Hormone Optimization Deep Dive: Why Your Hormones Are Making You Age Faster(And What to Do About It)

Are your hormones actually optimized, or just "normal"? There's a big difference.

In this episode, we are joined by Dr. Kris Wusterhausen   / drkriswusterhausen  board-certified family physician and age management medicine specialist, for a deep, nuanced conversation on hormone optimization for both men and women.

If you or your provider still believe HRT comes with extreme risks, this episode is a necessary intervention. We cover everything from the biggest misconceptions still circulating in mainstream medicine to why testosterone is not just a "male hormone" to how hormones affect relationships, libido, and long-term health outcomes.

In this episode, you will learn:
• 🔥Why low testosterone is actually a risk factor for prostate cancer (and why replacement therapy doesn’t "feed" it).
• 🧠 The hormonal decline that drives aging (not the reverse)
• 🤫 Why "Normal" lab ranges are failing you, and the critical "forgotten" hormone (Thyroid) that primary care religiously overlooks.
• 💪Growth hormone peptides and their role in body composition and recovery
• ❤️ Why hormone therapy is sometimes the best marriage counseling

Stop accepting fatigue, brain fog, and "the slow fade" as inevitabilities of getting older. It’s time to move from "Cell to System."

🔗 More about Dr. Kris Wusterhausen:
•   / drkriswusterhausen 
• The Resurge Clinic   / theresurgeclinic  https://www.theresurgeclinic.com/ 

Transcript

SPEAKER_05 0:00

The Celtic Systems Podcast is for informational and educational purposes only and does not provide medical advice, diagnosis, or treatment. Listening does not create a doctor-patient relationship. Always consult a qualified healthcare provider regarding your medical conditions or before changing your health regimen. Do not disregard professional advice or delay seeking it because of something you heard on the podcast. Reliance on the information provided is at your own risk. Guest opinions are their own. Celda Systems may utilize affiliate links, feature sponsored content, or discuss companies in which hosts or guests have financial or advisory interests. Relevant disclosures will be noted during the episode or below.

SPEAKER_02 0:38

All right, everyone. We have a special guest today, Dr. Chris Wosterhausen, who has a practice in um Weatherford, Texas, uh just outside of Dallas, and he is a board-certified family physician as well as certified in age management medicine, and teaches all over the world about hormone optimization, which I think is super exciting. So, Dr. Wosterhausen, thank you so much for joining us. Can you take us through what we all need to know about hormone optimization for both men and women and what are the big misconceptions?

SPEAKER_04 1:25

Man, that's a broad question, but I'll try to I'll try to handle it. So uh thank you. I appreciate that actually. So actually, I was talking about this with a uh today's been a busy day. I've had a uh a few new patients, and um one of the things that I'm still blown away by, even with black box warnings being taken away by the FDA, is still how many patients and actually how many providers still believe that hormone replacement comes with these huge risks, right? And I think that's probably the biggest misconception that is out there is that the safety of hormone replacement and how necessary it is. Like, I truly believe that there's so many females that don't understand the importance of like just estrogen, you know, how how they're lowering their risk of dementia, how they're protecting their bones, how they're protecting their skin, how their vaginal health, sexual health, like how it all wraps around uh estrogen. And then probably one of the other biggest misconceptions that I run into all the time is that testosterone is a male-only hormone, right? Like guys don't need uh uh shouldn't have estrogen, and girls shouldn't have testosterone, which is uh utterly and completely false. You know, in our practice, we always say, you know, estrogen does the job of protecting against all those things that we just talked about, in addition making like hot flashes go away. But testosterone, many times, is the one that actually makes them feel good, right? It's uh is so important for uh muscle mass, muscle mass. Like Leonard always says, there's two hormones that build muscle, burn fat, you know, and that's testosterone and growth hormone. So I truly believe that most practitioners out there still don't do not even look at testosterone in women, much less talk about replacing it because it's considered a male-only um hormone. And then, you know, still moving over to the guys, I mean, again, uh testosterone is what makes a guy a guy, basically. And and we're in a real epidemic in our country with low testosterone in men. And we're seeing it, and I'm sure Suzanne can back me up on this, we're seeing it at much younger ages than what I felt like I used to see in my practice. It's not uncommon now to get 20-year-olds with really low testosterone. And I think that's due to a lot of things like environmental factors and and mainly food and stress and all the things. But um, you know, it's just critical. Like one of my favorite things is actually in young men to actually check their hormones. Like, let's let's set a baseline of where you're at at 23, 24, 25, so that we can compare down the road and really know um, you know, what your blood looked like a decade ago. I think that's super important. So I just think the biggest misconceptions that I run into uh is that the safety of it, uh, is it really safe for the heart? Is it not really safe for the heart? Prostate cancer, you know, that's still one I'm running into a lot with men. Uh we actually know now that testosterone replacement doesn't feed uh uh prostate cancer. Heck, low testosterone is a risk factor for prostate cancer. And so these are just facts that we have to get out there. We have to educate our patients. Hell, we have to educate other providers, to be really, really honest. Um, and so that they understand there's so many people still hung up on stuff from 15, 20 years ago as providers because they're not staying current. So that would be kind of my take on that question.

