I had low T for many years. Back in March 2020 at age 66 I went to a urologist and he gave me injections every 2 weeks. About 8 months later I had to do blood work and my PSA was about 6.5, The next visit I was told no more T and that they wanted to do a biopsy. That was fast so I said goodbye and found another Doctor who has been prescribing ever since. All of the benefits of testosterone have made me at 70 feel fantastic and I plan to inject as long as I can. Dr Morgenthaler convinced me that Low T was a lot more unhealthy for me than than weekly injections.I am so glad I did my due diligence and have reaped the rewards for almost 5 yrs now.
I am 78. My PSA has been fluctuating between 6 to 14. for the past 10 years. The cause is BPH. About 4 months ago, I finally found a practitioner who would prescribe. Still "dialing in" but my performance in all areas of life has improved. I was required to see a urologist when I started TRT, and he confirmed...NO cancer! If your PSA is fluctuating, up and down, your chance of having PC is minimal. My last PSA was 9.2; the previous PSA was 13.4.
From Boston here too, Where Dr Morgantaler was based, he was my doctor. You really exemplify so many men, that are so careless when it comes to their concern over PSA levels. When I started with Morgantaler my PSA was 1.6, with a healthy prostate size of 20cc. This was about 12 years ago. After being on T, my prostate is 94cc, with a PSA of 11.5. Note, prostate cancer does not run in my family on either side. I never smoked, hardly ever drank, and eat healthy. I’m convinced TRT did this to me. I’m waiting on biopsy results
Oh yes treat the body like it's a car. Maybe instead of covering up symptoms you should try and cure problems! My doctor prescribed a testosterone that he was using to me but I wouldn't take it. I had a bad feeling about it. Then it gave him a heart attack and he died. Shortly after that it was recalled. If you take a testosterone supplement then you'll stop making your own testosterone and among other things it will decrease your fertility. I've had enough bad side effects from the other things I've been given by doctors.
I've been on TRT for 3 years now and switched to injectable recently. I'm 59. TRT has made a lot of changes in my life, basically I feel and function like a much younger man. And the effect on my sex drive is basically that I'm back to my 20s in terms of sex drive, which is also what my T level is now maintained at. Same range as a man in his 20s.
Superb interview. I'm 74, fortunate to be an expat living in Mexico for 27 years. Injectable Bayer testosterone (sold as Primoteston) is available here at any pharmacy with no prescription. I've been injecting 250 mg every week since 2009. Sometimes twice a week. Makes such a difference in mood, libido, mental clarity, etc. By the way Dr. Malik, you are looking hot AF conducting this interview. 🔥Beautiful, and so intelligent. 😉
I’ve been symptomatic for YEARS! Every Dr I see pretty much just tells me I’m depressed. I tell them I’m depressed because of my low libido, chronic fatigue, brain fog, poor sleep, irritable, etc. I just started learning about the importance of Free T. Not a single PCP ever even mentioned it. They look at my total and say, you’re normal. So just today I got my results back from my T test from my new PCP. Total was what it typically has been (around 500 ng/dL)..it has been as low as around 350. My Free T today is 5.3 pg/nL. I have a second T test tomorrow and I’ve asked to have my order updated to also test for SHBG. The first thing out of my PCP’s mouth when I mentioned TRT was that it causes prostate cancer or increases the stickiness of the blood. I’m 54, 190lbs, fit, athletic, but I’m in serious decline and have to REALLY push myself to even get out of bed. I’m glad there is info like this out there to at least help me be better informed.
I'm 54, too, and my primary doctor has no problem with it. Find someone to prescribe trt immediately. It'll blow your mind how good you feel. It's literally like flipping a switch. Just make it happen.
@ I’m still trying to get my second blood test for T levels. They botched my second test and actually didn’t even test for it. My second one is set for tomorrow. My PCP has already said he’s probably not the one to prescribe a trt regimen. We’ll see.
This is GREAT! I am on testosterone and beginning to feel much better! I was at the stage of feeling miserable and losing muscle mass. Thank you for this information
Thanks, Rena! I’m almost 67 and I struggled this issue for many years due to having damage to my endocrine system as a result of very high prednisone amounts due to transverse myelitis (TM) when I was 33. My T level months after this illness was 22. After injections, we got it back into the low 300s, but no sex drive. 15 years later, T was down to 160, so the endo doctor did a ‘stimulus’ test where they injected me with an agent and then measured the response over the course of a couple hours to see how the testes responded. That’s where the damage was. The gel worked well and I took it for 8 years. Lifesaver is all I can say. Everything that Dr. Abraham said was true. It just affects basically everything. I now live in Europe and have been working with a great endo doctor here. I now take Nebido (Aveed) and we are now close to having it stabilized again. I really wish these treatments would have been available when I got TM. It would have dramatically changed my life.
I've been on TRT since 2014 because of a varicocele that screwed up my natural production. Its been life changing all around. Mood, muscle building, sex...everything has improved.
I’ve been on 125mg of test weekly for almost six years, with blood work every four months. At 52, I’m in the best shape of my life. For me, TRT is a game-changer, especially for veterans like me who’ve dealt with the physical and mental toll of service. Will I ever stop? Hell no. This is about living my best life, staying active, and being there for my family. My advice is don’t ignore your health. Do your cardio, stay consistent, and if something feels off, get it checked out. Life’s too short not to feel this good!
A book that changed my life in ways that I never could imagine is "Secret Testosterone Nexus of Evolution".Drop whatever you're doing right now and go find that book. Trust me after I implemented things from the book my testosterone levels went beast mode
Unfortunately in 2024 there’s still a stigma in the medical community about Testosterone. I was diagnosed with low T, 150. My primary found it an refered me to a urologist. They started me on a low dose. It really changed my life. At an appointment with another doctor. The nurse found out I was on Testosterone. She rolled her eyes. The doctor told me I could survive with low T. Yes you can. But just surviving isn’t living. They demanded I come off ASAP. They use the, “you’re going to have a stroke any day” scare. I made the mistake of stopping my treatment without talking to my Urologist. This was a big mistake.
Did you restart? Polycythemia (high red blood cell count, "thick blood") is a common effect of TRT, but I think you would want to do blood work to see if that is happening to you or not. What happened when you went off TRT? Did you end up going back on it?
The nurse part of your story made me think of an incident I had. I had a moment that brought me some concern and now i need to see a urologist to really get good info on T levels. I just knew i had low T i asked my doc to add the test to the blood test he was a resident and he agreed and he added it. It came back as a low not very low but low i asked him what i should do and he mentioned taking testosterone could be an option. He went discussed it with his attending they said to him that it didn't matter and i could live with it. He seemed a bit off put when he relayed the attendees message and hos quoting of their words made the attendee sound dismissive. I felt like something was off come to find out the attendent was a woman which made me wonder if the dismissiveness was motivated by other thought processes.
@@karlint39 yes, I did restart. The problem was my hemoglobin and HCT was at the high end of the range. Not over but at the high end. With in 30 days my T levels tanked. I had all the symptoms come back. I felt like I had the flue for 3 weeks or so. It really didn’t go away until about a month after starting back. The moral of the story. If you have a good urologist. Trust them, they know what they’re doing. Just surviving is no way to live.
Dr. Morgenthaler definitely hit it on the head when he said each person has a different level. At the age of 50, I started exhibiting symptoms associated with low T, my MD ran tests and said I was "within range" . I requested a 2nd opinion and had a really good endocrinologist who ran several more tests and also made the point that the general MD had no data of where my free testosterone was when I was not having symptoms. He started me on a regimen where he slowly raised my testosterone, with testing throughout, and my feel normal rate is above the range that is normally acceptable. It's very difficult to find doctors that believe in testosterone treatment as a part of the complete system. GREAT Pod Cast!
What a valuable and informative conversation! Thanks to both docs for your hard work and sharing this knowledge with us. Dr Malik, we are so fortunate to have you presenting a steady stream of important evidence based medical information and doing it in a very “watchable” 😉fashion! Thanks!
