Barbell Shrugged - Is TRT Right for You w/ Dr. Ben House, Dr. Andy Galpin, Anders Varner, Doug Larson, and Coach Travis Mash Barbell Shrugged #616

Episode Date: November 17, 2021

Dr. House has a Ph.D. in Nutrition from the University of Texas at Austin, which is one of the top ranked public universities in the United States. Dr. House is also a Nutritionist (CN), Functional Diagnostic Nutritionist (FDN), and Certified Functional Medicine Practitioner (CFMP).    House was accepted to medical school without an undergraduate degree, but rescinded because during this time his father was fighting for his life with debilitating diverticulitis. The conventional medical model prescribed him pain killers, antibiotics, saltine crackers, and white bread. This pushed House to question the sick care model and look for the underlying lifestyle and dietary factors that could be the reason why his father was in so much pain.    Lo and behold his father had Celiac disease and within a week of removing all grains and dairy from his diet he was symptom free. This was Dr. House’s first taste of Functional Medicine and he knew at that moment that this would be his life’s passion. Since then he has studied under some of the best in the world and continues to regularly attend and present at conferences and seminars around the world.   In this Episode of Barbell Shrugged:   What is TRT and who is it for? What is the research behind TRT? What are the long term affects of TRT? Is TRT the better than natural remedies? Is TRT the best alternative to kickstart fat loss?   Connect with our guests:   Connect with Dr. Ben House   Connect with Dr. Andy Galpin   Anders Varner on Instagram   Doug Larson on Instagram   Coach Travis Mash on Instagram   ————————————————   Diesel Dad Mentorship Application: https://bit.ly/DDMentorshipApp   Diesel Dad Training Programs: http://barbellshrugged.com/dieseldad   Training Programs to Build Muscle: https://bit.ly/34zcGVw   Nutrition Programs to Lose Fat and Build Muscle: https://bit.ly/3eiW8FF   Nutrition and Training Bundles to Save 67%: https://bit.ly/2yaxQxa   Please Support Our Sponsors   Organifi - Save 20% using code: “Shrugged” at organifi.com/shrugged   BiOptimizers Probitotics - Save 10% at bioptimizers.com/shrugged   Garage Gym Equipment and Accessories: https://prxperformance.com/discount/BBS5OFF Save 5% using the coupon code “BBS5OFF”

Shrug family, this week on Barbell Shrug, we are hanging out with Dr. Ben House. This is his third time coming on to Barbell Shrug. We are talking about testosterone replacement therapy and is it right for you? Very interesting deep dive into TRT, HRT, and the science behind exogenous testosterone. And is it actually the most beneficial thing you can do if you are suffering from low testosterone? But before we get into the show, we got to thank our friends. Do you like free stuff? Well, you're in luck because Bioptimizers Black Friday deal starts now. And not only are they giving a huge discount all month long, they're also giving away over $200 worth in free gifts. This is their best sale of the entire year. So now is the perfect time to

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forward slash cryo, C-R-Y-O, that's completehuman.com forward slash cryo, and use the code shrugged15 to save 15% off both the commercial and the residential tub that's complete human.com forward slash cryo use the code shrugged 15 to save 15 off both the commercial and residential tub people these things are insanely nice and i highly recommend you get over if you are looking into having a cold tub in your house, completehuman.com forward slash cryo. Friends, let's get into the show. Welcome to Barbell Shrugged. I'm Anders Warner, Doug Larson, Coach Travis Smash, Dr. Andy Galpin, Dr. Ben House. We had two doctors on there. That's so fantastic. Today on Barbell Shrugged,

we're going to talk about TRT, HRT, some hormone replacement therapy in the testosterone world. And we had to cut Ben House off because he just went on like a – he basically just started the show without us. And dude, the idea of low testosterone. This is your third time on the show here. We've talked about testosterone in the past couple years back. We're at the points retreats, you just put an article up on Deconstruct Nutrition, which is your website where you post awesome articles. I love being a part of it.

And the one on TRT caught my eye because we were kind of like diving super deep into the testosterone world and a really good place to start for like a broad category of what low testosterone is, I'd love to just go back on that rant of what actually is low testosterone because that number varies so much and how are we actually supposed to categorize this before people even start to get into going to find some sort of hormone replacement therapy to, to get their levels back up. And that's one of the problems is like going to find, uh, so should you actually get a testosterone assay? Um, and how good is that

assay is kind of one of the big things. And honestly, like there are huge societies and groups of people that actually do not advocate just blanket testing of testosterone because you will pick up things. You will pick up low testosterone that is clinically low, but clinically irrelevant. So just because you have a low testosterone, like on a serum draw, doesn't necessarily mean that you have low testosterone. The problem being like have there, like on a serum draw, doesn't necessarily mean that you have low testosterone. The problem being like have there, like you just got a transient testosterone value that it can change testosterone's diurnal drops by potentially 200 nanograms throughout the day. And one of the craziest things is like, you could be hypogonadal, this is the terminology for low

testosterone. And then on a repeat test, 50 to 30% of people are non-hypogonadal. This is the terminology for low testosterone. And then on a repeat test, 50 to 30% of people are non-hypogonadal on that repeat test. So to get insurance to pay for TRT, you generally need two morning draws and both of those have to be low. And then you get into low by age. Does testosterone go down by age? That's even debated. Uh, so this is a very complex topic. And I think what we see on the narrative on the gram and on in socials is that it's very simple, like serum, serum, testosterone, low, go get testosterone, but that's not, it's not that simple. Um, and I'm, I'm actually not that against TRT when it's used properly. I'm not against it at all.

