Treating the Testosterone Lows

Most guys know something's off — they just can't name it. In this episode, Rick and Greg break down what to actually do about low testosterone: the lifestyle foundation that has to come first, the supplements worth considering (including why boron is getting more attention than it used to), and the three medication-based options your provider might discuss — SERMs, HCG, and full testosterone replacement therapy.

They also walk through the difference between total and free testosterone, why you can have a "normal" number and still feel terrible, and why medication without the foundation is a losing game.

If you've been dragging, or you know someone who has, this is the episode. Ladies, this one's for your husbands too.

Topics covered: sleep, resistance training, HIIT, nutrition, vitamin D, zinc, boron, sex hormone binding globulin, clomiphene, enclomiphene, HCG/Pregnyl, testosterone replacement therapy (injections and creams), LH/FSH signaling, cortisol and stress, and how to structure the conversation with your medical provider.

For informational and educational purposes only. Consult your licensed medical provider before beginning any hormone therapy, supplement, medication, or lifestyle program.

Transcript

SPEAKER_01 0:25

All right, good morning. Good morning. Good evening. We're doing it's morning today. Yeah. I think it's the first time we've uh done this in the morning. We're recording this pre-recording this one.

SPEAKER_00 0:33

Yeah, we'll see how clear our brains are in the morning. Yeah.

SPEAKER_01 0:36

We got enough sleep. All of our own advice. Hey, uh, this is Healthier Raptor. I'm Rick Sorensen. Greg Camp. Greg Camp. Uh we are here talking about uh healthy lifestyle, uh weight loss, and all kinds of things. Um, we wanted to get in a little bit last time. We talked a little bit about the testosterone, what are we going to call it? An epidemic.

SPEAKER_02 0:57

Yeah.

SPEAKER_01 0:58

Um, just how overall testosterone levels on average have been declining for a couple of decades at least. Um, and and you know, we got a little bit into the causes. We can kind of just review that a little bit. And then what we want to do today is get into uh what what do we do about that now, right? Right. And and and why would we why do we care? What do we do? Is it something we have to fix? How to do that?

SPEAKER_00 1:24

I think it's important to point out. So this episode is obviously we're gonna be uh based on the last episode, we're gonna be talking about male um testosterone. Now, female testosterone, every much is important, changing all the time. Now, we're gonna get into that on a later episode where someone uh that would be viewing this would be benefit like it where it benefit um a female to watch this is you probably have a male somehow, somehow in your life. So if you're curious about it, if I don't know, you feel like your husband's been dragging and you know you've kind of been wondering about his levels. Um, a lot of times uh where I see guys in clinic is actually because their wife drug them in by the year and they're like, hey, look, he's dragging, he doesn't feel good, and he won't do anything about it. So then the wife drags him in, we find out their testosterone levels are low, and then we work on a plan in order to help that. We're gonna talk about kind of what we see, uh, what the science says behind this. We talked a little bit about that before. And then now this episode is kind of gonna get to the what do we do about it?

SPEAKER_01 2:25

What do we do about it for the for male testosterone levels? Yeah, I'm super excited. You mentioned that we're gonna be uh going into our transition next week or or soon is uh probably uh multiple episodes on uh female hormone yeah, big one. Yeah, not just testosterone, they have like other stuff.

SPEAKER_00 2:42

I mean, I mean, both systems are complex. Um the female system is is obviously even that much more complex. So um, you know, we're we're hopefully hoping to have a guest on that specializes in female hormones and and uh yeah, she is passionate, she's passionate, she's and she's excellent, and she can really dive into this um probably better than me and Rick could ever could think about. But you know, we'll we'll get into the the male, male side of it today, and uh with hopes of getting into the female side of hormones soon. And and testosterone is a big part of that on the female side. I think, I think uh sex hormones in general, it's we associate estrogen with uh females and and testosterone with males. But uh no, both of us need a certain amount of each. And we'll talk about the male side and and of course get into the female side later.

SPEAKER_01 3:29

Well, and and I think today's topic talking about testosterone, we're gonna get into some therapies and uh strategies to uh increase that. And I think even more today, it's important to remember that uh this is informational and educational purposes only. Yeah. Uh we strongly recommend that before beginning any uh replacement therapy, medication, uh exercise regimen, diet uh, or other program uh that you uh speak with your licensed medical provider uh who can then give you direction and work with you uh on that. Yeah.