⁹19 years using TRT. 73 and healthy. The first urologist who worked with me at 54, when he saw levels around 100, said he didn't know how I was even walking around. Brain fog cleared and tiredness gone in days. Now, my PSA is at 0.7. Prostate and testosterone checked semi annually. At one point to prove need to insurance, the doctor took me off for several weeks. Dropped to 40. My issue is testicular, not pituitary.
Thank you, I am so glad I am listening to your podcast, I recently got prescribed testosterone and I love it and I am having my wife listen to it as well. Thank you 🙏
Dr Khera with Baylor College of Medicine has much insight on TRT and has performed extensive research on all aspects of treatment. Very humble and brilliant man and well worth the time to research.
Wow, was this an incredibly interesting and informative interview. I considered getting testosterone at one point and got scared off because of the general warnings out there. This is the most informative info I have ever seen on the topic. Get the guy back as much as you can! Fantastic.
I had been practicing medicine for years before he graduated. He makes it sound like no one had done TRT before him. In reality it was already common practice at least in my group. He is correct in saying that there were concerns about potential cancer and cardiovascular risk. And patients prescribed it were aware that research on these aspects were lacking. Lots took it willing to accept that potential risk. Here in Canada it was a common topic at any large CME event.
In your opinion, is the major drawback of T-treatment, that if you supply it to the body, then the natural mechanisms for T-production, become redundant and stop working, so that the patient becomes dependant on artificial Testosterone?
I wish my doctors would listen to this. Been fighting with this issue for 3 years now, particularly with Endocrinologists that are solely focused on TT and refusing to look at at or treating anything other than the number.
Dr Malik, I would find an episode specifically about your expertise but focused on diabetics in particular, VERY HELPFUL, and I suspect that MANY others would as well
What an incredible guest. Thank you so much for having him. Thank you both for all the work you do. I am currently on TRT and it gave me a second chance at life. My total T was “normal” but free T was 70. Had all the typical symptoms and was turning into an old man in my 40’s. Not including my job that’s very dangerous and I was making mistakes that could have costed me my life. Now on TRT and feel like a person I was in my 20-30’s. Thank you.
“Oh, my old friend is back” that’s exactly what I felt once I started T 6 yrs ago. I’m 65, and very happy. By the way I’ve known about this Doc for many yrs and shared his literature with many of my friends. My PCP is a big fan.
Great podcast. I wished the guest was asked if there are anyways to increase free testosterone by lowering SHBG, thus avoiding the need of TRT and any potential risks associated with TRT, such as shutting down the natural production of testosterone.
SHBG is important. It temporarily binds to ALL sex hormones to transport them around the body and then release them at the appropriate sites when needed. If you lower your SHBG to single digits it will not be good for your body. Testosterone is not something to be afraid of and the risks are made up lies that only apply to people with bad diets who don't exercise. The heart can fail in anyone at any time at any age. People on testosterone will have heart attacks just like anyone else but it will not be CAUSED by the testosterone as their is no mechanism in the body for this to happen. Your body has an organ that produces it for crying out loud, it is not a poison. Your natural production shuts down but you can take a LH/FSH stimulant or LH mimic such as HCG to keep them from getting atrophied. Regardless though, if you stop TRT your testicles will grow back, the main part of the testicles never goes away, think of it like a balloon, you can deflate it and then blow it back up again at any time to it's original size.
It may take some time to find your right dosage and frequency to get you in a sweet spot. Don't get fooled if you have a "honeymoon" phase in the next few weeks as your hormones rush up to higher levels. Injections take 6-8 weeks to reach a steady state. Then you check blood levels and how you feel, adjust, wait another 6-8 weeks, and re-evaluate again. You may get lucky or be on a 12+ month journey. Don't give up.
@travv88 i been feeling great since day one. No depression or anxiety at all. Like it just went away. And I seem to be putting on some muscle better than I have been. I take my 5th shot this coming moday. Definitely feel like TRT is a life changer at this point.
Does DHEA raise your free testosterone? Are there any advantages or disadvantages to taking DHEA versus a testosterone gel or injection? Are over the counter brands of DHEA safe and effective?
Everyone responds differently. I may be in the minority here. I've been on TRT for 2 years - it bumped my T from 200 to 900 ng/dL (average). I've experienced no noticeable difference in mood, wakefulness, libido, workout recovery or frequency of illness. I've always had a routine of daily exercise and working out 6 days/week, and I try to live healthy, avoiding sugar and processed foods. I see a lot of "it changed my life" comments here, and I'm glad it has had such a positive impact on those folks. If anyone reading this is wondering if something is wrong with them because they didn't notice a difference on TRT, hopefully it alleviates your anxiety a little to hear that others experience the same thing.
whats your free t? are you taking hcg or any other add-ons along with? you might have multiple pieces in the puzzle not being addressed. total t isnt the number that matters that much.
I am 60 years old neurologist, was recently operated on for PUJO with complete obstruction t 1/2 is zero on MAG3. I was shocked with the diagnosis especially no direct reason found and persumed to be congenital. I still have a serum creatinine of 0.7. Probably more public awarness is needed for the condition
I find this super interesting. I wish there a version of this in-depth discussion particularly focused on type 1 diabetes. I'm 50, "normal" ranges T, but wondering if overall endocrine issues elsewhere are a factor......
THANK YOU SO MUCH. This video is so informative. I will be making an appointment to see a urologist on Monday. I've been experiencing many of the symptoms described. Ive been concerned about the Cancer issue because of ignorance. Again well done Dr.Malik and thank you for your hard work.
Question doctor Rena do these supplements titan boost or any other dietary supplements help with size issues. Are they true. I'm 50. Just turned 50 and I see I lost a lot shrinkage not as big and I'm not getting no action.
Doctor, I went on TRT about 5 years ago. It’s been amazing but last year my prostate numbers went from 1 to 4.3 I just gave blood for a new test it’s been 6 months and I’m a little worried. I have not got results back yet and hope everything is ok. Just giving you. My story. Thanks for the video it gives me confidence it’s not from TRT.
@@Mark-zz9rt happened to me too. On TRT for 2 years then psa went up to 4.3. DRE ok, MRI came back ok but urologist wanted to do biopsy to continue trt. I declined. Been off trt for about 15 months now. I’m back to pre trt levels and symptoms. But I’m not poking holes in a perfectly good gland.
Excellent video! Everything makes sense to me now! The first port of call should be lifestyle changes like change of diet and more exercise and also environmental toxins need to be addressed!
I just saw my urologist this morning just for him to say my problem might be that I'm depressed SMH...I'm 52 with total testosterone at 298 and free testosterone at 9.9 I know why I have fatigue and no motivation and it's not that I'm depressed... forward on to the next Dr.
I am 53 and been on trt for 18 months. My T level was about 327 and I was tired all the time, depressed, muscle and joint pains, no sex drive and unable to build and maintain muscle mass. I started TRT and with 3 days I felt a tremendous relief and instantly felt like my normal self of when I was about 30! Just a general feeling of wellbeing! Now libido is high, happy, motivated, lost fat and built muscle and life is good again! I have found I feel best when my level is at total T is at or above 1000. There is so much to learn about this treatment and how you need to live your life to maximize its impact.
@@hubriswonk It's good to hear when someone like yourself has been able to get the treatment you need to get back to normal and feel better....I personally know quite a bit about the endocrine system and testosterone and today while I was talking to my urologist I had to finally say look I can explain to you everything you're trying to tell me and low testosterone can in fact cause depression but I'm not depressed and have never had any issues with it and he kept trying to tell me I might need to be on SSRI's and said absolutely not....he kept trying to say how my numbers were in range and normal for my age and to top it off I find out that today was the very first day of his practice opening and I was actually his first patient....I should have figured he was fresh out of school as he was really young.
