EP2: Understanding Hormones with Trevor Huckaby from Optimize U

Transcript

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Welcome to Healthy Knox, connecting Knoxville to better health. This is the show where we cut through the noise and get real about what it takes to live a healthier life right here in East Tennessee. Your hosts are two doctors who aren't just talking about health. They're living it and delivering it to this community every single day. Dr. Cherise and Dr. Trent from Corrective Chiropractic, let's get into it.

Intro

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What's up, everybody? today episode number two. It is long awaited. It's been a couple weeks because in my life, personally, we just had our second child about three weeks ago. So things have been a little bit crazy for us, but we are starting this episode number two highlighting a local business. Our project is to interview local businesses here in Knoxville that are on the mission to help identify Knoxville's growing health crisis and trends. Specifically, we are 44, 45th out of 50 states that are overweight, and so this has big imp- implications to health issues, and this is a kind of a launching point. So we're gonna be interviewing today OptimizeU of Knoxville, and our nurse practitioner today and expert we'll talk to is Trevor Huckabee. So we're we're excited to talk to him today about hormones and everything that they talk and focus on. So welcome, Trevor. Yeah. Thanks for having me. I'm excited for the opportunity. So just a little bit about myself. I'm a nurse practitioner. I've been practicing for a little over five years now. I've been in the hormone space about two years. But I've really learned a lot quickly and OptimizeU is great as far as getting you up to speed and really experienced and guiding your care. So OptimizeU is a hormone replacement clinic. The way that we work is through a, more of a membership rather than insurance-based. We're concierge-based. So you'll come in for initial labs, and then you'll- we'll do a full blood panel. We look at CMP, so liver function, kidney function, electrolytes, all your blood counts, all your hormone levels everything that we need to see to really evaluate you. You come in for an hour-long consultation. We talk about your plan based off your labs and then come up with a plan to get you feeling better. Let me ask you because the craze today is everything hormonally, and I think it's a great thing because being in... a practitioner myself for over 15 years now, trends come and go, and they're good for some reasons, but also there's a lot of caveats that I think the general public don't know about. Let's dive into probably just generically because we don't have a whole hour, two, three hours, and we could spend that on hormones. So tell me a little bit as a general specific, Sorry, that's a little bit two different things there, but general guideline about hormones, what that means in general, and why people should be interested, and then we can go from there, some other questions I have for you. So I would start with hormones, specifically testosterone, can really affect your motivation, your drive, Your energy levels, certainly. So when it comes to the conversation of weight gain and it... or is the hormone imbalance causing me to be overweight? It's certainly a possibility because it... Is it, the chicken or the egg? Am I not working out because I'm just lazy, and I don't have any ambition, or I don't care? Or is it I have a testosterone deficiency, and I really don't have any motivation and everything that I have in the tank is getting used up at work or in life, and I'm not just... I'm just not able to get there? So it's really, partly figuring out, what that is. As far from an ideal standpoint with hormone therapy, men are gonna lose about 2% of testosterone every year after age 35. But what we've been seeing is men's levels are declining generationally. And we don't really understand what the cause is, whether it's microplastics, environment, diet, genetics. We don't really have an answer. So me personally, I've been seeing, 25-year-olds come in my office for labs, and they have symptoms, and they're in, and they're in good shape. And you would think, "Oh, this is gonna be a really high testosterone level," but really it's not. Yeah. From a... As far as men are concerned, 35 and up is when you're really gonna start seeing a decline. Women typically around 40. That's the start of what we would call perimenopause. Perimenopause can last 10 years. It can last shorter. Some women go in later. Some women are earlier. But that's when women tend to start gaining weight, and they don't really have an explanation for it either. A lot of times it's around the midsection. So hormones can really affect weight in the perimenopausal realm too. And then, of course, I see a ton of post-menopausal women who need, all their hormones replaced at that point. So my, my question would lead into i- is it always symptomatic driven that somebody would come seek you out for your services? I would say mostly... the fact of the matter is a lot of times when you have a hormone deficiency, you're gonna have symptoms. It's very rare for us to draw a lab panel and see deficiencies and the patient not have any symptoms associated with it. But on the flip side of that coin, you could also say, if you're a 42-year-old man, and you have a lower end of normal testosterone level, you can really look at that, and you have symptoms, you can really look at that as more of a preventative health measure. Because, one, with