SPEAKER_02 4:55

That's a great overview of where we are uh with things today. And as we go deeper into this and talk about all the subtle nuances. I mean, I to kind of bring something up. You know, there was a lot of talk about testosterone replacement causing blood clots at one point in time. There's been all these different things that we've heard over the years. And um love to hear your take on that just really quickly before we move on, with regards to blood clots caused by testosterone replacement therapy.

SPEAKER_04 5:26

Well, I guess what I would say is that hormone replacement, in my opinion, is safe when done and monitored by an adequate provider. And, you know, the biggest the side effects of testosterone, uh, if you're doing the right labs, monitoring the hermatocrits, doing the things that we're supposed to do, we're actually not raising the risk of clotting in these patients if you're doing the right things. And it's I actually did a post, I don't think it's even been posted yet, where I was just trying to say like, who does these things matters. It matters who is monitoring your peptide therapy, who's monitoring your hormonal therapy. Um, you know, there has to be a baseline of knowledge in order to truly treat and monitor these patients correctly. It's why me personally, I'm not a big fan of like hims and hers and these type of things. So that these are things that just come down to knowing how to monitor these patients, knowing how to adjust these patients. Anybody can start hormones, right? I mean, like any provider can start somebody on hormones. It's like when things don't go right, that's what really separates one provider from another, in my opinion.

SPEAKER_02 6:37

It seems like there's two separate worlds. There's the I'm gonna DIY kind of world, and then there's the sort of in-between where you get it somewhere somehow, and then there's the real uh comprehensive way that it should be done, which everyone here uh is a part of. So I want to take it over to Christy really quickly, and Christy, just sort of um get your take on it. Um from an athletic standpoint, uh you see a lot of athletes in your in your clinic, a lot of um professionals. Um, and I I'm curious, like, how are people managing um their hormones in within your patient population?

SPEAKER_00 7:17

I start that, you know, I mean, regardless an athlete, a teacher, um, stay-at-home mom, father, whatever it is, that you know, we don't stop producing hormones because we age. We age because our hormones have started declining, right? And so just breaking it down that hormones are such a vital part to overall aging. I mean, um, and then I, you know, I think also as a society, we've kind of normalized feeling tired, foggy, inflamed. I mean, sadly, that's in your your standard practices, that's that's that's a normal, but it's not. It's hormonal. Um, as far as when people start complaining of those symptoms. Um, and then, you know, I think I'm a true believer that if you truly want longevity as a provider, as a patient, you have to care about hormones. I mean, bottom line. Um, I mean, there you you truly cannot have lasting health um if your hormones are not optimized. Um, you know, just with the topics we've talked about as far as, you know, like the m-bodies. I mean, so much of that is tied to the results on the mbodies is also um tied to the hormonal health. Um and so, and as far as just hormone therapy can is not about reversing age, it's restoring the cell functioning. You know, kind of how I break it down for patients is hormones act like a text message between cells. Um, and when levels drop, um, messages don't get delivered, which results in our symptoms, right? So fatigue, the brain fog, weight gain, poor recovery, mood changes, and so on. Um, but the basis is it of is that hormonal decline and I mean I've been doing hormones, I mean, since 2014. I mean, that's honestly what how I started my first practice was just you know, learning hormones. And I, you know, started with creams, um, because that's all I I understood at the time, and then moved to pellets. And, you know, now I think it's you know, finding that right method for each patient matters. Um, timing matters, and you have to individualize the treatment. Like, you know, some like do we do a lot of pellets? Yes. But do I also do a lot of creams and oral and injections? Yes, I do. I mean, it's I think it's really individualized uh per the patient.

SPEAKER_02 9:55

Yeah, getting a full sort of overview of what's happening for them, as Dr. Wosterhausen had mentioned previously, that's pretty um important. Something you think about all the time, Dr. Fare. Uh that you mentioned in the last episode, something I've been thinking about since that episode was that total sort of comprehensive look as we look we thought about that with Dr. Hussein, really getting that full sense of the patient and treat treating them holistically, again, as Dr. Wosterhausen just said, really kind of getting that sense of exactly how to do this the right way, managing everything. So, from your perspective, um how are you doing it?