SPEAKER_00 4:02

This is like a lot of um areas in medicine and with the availability of online stuff. I mean, people can kind of get into this on their own. You know, you can find ways around uh working with a medical provider. The problem is, and I do see it in clinic when when you know guys typically are like, hey, look, I've been going at it on my own and uh things are not quite right. I felt really good in the beginning. Now I'm not feeling so good. A lot of it is just because um, you know, you're you're just you only have half the puzzle. And so find a good medical provider if you want to dive into this more that that um works with hormones and does this is you know, it's it's not all providers are created equal when it comes to working with hormones. So find a good one.

SPEAKER_01 4:41

Uh we'll hopefully hopefully, hopefully our discussion today and uh upcoming episodes can serve as kind of a basis or some groundwork uh to just help you know how to have that conversation. What do you need to talk about? What questions to ask your provider to agree more? So yeah, with that, let's get into it. So just a little review. Uh, last time we talked about the um the epidemic, I made a couple notes that you know we talked about root root causes, um, why testosterone is declining. Yeah. Um a lot of it has to do with just our lifestyle, obesity and a high BMI um change. It's not just changed by testosterone, but it affects how your body regulates and generates um testosterone and other hormones. Uh sleep. Your poor we've got to do a whole episode about sleep. We'll probably hit that again sometime. Yeah. Uh, but uh poor sleep uh is is a a strong uh cause of or correlated with uh low testosterone.

SPEAKER_00 5:44

And and and so uh you talked about like night shift worker, shift, you know, just almost every shift worker, night shift uh human being that comes into my clinic and gets their levels checked on are notoriously on the either low or low end of normal uh when it comes to their testosterone levels. And uh so there definitely, at least anecdotally for me, has been a correlation there.

SPEAKER_01 6:07

Yeah. And other things, just just a sedentary lifestyle, uh chronic stress. We talked about these other things, tobacco use, uh carbonated soda, um decreases testosterone and excessive alcohol. So those are kind of some some lifestyle and metabolic causes. We also mentioned a little bit about environmental um toxins and things, um the the microplastics and fragrances, um, food packaging, pesticides, uh, sodium fluoride and water supplies, low vitamin B, uh vitamin B12 specifically. Um so those are other things that we can address. I think that's kind of our how we get it low.

SPEAKER_00 6:49

Yeah, I think even to hit on that, you're naming a lot of these things, and I I kind of would argue that there's probably if someone is dealing with low testosterone, you could probably pick, you know, out of those 12, 15 things uh that were mentioned, you could probably find most people have I don't think it's just one of these things. Sure, we know sleep. We talked about this actually before we started talking on this today, is that sleep is just one of those big, big, big factors. But I would argue that most people could say pick five of these things that they're like, oh yeah, I don't, yeah, that's that's a problem. Or so it's probably more of a um a little bit of this and a little bit of that than one thing. It's probably not just one thing. You you most people could pick out a few of those things where like, oh, either I don't know if that's a problem, or yeah, that's definitely a problem. Um, you know, so I think it's it is this uh comp combined effect of just our lifestyles and environment nowadays.

unknown 7:41

Yeah.

SPEAKER_01 7:42

Okay. So uh so what do we do about that? Let's talk about um first line therapies. Uh if if I say, okay, I'm my testosterone, my total testosterone is low, um, I'm gonna I how do I fix it?

SPEAKER_00 7:54

Yeah, right. Well, and I think uh we start at a base level of saying, hey, this is our foundation. You have to have a foundation in this because you know you can you can throw as much medication at a at a problem as you want. If there's no foundation, especially I found this with uh dealing with hormones, if if you're not putting in any work on your end to try to correct some of these uh, you know, these these causation factors, unfortunately what we find is that you're gonna get maybe a little bit of benefit, a little bit of relief from symptoms, uh, but unfortunately, it's going to be uh a hard journey because it just doesn't seem like it's it's longstanding. And so uh really you need to just start with a foundation. We talked about uh initially sleep, and so sleep being one of those big things, and and you know, if go back through our episodes, find the one on sleep, and we talk about it how it relates to weight, but I mean, in all of that, right, weight and lack of sleep are gonna be a huge factor in We could even do another episode on like some specific tricks of the trade for good sleepers. That's a that's a good that's actually a really good idea because I mean it's you know, most people, if you're just a great sleeper and and that's never been your issue, fantastic. You're not like you know, yeah, 75% of the people. Sometimes you've got to be actively engaged in getting good sleep. Yeah, you you do. It's it's a little bit of, especially if someone that doesn't just hit the ped hit head head hits the pillow and then you uh fall asleep. Uh, there are a lot of techniques and a lot of things that we're doing lifestyle-wise that unfortunately disrupt our sleep. And so um sleep is one of the bigger factors that do do affect this. So, look, you need to get your seven to nine hours of sleep on general. I mean, some people require a little less, some people require a little bit more, but in general, uh, you know, you need to be uh prioritizing sleep. I mean, this is gonna be one of your foundational things. So set the phone down uh an hour before bed and and really focus on trying to get some uh some good sleep, and that's gonna be one of your biggest foundations. Um obviously, we we're gonna talk about this probably in some way, no matter what topic. Um, exercise, activity. You got you gotta move. Yeah, um, there's so many factors uh that come in, or so many things that are affected by you being active and exercising, and hormones are no different. You know, in order to get your hormones optimized for your body to optimize your own hormones to the max amount that they will go. I mean, they you have to be active. And this is usually a mix of of resistance training as well as cardiovascular exercise. And um, you know, so those two things alone. Now you're talking about uh nutrition. Uh so you need to make sure you're getting a good variety of things.