But I think what is a little bit disconcerting is an overprescription of TRT by like 11 fold. If you look at like 2000 to 2011, it went up a lot. We're talking like 100 million to $1.8 billion. Yeah. So there's a lot of, the other thing is there's a lot of money're talking like a hundred million to $1.8 billion. Yeah. Like, so there's a lot of, the other thing is there's a lot of money to be made here. We're talking about putting on people on EFTs, residuals. And so whenever you attach money to things, it can get a little bit questionable. But I think that's the reason that people want to be very educated before they go into this. Because if you look at the literature, if you are given TRT and you don't necessarily need it, the discontinuation rates are insane.

We're talking 80 to 85% of people drop off. Whereas if people are given it and they actually need it, the drop off rates are probably much less 15 to 20%. And so those are just a little bit of snippets and we can dig into any of those. How do you really know if you need it? Like if your numbers don't tell the tale, it's numbers plus symptoms? Yeah, usually three symptoms. So this is the craziest part about it

because we're messing with a lot of placebo and a lot of things that people like think of as prototypically male. But if you look at the control literature, you don't, this is debated, but you generally don't get a lot of the sexual symptoms that people associate with low testosterone until less than 250, maybe even less than 200. Um, and that even for spermatogenesis, which is the bulk of your testes weight, um, is seratory cells, which makes sperm. Uh, so you don't get a lot of the, and the reason I say this is because a lot

of people go to testosterone because of erectile dysfunction. Like they're there because if you can't get an erection as a dude, like you're, that's, that's the one reason, like, yeah, that's the one reason dudes who are young are going to see doctors. Like I can't get directions. Like let's be honest. And so in that scope, it doesn't look like testosterone is going to be helpful if your testosterone is not very, very, like very low and lower than 200. What would cause like ED other than low testosterone? Yeah, that 200 number is so low, too. That's like basement level T, like testosterone levels, isn't it? Yeah, so here's some crazy stuff.

If you look at – you can't do this in humans. I mean, we used to do it in humans. We used to have eunuchs. We used to castrate people. I wasn't even thinking about that. That's zero. That's not not zero that's not actually zero huge huge percentages like not huge but like we're talking italy castrati we're talking about in china uh you had large like your third son yeah uh just because yeah i'm going to china for sure that was back back back in the day when they had eunuchs

who essentially guarded their harems. But this is... Gotta have one, man. Everyone needs one. This is not new stuff. Yeah, imagine going under that. The antiseptic for that was hot pepper.

Oh, shit. Are you serious? I mean, no. that's a big like your boys your boys and in your main your main event all gone yeah every time i think something bad is going on in the united states i'm like oh we're close to civil war they still haven't implemented the castration system so we should still pay for a couple more years before civil war breaks out. Yeah, when that shit starts, I'm out. Why? Yeah.

Going to Canada. I mean, so if you take TRT, there's a 96 to 98% chance that you will no longer be able to have a child. So, I mean, there is, maybe it's not that high. Sometimes it's a third. But you do, so when you take endogenously, when you take testosterone endogenously, this is one of the big things is like, if you want to have a child, these are things that you need to talk about with your prescribing physician, because your, your testicles are

based. So intra testicular concentrations of testosterone are 100X what's in your serum. And you don't actually need that much testosterone around to make kids. And so we know this research from rhesus monkeys. And so when they castrate them, they have way less sex. So they take all their testosterone out. They cut the balls off, way less sex. But they give 10% of the testosterone back. They go back to having the same amount of sex that they were having before. So it's from a, from a sexual standpoint, it's probably a very permissive hormone. Um, and even basins literature where they take people up 600 megs, we're talking,

uh, probably popping you to at least five to six times physiological. So 4,000 nanograms per deciliter. Uh, this is like 2,400 nanograms per deciliter. This is like 2,400 nanograms per deciliter a week after the injection. Did not see increases in sexual desire or sexual function. Even at those levels. I think you will see, if you talk to bodybuilders, people who are using extreme dosages, I think you will see an increase in phantization. I think we've all been through puberty. You remember like two minutes before the bell rang, you're like, damn, I got a boner again. Every class, you're like, where's my textbook? Where's my textbook? Let me cover this up. Anyway, so why is there this big misconception

then? How did this concept arise where people think that higher testosterone means more sexual desire and lower testosterone means lack of sexual desire. I mean, we, we have a, we're not very good at thinking of continuums. I think we just think of things as like on and off. We're not good about thinking about things like multifactorially.

