Demystifying Hormone Optimization Therapy for Men and Women with the Popkin Method

Welcome to another episode of The Popkin Method, where we’re passionate about restoring physiology, preserving lean muscle mass, stabilizing your metabolism, and building long-term resilience from the inside out. This week, Dr. Popkin tackles one of the most misunderstood and sought after topics in modern medicine: hormone optimization therapy.

You’ll hear why hormone issues aren’t just a women’s health concern, but instead affect both men and women, often creeping in silently and earlier than expected. We’ll walk through the top 10 questions about hormone optimization and unveil how The Popkin Method takes a comprehensive approach, prioritizing foundational restoration, supporting the body’s natural processes, and only turning to replacement therapy when truly necessary.

Plus, Dr. Popkin shares listener feedback, clears up misconceptions, and sets the record straight on DIY health fixes, hormone replacement, and when it’s actually time for advanced therapies like peptides, stem cells, or exosomes. If you’re ready to learn how lifestyle, diet, exercise, and targeted support lay the groundwork for genuine, lasting hormone balance, you won’t want to miss this episode.

Timestamps:

00:00 DIY health and lifestyle tips

05:43 Common causes of low energy

08:35 Lifestyle basics for hormone health

09:54 Improving health with lifestyle changes

12:56 Blood sugar and cortisol basics

16:58 Protein intake for ideal weight

22:49 Importance of D3, K2, and omega-3

24:56 Core supplements and healthy habits

29:28 Bioidentical hormone replacement basics

30:05 When to consider hormone replacement

34:00 Monitoring doses and health screenings

39:35 What's in the protein shake

43:14 Hormone support for young adults

45:14 Managing stress and cortisol levels

50:20 Addressing hormones and overall health

51:44 How to explore hormone therapies

You can see Dr. Popkin through his online virtual functional medicine program anywhere in the country or the world for that matter.

You can visit Dr. Popkin in his Hollywood Florida office for an in person weight loss experience.

Visit thepopkinmethod.com to send a message to schedule an appointment with Dr. Popkin or email Dr. Popkin at mcpopkinmd@yahoo.com.

Podcast Website - https://thepopkinmethod.com/

Matthew C. Popkin, M.D. - https://thepopkinmethod.com/about

Podcast Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

Transcript

SPEAKER_00 0:12

Welcome to the Popkin Method Podcast, where we focus on restoring physiology, preserving lean muscle mass, stabilizing metabolism, and helping you build long-term resilience from the inside out. Today, Dr. Popkin will address one of the most misunderstood and in-demand topics in modern medicine: hormone optimization therapy. There's a common misnomer that hormone problems are primarily a women's issue. But the truth is, hormone imbalance affects both men and women, often silently, gradually, and earlier than most people realize. Today we're going to walk through 10 important questions about hormone optimization. And Dr. Popkin is going to show you how to approach this using the Popkin method, where we restore first, support second, and replace only when it's necessary. But before we dive into our questions, Dr. Popkin, I know you wanted to share some comments from last week's episode.

SPEAKER_01 1:06

Thank you, Jamie. First of all, welcome to the podcast, everybody. And I want to thank everyone that has messaged in over the past several weeks. I wanted to address a few of the comments. We got a lot of comments that tended to center around the unfortunate passing of James Vanderbeek from colon cancer at the age of 48. And it's unfortunate that we're seeing cancers coming up more in younger people. And the messages that I had received were basically thanking me for having reminding people to get their screening colonoscopies and their cola guards. So I had several people that had said that they they had this on their mind and they wanted to do this and they just put it off for whatever reason. So I think it's a good public service announcement to make that for everybody to make sure you get your age-appropriate screening tests. So in women, you want to make sure you get your mammograms and your pap smears on a regular basis. For the men and women, you want to get your colonoscopies or your coligards, get your skin checked. If there's any suspicious-looking skin lesions, get them looked at. Just stay on top of your health from that standpoint. We had a pretty good response to that. Some of the other comments, people really liking the fact that it's more that what I do is more of a comprehensive program. It's not geared around taking a supplement or a peptide or stem cells or exosomes. It's about an entire program. So again, we see this a lot in the DIY space, do it your yourself, healthcare space. You see something on the internet and you you think that a supplement or or a hormone or a peptide or something will help fix all of your issues. And really what I like to focus on is the fact that you fix lifestyle, you fix your diet, you do some exercise, add some basic supplements, and then see where you're at that point. And most people can solve most of their issues with that alone. And then if you are going to move past that into things like peptides and hormone modulation, stem cell exosomes, any other types of things, you want to do that with someone who is putting this into a whole program. So having said that, I do appreciate the messages that we've been getting, keep coming in. And uh, I've responded to most of these on an individual basis. And also we offered some PDF versions of uh the shopping lists and other things that I've talked about on the podcast. And we're adding more of these learning to our uh toolkit. So if you're interested in any of those things, message me and I will send them directly out to you as well. So we've gotten a pretty good response from that. So having said that, I appreciate the listeners messaging in. Let's uh move forward with the podcast.

SPEAKER_00 3:36

Awesome. Yes, we love a tool in our toolkit that's so helpful, Dr. Bopkin. Thank you. So I think everyone's very familiar that hormones and how they can peak and uh dip in women, whether it's around pregnancy, whether it's around menopause, whether you're even a young teenage girl getting your menstrual cycle for the first time. That's very uh kind of readily talked about in society. But are hormone problems really that common in men? Is is this a thing?

SPEAKER_01 4:05

Uh yeah. Um actually uh it's very common. And unfortunately, uh it's often underdiagnosed or misdiagnosed.

SPEAKER_00 4:13

Good to know. We're not the only crazy ones.