SPEAKER_01 10:26

Can I have to go back on exercise? The studies, the studies talk about that. There's there's actually specific benefits um with resistance training, like working your large muscle groups with some resistance training. We've talked about that uh in relation to GLP1 use and mitigating the you know the protein or the muscle loss, yeah. That's quote, caused by that. And really it's caused by not working out those big muscle groups. Sure. So so uh resistance training is one, but then uh actually the studies also talk about high intensity interval training. Yeah. Um and and you know, that's one that that um my daughter has taken me and done some things like that. And it's just if it's not on a bicycle, I'm not good at it.

SPEAKER_00 11:07

But yeah, no, and I think I think it's just it is like, and we we can always dive into this, but I I really think that some people get hyper focused on, oh, what exactly should I be doing? Yeah. Actually, most of the studies show that it's whatever you like doing, moving. Like find some combination of something that you enjoy doing and and make that work for you. I mean, in Rick's case, he loves riding a bike. So I mean, he doesn't ride on flat ground, right? He'll go uh mountain biking and things like that.

SPEAKER_01 11:34

I mean, you if if you think riding a bike is easy, he says it's I'm nursing broken ribs from two weeks ago when I stopped mountain biking very quickly.

SPEAKER_00 11:43

Yeah, you should see him. He looks like some of our ER patients that we take care of with the, you know, he's pretty beat up.

SPEAKER_01 11:49

But I got back on the bike this week and it was.

SPEAKER_00 11:50

Oh, good, good. Yeah, avoided falling 15 feet or whatever you fell out. It was only like eight. Oh, well, yeah. Go fall eight feet onto rocks and you tell me how you feel after. Yeah. And Rick's not a young guy, okay? So he can't be falling like that anymore. We'll have a broken hip. We'll we're willing him in here. Um no, so uh we were being active.

SPEAKER_01 12:10

We were being active on how you can, what you like to do. I know like I think that's one of the that that sounds simple, but that's one of the most profound things when you say, you know, find something you like to do. It's more, I think, more important than than um how many intervals you do or how much weight you know you can bench press and squat, like your resistance training. It I far more important is something that you uh keeps you active, that you enjoy or can sustain. Because if you hate it, that's just another level of stress. And I I think that's just super important that maybe we brush over sometimes, but finding something that you you uh like to do is I I think top priority.

SPEAKER_00 12:55

So important. Yeah, if your only focus is just, oh, I need to do this because uh, you know, if exercise is drudgery, yeah. It's just not you're not gonna stick with it. You're gonna find every excuse in the world not to do it. So find excuse me, find something you like, uh get something that um can incorporate some uh resistance in some way, uh, get your heart rate up. And you know, I would say the the evidence would be overwhelming that you would have some benefit there uh if you can just stick with it. I mean, you can go high intensity on something you hate for two weeks. I don't think the that's gonna do a whole bunch for you. Um so no, I think that's a really good point on that. So find something you like to do and get moving. The uh so these are once again, these are the base, these are the core, these are the foundations of saying, hey, I want to optimize my my own uh hormone levels. This is how you do it. Yeah, um, as far as nutrition goes, obviously just a balanced diet, right? We need to get all our nutrients. We've talked about um a real food diet.

SPEAKER_01 13:54

It's interesting that all the things we've specifically talked about with with weight loss, yep, um, are the same things. Yes. I guess would be the word, normalize your your hormone levels. It's it just makes the whole system work better, and whether that's with the weight loss side or the hormone side, because they're so intertwined together, but it's it's just interesting. Like when we're talking about specifically what helps the testosterone, it's exactly the same stuff.