And then we also, people don't look for, I mean, it's definitely out. I wish that it was like 300 or 400, but it's not like you look at the, if you look at the preponderance of evidence, sexual function, and this is a big deal for older populations because this, then you get into a late onset hypogonadalism, which is fairly prevalent, um, depending on your, your, your diagnostic criteria, right?

So if you ask like why is low testosterone, I think because it's sexy, man. It's sexy to talk about this stuff. People want hormones to matter a lot. And I do think that they matter outside of physiological, but I don't necessarily know independently of raising your testosterone 100 nanograms or 200 nanograms independently i don't think that matters what's causing this thing what is causing the ed from the young guys

if it's not testosterone uh there's so many causes that that needs to be honest, sugar, wheat, gluten, dairy. Are you being serious? No, I'm not. I just wanted to help. Oh, yeah. I was like, man. Artificial sweeteners. What has happened? So I can speak a little bit of this because we opened the bag of worms of erectile dysfunction.

So if you can get an erection, you do not have organic ED. You have functional erectile dysfunction. And so organic is very different. That could be obesity, blood pressure, blood flow issues that needs to, if that is there, you're talking about like, you probably have a lot of other comorbidities that need to be addressed. If it's, if it's a dude who's 20, um, and he's struggling to get an erection and only some of the time, that's probably a psychologist to be completely honest.

It's interesting. I've actually seen that here later, that cognitive behavioral therapy specifically, like helps with all that, like dealing, dealing with trauma or, you know, if you, if you're married and like, you have a lot of resentment with your spouse, you're always in a fight. You can't be passionate and excited to have sex with each other if you're just angry at each other all the time. Those types of psychological factors I never really considered

when I was younger. I just figured you just didn't have blood flow so you needed Viagra or whatever and that was that. Maybe just have rough sex. Just kind of fight slash sex. I don't know everybody's different i mean i really like emily emily nagoski's book come as you are is is really good she's a sex therapist and it's kind of just gets into like everybody's different uh like we're all the same we're organized in different ways but whatever what people find exciting what people like she talks

about is like some people have different gas pedals, some people have different brakes, and just everybody's different. You know, right now I'm taking a class on ergogenic aids, and part of it talked about, you know, the steroid revolution started pretty much in the 80s. And so now these people are just now getting older. You know, they're getting their, their mind. And so do you think that has anything to do with this TRT? Because I personally know certain friends who are powerlessly friends of mine who cannot have kids, who have terrible ED. And like, obviously it's not me. I got four, just want y'all to know.

Anyway, but like, do you think that has anything to do with this rising population of trt i mean no one was challenging your manlyhood by the way in the middle of your own question this is this is crazy actually so this is not this is not new like back in the day uh like this idea of like holding on to our manlyhood, like Fountain of Youth. Even back in the 1900s, rich people were paying for the testicles of executed prisoners and they were putting them in their body.

And eating them, yeah. It's crazy. It's crazy. Much longer than that. People back literally, BC times were eating testicles of animals in hopes that it would give them, you know, increased testosterone. Well, they probably didn't know about testosterone, but it gave them increased, like, drive and, you know, desire.

We found testosterone was 100 kilos of bull testicles. 100 kilos of bull testicles. And the first, we extracted 100 kilos of bull testicles, and it gave us 10 milliliters of something. And then they injected that something into a rooster that they castrated, and it grew back its rooster comb. Like, this was the science. That's cool, right? Hell, yeah.

Good for that rooster. Good for that rooster. Got it back. So then we found testosterone in 1935 About And so we were able to isolate it Yeah Multiple places actually Amsterdam And then it hit

You kind of just breeze through history People started taking it because York Barbell Started taking it because it makes them yoked But Russia took it first Then somebody York Barbell, found out about from the guy from Russia.

Then York did. Then it just blew up. Then everybody in the 80s Olympics was on it. Like, that's just, that's just like, that's just like,

that's just like, yeah. Good for them. And so, like, the amount of TRT that goes to previous anabolic steroid users

is probably fairly high. What I would say is that if you wait long enough, your testosterone probably will come back. If they do abuse it. Cause I mean, you're talking about, yeah, like after TRT or after abusing steroids or actually,

now that I said that, I'd love to hear what you think the difference is between TRT and quote unquote doing steroids. I mean, we also have this rampant like TRT plus where we're going to take it. Like when people are taking, so TRT is generally like a hundred to 150 megs a week. That's,

that's going to pop people super physiological. It's going to pop you to 1400, 1500. So like, as soon as you're even on TRT dosages, you're probably 25 to 50% of someone who is normal diurnal from an area under the curve perspective, because you're going up to 1400. And then seven days later, you're maybe at 500 to 700 right so that's a normal trt dose bodybuilding dosage is like the median is like six times to almost we might be even getting into gram dosages like yeah i mean you're talking to like i think bret hart died with like 10 000 nanograms or something like that i mean there's just this escalating dosages. And the thing is, I think

you do see a dose response with testosterone and muscle outside of physiological. So if you look at Basin's dose response curve, you saw pretty crazy results with muscle in that without resistance

training over 20 weeks, people gained 18 pounds of fat-free mass at 600 milligrams. I saw that very study. It's wild. So there's a lot of... And I think that's why in the bodybuilding realm, that's how you get to 300 pounds on stage or 280 or 260, whatever that is. Yeah.