So what about DHEA, the precursor hormone to testosterone? My current understanding is that it too is labeled as increasing the risk of hormone-sensitive cancer such as prostate cancer.
cancer is not caused by androgens. Look up the noble rats study where the aromatase enzyme is genetically removed from the rats and they are given testosterone or DHT and are unable to get cancer but then when they add in estradiol injections the DHT+E rats got cancer at very low rates and then testosterone + E group 100% got cancer. Go look it up seriously it will blow your mind.
I am interested in learning more about Prostate Artery Embolism. Seems like a decent outpatient procedure to reduce the size of the prostate. At 61 I am going this Friday to get my T level, thyroid and prostate checked.
My doctor was pretty hostile to TRT when I was just looking for information. I had to work to convince her to even order a blood test. When the results came back within the "normal" range she was almost triumphant, even though my levels were at the low end of "normal". Part of it I get it, she is a woman and probably just doesn't understand and seems to assume I want to be a jacked up teenager again. Or I'm just a middle aged man that is afraid of growing old. But I just want a good quality of life and to be healthy as long as possible so I'm there for my family. Not just not dead yet.
i have noticed that since the invention of soft foam cushions and beds that have almost completely replaced cotton fibers the heat generated in the pelvic area has been higher almost constantly from the heat not being able to escape the pelvic area when sitting so much.
Enjoyed the interview. Surprised there was no discussion about insulin resistance. Only one remark about vascular disease (ED) which is caused by insulin resistance. Hormonal imbalance is always out of whack with insulin resistance. Yes, insulin is a fat storing hormone. We must limit the carbs in our diet. Testosterone will not work if we do not eat a proper human diet.
This is a very important You Tube Videos . Although there are other You Tube interviews with Morgentaler this is the most informative one. Every man , and Especially every Urologist, Endocrinologist and Internest should hear what Abraham "Morgentaler" has to say about Testosterone (Morgentaler's name is misspelled in Malik's summary paragraph above).
@@emanuelmota7217 Man, I didn’t even notice the resemblance till seeing your post 😂! Hilarious AF! And yes, we agree that Fred is truly an amazing talent!
Great video. It's one of the best I've seen on this topic. A topic typically misunderstood, if understood at all. And that is by professionals and laymen alike. Question. What do you do if you're a guy who has this issue but lives in a country(Israel) where prescribing testosterone is rarely approved. If you're a woman, hrt is readily available. If you are gay, and looking to "transition", no problem. But for a hetero guy, you would have to exhibit the testosterone level of a 90 year old, and be half dead at that to even be considered for trt. I kid you not. In my case, my total T is exceedingly high. Almost 1000. And I'm 70. But my free T is in the tank. They don't even measure free t here. I had to do it privately. So what are my options? Are there any reputable clinics that do hrt by way of telemed? Anyways, thanks again. Really great video. Very helpful.👍👍👍
It's likely your SHBG is high. It goes up non-linearly with age. It's OK for your total to go above 1000 if necessary to get your free out of the "tank". see a competent endocrinologist or urologist who has graduated within the last ten years.
@piezoe Thank you. I agree. My SBGH is too high. Tried a few different things to lower it...with no success. Boron. Stinging Nettle. High protein diet. A couple of others. No luck. Agree with you once again. Raising my total T is the way to go. But that puts me back to square one. Nobody here where I live will prescribe Testosterone under these circumstances. I may just have to travel abroad to get treatment. Thanks for your input. Much appreciation!
Here is the UK the doctors have not taken my symptoms seriously I've felt a nose dive of my testosterone levels just as I went over 50 and I've been telling the doctors to test me for low testosterone and they did eventually and it came back at 9 and it is on the boarder line low and I urologist said well we can give you a boost of testosterone and it will be 1 injection every 3 months which does not make sense. It been 10 months and I'm still waiting. I'm 54 now and I still waiting for the doctors to get back at me. The Standards of my life is terrible and I can relate to this podcast 💯.
I am one of those guys on TRT and regardless of how high my T levels are the symptoms remain extreme and it seems that all my doctor is concerned with is how the range looks on paper! I had some lab work done through an endocrinologist and the results came back listing me as a female and because of that, there isn't an accessible record of those labs. I've been on TRT for several years and the symptoms remain the same and I feel almost castrated. I don't know what to do! My free testosterone has ranged from 13.2 pg/ml to 24.5 pg/ml with a total of 382.5 -782. My LH results were in range after stopping TRT for six weeks and I did have the mumps when I was younger. TRT has done nothing for my libido. I suppose I'm an anomaly.
I appreciate this video but this is just the surface. If you want to dive deeper in the rabbit hole read Untold Testosterone boost guide. Thank me later
TRT treatments have changed my life. I told my doctor how great I'm feeling and he angrily compared it to crack cocaine. WTF? This episode was very informative. Thanks!
@@hojo70 the normal range cap gets lowered constantly. It used to be over 1500. They keep shifting the range downwards because everyone's testosterone levels are dropping from all of the pollutants in our water and food supply so they 'normal' is now going lower and lower. The range is not a reflection of optimal levels like we assume it would be, it's just a range of what people's levels are showing up as is in whatever small sample groups they choose to use.
Very interesting and informative. I would be curious to see an in depth discussion about options for testosterone therapy. Gels, implants, etc. I doubt I can cover the costs of weekly shots administered by a physician and am not willing to stick myself at home. Id like to hear some details about my options.
I felt the same way. I started supplementing with testosterone in Peru (South America) by going to the pharmacy once a week and having the pharmacist do the shot which I was ok with. Then, I moved back to the states and found out that shots can be done intramuscularly which is much much easier and no pain at all. The syringe used is an insulin pin (syringe) and its only inserted into a pinch of belly fat no deeper than a 1/4 inch and administering daily allows for a more even distribution of T similar to how our body does it.
SHBG binds to ALL sex hormones, not just testosterone. SHBG needs to be kept in a healthy range because too much is bad but so is too little. SHBG is an important component of sex hormone function. You need to be measuring their SHBG instead of free testosterone. When measuring their total testosterone, you need to use LC/MS and not the inaccurate immunoassay that cross detects DHEA and other androgens which causes inflated results that show testosterone higher than what is actually is. When patients have Low T with High Free T that is a sign they have low SHBG and that is a problem that needs to be addressed. They need to have their thyroid levels checked since low thyroid can cause low SHBG. Thyroid hormone stimulates the liver to produce SHBG so a low SHBG can be an indicator that thyroid is low.
I went to get my bloodwork done and my T is at 445. I’m 26 which is normal they told me, I started trt with 150mg a week , will I see results from that dose ? I barely started
@@teamplayer1634 the thing is want to get to atleast 1200 , to improve in muscle building, can I naturally get to 1200? I don’t want to take actual steroids, so I think upping my T would be the next best option
STOP. your naturally at a good level, get educated on red protein every 2 hours, sleep, testosterone boosters on ebay, boron 20mg/day... ect..train VERY SLOW AND HEAVY LIFTS, SQUAT , LEG PRESS WITH BELT
Very interested in you and the docs thoughts on Hematocrit / Hemoglobin elevations with TRT. Seems like a lot of online pharmacies etc. do not care about this or even check it. Isn't a hematocrit of 50+ and a Hemoglobin over say 18 a dangerous thing? Phlebotomy is the only answer?
You need to lift weights and do cardio to increase the hepcidin since androgens make it go lower. That's why bodybuilders are able to tolerate high doses of androgens, they work out all day and do tons of cardio. Hemoglobin is not dangerous, it is just a placeholder on each red blood cell that holds 4 oxygen molecules, that is a good thing. Donating blood is a necessary part of society because if no one donates blood then we don't have any available for transfusions. We should all be donating 1 to 2 times a year anyway if we are able.
@@Jaye-HormonesForMe I understand the physiology, the problem is that Hematocrit over 50% and especially over 55%-60% causes spontaneous clotting. Hepciden is important for iron but not related in a positive way to coagulation. In fact, in some studies, it's a biomarker for increased risk of VTE when elevated. It's not safe to walk around with VERY elevated Hematocrit levels. Donating blood is a good thing for sure, but for many TRT patients, it's necessary...Just wanted their opinions on that topic.