SPEAKER_01 4:17

Well, uh you gotta be careful when you use the word crazy, but it's unfortunate because a lot of issues that come up, they're either underdiagnosed or misdiagnosed as other issues. And that's why it's important to get a really good diagnosis, good history, good physical, look into all the different aspects of lifestyle, diet, exercise, what supplements people are taking, what things they're experiencing in their life, how they're sleeping, what their stress level is. Because it's so easy to label things as a hormone problem and just throw testosterone at it or estrogen at it or something. And you see, testosterone in men declines gradually, beginning in your 30s. As the testosterone begins to drop, that's when we start to see some of the symptoms come in and they mimic other symptoms. So if you're not sleeping well, you have a high stress job and you're not eating well, that could mimic some of the symptoms of low testosterone. So again, replacing, giving someone testosterone or modulating testosterone, but not fixing the other problems doesn't fix the issue. So unlike menopause in women, which is usually abrupt, it's recognizable. Most people, they know their mother had menopause at 50. They can anticipate something similar to that. They understand that it's almost understood that they know they're gonna go into this menopause state. And in men, we don't typically have that same mentality, but we are slowly, gradually losing testosterone. And male hormone decline is very subtle and progressive. And the symptoms may include decreased muscle mass, increased belly fat, low motivation to do things like work or exercise, decreased libido, brain fog, poor recovery at the gym. And a lot of these symptoms, they can be caused by low testosterone, but they could be mimicked by other things, right? I mean, all the symptoms I mentioned you can get from poor sleep, poor diet, high stress job, things that you can address and fix. So it's not as easy as saying, oh, you have a testosterone problem. Let's give you testosterone. So many times these symptoms are attributed to other things, most notably aging or work family stress, poor diet, other common causes. So you have to really talk to the patient and figure out what's actually going on here. And then beyond just testosterone, men and women also experience cortisol dysregulation, which we've spoken about at length in the other uh podcasts, uh, thyroid dysfunction, which is relatively common and often misdiagnosed, and insulin resistance, all of which affect hormone balance. If you listen to the previous episodes, we know how stress and insulin resistance affects pretty much everything in our body. So hormone imbalance, it's not a gender issue, it's a physiology issue that affects both men and women.

SPEAKER_00 6:54

Well, we've also we just talked about the symptoms, right? And in past episodes, we talked about what early warning signs can be when something is off in the body. So what are some early warning signs of hormone imbalance?

SPEAKER_01 7:05

Well, I I like to say that hormone issues generally whisper before they scream and become obvious. So some of the early signs that we want to look at is uh people needing caffeine to function. Everyone likes their morning coffee, but when you're having a cup or two before you leave the house and you're having two or three cups at work and you're stopping off at Starbucks on the way home, that is not normal. That's one of the things that we can see. Afternoon crashes where you wake up, you may have energy, but during the afternoon you just crash and lose your energy. Waking up for no apparent reason between two and four in the morning, you know, in the middle of the night you wake up, you don't know why, reduced stress tolerance, difficulty building muscle, despite exercising, belly fat, despite dieting efforts, mood changes, irritability. You know, these are all things that could point to a hormone issue or to other issues that we need to address. They're not just from aging. These are physiologic signals that something is in your body is off, and we don't just want to write it off as saying, oh, you're just getting older, and that's normal because it's not.

SPEAKER_00 8:06

Right. And it's usually things that we're doing or not doing in our day-to-day lives that can impact this. So let's talk about lifestyle, which we have talked about time and time again and how important uh it is. And it's really kind of at the starting point thing to kind of get off in in our physiology. But why must the lifestyle part be addressed before we start replacing the hormones? Why can't we just go straight to replacing what isn't there or what's off?

SPEAKER_01 8:35

Well, you know, like I said before, if we don't have a strong foundation or if something else is causing the issue and it's not related to hormones, then you've really kind of jumped ahead several steps and tried to correct something that didn't need to be corrected. So this is why lifestyle modification is the first component of the popkin method, followed very closely by diet and exercise, because the body needs a strong foundation to regulate itself. So if you're being nice to your body by you're not smoking, you're not drinking to excess or drinking at all, you're getting good sleep, you're not letting stress get to you, you're eating properly, you're exercising and moving around, you're getting sunlight in your eyes, you're not tied to a computer all day and then go home and sit in a cave at night and don't get any natural light. If you're treating your body well with the basics, then that should correct a lot of these problems. And hormone production is influenced by sleep, stress, insulin levels, which are affected by your sugar levels, body fat percentage, inflammation, which we talked about a lot in the last episode. And I got actually several uh really good comments regarding inflammation from the last podcast. And one of the listeners actually sent the term inflammaging, which is uh inflammation and aging. I was impressed by that. And muscle mass. These are all things that are affected by your lifestyle, your diet, and exercise. So if your lifestyle can clean up your sleep and your stress, and your diet can clean up your insulin levels and drop your body fat percentage and decrease inflammation, and exercise can help you improve your muscle mass, which will affect your body fat, which will affect inflammation, which will affect insulin levels, which will help you sleep better, which will help you decrease stress. These are all things that you can correct on your own. You don't need to go to the physician and try to fix these things. You can do this on your own. And if you correct those things and there's still a problem, then we start to look into other things. But as you can see, all these things that I just mentioned are directly affected by lifestyle, diet, and exercise, which everyone listening here can fix today. So if someone is sleeping five hours per night or less, they're insulin resistant, they're eating poorly, they're just not doing the things they should be doing, adding testosterone for men or estrogen for women without correcting those upstream factors I just talked about, all it does is just creates dependency instead of restoration, which just trades one problem for another. So at the Popkin method, I always ask, can we restore your natural production first using the basics that I just described? Lifestyle, diet, exercise, and some core supplements before resorting to more involved therapies like hormone replacement or hormone modulation. So without fixing the foundation, we're just adding complexity to a problem that's really easily diagnosed and treated by cleaning up your lifestyle, your diet, and adding some exercise to your daily routine. These are all things that are fairly easy to do.