It's part of it. I mean, there's a lot of the drugs are apart and then there's probably we know from literature there's also synergy um with a lot of these things and even training going on yeah polypharmacy yes is that a healthy uh healthy such a bad word but uh what are like the the effects on the body of waking up on a Monday, taking TRT and being at 1400. And then by Sunday of the same week, you're down to 400,

500 that can't, that, that like up and down flow, I assume can't be a, a good outcome on your, on your body. I mean, I think the biggest thing is like, so if we think about health, like what are, what are the risks of TRT? I think that's good.

Like, cause there's a lot of like, we fear what we don't understand. And so I don't want to sell fear here. And so there's different forms of that's a, that's like ethanoate or sipionate that's what that's those are those long form like longer form esters um you also have gels which are going to have like a more like a uh more standard rate you're going to put that on every day um and then you have patches you have pellets which will be like won't have those waves won't have those waves and dips um the me personally in my opinion the i'm the thing that here's what i think we have to worry about everybody in the

call like so i like to think in hypotheticals we all go on trt we get a little bit more jacked probably because we're training gives us a little bit gives us a little bit more runway right um we get a little stronger we feel a little better and then that probably stops like gives us a little bit gives us a little bit more runway right um we get a little stronger we feel a little better and then that probably stops like we get a little bit runway for a little bit and then it stops i think our risk comes from two things and that is left ventricular left ventricular hypertrophy so like whenever you have like we're talking about athlete's heart and so with this stuff especially at super physiologic high dosages you're likely increasing your risk of arrhythmias and then you got a way bigger heart um so it's less blood being punks and you combine that with poorly managed trt and

bodybuilding drugs and because what one of the things that yeah it's so heart attacks are probably the thing that we're thinking about the most. Because you got the risk of arrhythmia. You got your heart's just getting massive, potentially. And then testosterone upregulates EPO or erythropoietin. So you can... Then you got more red blood cells. Strokes.

Right. Then you got more red blood cells in the system. So if you're hematocrit, all of a sudden, your hematocrit is the percentage of red blood cells in the system so the so if you're hematocrit all of a sudden your hematocrit is the percentage of red blood cells that's in that tube if your hematocrit grows up to 52 to 53 percent and that's not being managed correctly then you got sludgy blood your blood becomes more viscous harder to pump now you're in this feedback loop where your blood's harder to pump you're massive so your heart's got to work harder to pump it all around anyways. Not good. None of this. Yeah.

You know, to your point, I have several of my friends who have died, like, doing exactly what you're talking about. One of my friends, Chris Clark, you know, God rest his soul, like, he was told that he had, like, 30% efficiency left of his heart, and he kept powerlifting. He kept doing things that he would do to powerliftlifting and literally just pulled over the side of the road and died one day. His heart just stopped. He's just one of several

who are my age or older who is now paying the price. You do that when you're young because you think you're Superman. I'm just saying, God, I did not. I always wanted kids so I did not get caught up in that whole mess. Some of these guys, they just take more and they they take more now they're dying i feel like a i don't know what the dose is but i feel like um exogenous testosterone is sold to us as a anti-aging

health product and that situation that hypothetical that you lay out kind of feels like the longer you're on it, the more your heart's going to grow, the bigger the problem starts to be. And that's like the anti, like it's not the longevity drug that we're sold. Or is there a dose or an amount that actually creates a healthier anti-aging longevity response? I don't know how high of the risk is for just TRT dosages. I think if you manage hematocrit and you manage some of this other stuff, I don't know. Me personally, if you're managing it and you're not using superphysiologic doses, I think personally I don't want to scare anyone.

I think your risk there is probably pretty low, especially if you're doing some other stuff in your track. What's the most likely thing to kill every one of us? A heart attack. And so maybe it ups your probability a little bit, but here's the kicker. You know what's also related to heart attacks, low testosterone. So like, so like there is a U shaped curve here, which people don't really think about. Um,

there's even a U shaped curve in perspective longitudinal research, uh, with testosterone. Um, so do you want to probably be in the middle? Yeah, I would, I would guess so because Because if you look at low testosterone is not somewhere you want to be either because then you're progressive. I mean, I think you can blunt a lot of this with resistance training and, and proper nutrition, but you, you do have the loss of muscle mass. And if you think about aging appropriately or, or what may be squaring off the health span or the lifespan curve, like you died,

you died fast. Like your, your buddy, he died fast. He squared his curve, right? He didn't die. He squared the shit out of it. On the side of the road. I think a lot of people now, like, so I have, I have pro bodybuilder friends who know, they know, like if you want to win the Olympia, that's the game you're playing, right? And so I think that now you do have a lot more informed consent.