SPEAKER_00 14:24

It is. And and it's yeah, so this is really just coming at it from a different angle of like, hey, if if weight loss isn't your motivation, I know some people that are actually quite thin, right? That that are dealing with, you know, really bad fatigue and um all these things that you end up checking their levels and they're quite low as far as the testosterone goes. And so these are things that they need to, you know, even if they're you know skinny, uh, you know, what does that even mean? Like some people are just naturally built skinny, they don't work out, they don't eat right, they just uh tend to, I guess, hit the you know, genetic glottery when it comes to not being able to pack on the weight. So um that doesn't necessarily uh being thinner, if that's just genetically predispositioned for you, doesn't necessarily mean healthier. So I mean, really, if you want to optimize this stuff, uh, you know, you're you're I agree, it's it's it's a lot of the same principles. So if if weight loss isn't your your thing, uh, well then maybe your motivation is uh trying to optimize your own hormones.

SPEAKER_02 15:24

Yeah.

SPEAKER_00 15:24

Um nutrition's a big one. Real food diet, we always push that. And that's that's mostly because the real foods are not typically the ones getting us in trouble. Hopefully, you can find more organic type things that you know you can avoid some of the other environmental factors. The uh real foods are the ones that are usually going to be packed with nutrients, right? The things that you need. There's some supplements that are you okay.

SPEAKER_01 15:47

How about this for a for a catchphrase? You you should eat foods packed with nutrients, not packed with plastic.

SPEAKER_00 15:55

Yeah. Yeah. It's there's a big thing with that right now. There's not a lot of people arguing about that. There's like, oh, there's something here with these microplastics. Like, what's going on with this? Yeah. And we don't really fully know yet. I think uh a lot of this is gonna come to light, and it'll probably change the whole way that they manufacture food eventually. Yeah. But right now, we don't really, yeah, it's early on. This is like we've kind of known, but uh, this is definitely being a new topic that they've dived into. And it's yeah, it's it's gonna be, I think, uh kind of a big deal coming on to it, because it's gonna really change the way that they manufacture and process food.

SPEAKER_01 16:31

Yeah, well, and talking about nutrition, it's important to talk, you know, some of the some of the uh like the micronutrients, the vitamins, I guess, vitamin D, zinc, B12.

SPEAKER_00 16:39

Vitamin D is a huge one key. Yeah. I mean, hormonally, vitamin D acts more like a hormone in the body than it does a vitamin. Uh, fat soluble vitamin, very important, especially when you're getting evaluated for your hormones. If your medical, if your medical provider is well versed in hormones, they probably will end up checking a vitamin D, but but if they're not, they may kind of brush over that one, ask specifically, are you checking a vitamin D level? It's very important. Um, you know, zinc is uh is a big one that's tied into um helping with hormone optimization, especially related to to male testosterone. That's been a big one for a while. Um, you know, another big one that is is kind of been more popular recently is boron. So boron is is one that um doesn't raise your total testosterone. What it does is unbind some of your testosterone. So, and we can dive into kind of what this all means. I guess this is the episode maybe to do it, but you have a total testosterone and then you have um a free testosterone, which is like what's actually available for your body to use. So just because your testosterone, if it's 800, it doesn't mean that you get 800 to use.

SPEAKER_01 17:49

So so would that mean um I guess trying to think a quick analogy on that would be like your total testosterone, it would be like gas in the tank. And your free testosterone is how many and how much how many injectors you're using to run your engine.

SPEAKER_00 18:06

Yeah, you're yeah, because yeah, you could have, I mean, all the fuel in the tank, and if you can't get it to the engine, yeah, then it doesn't matter. It doesn't matter. So yeah, it is really just what is uh remaining once your body, you know, because your body has what's called sex hormone binding globulin, and it binds up, you know, by design, binds up testosterone and estrogen. It's a sex hormone binding globulin, and your body does that to regulate certain things. And uh, you know, unfortunately, what happens with sometimes you just get too bound up. Sometimes it can be lack of activity, sometimes it can be um dieting. In fact, they found that even though fasting can do uh be really helpful for those that kind of I think it's not really like uh it's like unintentional fasting, these people that go along, long periods of times without eating, so that when they do eat, it's not necessarily focused on like, oh, I meant to do that fast and now I'm gonna eat really good. They can actually end up having a higher sex hormone binding globulin, which then so of course they're dragging because they have enough testosterone, uh, they just can't use it.

SPEAKER_02 19:10

It's just it's a storage thing.

SPEAKER_00 19:12

So yeah. Boron in in in several studies has been found to help unbind some of that. So it just makes more of your testosterone usable. I'm not telling everyone to go get a boron. This is once again why you need to meet with someone and say, Do I even have this issue where I have too much testosterone that's being bound up? But when we're talking about nutrition, boron is one of those supplements that's been found recently to be very helpful in unbinding some of that. Um so it should just make more available. But once again, work with your medical provider. Um so that would be something.