SPEAKER_00 11:30

The body's really incredible in how it can heal itself. So we need to figure out to what extent it can heal itself before we start adding in all the extras, right? But Dr.

SPEAKER_01 11:40

Popkin, I think most To your point, I'm uh sorry to interrupt, but to your point, I don't think we realize just how bad we are to our bodies because we're bombarded by marketing from different avenues, television, social media, that makes a lot of the things that we're doing seem healthy when they're not. You see commercials for Red Bull, these energy drinks, some of the other things that you see being advertised, these are not good things for you. On television, every other commercial is a pharmaceutical drug. But if you notice the other commercials that are there, it's fast food commercials, restaurant commercials, these are things that are not necessarily good for you. You know, fat, salt, sugar is what sells in restaurants, and that's pretty much what you're getting. And a lot of these things that were being marketed are just not healthy, but we are being brainwashed into thinking that a lot of them are. So go back to the basics: healthy eating, get good sleep, put the phone down and do things other than have your your face in a screen. And yes, your cell phone is a screen, just like a computer at work or a laptop, and be nicer to your body and try to recognize the things that you're doing that are not nice to your body.

SPEAKER_00 12:45

Aaron Powell When I think of hormones, I don't directly correlate it with diet, but as you've explained, there they kind of go hand in hand. So explain to us how diet directly impacts hormones.

SPEAKER_01 12:56

Well, I mean, as we discussed at length in episode seven, eight, and nine, we talked a lot about blood sugar stabilization and how foundational it is to how our body functions and how we eat affects blood sugar and how that affects the stress hormone cortisol, and how cortisol affects everything else that's your stress hormone. So chronic blood sugar instability and insulin uh elevation does lots of bad things to your body. As we said, it increases the stress hormone cortisol. And cortisol wreaks havoc on your body in many ways when it's elevated chronically. Cortisol is helpful. It's your fight or flight hormone. It helps wake you up in the morning, it helps give you energy during the day. But when it's overstimulated and it causes a chronic cortisol stress elevation, that's when it causes issues and wreaks havoc in your body. And we've discussed this in many, many ways on previous podcasts. And poor diet will suppress testosterone, it'll impair ovulation in women, it'll affect estrogen, progesterone, testosterone in women as well, increases belly fat and visceral fat. So when we talk about belly fat, that's obviously the fat you can grab. But what's happening inside is called visceral fat. And that's the really dangerous fat. That's the fat that's coating the your intestines and the inside that you can't feel. But that's that leads to heart disease and strokes and diabetes and all sorts of bad things. And as we spoke earlier, uh poor diet drives inflammation. Just watch and listen to episode 10. It'll talk we talked all about inflammation. So how we combat this is you know, how do we fix our diet? It's really not that difficult. Adequate protein intake will preserve lean muscle mass, which will improve insulin sensitivity and metabolic signaling. It'll help to drop that cortisol level. Healthy fats like avocados, olive oil, nuts. So you can listen to the previous episodes or request my PDF on my healthy eating grocery list. It will help you tell you what healthy fats are. These are essential because cholesterol is the precursor to the steroid hormones, testosterone, estrogen, progesterone. So we make our hormones from cholesterol and from healthy fats. Extremely low-fat diets can impair hormone synthesis, which leads to the symptoms I mentioned earlier. So people think they're doing themselves a favor by having these super low-fat diets, but we need healthy fats to make lots of things in our bodies, including uh hormones. So hormones follow metabolism very closely, which is dictated by a proper diet. So again, listen to episode seven, eight, and nine for a refresher course on healthy eating, but definitely diet will affect your hormones.

SPEAKER_00 15:31

All right. So we always hear, and you keep saying it, diet and exercise, diet and exercise. Let's talk and unpack exercise and what role that plays.

SPEAKER_01 15:40

You hear people that that talk about how they feel better when they exercise. They're moving around, they're less stiff, their endorphins are flowing, right? These are all hormonally based feelings that you're having. It's not necessarily fun to go to the gym and lift weights and run on a treadmill. What you're experiencing when you when you have that euphoria or you have that energy burst is your hormones interacting with your body. You're stimulating uh epinephrine, norepinephrine, dopamine, all the endorphins and the feel-good hormones in your body. So exercise is is very, very important to this. And resistance training is actually one of the most powerful natural stimulators of testosterone and growth hormone in both men and women. And yes, women do have testosterone. They just have way less testosterone than they do estrogen. And men have estrogen, they just have way less estrogen than they do testosterone. So raising your hormones alone without exercise will not necessarily lead to sustained lean muscle growth. So if we give you, if we give women hormones or men hormones, yes, it will help with muscle growth, but nothing really helps muscle growth more than exercising. And it seems simple, right? You don't need a shot, you don't need a pill. Exercise your muscles and they will grow and they will do good things for your body. So resistance training paired with proper protein intake, remember the formula I give everybody, one gram of protein per pound of ideal body weight is necessary to help stimulate muscle protein synthesis, to help you gain lean muscle and decrease body fat. So to do the math for people out there, if you're a female and let's say your ideal body weight, you want to be 125, 130, and let's say right now you weigh 150, 170, 180, 200, whatever it is, your ideal body weight, that's what you're supposed to be eating in grams of protein. So if you want to be 125 pounds, you should try to get 125 grams of protein in your diet, either through food and or supplementation. So that's very, very important for men. If you want to be, if your ideal body weight is 175 and you're rocking at 225, you want to drop 50 pounds, try to get as close to 175 grams of protein in your body spaced throughout the day. If you prioritize protein, you're gonna de-emphasize the carbohydrates. So all of the starchy carbohydrates, bread, rice, potatoes, pasta, cereals, sweets, sugary drinks, snacks. You want to eliminate those in favor of good, clean protein. So exercise will improve insulin sensitivity. You'll burn up the sugar, you'll use the sugar, so you won't stimulate insulin, you won't overstimulate cortisol. Exercise also enhances mitochondrial function and it'll provide stable energy throughout the day. You're gonna hear the term mitochondria and mitochondrial function many times on my podcast, you'll also hear them in social media and so forth. Mitochondria are the powerhouse of the cell, and they make our energy currency, which is ATP, adenison triphosphate. So if you can enhance your mitochondrial function, if you can make energy more efficiently, you'll have more energy, you'll grow more muscle, you'll burn more fat, you'll feel better. Exercise supports thyroid signaling. So your thyroid, which controls your metabolism, will be enhanced by exercise. Exercise lowers the inflammatory burden. Remember what I said that fat is an inflammatory tissue and muscle is an anti-inflammatory tissue. Again, go back to episode 10 on inflammation, but clearly you want more muscle and less fat. It's a simple equation. You want to be careful, however, overtraining can elevate cortisol, it can act as a stressor and suppress all of the sex hormones we talked about, estrogen, progesterone, testosterone. So that's why an individualized program that fits your body type, your age, your lifestyle, and your fitness goals is essential. I like to call it strategic training, which is preferred over chronic stress training. And I'll give an example. We see this all the time in January. Every year, when people hit the gym hard after months of inactivity, poor diet, poor lifestyle, and then they quit after a few weeks or in many cases after a few days because again, they're stressing themselves rather than doing something that's more structured and more appropriate for their lifestyle and their body type and their age and what they're trying to achieve. So exercise is vitally important to your hormones.