SPEAKER_06 10:33

Well, I hate to even begin to speak when we have the expert here in the room. But uh yeah, we we do a pretty comprehensive um test, uh testing um of these patients. We'll do either serum. Sometimes we'll start with serum, sometimes we'll start with with a urine test. I'm a big fan of the Dutch or the Humap, whichever um I can get them to do. And they both give us really great information. They give us different information. We use them in different patients for different reasons when they're already on hormones when they come to us, or if they're changing from one form to another, we might use one or the other. And this is where what what Dr. Worcesterhausen was talking about is it's so important that you have a provider who knows what they're doing when they, you know, all of us are people who continue to do research on a can on a ba on a regular basis. I mean, I have every single day alerts delivered to my box about 10 new articles that have come out on hormones in general. So we're not just talking about estrogen, progesterone, testosterone, we're talking about cortisol, growth hormone, thyroid hormone, you know, the cord uh, yeah, cortisol, we already talked about uh all the hormones. We're we're pulling all of these things together because they all are critical to what we're talking about. Um, and so you also need to understand, and I remember back when I was in um medical school working on infertility research and seeing it, learning that whole pathway, how that whole thing comes down and knowing the enzymes that are involved and having to memorize that in order to understand infertility. Well, that has played it so well into what I do now on a regular basis. So then we sit down and we talk to the patient about how these play together. This is not, you know, I'm trying to teach an AI learning, uh large language learning model now how to uh help me interpret labs. And so one of the hard things is um it's not just this is high and this is low, because it's it they're all interconnected. This is a symphony of hormones. So we're if the progesterone is high and the estrogen is low, then you might get estrogen deficiency symptoms, but you also might get progesterone excess symptoms. And the other way is true. And so if you make, if you make one little tweak, you're going to affect everything else. If someone in your family that you love dies, then that's going to affect the way your body uh uh handles all of those hormones. If I'm giving you testosterone pellets and all of a sudden you decide you're gonna train for a marathon, you're gonna, it's gonna change the way your body receives those hormones and it's gonna change the way we're gonna need to affect your diet, et cetera. Keeping in mind always, as we talked about on the last podcast, that the terrain is what's important, what's in the base of the person's body, what's in their blood, what's happening with their tissues, what's happening all, you know, if the patient comes to me, for example, I had one this past week, she's in her um early 50s, probably about the same age as me. And her husband sent her to me for because her libido was too low. Because her his doctor had put him on uh testosterone and he'd heard about me on a podcast, so he sent her to me. And so uh there's so many things that go into whether or not your libido is high. You can't just attribute it to a low testosterone. So we had a very long conversation about all the environmental influences in her life. She's getting ready to retire, she's the mom of two kids. And there's her whole identity is about to change. And so that may be also contributing. So we talked about that, yeah, she might get some improvement in her libido, but there are several other things we use. We use other hormones we can capitalize on, and hopefully soon uh we can capitalize even more on some of the other hormones like melanocyte stimulating hormone that will help increase libido. There's a lot of ways we can do those things that will help us with uh improving uh libido in addition to uh uh optimizing your hormones. We also always forget all the other benefits of testosterone. Chris, of course, mentioned a bunch of them. Uh uh urinary incontinence. There's a lot of benefit of that, bone density, cognitive decline, and all of those things we need to keep in mind as we are uh treating these patients. You're not just coming to me to get your hormones so that you look better and you have a better sex life, both of which are very important, but we're also looking at trying to make sure that the patient stays healthy and well, which is what Christy was talking about all along. Yeah. So I think that we have to realize there are more than just one thing. It's all about a symphony, and that um it depends on what the terrain is of the patient that you're that you're treating.

SPEAKER_02 15:10

Before we move on, the one thing I want to ask you about uh hearing a lot lately about people getting divorced, and Dr. Wosterhausen, maybe you know, you can chime in on this as well. Um, but there are a lot of like women get to a certain point in time. Dr. Wosterhausen, you mentioned testosterone, and there seems to be this aversion with women and testosterone, and yet the progesterone, estrogen, and testosterone combination, from what I'm understanding, seems to be the right combination for certain people. And there was somebody talking about how they're a divorce attorney and they were talking about the fact that they were seeing what was like uh, I don't know, sort of uh a certain point in time when women are going through menopause and they're very unhappy with their relationships because of their hormone imbalances, or they were attributing it to hormone imbalances. Maybe you could speak to that. Do you see that in your practice, um, Dr. Fare? Sure.