I did not have an issue obtaining TRT from a doctor, but I struggled with the insurance company and pharmacy. It took weeks for the pharmacy to fill my prescription. The insurance required an EKG annually.
So how do we get our doctor to prescribe trt? What’s the solution? I was tested and my level was 360. My doctors won’t give me trt because I have to be under 300 to be considered low t. I feel horrible and have no energy. I struggle to lose weight or build muscle. I’m 44 and I feel 80. So how do I get help? Do you have any suggestions for trt therapy companies that are safe and legit?
Here's some great antidotal information. I am a disabled veteran. I was a super soldier with all kinds of awesome training and deployed in 3 wars 10 years all in a row with just a couple months at a time home. One day I fell apart. After being in perfect health until I was 40. I had a massive widow maker heart attack (without any heart disease), I am on my second round of bi-lateral pulmonary embolisms and DVTs (with no lung disease), I have been diagnosed with a blood cancer Leukemia - Very high hematocrit, RBCs and Hemoglobin. I have taken TRT on and off to see if it changed any of my signs and symptoms of any of my medical issues and it didn't. It didn't even raise my Testosterone? I have had multiple surgeries in multiple joints due to joint and spinal injuries and I used TRT, Peptides and PRP injections to heal faster. The combination of injections helped me heal from surgeries in half the time with half the pain medications.
My personal family doctor, a general practitioner, would only give a very low dose of T cypianate. The vials were 200 mg. per ml. The dose was 1/2 ml. every 21 days. This was for 3 months, then a blood test was done. I asked for a higher dose with more frequent dosing, asking for doses every 4 days. He said absolutely not. He said my numbers were in the normal range, and he would not increase any dosages. He was treating me as a number, a statistic, not an individual patient.This was a total waste of time because at those doses, I gained nothing. Absolutely nothing. The only place I could find to get doses that would be beneficial were the TRT clinics, and the amount of money they charge is criminal. So, where can a man find a doctor, not one of those clinics, to be treated as a person and not a number.
The problem isn’t convincing primary care doctors, the problem is convincing the medical entities that employ the physicians and set the policies the physicians have to follow.
I am so impressed by your comment. This is the truth. Patients blindly trust doctors who also blindly trust their authorities. It is the top of the chain giving instructions to the sheep at each level that cause this problem.
Can low T affect sleep? Example, sleep onset insomnia. I have a hard time getting to sleep and staying asleep. No situational issues which would keep me up. I basically lay there, unable to get to sleep .
Yes, 100%. That was my primary symptom. Didn’t affect my libido or anything. Insomnia was so bad sleep meds had no effect. Insomnia and constantly feeling tired are big ones.
My PCP is at the VA. I got my testosterone tested a few weeks back I was at 285. I’m 30 years old with 3 kids, married for almost a decade. This past year I’ve experienced a lot of symptoms such as gaining weight, depression and anxiety. I attested the weight gain, weaker erections to my depression. But then I decided to get my testosterone tested and at 30 it should be higher IMO. Doc had me get it tested again yesterday and I’m waiting on results. I’m hoping I can get treatment immediately after, if they don’t want to prescribe it I’ll go toward an online clinic and then have my PCP monitor my levels.
Same here my total was 4 points away from 300 but my pcp at the v.a told me its low but normal..even though i wornout minimum 5x a week..my free t is very low gonna see what they say depending what he says ima take matters into my own hands as well
@@brucewillis2486 Just had mine tested at VA and not sure which to focus on, The Total Testosterone S/O is 8.8 which they list as high with the range of 2.80-8.00. The Testosterone Free and Weakly is 231 and the Testosterone Free (Calc) is 105. Meeting with my PCP Tuesday. In the past they have said it's within normal range... Not sure which one they look at to determine if it's low
Dr. Abraham, or Dr. Malik...can you provide reference for showing impact of past mumps sickness resulting in orchitis - eventually azospermia, and levels of testosterone, whether total or free? Impact on libido, muscle development, etc. Best regards. Greetings from the Philippines.
Very helpful. I recently read there is or may be a connection between low T and PE. Is this true? Can you comment? I am interested because I am 73 and have noticed more frequent PE than when I was younger. Thanks.
![I.N "HALLUCINATION" | [Stray Kids : SKZ-PLAYER]](http://i.ytimg.com/vi/n5B5q1Hwt_U/mqdefault.jpg)
Wonderful interview! I am a 46 year old male of healthy weight and lifestyle. I’ve been on TRT since 2019 and have zero regrets.
If you stop, would there be any loss to your own ability to produce T endogenously?
Clomid does wonders if you were to stop for some reason, but it wouldn’t make sense to stop if you’re feeling great.
I’m a recently retired Urologic pathologist… I thought this was an excellent podcast, thank you both 🇬🇧
Best video yet on testosterone!! Thank you! TRT has changed my life!!
Dr. Morganthaller should receive the Nobel prize for medicine.
TRT is life changing treatment
I had low T for many years. Back in March 2020 at age 66 I went to a urologist and he gave me injections every 2 weeks. About 8 months later I had to do blood work and my PSA was about 6.5, The next visit I was told no more T and that they wanted to do a biopsy. That was fast so I said goodbye and found another Doctor who has been prescribing ever since. All of the benefits of testosterone have made me at 70 feel fantastic and I plan to inject as long as I can. Dr Morgenthaler convinced me that Low T was a lot more unhealthy for me than than weekly injections.I am so glad I did my due diligence and have reaped the rewards for almost 5 yrs now.
@@gatorsfan146 thanks
did your PSA go lower or stay fhe same over time?
I am 78. My PSA has been fluctuating between 6 to 14. for the past 10 years. The cause is BPH. About 4 months ago, I finally found a practitioner who would prescribe. Still "dialing in" but my performance in all areas of life has improved. I was required to see a urologist when I started TRT, and he confirmed...NO cancer! If your PSA is fluctuating, up and down, your chance of having PC is minimal. My last PSA was 9.2; the previous PSA was 13.4.
From Boston here too, Where Dr Morgantaler was based, he was my doctor. You really exemplify so many men, that are so careless when it comes to their concern over PSA levels. When I started with Morgantaler my PSA was 1.6, with a healthy prostate size of 20cc. This was about 12 years ago. After being on T, my prostate is 94cc, with a PSA of 11.5. Note, prostate cancer does not run in my family on either side. I never smoked, hardly ever drank, and eat healthy. I’m convinced TRT did this to me. I’m waiting on biopsy results
Oh yes treat the body like it's a car. Maybe instead of covering up symptoms you should try and cure problems! My doctor prescribed a testosterone that he was using to me but I wouldn't take it. I had a bad feeling about it. Then it gave him a heart attack and he died. Shortly after that it was recalled. If you take a testosterone supplement then you'll stop making your own testosterone and among other things it will decrease your fertility. I've had enough bad side effects from the other things I've been given by doctors.
I've been on TRT for 3 years now and switched to injectable recently. I'm 59. TRT has made a lot of changes in my life, basically I feel and function like a much younger man. And the effect on my sex drive is basically that I'm back to my 20s in terms of sex drive, which is also what my T level is now maintained at. Same range as a man in his 20s.
What is your protocol if you don’t mind answering?