Like, people are honoring, like, this might take off five to 20, like five, maybe 20 years off the backside of my life. And they're kind of willing to do it. This episode of Barbell Shrug is brought to you by New Vitality. That's right, friends. The Diesel Dad is live in 2200 Walmarts nationwide. That means you can head to the pharmacy. That is where the performance nutrition section is.

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And make sure you go to proteechallenge.com. That is where you can download the ebook that I wrote, the 21 Day Challenge, the Protea Challenge. That's right. Lose nine pounds in 21 days, written by your boy. So get over to Protea Challenge, get to Walmart right now. Yeah. So in your mind, what is the healthy range for that U-shaped curve? I would say like 800-ish to 1,000, but I also think it think it's gonna be we can't even do that i'm you're gonna you're gonna try and put me in and i'm gonna say we can't do that because we got clearance we got angiointerceptor sensitivity but so the the thing that's crazy is

you could have low testosterone and be jacked out of your mind. I've seen it. And that's because you, this is not, it's not just about serum testosterone. You have so many downstream factors, um, that are, that are really in play here. So I do think that I use the shoe analogy. So like if you were a size 10 shoe and then you drop to a size five shoe, that's not going to feel very good. Um, and I think everybody's a little bit different. And so what I think is that it's just this individual drop. And so that's where I think like serial testing, if you have it is probably the best thing. Like if I don't have a son, but if I had a son, I would get his testosterone at 16. I wouldn't let him see it. I would black

them out to the data. I would get his testosterone at 16, 17, 18, 19, 20, just so he had that value. Um, and then you could, you could test it. And then your, your range of statistical significance on the individual level is probably around 150 nanograms per deciliter. So if he dropped by 150 to 200 nanograms per deciliter, I'd be like, Oh, what's going on? Do you get hit in the head? Uh, are you, are you shredded to the gills? Uh, what the gills? What's your energy availability like? Did you blow a vein in your testicle out on your last deadlift, which is called a varicocele? Oh, Dan, that's a real thing.

Wow, I thought you were kidding. No, yeah. In our population, this is what – we talked about this a bunch and freaked people out on the Iron Culture podcast. Varicoceles are probably the most prevalent reason for low testosterone in athletes. Wait, how do you know it happens? Like, oh, my God. So it's an enlarged – so if we're just thinking about probability rates, like what is the, if you're under 40 or under 50 and listening to this podcast, what is the most likely thing that could cause you to have lower testosterone and you lift? Because we're creating pressure always down there. It is that, and that's easily like by probably a urologist um and so that and then if you if

that's repaired you generally get that 100 to 200 nanogram bump in testosterone um so that's that's one of the ways that we can potentially test um whether physiologic ranges of testosterone could potentially lead to more of the things that people on listen to this call want like hypertrophy and strength. Right. What does the research say about, about TBIs and head injuries and testosterone? Like I know many of us played football, like a five MMA boxing,

kickboxing, all that stuff. We've all been hit in the head plenty of times, I would assume. What does the research say on all that? Yeah. I mean, I've had three hospitalized concussions before the eighth grade,

like all playing backyard football. No way. Got my bell rung. Playing backyard football. Are you serious? Bad. Like ran into a light pole, bro. Like dove, caught the ball, dove, caught the ball in a parking lot,

hit a light pole, had a goose egg like this bad, dripped into my eye, didn't even know where i was just woke up holding the ball um run it back run it back that's how you play i just remember playing. Like, that was my age, man. We played football. Like, you had to jump over the lawnmower.

Like, it was crazy, dude. Same. Same. And we do have some. So, Doug, to answer your question, moderate to severe TBIs, 100%. Knockout within 10 days. 100%. Does transient. That's transient.

Looks to be like 40 to 50%, 44 to be, if you look at prospective research, would be offline, potentially. It's called persistent hypogonadalism from, but moderate to severe. Remember, we're talking about like falling off a bridge here, probably like pretty bad car accident. If you're talking about getting,

like, so that's bad. Like that's bad. Like that's, that's bad. Um, but you probably got a lot of other stuff. If you get hit that hard in the head going on. Um, this is like,

this is, this is a brain specific thing. Like a pituitary thing. Like you're like, you're a luteinizing hormone goes down. So your testosterone goes down that type of thing. Or am I off base? No,

that's exactly what you're talking about. Like, well, you also have a lot of, uh, inflammation running around whenever that happens. Um, but yeah, you can have direct, like your pituitary stocks right here, you get, you get knocked right there in the front of the head. You can definitely get pituitary damage. So yeah, GnRH, you got it, you got into luteinizing hormone and kind of how we would diagnose

as a, as a medical community, secondary versus primary hypogonadalism, primary being like your testicles don't work, the factory, that's probably very low. That's probably like 2% to 3% of people versus secondary, which is a problem with the brain, signaling-based mechanism. To answer your question about bell rung, we have a really good study in the JAMA Neurology, which looked at a big sample size,