SPEAKER_06 16:08

Yeah. And and we'll see that they'll that this is about that 50-year-old time frame. And the question is, is this because of their hormone imbalances, or is it because they're just not gonna take it anymore? Um, as a one of them. There is an element of women who come into this a this age, uh, be get to a point where sometimes they're trying to use hormones to silence some of that speaking their truth because they get to that age of 50 and they start speaking their truth and saying, it's not okay. This isn't okay with me anymore. And so sometimes they're trying to use the hormones to silence that truth. And I that this is why for me, it's these are big long conversations where I say, hey, you have to realize. But also on the other side of that, if men are getting treated with testosterone and they're not having the conversation with their wife about the fact that they're being treated with testosterone, that's also really not very fair. So part of the conversation with my male patients is, hey, do you need me to have a conversation or do you need to have a conversation with your wife? Because I don't want to start you on this therapy unless you are, this is a couple's, this is a couple's hormone treatment, right? We can't raise, raise up your sex drive if hers is where it is, wherever it is. And if she doesn't know, then there will be a whole conversation about why is your sex drive so high? What's happening in your, what's going on right now? Are you getting uh ripped because you're trying to leave me and whatever's happening, right? So there's a there's so many things that are happening in that time that we want to make sure that we're preparing the couple and realize that it that you are not just treating one of the two. You've got to engage both members of this partnership in what you're doing for their um for their hormonal health, their longevity.

SPEAKER_04 18:01

Yeah, if I could actually add on to what Dr. Faree was just saying, and I think that was perfectly said, is I actually see hormone replacement many times for my patients as marriage counseling. Basically, we bring marriages back together. And what I would say to someone who says about divorce uh in my practice, I think it's don't get me wrong, we've had patients get divorced. I mean, that happens. And and, you know, uh many times though, when you can actually bring these couples in and you can put them both on hormone replacement, as Suzanne said, it's not really fair if the guy's out there getting hormone replacement, not telling his wife, feeling better, and like, oh well, I'm not going to share this with you. But most of the time, this is an open communication. Most of the time in my practice, it's still females first, men second is still what comes into my practice. And I always talk about a guy that one time he came in, and in the majority of our patients, we do pellet, but we do just like Christy was saying, we do oral gels, creams, injections, everything. And he came in for a new patient consultation. It's a couple years ago, and I was going through testosterone and everything goes, hey doc, you can stop. Can you just put the pellets in? Because like I got to feel better and keep up with her because her libido is better, mine's not. And I'm like, no, we have to go through this. But I'd like to discuss libido for a second. So libido is typically libido for a guy is pretty easy. I don't know if the other providers agree with me, but give them testosterone. And if they just get a hint that their spouse is interested or their significant other's interested in them, you know, as guys, we're good to go. The ladies take a lot more effort. There's a lot of more emotional sides of this, their stress levels. How are they sleeping? Uh, kids. Um, and I always say, Do you actually like your spouse? I mean, you do kind of got to like your spouse.

SPEAKER_06 19:47

I mean, uh I say, does he take the trash out?

SPEAKER_04 19:50

Yeah, yeah. Because sometimes it's like, hey, I can't fix that. If you don't really like your partner, I can't fix that. But hormones, and by the way, uh JP, I'd throw one more in there. You you'd said progesterone, estrogen, testosterone, thyroid, uh, really, really crucial to throw thyroid in there too. It's sometimes the forgotten hormone that we should not forget about. And I know no one here does, but I'm just saying a lot of providers do see a lot of suboptimal thyroids that are told uh their thyroids are perfect. So anyway, but no, hormone replacement should be uh something that's embraced for a marriage because the one thing I tell my patient, uh, a marriage without intimacy is a marriage that's most likely going to fail. Or a relationship. It doesn't even have to be a marriage. But, you know, as I get older, intimacy should actually get better, not worse. You know, as the kids move away and you have more time and you know, you get back to the two of you. The reason I think so many marriages fail after the kids leave the house is people grow apart. Um, and I think hormones can help bridge that gap of bringing them back together and open communication.

SPEAKER_02 20:55

Wow, that's that is a so phenomenal. What an interesting perspective on that. As our kids went off to college and all of a sudden it was just the two of us, and um, we were there. It was like, oh wow, there's a real opportunity to do something cool and new and kind of like all these things that we couldn't do for years. Um, and you know, Craig, you're right in the middle of little kids. So I'd love to hear your perspective on on this and um coming back from vacation after that and and how you how you do things in your practice.