You used to take the cream, was it less effective for you? I asked because I don't think I can give myself and injection
Superb interview. I'm 74,
fortunate to be an expat living in Mexico for 27 years. Injectable Bayer testosterone (sold as Primoteston) is available here at any pharmacy with no prescription. I've been injecting 250 mg every week since 2009. Sometimes twice a week. Makes such a difference in mood, libido, mental clarity, etc. By the way Dr. Malik, you are looking hot AF conducting this interview. 🔥Beautiful, and so intelligent. 😉
Each vial of Primoteston costs me $300 pesos. (About 16 USD.)
try lower your dose over several months to 100mg /week , that is a standard dose TRT
I’ve been symptomatic for YEARS! Every Dr I see pretty much just tells me I’m depressed. I tell them I’m depressed because of my low libido, chronic fatigue, brain fog, poor sleep, irritable, etc. I just started learning about the importance of Free T. Not a single PCP ever even mentioned it. They look at my total and say, you’re normal. So just today I got my results back from my T test from my new PCP. Total was what it typically has been (around 500 ng/dL)..it has been as low as around 350. My Free T today is 5.3 pg/nL. I have a second T test tomorrow and I’ve asked to have my order updated to also test for SHBG. The first thing out of my PCP’s mouth when I mentioned TRT was that it causes prostate cancer or increases the stickiness of the blood. I’m 54, 190lbs, fit, athletic, but I’m in serious decline and have to REALLY push myself to even get out of bed. I’m glad there is info like this out there to at least help me be better informed.
I'm 54, too, and my primary doctor has no problem with it. Find someone to prescribe trt immediately. It'll blow your mind how good you feel. It's literally like flipping a switch. Just make it happen.
@ I’m still trying to get my second blood test for T levels. They botched my second test and actually didn’t even test for it. My second one is set for tomorrow. My PCP has already said he’s probably not the one to prescribe a trt regimen. We’ll see.
Finally had my second blood test for my T levels. Total=447 and Free=5.0pg/mL. I’ll see what my PCP says, but I’m 99% sure he’ll refer me out.
Good luck brother. 👍
This is GREAT! I am on testosterone and beginning to feel much better! I was at the stage of feeling miserable and losing muscle mass. Thank you for this information
Thanks, Rena! I’m almost 67 and I struggled this issue for many years due to having damage to my endocrine system as a result of very high prednisone amounts due to transverse myelitis (TM) when I was 33. My T level months after this illness was 22. After injections, we got it back into the low 300s, but no sex drive. 15 years later, T was down to 160, so the endo doctor did a ‘stimulus’ test where they injected me with an agent and then measured the response over the course of a couple hours to see how the testes responded. That’s where the damage was. The gel worked well and I took it for 8 years. Lifesaver is all I can say. Everything that Dr. Abraham said was true. It just affects basically everything.
I now live in Europe and have been working with a great endo doctor here. I now take Nebido (Aveed) and we are now close to having it stabilized again. I really wish these treatments would have been available when I got TM. It would have dramatically changed my life.
Rena. This is absolutely the best podcast I’ve listened to. I just love his study and knowledge of Test.
I've been on TRT since 2014 because of a varicocele that screwed up my natural production. Its been life changing all around. Mood, muscle building, sex...everything has improved.
I’ve been on 125mg of test weekly for almost six years, with blood work every four months. At 52, I’m in the best shape of my life.
For me, TRT is a game-changer, especially for veterans like me who’ve dealt with the physical and mental toll of service. Will I ever stop? Hell no. This is about living my best life, staying active, and being there for my family. My advice is don’t ignore your health. Do your cardio, stay consistent, and if something feels off, get it checked out. Life’s too short not to feel this good!
A book that changed my life in ways that I never could imagine is "Secret Testosterone Nexus of Evolution".Drop whatever you're doing right now and go find that book. Trust me after I implemented things from the book my testosterone levels went beast mode
Looks like a scam website...
Lol u guys
Unfortunately in 2024 there’s still a stigma in the medical community about Testosterone. I was diagnosed with low T, 150. My primary found it an refered me to a urologist. They started me on a low dose. It really changed my life. At an appointment with another doctor. The nurse found out I was on Testosterone. She rolled her eyes. The doctor told me I could survive with low T. Yes you can. But just surviving isn’t living. They demanded I come off ASAP. They use the, “you’re going to have a stroke any day” scare. I made the mistake of stopping my treatment without talking to my Urologist. This was a big mistake.
Did you restart? Polycythemia (high red blood cell count, "thick blood") is a common effect of TRT, but I think you would want to do blood work to see if that is happening to you or not. What happened when you went off TRT? Did you end up going back on it?
The nurse part of your story made me think of an incident I had. I had a moment that brought me some concern and now i need to see a urologist to really get good info on T levels. I just knew i had low T i asked my doc to add the test to the blood test he was a resident and he agreed and he added it. It came back as a low not very low but low i asked him what i should do and he mentioned taking testosterone could be an option. He went discussed it with his attending they said to him that it didn't matter and i could live with it. He seemed a bit off put when he relayed the attendees message and hos quoting of their words made the attendee sound dismissive. I felt like something was off come to find out the attendent was a woman which made me wonder if the dismissiveness was motivated by other thought processes.
@@karlint39 yes, I did restart. The problem was my hemoglobin and HCT was at the high end of the range. Not over but at the high end. With in 30 days my T levels tanked. I had all the symptoms come back. I felt like I had the flue for 3 weeks or so. It really didn’t go away until about a month after starting back. The moral of the story. If you have a good urologist. Trust them, they know what they’re doing. Just surviving is no way to live.
@@bobdrawbaugh4207 How much TRT do you take every week?
Who works for who? Thats the big question I have / stand your ground - it’s YOUR body.
Dr. Morgenthaler definitely hit it on the head when he said each person has a different level. At the age of 50, I started exhibiting symptoms associated with low T, my MD ran tests and said I was "within range" . I requested a 2nd opinion and had a really good endocrinologist who ran several more tests and also made the point that the general MD had no data of where my free testosterone was when I was not having symptoms. He started me on a regimen where he slowly raised my testosterone, with testing throughout, and my feel normal rate is above the range that is normally acceptable. It's very difficult to find doctors that believe in testosterone treatment as a part of the complete system. GREAT Pod Cast!
Excellent information. I've had been on TRT for two yesrs and have never felt better.
What a valuable and informative conversation! Thanks to both docs for your hard work and sharing this knowledge with us. Dr Malik, we are so fortunate to have you presenting a steady stream of important evidence based medical information and doing it in a very “watchable” 😉fashion!
Thanks!
Thought I knew everything about testosterone, but ‘You Are Stronger Than You Think’ by Borlest really proved me wrong. A must-read!
Not on Amazon (only a "religious" scammer), so where is this available
Nice try Diddy
I felt like you and your guest were describing my life. I learned a ton of info I never got from my Urologist or radiation oncologist. Thank you.
⁹19 years using TRT. 73 and healthy. The first urologist who worked with me at 54, when he saw levels around 100, said he didn't know how I was even walking around. Brain fog cleared and tiredness gone in days. Now, my PSA is at 0.7. Prostate and testosterone checked semi annually.
At one point to prove need to insurance, the doctor took me off for several weeks. Dropped to 40. My issue is testicular, not pituitary.
Hello sir !
Does TRT could help you with sexual functions despite your problem is testicular ?
@@2cc91 Yes
@@VoCodebcv thank you very much !
Thanks Doc, please have him on again. I learned so much!
This was one of your BEST PODCASTS EVER. THSNK YOU. 🙏🌎
Thank you, I am so glad I am listening to your podcast, I recently got prescribed testosterone and I love it and I am having my wife listen to it as well. Thank you 🙏
Dr Khera with Baylor College of Medicine has much insight on TRT and has performed extensive research on all aspects of treatment. Very humble and brilliant man and well worth the time to research.
Wow, was this an incredibly interesting and informative interview. I considered getting testosterone at one point and got scared off because of the general warnings out there. This is the most informative info I have ever seen on the topic. Get the guy back as much as you can! Fantastic.
I had been practicing medicine for years before he graduated. He makes it sound like no one had done TRT before him. In reality it was already common practice at least in my group. He is correct in saying that there were concerns about potential cancer and cardiovascular risk. And patients prescribed it were aware that research on these aspects were lacking. Lots took it willing to accept that potential risk. Here in Canada it was a common topic at any large CME event.
In your opinion, is the major drawback of T-treatment, that if you supply it to the body, then the natural mechanisms for T-production, become redundant and stop working, so that the patient becomes dependant on artificial Testosterone?
Thanks!