3,500, around 3,500 pro football players, former pro football players. And the percentage of low testosterone was only 18%, which goes against my bias, to be completely honest. If you would have asked me, what would that be? Think about it. You have high BMIs, because a lot of those guys are overweight or obese now um so you got and it was only 18 there was a it did look like there was kind of a linear relationship between how many times like self-reported loss of consciousness and low testosterone um so i i think that is a

population so it definitely tempered me and that if you were, if you did get your bell rung, I don't think it's automatic. Um, I, and that's, that's pretty cool. Uh, these mild concussions and I, we got Andy on, so this is probably a huge issue in the MMA. I actually, does the age at which you get your bell rung – because I can remember the very first time I got hit so hard that I had no idea where I was playing ice hockey. And does that age in which you have your first concussion, especially if that's pre-puberty, does that make a difference in the ramp that you're on for the rest of your life, maybe not the rest of your life, but getting through puberty and testosterone production. If there's a, there's a time, like, so there, if there's a time where testosterone is really, really important for dudes, it is that, you know, but that isn't the, like you talk, we have, there's other times where

testosterone is really important. Like we haven't, we have testosterone goes up to puberty levels inter, inter utero too so like if you miss any of those big testosterone spikes let's not use the word that you're screwed because that's automatically like very gender specific for wanting to be a male um like but there you are probably those are very important for male characteristics let's just let's just put it that way. For instance, there's individuals who have, this is a good way to talk about this, 5-alpha reductase is the enzyme that converts testosterone. It is a big deal in Olympics right now. So that's why Andy's nodding his head. So 5-alpha reductase is the enzyme that goes from testosterone to dhd and so if you are insensitive to if you if

that enzyme doesn't work you miss inter utero effects so you essentially look like a female but you have x y chromosomes and and then you hit puberty and then and this is there's actually fairly large but there's actually fairly large, but there's not, I don't want to say large populations, but it's not as low prevalence as people think it is. And then you would get, then you would start to show some male characteristics and in that pubertal range. So there's, there's a lot. Yeah. There's a lot of, yeah, go ahead.

I'm sure you're familiar with the, the, the Dolce huevos story, the classic one you can uh you can elaborate on that one here if you want i'm sure you guys have probably come across it as well yeah remind me what is that i don't know the basic the quick version is we're all female this is i'm gonna abuse this a little bit but we're all female in utero and then if you have enough testosterone it'll kill off the female genitalia and develop the male genitalia, right? So I grossly made that wrong, but it's getting to the point, okay? So to Ben's comment here, if you have testosterone and you need it to get into the active form of

DHT in these areas, that requires 5-alpha reductase. So folks that either don't have it or are insensitive to it have a genetic mutation where they don't have it or use it very well. They are then born with looking like female genitalia, despite the fact that they are chromosomal male, which is what Ben just talked about. And while they call it dos e huevos, pardon my Spanish, I'm sure you could do that much better, Ben, it's 12 eggs.

So the reason I call it that is because a famous, I think, group of children in the DR were identified many, many years ago in medical literature where they're female, they look female, they're born and raised female. No one has any idea. They're not little girls and around age 12 or so, all of a sudden they start developing very clear male genitalia. And that's exactly what Ben was talking about and so um this is a whole different conversation about if you want to watch that exact thing happen watch the documentary the nine months that make you on netflix sorry go they talk about an entire section on on exactly that story go ahead yeah so point being uh separate things aside like it's not exactly the most straightforward thing

of identifying male versus female and all that, but with the testosterone focus here, it's pretty difficult to figure out what's going on. You can imagine something happening there in utero at that time,

which is that surge, which is a very important point that Ben was talking about, or even during puberty, it has real potential consequences. That's for sure. But the last thing I want to say on that is I want to make sure it's very clear. Ben said very clearly, like severe TBIs. If you got a concussion in middle school, you're fucking fine. Like everyone thinks they had a TBI. Like you almost surely did not have a TBI to the level that it is chronically crushing your testosterone.

That is very rare. The vast majority of you, oh, I got knocked out once. It's not why you have low T. You probably don't have low T, but like, like that doesn't. So, cause we hear this all the time. It's like, oh yeah, I got knocked out one time in soccer when I was 14. Like, yeah, you're fine. Like, you're almost surely fine. So the rate of these things are car crashes. These are, like, massive. If you have persistent TBI that happened 15 years ago, almost surely you're going to know that.

Like, oh, I can't concentrate. I'm sleepy. Okay, you're 40, and you work two jobs. Yeah. That's because you're tired. We have to temper that quite a bit. I swear to God, everyone I talked to who's past age 20 was like, oh, TBI.. That's because you're tired. We have to temper that quite a bit. I swear to God, everyone I talked to

who's past age 20 was like, oh, I have a TBI. Like, no you didn't. It's called a concussion and you're fine.