SPEAKER_03 21:26

Yeah, well, um I will say I am not yet on uh testosterone replacement therapy myself, uh, but you know, have that on the horizon. I've been, you know, testing my levels and whatnot over the year, um, you know, past couple of years and um, you know, just not quite there yet. Uh, but it's something that I'd you know be interested in implementing for sure down the road. Um, you know, I do have my wife on HRT. Um, she's you know in the thick of perimenopausal years and she does. Really well with a little bit of progesterone and some testosterone. And we have her on some thyroid optimization as well, because that is the critical element that often goes overlooked. And unfortunately, you know, it goes overlooked somewhat religiously, you know, in standard primary care practices, at least to the extent that we're diving in in these longevity cellular medicine practices, you know, looking at thyroid and thyroid signal in a much deeper level. So yeah, and I think, you know, couples that are coming into the practice, coming into practices like ours are really in it to win it. When they start seeing, you know, that positive changes are happening, um, you know, it motivates them to, you know, perform at a higher level, often in conjunction with one another. And these are the patients that uh, from a practice standpoint, are going to then refer their other um, you know, colleagues and their friends and their family back to your practice, uh, which really gives an excellent opportunity for clinicians to really, you know, sort of capitalize on how we can help optimize people's health. Um, you know, so it's a fantastic time. One of the things that I really um, you know, love to focus on is the, is the fact that, you know, as Dr. Wosterhausen mentioned earlier, we're seeing these much larger, much broader ranges with which people are benefiting from hormonal support. I mean, if you think about the various things that can drive down a young man's testosterone level, well, you know, how many, how many people out there have kids that are playing high school football? You know, they're they're playing soccer, they're heading the ball routinely, they're getting, you know, minor uh concussive head injuries, you know, some possibly can uh component of pituitary hypofunction, right? And so we can see lutinizing hormone levels and things like that that maybe are not um, you know, adequate for their age or, you know, their level of performance that they desire in their life. So, you know, we can use various different therapies. There's, you know, enclomophene, which is a CERM, uh, which we can use to sort of augment LH levels and uh give the testes a little bit more of a push there to produce adequate testosterone. Um and then on the other side of things, you know, people that are aging, right? We know now that uh, you know, the 2020 re-evaluation of the Women's Health Initiative uh showed that, you know, by and large, women before the age of 60 or within 10 years of menopause are benefiting from hormone replacement therapy. But that's not to say that women who are beyond the 10-year scope uh are not getting benefits, you know. So um we can look at the cognitive uh aspects of hormone replacement. Uh, we can look at the bone density preserving aspects and um, you know, certainly look at some of the growth hormone aspects uh and how that relates to both cognition and uh bone density and and other things like you know, general energy and repair. So um, you know, it's wonderful to see positive changes uh in in younger folks, and it's wonderful to see these positive changes in older folks as well. You know, maybe they're in their late 60s, early 70s, and uh they're really you know starting to you know just feel much better than they had in in recent times.

SPEAKER_02 25:23

Yeah, it's like a whole new world. Hey, Leonard, um Craig mentioned growth hormone and how that plays a role in all of this. Maybe you can chime in on that.

SPEAKER_01 25:33

Sure. I I did want to comment though, I've been learning a lot on this on this podcast. Um I've uh I've I've I've done the math myself and um I'm realizing that I I'm I'm married and I have two young daughters. And in about seven to eight years, all of them are gonna be going through a lot of changes. And and I also realized that I didn't take the trash out yesterday. So I'm getting more and more nervous as I'm listening to you guys talk. But um, but I I loved I loved how you guys talked about relationships because I've actually talked to Dr. Chris's wife, uh Crescenta, and she's told me some stories about some marriages that have been saved with uh hormone replacement therapy. And I um I don't think any I've I've never really heard people talk about it the way that you guys have talked about it today and thinking about the the couple as a whole. And I think that that's um super interesting and and something that needs to be talked about a lot more. I actually have some more questions for you guys uh because you know, you guys are doing things the right way, but I I do notice that you know this kind of turns into a business sometimes. And I I have noticed that some younger folks coming in um might be um prescribed hormone replacement therapy a little bit sooner than they actually need it. And I know at one point when I was uh metabolically unhealthy, I was on the lower end of normal for testosterone, but still in a normal range. And I I was lucky to be around people that were um had a different thought process. But I think if I would have walked into the wrong clinic, they would have automatically said, hey, you need to be on testosterone right away. And um, you know, when I changed my health and when I changed my metabolism, my body composition around, um, you know, my testosterone levels are actually really high. And um, and I've I haven't needed it yet. But I was wondering, you know, how do you know that someone needs to either start testosterone replacement therapy because it has so many benefits, or is there a route that you take where if we improve metabolism, improve body composition, a lot of these things kind of fix themselves where hormone replacement might not even be necessary earlier on in life? How do you how are you guys judging that um for your, you know, your 30-year-old patients that are coming in that might be metabolically unstable?