I wish my doctors would listen to this. Been fighting with this issue for 3 years now, particularly with Endocrinologists that are solely focused on TT and refusing to look at at or treating anything other than the number.
Because they're zombified.
Dr Malik,
I would find an episode specifically about your expertise but focused on diabetics in particular, VERY HELPFUL, and I suspect that MANY others would as well
What an incredible guest. Thank you so much for having him. Thank you both for all the work you do. I am currently on TRT and it gave me a second chance at life. My total T was “normal” but free T was 70. Had all the typical symptoms and was turning into an old man in my 40’s. Not including my job that’s very dangerous and I was making mistakes that could have costed me my life. Now on TRT and feel like a person I was in my 20-30’s. Thank you.
“Oh, my old friend is back” that’s exactly what I felt once I started T 6 yrs ago. I’m 65, and very happy. By the way I’ve known about this Doc for many yrs and shared his literature with many of my friends. My PCP is a big fan.
Great podcast.
I wished the guest was asked if there are anyways to increase free testosterone by lowering SHBG, thus avoiding the need of TRT and any potential risks associated with TRT, such as shutting down the natural production of testosterone.
SHBG is important. It temporarily binds to ALL sex hormones to transport them around the body and then release them at the appropriate sites when needed. If you lower your SHBG to single digits it will not be good for your body. Testosterone is not something to be afraid of and the risks are made up lies that only apply to people with bad diets who don't exercise. The heart can fail in anyone at any time at any age. People on testosterone will have heart attacks just like anyone else but it will not be CAUSED by the testosterone as their is no mechanism in the body for this to happen. Your body has an organ that produces it for crying out loud, it is not a poison. Your natural production shuts down but you can take a LH/FSH stimulant or LH mimic such as HCG to keep them from getting atrophied. Regardless though, if you stop TRT your testicles will grow back, the main part of the testicles never goes away, think of it like a balloon, you can deflate it and then blow it back up again at any time to it's original size.
I heard working out with heavy weights, especially legs but you have to have the energy to want to work out.
Got my 1st TRT shot today. Hoping for great results in the coming months
It may take some time to find your right dosage and frequency to get you in a sweet spot. Don't get fooled if you have a "honeymoon" phase in the next few weeks as your hormones rush up to higher levels. Injections take 6-8 weeks to reach a steady state. Then you check blood levels and how you feel, adjust, wait another 6-8 weeks, and re-evaluate again. You may get lucky or be on a 12+ month journey. Don't give up.
How are you feeling now? I'm about 3 months in, it gets better.
@travv88 i been feeling great since day one. No depression or anxiety at all. Like it just went away. And I seem to be putting on some muscle better than I have been. I take my 5th shot this coming moday. Definitely feel like TRT is a life changer at this point.
@counterbalancelife4305 I think I'm in the honeymoon phase. Feel better than I have felt in a very long time.
@@dontmindme7997 I feel like the idea of the "honeymoon phase" is kinda BS because I keep feeling better lol.
super well done show and so helpful for somebody like myself that has been suffering from low “t” and they continue to try to treat it properly
Does DHEA raise your free testosterone? Are there any advantages or disadvantages to taking DHEA versus a testosterone gel or injection? Are over the counter brands of DHEA safe and effective?
I was wondering the exact same thing and was hoping to find some info in the comments on this.
It didn't raise mine when I tried it. DHEA raises your DHEA.
No it does not. There is a persistent myth among practictioners that it helps. It does not do anything.
Awesome video! I was very impressed and this really spoke directly to me! Thanks for all you give to your viewers.
Glad you enjoyed it!
Everyone responds differently. I may be in the minority here. I've been on TRT for 2 years - it bumped my T from 200 to 900 ng/dL (average). I've experienced no noticeable difference in mood, wakefulness, libido, workout recovery or frequency of illness. I've always had a routine of daily exercise and working out 6 days/week, and I try to live healthy, avoiding sugar and processed foods.
I see a lot of "it changed my life" comments here, and I'm glad it has had such a positive impact on those folks. If anyone reading this is wondering if something is wrong with them because they didn't notice a difference on TRT, hopefully it alleviates your anxiety a little to hear that others experience the same thing.
Is it possible you're not dialed in enough?
whats your free t? are you taking hcg or any other add-ons along with? you might have multiple pieces in the puzzle not being addressed. total t isnt the number that matters that much.
Do you have any underlying conditions that might mimic low-T ?
Thyroid for example.
thats high number, free?
I am 60 years old neurologist, was recently operated on for PUJO with complete obstruction t 1/2 is zero on MAG3. I was shocked with the diagnosis especially no direct reason found and persumed to be congenital. I still have a serum creatinine of 0.7. Probably more public awarness is needed for the condition
Thanks ! Best video anywhere on the the subject of testosterone. Keep doing them .
Very interesting topics and I really learned a lot👍🏾
Thank you Dr Malik
I find this super interesting. I wish there a version of this in-depth discussion particularly focused on type 1 diabetes. I'm 50, "normal" ranges T, but wondering if overall endocrine issues elsewhere are a factor......
Love this! Sharing this video with my colleagues without question.
THANK YOU SO MUCH. This video is so informative. I will be making an appointment to see a urologist on Monday. I've been experiencing many of the symptoms described. Ive been concerned about the Cancer issue because of ignorance. Again well done Dr.Malik and thank you for your hard work.
Question doctor Rena do these supplements titan boost or any other dietary supplements help with size issues. Are they true. I'm 50. Just turned 50 and I see I lost a lot shrinkage not as big and I'm not getting no action.
Doctor, I went on TRT about 5 years ago. It’s been amazing but last year my prostate numbers went from 1 to 4.3 I just gave blood for a new test it’s been 6 months and I’m a little worried. I have not got results back yet and hope everything is ok. Just giving you. My story. Thanks for the video it gives me confidence it’s not from TRT.
What happened? Did you get your results back.
@ yes it went down to a 2.5 doctor said we will check it in a year.
Same thing happened to me off TRT now. I don’t know what to do now. Really confused
@@Mark-zz9rt happened to me too. On TRT for 2 years then psa went up to 4.3. DRE ok, MRI came back ok but urologist wanted to do biopsy to continue trt. I declined. Been off trt for about 15 months now. I’m back to pre trt levels and symptoms. But I’m not poking holes in a perfectly good gland.
Excellent video! Everything makes sense to me now! The first port of call should be lifestyle changes like change of diet and more exercise and also environmental toxins need to be addressed!
This video was extremely helpful to me. Thank you both for your hard work
I just saw my urologist this morning just for him to say my problem might be that I'm depressed SMH...I'm 52 with total testosterone at 298 and free testosterone at 9.9 I know why I have fatigue and no motivation and it's not that I'm depressed... forward on to the next Dr.
I am 53 and been on trt for 18 months. My T level was about 327 and I was tired all the time, depressed, muscle and joint pains, no sex drive and unable to build and maintain muscle mass. I started TRT and with 3 days I felt a tremendous relief and instantly felt like my normal self of when I was about 30! Just a general feeling of wellbeing! Now libido is high, happy, motivated, lost fat and built muscle and life is good again! I have found I feel best when my level is at total T is at or above 1000. There is so much to learn about this treatment and how you need to live your life to maximize its impact.
@@hubriswonk It's good to hear when someone like yourself has been able to get the treatment you need to get back to normal and feel better....I personally know quite a bit about the endocrine system and testosterone and today while I was talking to my urologist I had to finally say look I can explain to you everything you're trying to tell me and low testosterone can in fact cause depression but I'm not depressed and have never had any issues with it and he kept trying to tell me I might need to be on SSRI's and said absolutely not....he kept trying to say how my numbers were in range and normal for my age and to top it off I find out that today was the very first day of his practice opening and I was actually his first patient....I should have figured he was fresh out of school as he was really young.
@@hubriswonk glad to hear you were able to get the treatment you needed....wish me luck I'm switching doctors.
@@brianpulley8652 Don't stop looking until you find one that is up to date on current events!
Key number there is Free Testosterone.