SPEAKER_00 19:59

All right. Diet and exercise. We cannot say it enough. Let's talk about the extras now. Can supplements and peptides are hot button words these days stimulate natural hormone production with or without that diet and exercise?

SPEAKER_01 20:15

Well, again, everything we do at the Popkin method, everything you should be doing, all the listeners, is again start with the basics, lifestyle, diet, exercise. Then we're going to talk about some basic supplements. And we talk about them. Supplements are exactly that. They are to supposed to supplement your healthy diet lifestyle exercise. So in selected patients, supportive therapies, yes, they may help optimize endogenous normal hormone signaling. And I talk about my core five supplements to provide the nutrients that most people are lacking because of our Americanized diet and other uh issues that we have here in this country with our food supply. Magnesium, most people are deficient in magnesium. The form is very important here, the form of magnesium. You don't want to be taking magnesium oxide. That 96% of it does not get absorbed, which means you're only absorbing 4% of it. So that other 96%, it gets dumped out in your stool and causes bloating and diarrhea. So magnesium oxide supplements, that is milk of magnesia, which you take uh when you're constipated. So you do not want to be taking magnesium oxide to get you your supplemental magnesium. I like to use magnesium glycinate or magnesium malate. If you take magnesium at night, it helps you sleep. Magnesium is super necessary for hundreds of metabolic processes in the body. So uh magnesium, a good rule of thumb here. Women approximately 200 milligrams a day, men approximately 400 milligrams a day. It helps with blood pressure, it helps with sleep, it helps with many, many different things. Vitamin D3 and K2, it supports so many body systems, too numerous to mention. Even here in South Florida, I check people's vitamin D levels, and everyone thinks because oh, I go out in the sun, my Vitamin D is fine. No, I see this all the time. People are deficient in vitamin D. It's very interesting. And what's even more interesting is people that are on vitamin D supplements and their vitamin D level is low. So why does this happen? Well, for two couple of reasons. One, maybe the vitamin D they're taking is not a good quality. So maybe the supplement isn't good. Maybe it doesn't contain any vitamin D. Maybe it contains poor quality vitamin D. Perhaps they're not absorbing it because they're not taking it with fatty foods. Vitamin D is fat soluble, so it requires fat to be absorbed. They could be deficient in boron. Our soils are deficient in boron. So that could be one of the other reasons. When you take D3, you want to pair it with K2, a vitamin K2. What happens is D3 helps to absorb calcium from your food and it puts it, stores it in your bones, but it also stores it in soft tissues and arteries and other places where you don't want it. The K2 drives it preferentially into the bones where you want to store it, not in your coronary arteries, which can cause a heart attack. So D3 with K2, omega-3 fatty acids, either in food form, right? Eating fish, eating healthy fats that we talked about. And so you can get your omega-3s or fish oil supplements. Got to be very careful that your fish oil supplement comes from a healthy source. You don't want to get rancid fish oil that is inflammatory. You're defeating the purpose. You want to get a good quality fish oil that is anti-inflammatory. I have a link on my website to the supplement company Thorn, T-H-O-R-N-E. You can do your research. They're a high-quality supplement line that is third-party tested. They're labeled transparent. So they're a good quality supplement line, research them. And there are other really good companies out there as well, but you want to make sure you're getting good quality supplements. The anti-inflammatory effect of omega-3s, it's like a natural anti-inflammatory. So hopefully you're not jamming ibuprofen and motrin and advil and a leave to try to decrease inflammation. You can do this on a daily basis by getting a good amount of omega-3s. Typically two, two grams per day is what we're looking for. And then pre-improbiotics for improved gut health, right? We talked about this in episode seven, really talked about it in episode eight, how pre-improbiotics help support your gut lining, which keeps all the inflammatory substances out. It protects the barrier so that the bad stuff we take in gets put out through the stool, not absorbed into your body, which causes systemic inflammation. So pre-improbiotics, creatin, you'll never hear me talk uh enough about creatin, one of the most studied supplements uh out there. Very, very safe. It's my go-to supplement for many issues, including adding lean muscle mass, increased energy level, improved cognition. Creatin monohydrate is a phosphate donor for our energy source, ATP, that's made in the mitochondria. I'm going back, creating these biochemical pathways for you here, but creatin is very, very helpful for people. I take my creatin, I take five grams in the morning, gives me energy, I take five grams after a workout. Rule of thumb, women, five grams uh per day, men, ten grams per day. Research it, it's very safe. If you have any specific kidney issues, I would be careful with creatin with that, but for the most part, a very safe supplement. And there are some others like zinc, boron, some trace minerals, things like that that you need to get in your body. But the core five supplements are really important for people and it fixes a lot of the issues that people have. So again, we're not jumping to the more exotic treatments. Diet, exercise, lifestyle modification, good sleep, a couple of supplements to make you feel better. And then at that point, if we're not uh where we need to be, we look at other sources. So these supplements, they support healthy endocrine function when deficiencies are present. If you're not deficient in magnesium, it's not going to help you, but most patients are deficient in magnesium, as I mentioned. Most patients are deficient in vitamin D. So these are good rules of thumb to look at. In more complicated cases, I use some more advanced supplementation, especially with regards to hormones. So toncat Ali, Fedogia erestus, ashwaganda. These are all things that help stimulate hormone signaling in your body to make more of its own natural hormones and also decrease late-day cortisol. So these are all things that are making your body work more efficiently to do what it's intended to do, which is manages hormones on its own. It does it all by itself. Sometimes it needs a little bit of help. And in certain cases, you mentioned peptides, scission-prescribed peptide therapies may be considered to support physiologic signaling pathways that are involved in growth hormone release, tissue repair, sleep architecture, and recovery. Episode six, we talked a lot about this. I did get some questions over the past couple of weeks on peptides. I do use a lot of peptide therapy in my practice. Questions that I'm getting are what are the most common peptides that you're using and what are the benefits of them? So I use a lot of growth hormone stimulating peptides. So CJC1295, Surmorolin, Ipimorin, and Tesamorlin. They increase your body's own natural growth hormone production. And I won't go into it here, but just Google what does growth hormone do for your body, and you'll understand why we use these peptides in selected cases. I use BPC157 and TB500 to help with tissue repair. You combine those two together. It's called the wolverine stack. Add in copper peptides to that to boost the effectiveness of the stack. They call that the glow G L O W stack. I'm currently on BPC157, TB500, and the copper peptides. I just had surgery last week, so I'm using that to help with recovery. I use MOX C, M-O-T-S-C to stimulate mitochondrial function. It increases energy production and helps to improve your exercise efficiency. AOD 9604 targets fat metabolism without affecting blood sugar levels. Basically, it helps your body burn, mobilize, and burn more fat. And then, of course, everyone knows about the GLP1, GIP, and glucagon agonist peptides for weight loss. They're all a rage right now. I use a lot of this in my practice in selected cases where we've tried everything else to help patients lose weight. So those are the peptides that we talked about. It is very important for you to understand, though, that peptide therapies are prescribed only when medically appropriate after full evaluation. They're not FDA approved for anti-aging purposes, they're not intended to diagnose, treat, cure, or prevent disease outside of their approved indications. And all therapies are individualized. They're monitored under direct physician supervision. So I don't like when I see people getting peptides off of the internet. They're using research peptides, they're getting peptides from other countries. A physician is not directing them, or if they are, it's a telemed physician that talks to them for five minutes and then they get their peptides. I don't recommend doing that. I recommend going to a physician that understands peptides and it puts it into a fully packaged program that includes, you guessed it, lifestyle, diet, exercise, supplements, and adding peptides on top of that. The goal is physiologic optimization, not supraphysiologic enhancement and overdosing. We only want to use these products if they're clinically necessary. And we want to do a full evaluation and customize a plan that fits what you're looking to achieve.