men in particular, the range of testosterone is 264 to 916. So it's a huge range, right? You could be at the bottom end and three, almost four X the number and still be in the normal range. Yeah. So at Optimize You, we, we really don't... Our, our- You know, motto is normal is not optimal. And what we mean by that, we don't mean that having, super high levels is what we want. It's that you can fall within the normal limits and still have symptoms and still not be, have an optimal level to where you're functioning at your highest ability. Yeah it's a great point, and I've done some work with you, and I'm not symptomatic, but we've gone through it, and I think I'm due for another round for you to kind of- Yeah, it's ki- I think you're coming up pretty close. Yeah. And for me, I've started pulling my testosterone a couple years ago, not really out of necessity. It just happened because I had a health challenge at the time, and we pulled it, and it was very interesting. So the practitioner I was working with at the time, he he wanted to do some treatment of some, I think, TRT stuff. Before we got to TRT, but, there's different tr- and maybe you can talk about this, but there's different steps before you go to full-blow TRT therapy. And I wanted to with my background and information, I was really adamant. I was like, "I know I can change this via lifestyle habits, and then I want to see where that goes before I do any intervention." So why I bring that up because I want to talk about how much of lifestyle factors are impacting this for male, males and females, and then how do you guys go about h- that conversation, and then of course, treatment protocol? Yeah, it's definitely interesting because, like I s- said earlier, I have some younger men who come in, and they're in really good shape, exercise regularly, eat a very clean diet, and they still have deficiency. Now, I have on the other side of that people who aren't really exercising as much and they're low. So it really just comes down to a personalized approach, and if the person is more, in line with, "I really just would rather change the lifestyle first to see if this can make a difference"- then we help, help them pursue that. But what I would say, when it comes to testosterone, if you're over 35 years old, and you're looking to make a lifestyle change to significantly improve your testosterone level, you're really fighting an uphill battle because it's more of a biological problem than it is your lifestyle. So but things to do naturally would be of course exercise. Yeah. Sleep is a big one, making sure you're getting enough sleep, good sleep quality. Diet, vitamin D, zinc, all these micronutrients can really play a big role too, so have you had any anecdotal clinical data where you had cases where they're like, "Hey, yeah, I wanna change some lifestyle stuff," and then when you pulled their blood work- Without doing any via treatment you guys do. Have you seen any changes, whether they've been significant or not, but- Yeah, I've seen some people who are able to change it 300 points. Two, 300 points. Wow. So you can have some various swings. Now, p- part of that too is timing of the lab. So if you, if... You're gonna test your absolute highest level of testosterone at around 8:00 in the morning. So the later in the day that you test, you could have a little bit lower result. Sure. Now, you're not gonna have a huge swing. A lot of times people think it c- it's gonna be this massive swing and it's not really that. I would say maybe 10, 10%, 15% maybe. But yeah. You can certainly change some things lifestyle wise and make a difference on your hormone levels for sure. I know with m- with me, when I was working with this practitioner, I changed things and my... It changed from 300 to almost close to doubled it. Now, I didn't notice symptomatically any changes really in terms of- oh, my energy levels like skyrocketed or I got better sleep. I really didn't notice those things. So maybe talk a little bit about how higher score doesn't mean necessarily better outcomes in terms of what you feel. That conversation is really deep because from a personalized approach, you're gonna react differently. People react differently to levels of testosterone. So where some men may feel fine at 300, s- other men may be symptomatic at 600. So it's really, there's what's called CAG repeats, and that's the testosterone binding site- in your tissue receptors, and some people have longer CAG repeats, some people have shorter CAG repeats. Depending on the length of the receptor determines how tightly you bind to the testosterone particle. And that, that's... We don't even fully understand that yet, but that's kinda where that comes from, is where, everybody is gonna be a little bit different in terms of levels versus when they present with symptoms or get symptom improvement. I have two more questions. One is- And a standard protocol, what you guys do, kinda walk us through g- generically, somebody comes in. Yes, you've done the intake, they've got symptoms, maybe semi-symptoms, male or female, just in general. W- walk us through what you guys do in terms of your approach, and then walk us through that treatment in general. I know this is a very loaded question 'cause everybody's so unique and personalized. And then what does that look like for follow-up, and then I have a follow-up question after that. Go ahead. Okay. For sure. So to get started at Optimize You, you would come in, we do an initial lab panel. After we get those results back, we'll have you come into the office for an hour consultation. And I