Yes. Yeah. I worked with TBI. You know when someone's TBI. My God, like the things that change in your body is crazy. It's a very different experience.

Isn't it sometimes a TBI can actually go the opposite way and get an influx of testosterone? The people I worked with, the group, there was a few of them who were overly active, if you know what I mean.

They were sexual demons. It was crazy. I don't know if Ben stops on that, but I would assume that's probably not because they get a jack up in testosterone. There's probably other things at play. Who knows? You're talking about probably a very risk, not averse population.

And so I think that's, in general, that's generally what you see with anabolic steroid users. If you had to pick them out of a crowd, they're probably those people who are not very risk averse. So if you put that individual into other settings again they're probably more likely to do drugs more likely to do other things um and so like yeah you you combine hyper levels of super physiological testosterone with cocaine and other things and you're potentially that's the problem we need that proprietary blend

get it on the market uh you mentioned you mentionedalpha reductase and DHT. More relevant to people in their 30s, 40s, 50s that are doing hormone replacement therapy, testosterone therapy. If your 5-alpha reductase gets too high and your DHT gets too high, you get hair loss, right? And then is there a way to kind of buffer that for people that don't want to lose their hair? So this is one of my big qualms with TRT, um, to be honest, is that it's normally turns into polypharmacy, um, because you get on TRT, it's, it's kind of going well, but then you, like you think about the number one side effect that people complain about. It's acne. So then you're probably on Accutane or something like, or, or you're on for nest of mine. Uh, so in for nest of mine is a five alpha reductase blocker. And for nest of mine, actually, if you look at the control literature, it does not augment hypertrophy responses or strength responses.

So that's kind of, that throws a ball in this DHT is the number one, whatever. This is the game Rogaine played right for hair loss. This is Rogaine. And so I do think that TRT, like, the number one reasons people stop are not, like, heart attacks. It's increasing male pattern baldness. It freaks people out.

They're like, dude, I'm out. Or it's cystic acne that sucks. Like, you take TRT to take your shirt off, and then you got, like, things on your back that everybody wants to pop it's gross it's gonna be really gross do you know if it's true like the story that was always

kicked around is that effectively Viagra was developed as a countermeasure for testosterone because of the effects I don't know so that's what people always talk about is like you're gonna have these issues right of taking different forms of testosterone so the byproducts being hair and then ed and so uh the the the rumor and story is always that viagra was type developed primarily as a solution to counteract because they're gonna

they knew they're gonna have to stack yeah they knew they were causing this problem so they're gonna have to stack something back on top of it so i don't know if those are true we got 70 testosterone drugs right now like there's so many derivatives that are all about doing that like finding like so we talk about anabolic versus androgenic effects and some of them are even like antivirus fda approved So is an androlone. Yeah. For HIV, for muscle wasting. Yeah. And so I think like if we, if we think about the anabolic and androgenic effects,

androgenic effects being the things that, that Doug was talking about, the bad stuff. Like hair loss. Also something else is prostate growth. So that's an androgenic effect. And that's actually how we, like, if you look at how they measure androgenic effects, it's in, it's generally in rats and it's, it's a ratio of the different muscles that in specifically in the related to our,

in the genitalia, um, prostate versus another muscle. Um, I think the chromaster and so they look at the gains in those to get an androgenic to anabolic ratio of how much it's going to be influenced those male sex characteristics which you actually kind of don't want if you're chasing the performance enhancing effects of testosterone which is why we have SARMs um yeah it it's selective. So now you have, now you got a lot of people just taking SARMs out of their garage, which to me is... Sounds like CrossFit.

Yeah, it does sound like CrossFit. Yeah, you had multiple people get busted for SARMs. So they're all on it at this point. It's so hard to test for and it works. It's like me and my crew now all this point. It's so hard to test for and it works. That's an arms race. So like the arms race.

And I think that's why we hold blood in Olympic sports now. Cause you're going to, maybe you want to win right now, but four years from now, eight years from now, the testing is probably going to catch up and you're going to get got. Yeah. But I, I do think that this research is really, really cool, but I would, I would caution people like, okay, we have one eight week study in HIV patients. Are you willing to take that stuff for 12 years? Like, are you willing to like,

that's not the same thing. So yeah, it didn't have side effects in that population in 12 weeks. Are you willing? And some people are like, okay, yeah, no problem. I'm ready to roll. I'm not. Like, I'm a little bit more tempered. They won't take a vaccine, but damn, I'm taking some SARMs. It's never had any testing going on.

Anyway, I just made this super political. My bad. So I have I just made this super political. My bad. So I have a question on this realm then. I'm sure you've experienced the same thing, right? A huge percentage of people that come to you are self-diagnosed with low testosterone,

right? And they want to get something. They want to figure out if they actually are or whatever. And you've talked earlier in the conversation about hey like probably not a single blood draw is very effective for a variety of reasons um and then you talked about the fact the effectiveness of testosterone is because of things like you also have to consider receptor sensitivity and whole codes of these things so even if you got a blood draw every day for seven weeks,

you still wouldn't necessarily even know if that's exactly why you're feeling what you're feeling, right? Because typically they come in with symptomology and they're associating it with theirs. So what they really want to correct is the symptomology, hopefully, right? They want to feel better, stronger, have better erections, all this stuff. So the question then becomes like, if that's not the best way, where is it?