SPEAKER_00 29:06

So we've obviously talked about our foundational elements diet, exercise, lifestyle modifications, and then potentially adding in some supplements, maybe even peptides. But at what point do we move to the bioidentical hormone replacement therapy? When is it time, once we've gone through all those steps, do we move into that?

SPEAKER_01 29:28

Great question. And this is where, you know, when when I see a patient in the office, we're on what half, three-quarters of the way through the hormone podcast, and we're now finally getting to bioidential hormone replacement. So you can see I don't jump right to replacing hormones. Most of the time, if we fix the issues that we talked about, you don't necessarily need hormone replacement. You can do hormone modulation, which with all the things I mentioned, lifestyle helps, diet helps, exercise helps, some basic core five supplements can help, some targeted supplements that I mentioned can help as well. Some peptides can help. Now we're talking about actually replacing the hormones directly. And we do this when all the other methods that I mentioned have not fixed the issues, and there are actual hormone level imbalances that we've measured in the blood that need to be addressed. So, in particular, when lifestyle interventions have been implemented, sleep optimization, stress reduction techniques, clean eating protocol, muscle gaining and maintaining exercise and protein schedules are implemented, removal of all the inflammatory mediators we talked about, like smoking, alcohol, microplastics, hormone disruptors like glade plug-ins, scented candles, touching those receipts that are printed with that, with that ink that is toxic to us. We've removed all of these things. When labs confirm that there's a deficiency in testosterone, estrogen, progesterone, DHEA, pregnenolone. We'll talk more about that later, but you have to measure the whole spectrum of hormones, not just testosterone in men and estrogen in women. When symptoms still persist after making all the changes that I mentioned, and when quality of life is impaired, that's when we put all that together. Now we're talking about actually replacing your hormones. And the bioidentical hormones that we use, they are structurally identical or very, very similar to your body's own endogenous hormones that you naturally produce. And these can include testosterone in men. And yes, women, we give uh women testosterone as well, estradiol or estrogen in different forms, progesterone, which is another female hormone. Then we get into DHEA, which is a precursor hormone, pregnenolone, same thing, precursor hormone, and thyroid hormones when it's clinically indicated. The goal, as we talked about, is physiologic restoration, meaning put your body back to where it's supposed to be, not excessive performance enhancement as is common in some sports and some other biohacking realms, so to speak. We want to get your body back to where it's supposed to be. We don't want to overshoot the mark. And I'm correcting the levels to approximate what your body needs for optimum performance and not over-correcting to supra physiologic levels or overdose levels.