just start the conversation by talking to you, taking a medical history, seeing if there are any symptoms. A- and you don't necessarily even have to have symptoms to come in because, it's really good to have a baseline. Even if you're feeling, if you feel great, get a baseline of your level so that you know going forward where you feel your best at. We have that conversation, then we get into the labs. We take a look at everything, and we see if we can make sense of your labs based off of, your symptoms. I think too many times in healthcare we have gotten to where we're just looking at labs and not treating the patient, and really, I try to listen to my patient first and make sense of the labs based off of what they're telling me, rather than telling the patient how to feel based off of the lab value. So when they come in, if they have a deficiency, then we come up with a treatment plan to get started. We do labs in six weeks after the initial follow-up. We'll look at numbers again, see how the patient's feeling, make adjustments if needed, and then every three months we're gonna repeat labs. Okay. No, that's great. Some questions I have main one off the top of my head is and maybe it'll be a great episode another time too to really dive into specifically just this, is TRT. I've heard the notion, and maybe we can just touch a little bit on it, but once people start TRT, is it something they have to do forever? How easy is it to get off TRT? Those are some, I think, questions that float out there right now in the space- For sure of hormones. So yeah when you start testosterone replacement, you really need to go into it with the mindset that this is something I'm gonna continue for the rest of my life. Because you have what's called the hypothalamus pituitary gonadal axis, or HPG axis. When you start taking testosterone it's gonna shut this axis down. When this axis shuts down your body is no longer going to produce testosterone while you're taking testosterone therapy. Another implication of shutting the axis down is fertility. So if you are wanting to have children in the future- testosterone might not be the right call at th- at this time. But there are other methods that we can use to improve testosterone without shutting the axis down from a lifestyle approach and also, a pharmaceutical approach as well, and that, that's a whole other thing we could get into. But as far as getting off of testosterone, you're looking at about six to eight weeks before your axis is gonna restart and you're gonna start producing testosterone again. Now, one of the things to consider, naturally your levels are gonna decline with age. So if you're on testosterone therapy for 10 years and you're 50 years old and you're coming off at, let's say, 60, then it's likely that when you stop it and you go back to producing testosterone again, your levels are gonna be naturally lower anyways. It wasn't that testosterone damages the system and, you know- it's just a natural decline to where you're gonna end up lower biologically anyways. But six to eight weeks to keep it short is what we're looking for to get the axis restarted. Okay. And I want people listeners to under- understand too, I use an analogy and you can correct me if this sounds good and works, but your, you've, inside your body, your glands that produce hormones they're like a factory. And so when you're taking something exogenous, so you're shooting it into your body, taking it somehow orally, what happens is now the factory that's producing the hormones, or let's say it's producing cars in this case- and then now you're importing cars from another element or factory, that main factory doesn't have to produce as much, and it recognizes it. So then the production of those cars or said hormone starts to become less and less. And so when you impr- increase more and more outside source production, the body recognizes it, said, "Hey we already got it. We don't need to produce it." And then it starts to, that gland over time atrophies or shrinks. Is that correct? That's true, yes. I would say that's 100% correct. That's a very good analogy and a good way to put it so that it's easy to understand. Okay. Some questions too as we're getting closer to the end of our time with you, but what are some supplements that are overhyped and some that are actually useful for hormonal optimization or just supporting hormones for males and females? I know it's a different- category, but... I think vitamin D is one of the best, it does so many different things in your body. Almost everybody in this area is deficient. I think, one- It's due to the amount of sunlight that we have here in East Tennessee. It's probably not enough. But vitamin D even extends beyond that because places that get a lot of sun, you can't always stay in the sun because you're gonna get burned. But vitamin D is probably one that, that you can't really settle on. You really need to be taking it. Yeah. What's interesting is I just did a vitamin D challenge with you guys being a partnership with us. In D? Yeah. And we, out of all of our challengers I already suspected that they all would be deficient, and they were borderline just hitting baseline just like- Barely making it above normal, yeah. A lot of this people don't understand is that we're indoors majority of our days. And so the first line to get vitamin D is that sunlight. But then there's a whole system to it, right? It's not just, hey, supplement vitamin D, you're good to go. This is a system. This, the sunlight hits your skin and then goes to your liver to what is it? Activate it, I