you on the schedule. Yeah, I knew you were going to say that, yeah, check your levels.
Speaker 2:Check your levels. It's a free consultation. So is it blood, is it urine, is it saliva?
Speaker 1:No.
Speaker 2:Saliva.
Speaker 4:I wish Good.
Speaker 1:No, we'll draw your blood and get two tubes. Not too big, it's not a lot of blood. I hate needles, bro. I hate needles too. I know, dude, you have no idea.
Speaker 3:I still look the other way. I can't stick myself because, oh, speaking of which, the injections, because that's what I opted to do. Yeah, and I kept coming in and her medical assistant kept saying you know, she would say you know, you could do this yourself, you don't have to drive an hour and a half.
Speaker 2:No, I can't.
Speaker 3:I'm like there's no way I'm sticking myself with a needle I don't care how much time you show me how to do it um but you can always get your spouse to do it. That's what she's been. They're usually happy about poking no no, Well, she's happy about it, but my God a little too happy.
Speaker 2:You can watch those dishes. No, okay, cool, let me do your injection now. No, so okay.
Speaker 3:I fidget a lot and I I really kind of act like a baby about it. Come on already. Well, it's not that bad, I'm just like it is that bad.
Speaker 2:I mean it's going into the muscle, not the, not a vein right no, it's going in your muscle. Yeah, she can just close her eyes and do it.
Speaker 3:Yeah, yeah, exactly that's what I feel like she's been doing. Boom, I'm like you're in there too long and I'll complain. And I'll say you know, when I'm in the clinic they're just kind of like poking. They just take it out real quick. I'm like you, I feel like you're dragging it out slowly and you're taking too long. She's like well, go there then stop bothering me, just go there and get it done.
Speaker 1:She's trying to hit a bone, but yeah, hopefully she's not going in your bone.
Speaker 3:Nah, she's doing a good job, but I do. I do. It's needles, it's just me and needles it's my own personal. I couldn't do it sometimes distraction, distraction helps.
Speaker 1:Maybe watching tv oh I know it's just drop and needles.
Speaker 2:It's my own personal. I can do it Sometimes distraction uh distraction helps maybe watching TV.
Speaker 4:Oh, I know it's coming, just drop it on your leg Sell that up, all right.
Speaker 3:So hey, we didn't flip a coin today. So traditionally, what we do at the end of the show is someone who loses just says and teases the next episode and just the out does the outro.
Speaker 1:Why eases the next episode and just the?
Speaker 2:out does the outro. Why is everybody looking at me? Because one of you guys do it, because one of you and all you have to say is thanks for listening how about the rock? Yeah, how do you? I?
Speaker 3:don't know how to talk like the arnold. Okay, all right, jabari, you're gonna do arnold, take us out, brother welcome to another exciting episode of manhood matters.
Speaker 4:Next week, we'll be talking about something amazing as well. Oh my god, I'm feeling the pump right now we had a great show. Please like and subscribe. Uh, make sure you go online and you find game day with minal, because she's amazing and if I didn't have her, I wouldn't be mr olympia 17 times in a row. So, once again, like and subscribe. I'm pumped. I'm pumped right now. I'm pumped right now. I feel the.
Speaker 2:I'm coming in the gym. I'm coming at the clinic. I'm coming all the time. You've seen my movie. You've seen Pump.
Speaker 3:It's great.
Speaker 1:Awesome Game Day, men's Health, alpharetta, woo-hoo issues that never end. From our perspective, a podcast for all but a point of view.