SPEAKER_03 27:38

I think it's really important to look, you know, first at just general inflammatory load alongside how the patient is sleeping and their micronutrient status. I mean, we know the steroidogenic properties of something, you know, as simple as vitamin D and how many patients come into the practice and they've got a vitamin D of 26 or 33, you know, which is really just it's not sufficient, you know. So um, and a lot of times these patients are, as you alluded to, they're they're sort of eating like junk, they're not exercising, they're not lifting weights. Um you know, so you have to take all of that into consideration first. And besides just looking at that, you know, you also have to factor in like, okay, for a guy, for example, you know, 20s, 30, early 30s, uh, you don't want to necessarily give them testosterone uh if they have fertility aspirations, right? And they want to have and bear children.

SPEAKER_01 28:34

I think that's a really big point. You know, I've run into some um some people in their 30s and they got really bad advice early on and they were on really high doses of testosterone early on, and they they they had trouble having children later, and they wish that somebody would have talked to them about it. Um I think it's a little bit people are more a little bit more aware, but it was it's like kind of like Dr. Free was saying, it's the the terrain is is a big part of everything. Um and it's it I've always struggled with this question, is it like the chicken or the egg first? Um, because I I I there's people that I respect on both sides of it that say, hey, you know, I think that the uh hormones are the foundation. We get that ready, and then and then we can do all the other stuff. And I've I've heard the other side, and I see both of those practitioners having great success in in the way that they do it. And so I think that that might be a little maybe confusion out there for some folks that maybe their libido is low, or maybe they're um they don't have the energy um and they're struggling and they're wondering is do I start hormone therapy now, or um is it for me now, or is it something that I need to kind of wait for? And um, and so and that's why I I well, you you asked the question about growth hormone. And I think that um especially growth hormone peptides are really interesting because, like uh uh Craig, you mentioned stereotogenesis and the impact that we can have on hormones when we just exercise or when we lift heavy things. Uh, I found that um, you know, as people age, growth hormone declines as well. And it's not just about putting on more muscle or growing, but uh, you know, these growth hormone peptides, they allow people to exercise better and recover from exercise better that also is going to have an impact on your other hormones. And so I think in the in the conversation around hormones, that one kind of gets left out. But I think it's uh it's important because like Dr. Chris said, there's two hormones that are uh, and we had this conversation in one of our last podcasts around body composition. There's two hormones that are uh catabolic to fat, which is what we want, and anabolic to muscle, and it's testosterone and growth hormone, indirectly through IGF one signaling, but they're doing exactly what we want them to do. And um, and Dr. Free, you talked about it being a symphony. I think that's the perfect way to describe it because you know, what are the things that are going to counter what we want? Things like cortisol that are gonna be the opposite. They're gonna be catabolic to muscle and anabolic to fat. So I think that uh growth hormone plays uh a role in all this. And um, and from what I've seen, I've seen, you know, really successful practitioners out there uh using hormone therapy as a baseline. And then uh, because Dr. Chris says this all the time. I'm calling you guys all out because I learned so much from you guys. But Dr. Chris always says that he gets people stabilized on hormones and they're doing great and they feel great. And there's always this time period later on where it kind of like teeters off and they're wondering, well, what's next for me? And that's when you can kind of throw in peptides and some other things to kind of get to that next level of optimization.

SPEAKER_04 31:22

Backing up on what Craig said uh about Leonard's question, and and I think he did a really good job of answering it. I think it's just about the phase of life that a patient is in or what's going on with their overall health. I agree with Craig, you'll get a lot of these young guys and girls that are really inflamed, hype, you know, insulin resistant, and you know, where you can make a really big impact. You know, the, you know, you you look at their phenotype and you see that, you know, we got to get this adipose tissue off. We have to get the testosterone up in many of, especially these young men, because it's going to be one of the major fixes, is just how do we do it? And like Craig was saying, I find too many practitioners not thinking about spermatogenesis for this patient in a few years. They're just thinking about today, not five years from now. Because, you know, a guy may tell you at 25, you don't want to have kids, but at 30, he's gonna feel differently about that, most likely. So I agree, but if you get a guy that's a little bit older, like maybe they're saying they're they're in their mid-30s, they've got two kids, they've already had a vasectomy, they're low T, they're not really that inflamed. That's typically when I will go ahead and progress uh over to actual testosterone replacement therapy. So as Craig was saying, you just got to look at each patient very individualized. And to back you up on the growth hormone, because Leonard, you always talk about this study, an older uh gentleman has just as much ability, though, to make growth hormone as a young man, right? Like we're we're not making it, but we have that ability, which is where I know that's not what the podcast is about, but it's where those growth hormone peptides can be such a great symbiotic relationship to our hormone replacement, specifically testosterone.