SPEAKER_01 19:43

I mean, that talking about that, that you could be in a situation where your total testosterone is good, you have a good level, but your body's just not using it because it's not freed up from those binding globulins. It's it's kind of sitting there in storage, and and we're looking for a way to get that into the active system that you're using.

SPEAKER_02 20:02

Yeah.

SPEAKER_00 20:02

Right. Yep. And and so exactly. So you just need you just need to release some of that testosterone. You have it, you just need to unbind it. You know, to try to describe this, it's just you can't use something that's bound up. It needs to be free. And this goes for a lot of things. Testosterone is no different. You cannot use uh something that's bound up to a protein. There's it specifically stops it from binding to receptor side. So you the only testosterone that you can use is is what's free. And so making sure that that, you know, you have enough free testosterone to actually use it and feel good is an important factor. And so um, so supplements, yeah, those that's a big deal. And then stress. I mean, this is a hard one because I mean, it's not easy to just be like, well, I'm just not gonna be able to do that. Turn that off. Yeah. Turn the stress off. We know that that increases cortisol levels. We've talked about that before. We we know that um, so it it affects your weight. Well, while it's affecting your weight, uh, it's all tied in, right? This can uh significantly lower um what's available testosterone-wise. Your body really just doesn't like to be in a in a sustained state of stress. There's normal to have short amounts of time where you're stressed. Um it's not normal to stay in this sustained state of stress. So finding different ways, well, heck, it's therapy or or or uh once again, activity we know can significantly help with uh your body managing stress, obviously staying nutritionally sound. If it seems like all of this is tied in and it's repetitive from what we talk about weight loss and just overall wellness, it's because it is. It is. Yeah, it's it is repeat. Yeah, it is which is good.

SPEAKER_01 21:40

Um, I mean, just it's another application uh uh and perhaps maybe motivation to sort of work on doing the things that that lead to better health, really. That's why it's it's healthier ever after, not skinny, not low BMI, not high testosterone. It's healthier, it's and and all of this does well. work together and and the end goal is to be lastingly healthy. Yeah.

SPEAKER_00 22:06

I would and I would say if if you're listening to this and you're like, boy, I would love to do all that. And it's just overwhelming. You know, kind of think about back to some of the things we've talked about. You know, pick one thing. You know, it doesn't have to, you don't have to get all this down in in you know a week. You know, pick one thing that you think you can focus on and when we're listing off this stuff and and you know just start working on one thing at a time. And I think in a lot of cases like we start building this nice base to where the thing that you was hard before you're now doing daily and now you can start adding additional things in.

SPEAKER_02 22:38

Yeah.

SPEAKER_00 22:38

It's not, I mean this is not meant to um this is not meant to be something that you, hey, I'm going to change all this today. Yeah.

SPEAKER_01 22:44

And and and and nothing that we talk about is is um should be thought about as like a quick fix. Hey, I'm going to do this for a couple weeks and go like like when we talk about um moving more exercising you know supplements diet nutrition whole real foods um all of those things that our our timeframe is forever. Like like for short term goals like let's you know in when we talk about weight loss I have a goal weight right I want to get that goal weight I want to lose 50 pounds. I mean we're not talking like a few months you know you usually usually on the onset of something like that with a defined goal um we're talking about let's plan for two years three years and that's the that's the time frame just to kind of reach this this desired goal and a lot of times it happens quicker but but certainly not like less than 10 months a year but that's the time frame we're talking about this isn't like a few weeks thing and and all of this goes together like that that to kind of expand your time frame. So do one thing like you were saying and do that well for a few months. And then and then as you as that becomes the kind of the normal you can add another little thing because this really is a lifetime lifestyle adjustment that we're working on making it. And so it it there's not really an end point other than you feel better during the last you know 20 30 years of your life.

SPEAKER_00 24:07

Yeah. And you just kind of remind you know it seems like just kind of thinking about that and working with a lot of patients that that we talk about a lot of lifestyle stuff it seems like good behavior or healthy behavior if you want to like stay away from good versus bad it's not like evil um healthy behavior feeds into healthy behavior. I find that a lot of people that start doing one or two things and can get over that hurdle it seems so much easier for them to start adopting these other lifestyle behaviors. Yeah. So it's it's not like a um you know it's not like the incremental change to to then add on one little one thing is is less. Yeah. And I'm sure there's some awesome science behind that. I don't know what it is but it's just observing this it seems like people that are able to change a few little things and and and take that initiative it seems like the other things come a lot easier.

SPEAKER_02 24:59

Yeah.