SPEAKER_00 32:14

Right. Are these bioidentical hormones safe?

SPEAKER_01 32:18

Like anything else, in the right hands, they are safe. And safety, however, depends on many different factors. It depends on proper patient selection, right? You want to make sure that we're replacing hormones in patients that have a deficiency that needs to be replaced. You've tried to do everything else first, and there's a deficiency, and symptoms still persist. Appropriate dosing. We don't want to give patients any more than they actually need. So we like to use the lowest effective dose. Can't tell you how many times I get patients coming to my clinic. They're already on either estrogen or in women or testosterone in men, and they're on doses that are just unbelievably high and they're still having symptoms. And I'll talk about this a little bit later about why they're having symptoms, even though they're being over-replaced on their hormones. Safety depends on monitoring lab work. I monitor my patients' labs generally every three to six months. I can't tell you how many patients that come into my clinic as new patients that have been on or are currently taking hormone therapy. They haven't had lab work done in a year or two, yet they're still getting their hormones. That blows my mind. We want to measure the levels of the hormones, but we also want to level things, we want to measure things like PSA, prostate-specific antigen in men. We want to look at liver function, kidney function. We want to look at hemoglobin and hematocrit on patients on testosterone because it can raise up your red blood cell count. And if you don't follow that, patients can get too much red blood cells in their body, which can lead to heart attacks and strokes. Certainly not the intended outcome in putting patients on testosterone. So you want to monitor labs. The delivery method is important. You don't want to give patients testosterone orally because it goes first pass effect into the liver, which destroys 90% of it before you can even use it, and also taxes your liver. We don't want to do that. Ongoing reassessment. How are you doing on the dose? Do we have to increase the dose? Do we need to decrease the dose? Yes, I do decrease the dose in many of my patients because they don't need to be on such high doses. And then, of course, as we talked about in the very beginning of this podcast, age-appropriate cancer screening, mammograms and pap smears in women. You don't want women on estrogen progesterone and not have them do their regular self-breast exam, not have them get their mammograms or their pap smears. They need to see their physician regularly. They need to monitor these things. And in men, you want to do PSA screenings and digital rectal exams. So you want to make sure that we're not affecting the prostate. Hormones themselves are not inherently dangerous. Improper dosing and lack of monitoring are. You do not want to biohack with your hormones. Again, I can't tell you how many patients I see. They come in and they haven't had these tests done. They haven't been monitored. And you'd be surprised how many patients, when I ask them, where are you getting this from? What doctor is going to give this to you without doing these tests? And I think you pretty much know what the answer is. They're not getting it from a doctor.

SPEAKER_00 35:07

They're getting I'm not getting it from a doctor.

SPEAKER_01 35:09

They're not getting it from a doctor. They're getting it from some dude at the gym or their trainer or their friend, or usually it involves a gym somehow where they're getting this, or they're getting it on the internet somehow. Or they went to one of these clinics that telemedicine doctor saw them once, they get their medication and they're not being closely followed. Do not biohack and DIY your hormones that causes bad things to occur. Go to someone who knows what they're doing. This is not anti-aging medicine. This is endocrine restoration. You want to get your body back to where it wants to be. Help it if it needs by giving hormone replacement if necessary, but fix everything first and be very careful when you do replace.

SPEAKER_00 35:52

Not anti-aging medicine. I think we need to say that louder for the people in the back. I think there's a really good distinction there. So do not DIY your hormones. I love it. I want that to be the tagline for the episode. What about more regenerative therapies like stem cells, exosomes, and secretomes? Like, is that something I can DIY? Is that gonna help my hormones? Let's talk more about that.

SPEAKER_01 36:16

When we talk about these regenerative therapies, this is an evolving area that is very exciting and as such is receiving a lot of attention. These biologic therapies may support uh reduction in systemic inflammation. Remember, we want to decrease inflammation in every way possible. They may help with tissue signaling improvement, microenvironment repair. What does that mean? Well, if you decrease inflammation, you're decreasing the damage that is being caused to your nerves, your blood vessel linings, your endocrine organs, and it creates endocrine resilience, meaning it helps your body to establish a more normal feedback loop to create the hormones that your body needs and not create and not overshoot that mark. So again, I'm going to go into some compliance safe language here because we want to be responsible with this. Uh, it's important to note that these regenerative therapies, including stem cells, exosomes, and secretomes, they are investigational in many applications. They're not FDA approved for hormone restoration or anti-aging, but they are used to help supplement and help the body to optimize hormone production. These therapies are considered only in carefully selected cases and when regulatory guidelines are followed. The outcomes vary. There's no specific results that are guaranteed. And again, we only get to this when we've tried to fix everything upstream. So again, everyone can recite it now: lifestyle, diet, exercise, some basic supplements, some targeted supplements, possibly some peptides now getting into things, hormone optimization, and of course, stem cells and exosomes and secretomes. So the goal is not necessarily hormone replacement, but rather the potential restoration of hormone tissue signaling. And when appropriate, stem cells, exosomes, and secretomes can calm the inflammatory environment to help the body normalize hormone production. So you want to put the body in a metabolic environment that is more regulated and less inflammatory. And that helps the body do what it's intended to do, which is create the proper hormone balance for optimal performance. And these therapies can help the body do that. Again, you want to have this involved in wrapped into a good program that involves all the things that I mentioned. And realize that these therapies, they are advanced tools. They're not first line treatments.

SPEAKER_00 38:40

All right. Not first line treatments, advanced tools, only done by a professional, only administered by a professional only. What does long-term hormone optimization look like? And can you give us a few examples of patients that you have treated this way? I love the popkin method merch. Got a call, we gotta call out the popkin method tumblr.