think. Yeah. And then from there, it goes to your kidneys to make it useful. It's a whole system of supporting liver, kidneys, and it's not just taking a supplement. Then you gotta add in things that are helpful to absorb vitamin D. So you've got your magnesium you've got- K2 K2, 'cause if you don't take K2, then the shuttling of the calcium is going to go into the arteries more than likely, and we wanna shove it and direct it to- we need to direct it to where it needs to go yeah, to the bones. So I think 100% that's awesome. Do you think there's a supplement out there right now that is over-hyped and is under-delivering and people are buying into it? I don't know. There's a lot of when it comes to hormones in particular, there's a lot of supplements that really claim to boost, boost your testosterone level and, it, it keeps you from having to get on TRT. And I just think a lot of those symptoms or those supplements are just not... They're just placebo. Do you know some, the names? Like ashwagandha? I don't wanna... Ashwagandha is controversial. I've had people use it. I've had pe- some people who levels, they've actually taken it and they've actually went up. Now, is it ashwagandha? Is it not? There's one. Let me see if I can find it really quick. Have you heard anything about tongkat ali? Yeah, a lot of people really use it. They think that it lowers SHBG, which is sex hormone binding globulin. So the higher your SHBG is, the lower your free testosterone is gonna be. Which that's a, that's a whole other conversation, getting away from total versus free- Yeah testosterone. But yeah people think that tongkat ali could potentially lower that one. There's one, I think it's, think maybe it's- I don't know. This may be a brand. What I would say, I'll keep it short. What I would say is when it comes to the supplements, I don't wanna call any specifi- specific brand out, but when you're over 35 years old and you're taking a supplement your body your levels are naturally declining anyways. So you s- you really need testosterone replacement. A supplement is not gonna be enough to really restore your levels to what we would say is an optimal range. Yeah. A 100%. A lot of the things that our approach here and what I do clinically is, it-- we wanna try to maximize the principle things that most people have forgotten about because it's gotten too easy with a lot of cultural stuff nowadays of what's the next thing. But we get back to the basics, which is exercise as often, as regular as possible, and there's different forms of activity that our body needs. So we cover that. Nutritionally, try to eat nutrient-dense whole foods first as much as possible, and there's gaps we have to fill with supplements just because the overproduction of our food supply the soil's depleted, things like that. And then of course, mental, emotional regulation. In this day and age, finances and relationships are challenging for a lot of people. I think those are things that we need to get back to is the basics, and then looking after we make those lifestyle changes more as our everyday lifestyle, then it's kinda looking at, okay is it moving the needle of what my problem is or what I'm kinda going through? Yeah. How do-- If it's not, then that's when we need to reach out to places like you. So what's, I think too, w-to add to that- Yeah I don't think, what we do at Optimize You is d-it's definitely not replacing lifestyle, or diet. It's not an easy fix. It's not take testosterone, and then you're gonna be in shape, and we don't have to do anything else. It really needs to be u-utilized together, right? And sometimes getting your testosterone level fixed can really energize you to want to make, it fixes that motivation problem to where you're more likely to stick to a cleaner diet. You're more likely to exercise more. And then also, some people who have lower testosterone levels, when they go to the gym, they don't get as much return, or they work really hard, they diet, but they don't really see the return from their workouts. And testosterone really helps to kinda get your body working for you rather than against you. I think we can spend more time, and maybe I'd love to circle back another episode with you, as we're running short on time- Yeah just to keep these short. But let's, what's, who's the right person to reach out to if they're interested in hormones or they're just curious? How would they reach out to you, and what's the person that you guys love working with? So our... ideally, men over 35. And then women who are perimenopausal or post-menopausal are our ideal clients. So women, 35 to 50 and older, and then men 35 and older basically is our ideal client. To reach us, you can get online, go to OptimizeU Knoxville. You can book through our portal. You can call us schedule your labs, and that's how you can get started. Awesome, Trevor. I always appreciate talking with you. I think you're a wealth of knowledge, and I hope people and our listeners and followers have gotten some value out of this. And if you guys have, please and follow us, and then also please check out OptimizeU of Knoxville. And then just remember, when it comes to your health, you're worth it, and then we'll catch you next time. That's a wrap on Healthy Knox. Thanks for spending some time with us today. If something we said stuck with you, share it with someone in your life who needs to hear it. And if you're ready to take the next step toward feeling better right here in Knoxville, come see us at Corrective Chiropractic. We're not just your doctors, we're your neighbors. We'll see you next time.