SPEAKER_01 25:00

So I I think to take that into a funny just comes to mind the the old story about the British um cycling team um I don't know when this was well research but um they they were like horrible last in the world you know and and they got a new trainer and he talked about um like like we want to make sure our chains are clean or you know the air pressure in our tires is just right or what you know what tiny little changes that make almost no difference. And his his whole point was like he says he talked about the combined or the cumulative effects of small incremental changes. And and so if if keeping your chain clean increases your by one percent you know and then do another thing that's one percent like over time the cumulative effects and they became like world class champion race team by by adopting that that strategy. And I think a lot of that has to do with what we do here. We talk about small incremental changes and and what we're working on is the cumulative effect of that yeah um as as you make you know small changes multiple small changes add another little small change but but in time the cumulative effect of that is is much greater than any of those individual things.

SPEAKER_00 26:27

I I agree and and I think a lot of it is uh some for some people it is an all or none. I think sometimes we can get distracted by well if I had these goals and I was doing pretty well at who cares exercising sleeping better all that um you're working on something and then we go on vacation or we have something that throws it out of whack a little bit. I think sometimes those can be the times where we are like oh well I messed it up. I promise you you did not mess it up if you had a three day stint where you went to Vegas and you had a great time and you didn't sleep well and all that stuff because you were just having fun and and you were you know you're getting in a little bit of trouble, you didn't mess it up. Like you what you did is you you you know you went and you probably took some much needed uh downtime uh to relax and and rest and there's some benefits there. Um when you get back it's not like you messed everything up or or or you you know you're starting back from ground zero. You took a few days away from what your normal habits were just erase that from your memory you had a great time and move on. Sometimes I think all of us do this. I know I've been there before where I felt like oh I messed it all up like I'm starting back from ground roots so did you feel that way when you came back from Costa Rica? Yeah I'll tell you what yeah that was I wasn't a deal like this is the guy who was just in Costa Rica you're definitely getting back into it mentally when you get back uh you know yeah you're like you're kind of like oh geez like Costa Rica it was great um over ate uh you know and did other things yeah we ruined everything but no really I mean honestly what it was is that you know what you you go and you enjoy yourself and I'd argue that that short stent of relaxation and enjoying yourself is every bit as as as important as any of these things together. You got to have those breaks but don't don't let it throw you off mentally you you didn't you didn't take three months of progress and mess it up in three days. You couldn't you couldn't do it if you tried. And so don't get distracted by the times where you're like hey look got a little off track because we went and had a good time.

SPEAKER_01 28:25

Try to focus in on the fact that you've been three months in you had three days and you're like hey it was a good time let's move on and I think mentality wise and we've talked about I think that was our second episode yeah was uh talking about uh just have that the mentality you have I think mentality wise you got to focus in on that but let's um obviously uh get into how we help with testosterone so so what we talked about the the exercise sleep stress nutrition those are all kind of addressing the lifestyle um causes most of that of of low testosterone but what happens when that's not quite enough like I'm doing all these things yeah and I go to my doctor and he says hey your your free testosterone is really just still not quite where it ought to be it should be yeah like what's the next step?

SPEAKER_00 29:10

So a lot of times this is when we talk about medications and this can be controversial a little bit and I'll tell you why I mean a lot of people just don't agree like some people think that everyone just needs to be on testosterone replacement therapy therapy meaning you're getting some kind of exogenous or external testosterone for your body that's not always the case we're gonna talk about like kind of the the three general methods for trying to help with your testosterone medication wise that are available and why you know why they matter why it um makes a difference. So um the first one I would say starting with a lot of people don't necessarily especially if if you want to continue to have children because you know testosterone and sperm are all uh you know kind of made by the same general uh signals from your brain um and that is so you have your pituitary gland which sends a signal to your your your testicles which is glutenizing hormone and follicle stimulating hormone so these are the ones that are responsibility for sending uh essentially the signal to your testicles in order to be able to create testosterone now uh we could talk about secondary or primary uh reasons why why testosterone is low. So sometimes that signaling system is just broken. And so if that's the case um short of a fix for fixing that then no you probably just need to replace your testosterone meaning that you do it exogenously and we'll like I said we'll talk about that. I guess uh I guess there's just a lot of different avenues we could go about this. But let's just say that you're a person that you've had your labs checked by your provider and yet you're still wanting to remain fertile for whatever, you know, if you're still having children or or things like that. Or let's just say that you don't you're not quite ready to commit to to shutting down your own testosterone supply. We'll talk about that. And let's say that you'd like to do uh more of a boost on your own system. The two methods for this uh that are currently available um short of doing something that's kind of like uh online not really guided by a medical provider are um CERMS so these are estrogen modulators and that's usually clomophene or N-Clomophene and these are are medications that are prescribed by a medical provider and these what they do is they boost the signal from your pituitary gland which is LH and FSH and they send that signal a higher signal to your testicles in order to increase your testosterone your total testosterone which then should increase your free testosterone if you're not binding up too much.