SPEAKER_01 39:01

I did get a message asking where they can purchase Popkin Method merch. I don't have a link to that yet. I didn't actually think about that, but we gotta get it on the website. Yeah, we'll we'll do that. The people that made this for me, actually, this was uh this was a gift by some very uh very nice people who support what I do. So perhaps we'll have to get them involved and uh put a link on there. They they do make very nice products, and it was a total surprise. I don't even know where they got the popkin method logo from. I guess they just snatched it off the website or something. It was definitely fun to see a request for the popkin method merch. I guess we'll get to that at some point. And by the way, what's in here? Someone asked, what is actually in here? I generally have protein, protein shake that's in there that is mixed with in this particular shake, I mix it with almond milk and I put in a little natural sea salt, which has all the trace elements that are that we need and that that we discussed. And I actually put a little of um in all my shakes, I either put in a little bit of MCT oil, uh, which is medium-chain triglyceride oil, which is uh derived from coconuts. And MCT oil did not get digested or broken down, it's converted directly into ketones, and ketones are another fuel source as opposed to glucose. So it's sort of along the lines of, let's say, the keto diet, although I do not do the keto diet. When you're adding ketones, it's kind of like adding nitrous oxide to your gasoline in your sports car. So it's kind of like that. And not for nothing, but I also just take good, I have a really good quality olive oil that is extra virgin olive oil, single-pressed, cold pressed, single-sourced cold pressed, and I just put it in there and mix it up. So I have lots of really good healthy fats, anti-inflammatory products, protein, and I get all my nutrients from not only the sea salt, but various other supplements that I take. I do practice what I preach, and it's helpful. I try to shoot for a protein goal of 150 to 175 grams a day, which is tough without having protein shakes. It's a lot of steak, eggs, chicken, and vegetable type proteins that you have to try to eat. So I generally will have a shake in the morning, typically after I exercise. And I do actually take some protein at night before I go to sleep. So that is helpful. So that's a little bit of a divergence there. But so we were talking about what long-term hormone optimization looks like. And I believe you asked for a few examples. Well, this will kind of wrap everything up. And from a day-to-day standpoint, hormone optimization feels like having more stable energy, gaining and maintaining lean muscle mass, healthy metabolic function with better insulin sensitivity, less sugar swings, clearer cognition with less brain fog, thinking more clearly, emotional resilience and stability. So being less moody, more restorative sleep, right? Everybody wants that. Package it in a pill, sell it. You know, if someone can create a pill that does all that, you know, they'll be multi-billionaires. Unfortunately, there's no easy way to do all of that. You do all that by following a very strict method, whether it's the popkin method or your own method where you clean up your lifestyle, diet, exercise, some core supplements, targeted supplements, peptides, hormone modulations, stem cell, exosome, secretome. And I did forget to mention management of prescription medications, because there are patients that are on prescription meds or require prescription medications. I do like to make sure, again, we use the lowest possible doses. So if you're on blood pressure medicines, diabetes medicine, cholesterol medicine, if you fix up a lot of these things that are upstream that are causing the issue, you can decrease your prescription medication burden as well, which helps to decrease cost, decrease burden on the healthcare system, helps your liver and kidneys that have to process these medications. So it's better to do things naturally. But of course, if you need support with prescription medications, that's part of the popkin method as well. So sometimes lifestyle, diet, and exercise and general supplements like the core five that I recommend, sometimes they're enough. And most of the time they're enough. And everyone listening today can follow that program. Everyone that's listening can fix up your lifestyle, get better sleep, eat better, exercise, take some of the core supplements if you feel that they're going to be helpful, and you don't need anything further than that. It fixes most of the problems. It really does. Sometimes hormone-specific supplement support, like Toncat LE, Fagogia errestus, boron, ashwagandha, other things that you'll see out in social media, or other things that I prescribe in my practice. Sometimes adding that is enough if the body's capable of increasing its own production of hormones. This is usually in young men and young women who have sabotaged their hormone uh system by doing bad things to their body, all the things we mentioned poor sleep, poor diet, no exercise, lots of stress, things of that nature. So, as an example, there's actually a patient I saw yesterday, a 34 year old man, common symptoms that could be attributed to hormone issues. He came in feeling tired. He came in saying that he was gaining weight, wasn't getting gains at the gym. Decreased libido, not feeling it at work. I forget exactly what he did at work, but I believe he did something along manual type work. These are all things that could certainly be attributed to low testosterone. They could be attributed to poor diet. They could be attributed to poor lack of sleep, lots of stress, but likely they were related to his lifestyle, diet, exercise, and lack of specific nutrients. And in fact, when I checked his lab results, his testosterone was fine, his free testosterone was fine, his estrogen levels were fine, DHEA, pregnetolone, all fine, sex hormone binding globulin or SHVG, which is the carrier protein that carries testosterone throughout your body. Those levels were fine. Everything was good. And I told him that in most testosterone clinics, if he would have walked in, because we're not a testosterone clinic, I said, but if you had gone anywhere, you'd have left in five minutes with a prescription for testosterone. But we're not going to do that here. And I told him that what I wanted to do is I put him on, again, lifestyle modification program, increase the protein, decrease the carbs, the starchy carbs, bread, rice, potato, pasta, cereals, sweets, sugary drinks, all the stuff that I took away from you before and you didn't like, uh, we're going to keep doing it. Increased resistance exercise. I'd rather you lift weights than run an hour and a half on the treadmill. And some of the core five supplements I put him on, I did add Ashwagandha to his stack there because he did say he had a high stress job and he was waking up in the middle of the night for no apparent reason. He's 34. He's not waking up because he's having prostate issues. He's not waking up because he doesn't have a child. There's no reason for him to wake up. Typically, when I see people waking up in the middle of the night, it's because their cortisol stress hormone is chronically elevated. And what happens is when we go to sleep at night, our cortisol levels are low. When we wake up, because our cortisol levels increase throughout the day, they increase. And then as we round out our day, our cortisol should start to wind down. And when it doesn't and it remains elevated, that's when it causes blood glucose fluctuations and other things in the body that then wake you up in the middle of the night. So I added ashwagandha, 600 milligrams in the evening to help decrease his cortisol and help him sleep. So again, sometimes direct hormone is necessary. In that particular case, it was not. So we didn't have to replace hormones in that patient. But sometimes it is necessary to replace hormones in men and women, patients that are in their 40s and 50s, and as we start to move on, women in their menopause, they're not going to make more hormones because their ovaries have shut down. Men, you can sometimes get the testicles to start producing more testosterone again by doing all the things that I had mentioned as well. What's important here though is I routinely, in order to understand who we're going to do the basic lifestyle modification on, who we're going to do targeted supplements on, and who we're going to do direct hormone replacement on, you have to check a multitude of blood tests. So I routinely check a broad array of hormones and carrier proteins, not just testosterone in men and estrogen in women, but testosterone, estrogen, progesterone, LH, which is lutinizing hormone, FSH, which is follicle stimulating hormone, SHBG or sex hormone binding globulin, DHEA, pregnenolone, all of these things. And I typically don't see this being done in most other clinics. They just go right for testosterone or estrogen replacement, and that's not the right thing. If that replacement is needed, we're replacing the full spectrum of hormones to optimize the therapy. I'll give you an example to answer your other question. Do we have examples? Here's another one. Most patients I get from other clinics, they've never checked the support hormones like DHEA and pregnenolone. And they come to me and they're already on way too much hormone replacement dosages. They're on very high doses of testosterone, or the women are on high doses of estrogen and progesterone. And what happens is they go to these clinics, they measure the estrogen, it might be low, or in men they measure the testosterone, it might be low. They put them on the hormones estrogen or testosterone, but they don't measure DHEA and pregnenolone. So if those levels are low and you're only correcting the testosterone and the estrogen, these neural hormones, DHEA and pregnenolone, that helps your body, their precursor hormones, right? So what they do is DHEA and pregnenolone make testosterone and estrogen. So if you don't have those precursor hormones are also active in the brain. So what happens is you can have a lot of testosterone in your body, but if DHE and pregnenolone are not active in your brain or at sufficient levels in your brain, then what happens is you don't feel the effects of the testosterone or the estrogen. So that's where you still have brain fog, you still have fatigue, you still have poor sleep problems. So what does the doctor do? They raise the level of testosterone. They raise the level of estrogen, and they haven't corrected the DHEA or the pregnenolone. So that's why I look at a broad spectrum of hormones. So example that I'm giving is that a lot of times what I will do, and I saw one of my patients in follow-up yesterday, she was doing great. She's been on my program for at least three or four years. She came to me with exactly that problem. I decreased her dose of estrogen, decreased her dose of progesterone, added in a little bit of testosterone, added in DHEA and pregnenolone. This is all in topic click, topical form, and corrected her issues on lower doses of testosterone and progesterone because we're also replacing DHEA and pregnenolone. So the moral of the story here is that a higher dose is not always best. The proper ratios of these hormones are what we're looking for. Sometimes advanced therapies like peptides, stem cells, exosomes, and secretomes are considered when all of these things have been done and we're still having some lingering issues. So I have some patients that actually get regular treatments with these biologic products, either stem cell, exosomes, secretomes, and peptides for overall wellness and hormone regulation and symptom control because they help the body do what it's intended to do, which is repair and regulate itself. So sometimes the body just needs some additional assistance after the overall environment is stabilized and supported by more natural means. However, the philosophy never changes. We restore what we can, we support the things that we must support, and we replace only when needed.