SPEAKER_03 32:57

How much tracking, you know, in in your practices are you doing of IGF one just to look at, you know, the signaling there once you start somebody on the Peter Peter.

SPEAKER_01 33:05

For me, in my uh smaller experience compared to you guys, it's um, you know, those people that don't like to cycle because they feel so good when they're on it and they want to be on it continuously, is when um we tend to try to try to look at it more. Um and especially with Tesla Morelin, because it's just more potent rise in in IGF one. Um but uh yeah, I'd I'd love to hear what you guys think about that as well.

SPEAKER_06 33:28

We follow ours pretty closely. I mean, especially if any, especially our new patients, we're gonna see them super often at the beginning. And I'm gonna do uh every six weeks for a little while, especially like Leonard was saying, if they're on um Tessimerellin, we're gonna do an every six weeks follow-up. We're gonna, yeah, probably close, close follow-up is the is the big key with that, making sure keeping in mind there are there is a third option. There's there is a um don't give them any hormones, and then there's the and treat all the terrain. There's the option of give them hormones and treat, you know, and treat the terrain, or there's kind of a third option. This is what we've found has been really helpful in our practice. So let's say it's your, you know, no man's land kind of patient that's 30 and not sure about his fertility, because a lot of people are are getting, you know, are having babies into their 40s and 50s. So uh this is the guy that you say, okay, here's an alternate way we can do this. And we're gonna do some sort of amalgam of what we've just been talking about. So we might do a cycle of testosterone with a little enclomophene for a while. We might do um, we might be giving them some growth hormone as a third. So we do a cycle of uh growth hormone peptides, we might do a cycle of testosterone, a cycle of growth hormone peptides. All of this is trying to restart their systems to make their own rather than, you know, and then while we're doing that, they're also getting into the gym. We're working on their sleep patterns, we're taking all of that information from their inflammation and decreasing that inflammation with all the things we know that work really well for decreasing inflammation.

SPEAKER_01 35:08

That's great. You can't do that with hymns.

SPEAKER_06 35:10

Yeah, you can't do that with hymns.

SPEAKER_02 35:12

One thing I wanted to ask Dr. Wurstrausen is how does somebody actually make the right choice? Because all everyone's sort of brought this up in their own way. How do you know that you're going to the right provider?

SPEAKER_04 35:24

Well, so first of all, I think it's really awesome how every one of us does it slightly differently, right? Like I think that's what's really cool because what you don't want to be is the one that does it exactly the same way every single time. And I love hearing how everybody does it a little bit differently. And uh, I'm very proud of the fact that we use all modalities and every patient we treat a little bit differently. And I'm not always as hung up on labs as I am how they're actually feeling and doing. I always tell my patients after I start hormonal therapy, most of the time labs for me are just making sure that I don't feel like we're in any form of a danger zone, right? Like that's really what labs are for me after that. Because, like, I know Suzanne could back me up on this. Like many times they can tell you what's going on, and you pretty much already know what they're either too much of or not enough of. Like we talked about the other day about progesterone. Like, I'm actually one that doesn't routinely measure progesterone. I use it as I feel it's necessary to use. JP, unfortunately, there's no perfect answer to that question. I I think that the biggest answer to that question is is know your provider, researcher provider. Does your provider make you feel comfortable? I I know this is a silly question, but every new patient, before I move forward with them, I go, are you comfortable with what we just said? And are you comfortable with me guiding you from this point on? And I always say, if the answer is I'm not sure, or I don't know, or even if they make me feel uncomfortable, I say, we're gonna pause the, we're gonna pause the visit, we're gonna repick this up in a week or two when you're ready. Because the last thing I want as a provider is a patient that's not a hundred percent on board with what we're doing. Because I'm writing that down, Chris. There was a time in the past where I used to would treat a patient like, okay, we do a lot of pellets, and you you you consult the person and they're like, yeah, okay, let's do it. And they kind of give you that kind of nonchalant answer, like, sure, let's do it. That was we're always the ones that seemed to give me the problems down the road. Not the lady that's like, oh my God, yes, please, this is going to really change my life. Because I do believe being mentally bought into something matters. And if you just are kind of wishy-washy on it, your success is going to be poor. So I I I actually did a um uh Leonard's gonna, Leonard makes fun of me, I think. But we're I'm trying to get into social media, I'm struggling. Uh, but I did another video yesterday on literally in my area, uh, peptide clinics are popping up by the day. And I'm not even joking when I say that. And, you know, like not that I guess it's horrible, but one's in a trailer. And I was like, not that that could be bad, I guess, but I'm just like, know your provider, know who they are, what's their education level? Uh, are they learning? Um, I think that you can get a feel as a patient if you ask the right questions to your provider. And please don't ever be afraid as a patient to ask questions. I mean, I think that's the biggest thing. And if you're not comfortable, you should move on to the next person. And I tell my patients that all the time: if our personalities don't jive, you owe it to yourself to go find the person that does. Because look here, here's multiple people that do it slightly differently, and that's just the way it is. And I think that's awesome.