So what about DHEA, the precursor hormone to testosterone? My current understanding is that it too is labeled as increasing the risk of hormone-sensitive cancer such as prostate cancer.
Adding DHEA/Pregnenolone has helped with mood/libido/sensitivity
DHEA is very important. Just test your levels and supplement to correct the deficiency.
cancer is not caused by androgens. Look up the noble rats study where the aromatase enzyme is genetically removed from the rats and they are given testosterone or DHT and are unable to get cancer but then when they add in estradiol injections the DHT+E rats got cancer at very low rates and then testosterone + E group 100% got cancer. Go look it up seriously it will blow your mind.
Very informative interview, Dr. Malik!
I am interested in learning more about Prostate Artery Embolism. Seems like a decent outpatient procedure to reduce the size of the prostate. At 61 I am going this Friday to get my T level, thyroid and prostate checked.
Thank you for your educational website it is excellent
This is a detailed interview thank you so much you Rock!
My doctor was pretty hostile to TRT when I was just looking for information. I had to work to convince her to even order a blood test. When the results came back within the "normal" range she was almost triumphant, even though my levels were at the low end of "normal".
Part of it I get it, she is a woman and probably just doesn't understand and seems to assume I want to be a jacked up teenager again. Or I'm just a middle aged man that is afraid of growing old. But I just want a good quality of life and to be healthy as long as possible so I'm there for my family. Not just not dead yet.
i have noticed that since the invention of soft foam cushions and beds that have almost completely replaced cotton fibers the heat generated in the pelvic area has been higher almost constantly from the heat not being able to escape the pelvic area when sitting so much.
bph plastic molecules in bottles dropping T RATES WORLDWIDE, also, fertility docs focus on testi. temps.
I just started Androgen 1.62%,two pumps daily. So will you need to give blood periodically?
? doseage?
Just watching Rena raises my T levels
and something else!!!! thanks Rena
Makes the testicles bigger and raises testosterone for sure haha
She raises my awareness.
She has great T’s and it helps my T
me too , 🤷♂️
Enjoyed the interview. Surprised there was no discussion about insulin resistance. Only one remark about vascular disease (ED) which is caused by insulin resistance. Hormonal imbalance is always out of whack with insulin resistance. Yes, insulin is a fat storing hormone. We must limit the carbs in our diet. Testosterone will not work if we do not eat a proper human diet.
This is a very important You Tube Videos . Although there are other You Tube interviews with Morgentaler this is the most informative one. Every man , and Especially every Urologist, Endocrinologist and Internest should hear what Abraham "Morgentaler" has to say about Testosterone (Morgentaler's name is misspelled in Malik's summary paragraph above).
This was a fantastic interview, Thank you!
Fred Armisen’s best role yet!
😂
He's always good.
@@emanuelmota7217 Man, I didn’t even notice the resemblance till seeing your post 😂! Hilarious AF! And yes, we agree that Fred is truly an amazing talent!
Very informative... My doctor should watch this...
Great video. It's one of the best I've seen on this topic. A topic typically misunderstood, if understood at all. And that is by professionals and laymen alike.
Question. What do you do if you're a guy who has this issue but lives in a country(Israel) where prescribing testosterone is rarely approved. If you're a woman, hrt is readily available. If you are gay, and looking to "transition", no problem. But for a hetero guy, you would have to exhibit the testosterone level of a 90 year old, and be half dead at that to even be considered for trt. I kid you not. In my case, my total T is exceedingly high. Almost 1000. And I'm 70. But my free T is in the tank. They don't even measure free t here. I had to do it privately. So what are my options? Are there any reputable clinics that do hrt by way of telemed?
Anyways, thanks again. Really great video. Very helpful.👍👍👍
It's likely your SHBG is high. It goes up non-linearly with age. It's OK for your total to go above 1000 if necessary to get your free out of the "tank". see a competent endocrinologist or urologist who has graduated within the last ten years.
@piezoe Thank you. I agree. My SBGH is too high. Tried a few different things to lower it...with no success. Boron. Stinging Nettle. High protein diet. A couple of others. No luck. Agree with you once again. Raising my total T is the way to go. But that puts me back to square one. Nobody here where I live will prescribe Testosterone under these circumstances. I may just have to travel abroad to get treatment.
Thanks for your input. Much appreciation!
Here is the UK the doctors have not taken my symptoms seriously I've felt a nose dive of my testosterone levels just as I went over 50 and I've been telling the doctors to test me for low testosterone and they did eventually and it came back at 9 and it is on the boarder line low and I urologist said well we can give you a boost of testosterone and it will be 1 injection every 3 months which does not make sense. It been 10 months and I'm still waiting. I'm 54 now and I still waiting for the doctors to get back at me. The Standards of my life is terrible and I can relate to this podcast 💯.
I am one of those guys on TRT and regardless of how high my T levels are the symptoms remain extreme and it seems that all my doctor is concerned with is how the range looks on paper! I had some lab work done through an endocrinologist and the results came back listing me as a female and because of that, there isn't an accessible record of those labs. I've been on TRT for several years and the symptoms remain the same and I feel almost castrated. I don't know what to do! My free testosterone has ranged from 13.2 pg/ml to 24.5 pg/ml with a total of 382.5 -782. My LH results were in range after stopping TRT for six weeks and I did have the mumps when I was younger. TRT has done nothing for my libido. I suppose I'm an anomaly.
Demand the following lab tests and report back: total testosterone LCMS, Estradiol Ultrasensitive, Prolactin and SHBG
Can receptors for the testosterone be a problem? If the free test is ok, but still have symptoms- could the absorption of the molecule be an issue?
High cortisol will generally Block all sexual hormoner in both sexes.
It is possible. What are your total testosterone, free testosterone, SHBG and estrogen levels?
I appreciate this video but this is just the surface. If you want to dive deeper in the rabbit hole read Untold Testosterone boost guide. Thank me later
What website sells that book?
Nice try diddy
@@Plato76...😂😂😂
TRT treatments have changed my life. I told my doctor how great I'm feeling and he angrily compared it to crack cocaine. WTF? This episode was very informative. Thanks!
I was on TRT and my psa went up rapidly. I had a biopsy for prostate cancer and came back negative, your thoughts?
Thanks Rena this was a boat load of valuable information for me
Does TRT can help in primary hypogonadism (testes failure) ?
Of course. Just as type 1 diabetics need insulin.
yes
You were talking about testosterone being at 3:50 is a good area. I’m 71 and my testosterone is 807. Should I be concerned?
1000 is upper limit or normal, issues can occur above 1100
No. 807is incredible for your age you’re fine without it
@@Jakeandbakex thank you
@@hojo70 the normal range cap gets lowered constantly. It used to be over 1500. They keep shifting the range downwards because everyone's testosterone levels are dropping from all of the pollutants in our water and food supply so they 'normal' is now going lower and lower. The range is not a reflection of optimal levels like we assume it would be, it's just a range of what people's levels are showing up as is in whatever small sample groups they choose to use.
thats high , lower dose...natty = your lucky
Very interesting and informative. I would be curious to see an in depth discussion about options for testosterone therapy. Gels, implants, etc. I doubt I can cover the costs of weekly shots administered by a physician and am not willing to stick myself at home. Id like to hear some details about my options.
I felt the same way. I started supplementing with testosterone in Peru (South America) by going to the pharmacy once a week and having the pharmacist do the shot which I was ok with. Then, I moved back to the states and found out that shots can be done intramuscularly which is much much easier and no pain at all. The syringe used is an insulin pin (syringe) and its only inserted into a pinch of belly fat no deeper than a 1/4 inch and administering daily allows for a more even distribution of T similar to how our body does it.
Excellent episode! 🎉 I am from El Paso, TX. I will definitely consider you in the future for an appointment. Keep up this type of information!
My Free (Calc) is 105.0. My Free and Wkly Bound is 231. Which one should we focus on and would my situation warrant replacement therapy?
Doc, you look fabulous!