SPEAKER_00 50:11

Wow, Dr. Popkin did not realize how intricate those hormone replacement treatment protocols actually are. Those patient examples were really compelling.

SPEAKER_01 50:20

It's important because everybody's different. I I think the real message here is that if you're not looking at the whole array of hormones that are in your body, you're not doing a service to the patient. So you really have to look at all of the hormones we talked about. You have to look at the thyroid, you have to look at all the other things that we talked about from lifestyle all the way on up through diet, exercise, supplements, peptides. So if you're struggling with energy, muscle loss, weight gain, mood shifts, or poor recovery at the gym, don't assume it's just aging. Don't let your physician tell you everything is normal on your basic lab work and there's nothing wrong with you. Ask yourself and your providers better questions. Evaluate your current physiologic environment and make the necessary changes. With the Popkin method, we believe optimization begins with understanding how your body is designed to function and then helping it return there to restore itself naturally while giving appropriate help along the way. Always remember to focus on restoring and supporting physiology first and replace only when needed. So if this episode resonated with you, share it with someone who needs it. As always, message me directly if you'd like a downloaded PDF version of my hormone optimization education form. And as always, feel free to reach out to me at the Popkin Method website or on any of my social media profiles to schedule a discovery call or an in-person visit with me at my Hollywood, Florida location.

SPEAKER_00 51:44

Yes. Thank you so much, Dr. Popkin. Please head to the website, check out the tools, download the PDFs, all of the things so helpful when educating ourselves to make better decisions with our lifestyle and our health. So thanks so much for educating us today and every week. But just to reiterate, everyone, hormones don't fail randomly. They respond to the environment that you give them. So if we upgrade our system and strengthen the foundation and support the physiology, the proper hormone response will follow suit. First, we need to restore. Next, we will support. And then, and only then we will replace if necessary. If you are ready to explore these therapies the right way, visit thepopkinmethod.com to learn more and schedule an online discovery call or an in-person visit with Dr. Popkin today. This is the Popkin Method, and we will see you next time.

SPEAKER_01 52:41

See you next time.