SPEAKER_01 31:44

And so that's just a more of a what we would call I guess natural way it's not so it's using your own your own uh factory to produce the testosterone it's just sending us a it's boosting the signal yeah so that it um kind of turns the factory up more than your own body is doing on its own.

SPEAKER_00 32:02

And it's all on a feedback loop and it uses actually estrogen is is the one thing that we use to actually like feed that feedback loop. So your body senses and estrogen uh the pituitary gland sends out a signal based on that. So you know if you're a lot of times we can just bolster that that signal should um increase your LH and FSH and then therefore if your testicles are working the way that they should be then they will just increase your testosterone. And in turn if you're using a CERMS which is like I said clomophene or anclomophene you will increase your sperm count. Maybe you care maybe you don't but you know it's it it does happen kind of together. And so that can I see two to three times. So let's say someone comes in at a level of 300 they're having symptoms of hypogonadism or low testosterone and I've seen patients that will get on these medications it's usually a daily pill um something that you do daily I usually see two to three times a boost. So if they're at 300 I'll see anywhere from 600 to 900 uh within a within a few months most guys tolerate these medications well there's very few uh side effects vision changes is the one side effect that uh very few people have had like just a little bit of blurry vision they stop taking the medication it goes away there's really just not a lot of um there's really just not a lot of side effects that are associated with these and even the ones that are out there is just something we don't see a lot it's just a very low probability of that. So just don't see a lot and uh this boosts your own natural testosterone. If you stop taking them you should essentially just return to normal. Now what's normal right? Like let's say that you started at 300 you get up to 900 and you're feeling great but then you decide you want to go and do it on your own or you just don't want to take those pills anymore. What we found is I've had some people where they've gotten off and we've tested them later and they are actually at a higher base level than they were when we originally started. Now think about it they got up to 900 uh you know we're using the serums and their own natural testosterone they started working out they started sleeping better they started feeling better so naturally their base may end up just being a higher than it was when they got on the serum.

SPEAKER_01 34:04

So it's kind of nice that way it's I I can't really say that there's any evidence or or study that shows if you do this for a certain amount of time that you're going to increase your own natural base testosterone what you make naturally but it makes sense if you if you if you've made those little lifestyle changes as part of having that um level increased that would that would maintain some of that just by the things we've previously talked about.

SPEAKER_00 34:29

Yeah it's just a lot of times I look at it just like a catalyst. I have a lot of people that get on them and stay on them they feel good there's no problem with that um but if if someone would want to get off at some point a lot of times we would argue that their base may be a little bit higher. So the other way to do this uh is a little bit different way it's called uh uh HCG pregnal is kind of the brand name um it's a lutinizing hormone so this is an injection that you usually do two to three times a week um and essentially this bypasses the the um if if if the theory is if you have a provider that checks into this and they think hey the the bo the boys the the testicles are working we just we just uh don't the boys the boys are working is that medical can we say that hey I'm not your medical provider so you're not your medical provider so we can say the whole thing is we can say the boys are working they just really you're just wanting to bypass the pituitary gland because that's obviously that's a more complex system right you have to that's just setting up your own signal. Yeah so so this is uh basically a way to bypass the pituitary gland and really just send lutinizing hormone directly to the testicles you do an injection and what this ends up doing is supposed you know specifically helps your body focus in on uh really just creating more testosterone through those injections it does it by the same mechanism meaning that all you're boosting is your lutinizing hormone which is the one primarily responsible for creating uh telling your your testicles to create testosterone and so you do this injection two to three times a week depending on what your provider's preference is and I guess yours and then uh yeah and then and then so you're really just doing HCG is good. It's usually $200 to $225 a bottle that lasts you a couple months. So not the cheapest way to do it. It it definitely can be a little bit pricey. But a lot of guys really like that uh using the lutinizing hormone. And so it is something to consider. You can talk to your provider about it. Um I usually see at least a double in their testosterone levels depending on how high you're going. And um so yeah talk to your medical provider about that one if that one sounds more appealing to you. And it really just bypasses the whole pituitary gland altogether and it doesn't stop you from making your own testosterone and maintains fertility which is a real big promoter for a lot of guys especially younger guys that are looking to really just bolster testosterone without um decreasing sperm counts. So then does that bring us to the last it does let's say that all these fail let's say that you know you're over you know you're over 50 you're over 60 and and you just feel like hey look the system they check everything out and maybe either you you they don't feel like the system is is is in a position to be able to to help by you trying to boost your own natural testosterone. Maybe you just don't want to do any of that. Maybe you just don't want to try to take an old car and fix it up. Maybe you just want a new car. You know maybe you don't want to have to try to you know fix up the old car and get it going. And uh and that'll be a discussion between you and your medical provider. The reason why testosterone is a controlled substance is because you do you you become reliant on it. Your body will become reliant on it because you will stop making your own testosterone.