SHBG binds to ALL sex hormones, not just testosterone. SHBG needs to be kept in a healthy range because too much is bad but so is too little. SHBG is an important component of sex hormone function. You need to be measuring their SHBG instead of free testosterone. When measuring their total testosterone, you need to use LC/MS and not the inaccurate immunoassay that cross detects DHEA and other androgens which causes inflated results that show testosterone higher than what is actually is. When patients have Low T with High Free T that is a sign they have low SHBG and that is a problem that needs to be addressed. They need to have their thyroid levels checked since low thyroid can cause low SHBG. Thyroid hormone stimulates the liver to produce SHBG so a low SHBG can be an indicator that thyroid is low.
I'm 44 with high SHBG but tried all sorts of supplements & nothing seems to lower it to more normal level
@@joeairwolfboron 20mg/day
t3, t4 thyroid levels
@@lunam7249 tried it @12mg/day a number of times & not helped, might look at higher dose
Does testosterone make you smell? I’ve had two shots of Aveed, and I now sense I have a musky smell. If so, does it get better? Thanks.
yep!!! guys hate the smell! 75% girls love the smell, shave armpits, use "coast" soap
so . . my 45 year old vasectomy - how has it helped or not?
What is the best way to administer testosterone?
look at vids, for new TRT, 5mg gel pack/2 week or once a day
If all else fails try Oyster stew.. My grandmother used to get a worried look on her face when granddad opened a can of oysters at Christmas..
😂
Thank you for this very good podcast!
Thank you for another amazing video. So much truth.
I went to get my bloodwork done and my T is at 445. I’m 26 which is normal they told me,
I started trt with 150mg a week , will I see results from that dose ?
I barely started
You will crash natural production. IMO taking trt at 445 is a terrible idea. Stop it immediately and focus on natural ways to up your T.
@@teamplayer1634
the thing is want to get to atleast 1200 , to improve in muscle building, can I naturally get to 1200?
I don’t want to take actual steroids, so I think upping my T would be the next best option
STOP. your naturally at a good level, get educated on red protein every 2 hours, sleep, testosterone boosters on ebay, boron 20mg/day... ect..train VERY SLOW AND HEAVY LIFTS, SQUAT , LEG PRESS WITH BELT
Very interested in you and the docs thoughts on Hematocrit / Hemoglobin elevations with TRT. Seems like a lot of online pharmacies etc. do not care about this or even check it. Isn't a hematocrit of 50+ and a Hemoglobin over say 18 a dangerous thing? Phlebotomy is the only answer?
You need to lift weights and do cardio to increase the hepcidin since androgens make it go lower. That's why bodybuilders are able to tolerate high doses of androgens, they work out all day and do tons of cardio. Hemoglobin is not dangerous, it is just a placeholder on each red blood cell that holds 4 oxygen molecules, that is a good thing. Donating blood is a necessary part of society because if no one donates blood then we don't have any available for transfusions. We should all be donating 1 to 2 times a year anyway if we are able.
@@Jaye-HormonesForMe I understand the physiology, the problem is that Hematocrit over 50% and especially over 55%-60% causes spontaneous clotting. Hepciden is important for iron but not related in a positive way to coagulation. In fact, in some studies, it's a biomarker for increased risk of VTE when elevated. It's not safe to walk around with VERY elevated Hematocrit levels. Donating blood is a good thing for sure, but for many TRT patients, it's necessary...Just wanted their opinions on that topic.
I did not have an issue obtaining TRT from a doctor, but I struggled with the insurance company and pharmacy. It took weeks for the pharmacy to fill my prescription. The insurance required an EKG annually.
So how do we get our doctor to prescribe trt? What’s the solution? I was tested and my level was 360. My doctors won’t give me trt because I have to be under 300 to be considered low t. I feel horrible and have no energy. I struggle to lose weight or build muscle. I’m 44 and I feel 80. So how do I get help? Do you have any suggestions for trt therapy companies that are safe and legit?
online TRT Clinics are available and easy
Here's some great antidotal information. I am a disabled veteran. I was a super soldier with all kinds of awesome training and deployed in 3 wars 10 years all in a row with just a couple months at a time home. One day I fell apart. After being in perfect health until I was 40. I had a massive widow maker heart attack (without any heart disease), I am on my second round of bi-lateral pulmonary embolisms and DVTs (with no lung disease), I have been diagnosed with a blood cancer Leukemia - Very high hematocrit, RBCs and Hemoglobin. I have taken TRT on and off to see if it changed any of my signs and symptoms of any of my medical issues and it didn't. It didn't even raise my Testosterone? I have had multiple surgeries in multiple joints due to joint and spinal injuries and I used TRT, Peptides and PRP injections to heal faster. The combination of injections helped me heal from surgeries in half the time with half the pain medications.
Did you take the C Ovid vaccine?
My personal family doctor, a general practitioner, would only give a very low dose of T cypianate. The vials were 200 mg. per ml. The dose was 1/2 ml. every 21 days. This was for 3 months, then a blood test was done. I asked for a higher dose with more frequent dosing, asking for doses every 4 days. He said absolutely not. He said my numbers were in the normal range, and he would not increase any dosages. He was treating me as a number, a statistic, not an individual patient.This was a total waste of time because at those doses, I gained nothing. Absolutely nothing. The only place I could find to get doses that would be beneficial were the TRT clinics, and the amount of money they charge is criminal. So, where can a man find a doctor, not one of those clinics, to be treated as a person and not a number.
indocrinologists ...seek and ye shall find
The problem isn’t convincing primary care doctors, the problem is convincing the medical entities that employ the physicians and set the policies the physicians have to follow.
I am so impressed by your comment. This is the truth. Patients blindly trust doctors who also blindly trust their authorities. It is the top of the chain giving instructions to the sheep at each level that cause this problem.
Can low T affect sleep? Example, sleep onset insomnia. I have a hard time getting to sleep and staying asleep. No situational issues which would keep me up. I basically lay there, unable to get to sleep .
Yes, 100%. That was my primary symptom. Didn’t affect my libido or anything. Insomnia was so bad sleep meds had no effect. Insomnia and constantly feeling tired are big ones.
@TangoKilo-fp8uu what were your levels, mine's close to 400?
yes, in the adrenals testo. decomposes into melatonin, sleep hormone
great work dr. malik
Hello, how can I get in contact with Dr. Abraham?
My PCP is at the VA. I got my testosterone tested a few weeks back I was at 285. I’m 30 years old with 3 kids, married for almost a decade. This past year I’ve experienced a lot of symptoms such as gaining weight, depression and anxiety. I attested the weight gain, weaker erections to my depression. But then I decided to get my testosterone tested and at 30 it should be higher IMO. Doc had me get it tested again yesterday and I’m waiting on results. I’m hoping I can get treatment immediately after, if they don’t want to prescribe it I’ll go toward an online clinic and then have my PCP monitor my levels.
Same here my total was 4 points away from 300 but my pcp at the v.a told me its low but normal..even though i wornout minimum 5x a week..my free t is very low gonna see what they say depending what he says ima take matters into my own hands as well
@@brucewillis2486 Just had mine tested at VA and not sure which to focus on, The Total Testosterone S/O is 8.8 which they list as high with the range of 2.80-8.00. The Testosterone Free and Weakly is 231 and the Testosterone Free (Calc) is 105. Meeting with my PCP Tuesday. In the past they have said it's within normal range... Not sure which one they look at to determine if it's low
Incredible dialogue! Thank you
Dr. Abraham, or Dr. Malik...can you provide reference for showing impact of past mumps sickness resulting in orchitis - eventually azospermia, and levels of testosterone, whether total or free? Impact on libido, muscle development, etc. Best regards. Greetings from the Philippines.
Excellent !! More.... can't get enough of this info.
A lot of good information but did not get any information that I can use on an individual basis.
Very helpful. I recently read there is or may be a connection between low T and PE. Is this true? Can you comment? I am interested because I am 73 and have noticed more frequent PE than when I was younger. Thanks.