SPEAKER_00 38:35

If I'm having to try to convince a patient that a hormone is the way to go, or even a peptide or whatever it might be, they're just not the right patient at this point in time. Not to say that they will never become that patient. Um, but it's something early on when I started doing hormones that, you know, I I saw that, like, if you know, it's because you're passionate about it. You know, I remember coming back from my very first training, you know, I'm like, I'm all gun hole. Um, and you know, you you just want to, you're like, oh, I can fix this person. No, you can't fix every person, and you sure for sure cannot fix crazy. I mean, I think we've all made that mistake when we've, oh, they're just hormonally imbalanced, they just need some hormones. And I mean, we've all made that mistake. But, you know, that's something that for myself, that if I'm having to convince a patient to do something, they're just they're just not ready for it. And then, you know, I'm you know, I have my staff makes fun of me, but I I literally have a library and and I hand out books all day long. Um, and because, you know, some people want that information or, you know, pamphlets of just what I've created and my other resources. Um, and then, you know, as far as one thing through my years that I first started that I was not paying attention to and I've become or in my practice is thyroid and gut. Like you can get, I feel like that, and and I know us all here is some, but like just early on, like I look back even just five or six years ago, I was missing a lot of suboptimal thyroids that I should have probably been treating. And I mean, thyroid supplementation can do amazing things. And then also the gut. I mean, you know, having the gut tides um with Leonard and then the powders with the L-glutamine. I mean, it's just it you can truly change going back to that picture as far as if a patient is too young and they're still wanting to conceive a child, um, you know, just and but yet they have that that inflammation, I mean that that typical patient we all see, that older 20-year-old, but like it's like we don't want to touch this with hormones because of the liability. Just simply fixing their gut and and getting them moving can completely turn the picture. And then, you know, I'm also a big advocate that, you know, you can't just treat one hormone because then you're just playing whack-a-mole with the symptoms, right? Like you're just like, and and and again, through the years, I've, you know, you you've got to truly look at the whole system, not only the whole patient, but the whole hormonal system, as we've talked about, the progesterone, the DHEA, the thyroid, the cord um cortisol. I mean, it's not just about progesterone, testosterone, and estradiol. Um, and then, you know, progesterone for my younger, I mean, I can tell you story after story of these, you know, young women in their young 20s and even their teens that are just severe PMS that I mean to the point suicidal. I mean, I I know we all have a story there, right? That that just progesterone is a phenomenal hormone for our younger population. And then obviously talking to them about their gut.

SPEAKER_06 41:48

And pentasin polysulfate.

SPEAKER_02 41:50

And pentocin polysphate. Let's go into that. What uh tell us more.

SPEAKER_06 41:55

What she's talking about has the flavor of endometriosis. And mechanistically, pentasin polysulfate works on reducing the production of a uh the activity of an enzyme called MMP9, which is the reason why endometriosis plots get stuck on the outside of intestines and are able to actually integrate themselves into the intestinal wall, is because of that MMP9 enzyme. So if caught really early, some of my patients with endometriosis get some improvement in their pain symptoms and decrease in the progression of their endometriosis when I use um pentosane polysulfate.

SPEAKER_02 42:38

Very interesting. Well, we have covered a ton today, and there's so much more. I always feel like we could just keep going and talk for hours. However, we're kind of coming to that point in time when it's time to wrap it up. Um, Dr. Wisterhausen, thank you so much for being here today. Um, it's such an uh informed conversation. I learned so much. I think the entire group um really benefited from having you here. Um final thoughts? Anything that you you want to share with the world before we go?

SPEAKER_04 43:07

No, I just think that patients shouldn't be afraid to actually talk to their providers, find that right provider, you know, uh get your labs checked, uh, and really get a comprehensive look at what's going on. It really can change your life. And I know every one of us see it literally every day.

SPEAKER_02 43:23

This has been a fantastic episode of Celtic Systems. Thank you all so much for joining us. Remember to like, share, and subscribe. And for those people that might know some folks who are struggling with any of the things that we talked about today, please share this episode with them so that they can get the help that they need. Thanks so much for watching and catch you on the next one.