SPEAKER_01 37:31

So exogenous testosterone or or giving yourself testosterone injections stops your so this is and this is any like this is any testosterone that I'm taking and putting into my body injection the gel the creams any of that that I'm taking testosterone and just putting it in my body and it's the testosterone that now my body's using yep what you're saying is that that will ultimately that feedback loop will send a signal say hey I have enough testosterone don't make any don't make any because it's because I got enough yeah but the enough you have is what you're putting in just to be clear.

SPEAKER_00 38:00

Yeah so you will you will eventually become reliant on this. If you do this you will eventually now there are people that get off and then start on like a CERMS or an HCG to bolster back their own levels. Let's say that they just I don't know they change their mind or something. So we people can recover from this right you can fire back up that system but eventually we don't really know we don't we really have no evidence that or five years or how long you have to be able to fire up the system. So there are people that go off testosterone for whatever reason spontaneously and all of a sudden you know they're gonna have to make their own and I've seen people's levels recover not usually back to anything what they were usually it is quite low. So this is a big commitment you need to talk to your medical provider and understand what you're doing. It's a great thing. Like if someone benefits from this maybe they've tried those more conservative methods and it just wasn't working for them. I mean testosterone therapy can be a fantastic thing. It can help with so many things bone strength, you know, heart uh heart health I mean uh obviously keeping good amount of muscle I mean there's so many benefits um to having a good testosterone level mood energy you name it um but this is doing it exogenously through shots or the creams and can be really helpful I've had a lot of uh men that come in and they get on these uh on testosterone and we feel like that's the best method for them and boy I watch it change their lives in fact I've watched a lot of guys come in and they think they're you know really depressed they're even on antidepressants they get on testosterone and all of a sudden we're taking them off their antidepressants and they're feeling so much better. Their issue was never really primary depression anyways it was actually just low testosterone. So I'm not saying that's always the case but I'm saying that I've seen many cases where really um they were just kind of attacking the wrong the wrong the wrong thing.

SPEAKER_01 39:44

Yeah. So so summarize then um get with your medical provider get some labs checked uh based on that work on some lifestyle changes. Yep. Um and then reassess in three to six months time frame.

SPEAKER_00 39:58

Yeah yeah usually just re reassess at that time and and initially sometimes the labs are more frequent and then they'll you know usually extend them out as you've once you optimize your testosterone levels you're feeling good. What I will say though is that doing testosterone therapy no matter how you're increasing it as far as medications go does not replace the foundation. If you are not doing those foundational things I can tell you it doesn't matter how high you get your testosterone levels, you are not going to feel better. So yeah, maybe you need that little bit of help to get motivated to go to the gym because you're just dragging. So maybe initially getting your testosterone levels will help with that. But if you don't take the initiative to do some of those things I've seen it time and time again that guys will feel good for a little while and then they go back down to where they're just not feeling that great. You need to be active and moving you got to eat decent you know you got to do those things. Otherwise you're just taking something that frankly any medication will have some risk you're taking something uh for a little bit of benefit um for much higher risk. I just don't think it's worth I just don't think it's worth it if you're not going to put in some some effort some work.

SPEAKER_01 40:59

Yeah no perfect and then and then you reassess three to six months and if you need there are other options to then boost your own system or or replace uh exogenously so yep. So anyway that's our testosterone rundown.

SPEAKER_00 41:14

Yeah that's a lot of information about it. Yeah it's just it's really just the information to get you to the point where you ask the right questions when you go see a medical provider or you drag your husband in to do it.

SPEAKER_01 41:23

I was like ladies if you're listening to this um this is so you can fix your man.

SPEAKER_00 41:27

Yep. So yeah that honeydew list isn't going to get any shorter so you know you gotta you gotta get him in there get it going.

SPEAKER_01 41:34

How to how to shorten your honeydew list. That's that's if that's not motivation I don't know what it is. Yeah. Well okay we appreciate it uh again uh talk to your medical provider that's uh especially on this this stuff it's a key thing um we are here for educational and informational purposes only uh but really our goal is that you can uh make some of these changes and and live healthier ever after. Yeah. So with that