How do you guide someone? They say, okay, like, I think I may have this issue. Or maybe I don't. I want to just make sure I don't. Like testing-wise, best starting place, best place to go. Like, what do you go after with diagnostics? Or do you just tell them, hey, we're just going to go after symptomology? And down the line, we'll go for testing on testosterone if we need to.

Well, I would counter that, Andy, with, I think what that person is probably feeling if they're training is functional overreaching. I would say like, do they even know their testosterone value? Right? Because if we think about the, I feel like shit, I'm not adapting to training. If it's feel like shit-itis and if we think about the really definition of overtraining is you're not adapting with an increase in demands and you don't have a motivation to train. So if that's not there, then the first thing I'm going to is not testosterone. I'm going to go to a lot of other things,

like what's your sleep quality? What's your overall, are you too shredded? That I think that's one of the, one of the big things like, what's your energy availability like? Um, and that means the actual amount of calories you have to keep the lights on. Um, and this is super prevalent in endurance sports, super prevalent in mixed martial arts, any, anything where there's a weight component, um, people are just kind of living too shredded and CrossFit too, probably very, very prevalent in CrossFit. Um, especially now with having to like compete all year round. Um, and so that, those would be the first things that I would look at. Um, and this is kind of the big conundrum, right? Because the medical community is not, they have in general,

there's always exceptions to the rule, but the medical community does not know these things. They are not, and this is to their benefit, this is only kind of 10 years old that we've kind of figured out that dieting to an extreme degree can lower your testosterone. I mean, we're talking low. Like we have bodybuilder case study, 9% body fat on a Dexa eating in a deficit dropped under 300 a week before stage 128 nanograms per deciliter, uh, Active thyroid hormone, half of what it normally is. So this dude, if you know values, his total T3 went to sub 50, which is wild. Like normal's probably above 90.

Standard reference range is above 70. So this dude's TRT is – this dude's thyroid is knocked out, testosterone is knocked out, and he subsequently still lost 20 pounds of adipose tissue and maintained all of his muscle. So if you think this is one of the – if you think that thyroid hormone and testosterone are causing you to not be able to do something, I would heavily, heavily temper that. Those values self-corrected as you got away from the competition and put back body fat? 100%.

Here's the crazy part. Here's the craziest part about it. 9% dieting, testosterone and thyroid crushed. 9% body fat gaining weight, thyroid 120. It's not just body fat gaining weight thyroid 120 it's not just body fat percentage it's active energy gotcha so if your calories are super low it can crush your hormones just regardless of body fat percentage if your calories are are in a surplus then you're back to normal so to speak yeah and this. And generally, we think this happens faster in males than females. And we've seen the exact same thing almost with a 280-plus pound heavyweight.

Nowhere, like you're talking probably 30-plus percent? Yep. 100% like consistent, constant, low-calorie dieting. Right? Energy goes up. everything gets corrected. This is a huge deal right now because a lot of the things that we think about from, so we've all heard about the side effects of weight loss, low thyroid output, high ghrelin, low leptin, um, hyperphagia appetite goes up. There's a huge debate now. Um, Martin's at all. Y'all, y'all, you can, you can, it's, it's, it's in the published literature.

Um, people are debating these and saying that all of those findings are predicated on two things, people losing large amounts of muscle from dieting and not effectively getting them back up to energy balance. So these people are living in low energy states and they're not actually able to get up to maintenance calories. And so there's a huge push now for maintaining muscle mass and weight loss because it looks like the body does defend our muscle mass to some degree. And then getting people back up to energy balance is really, really, really important. So for athletes, that's my first thing that I would do is how much food can you eat and stay weight stable? And that is very, very scary for a lot of people who associate their identity with their six pack

because of early phase weight shifts. And this is the craziest part about it because Andy's smiling because he knows what I'm talking about. You can gain eight to 10 pounds of fluid just by going into an excess of calories. your scale weight, and it's completely, if you don't see the word huge in the literature very much, but here you see huge inter-individual differences and fluid dynamics from going from a caloric deficit from, these are 50% underfeeding generally to 50% overfeeding. And their fat mass is actually very linear. The amount of fat mass they lose and gain is very linear, but the amount of noise in that lean body mass is absolutely nuts. So somebody could be living in a, in a slight caloric deficit,

maybe not even, and they're, and then they go into an excess, they go into a slight surplus and they gain 10, maybe like five to 10 pounds of fluid and they, and they freak out. Yeah. Yeah. This is, if you really know what you're doing and you can pay attention to this, this is what can make a fighter like easily go up and down 20 pounds in a

week, go up and down like 10 pounds and feel horrible. 10 pounds can be very, very, very hard or 2025 can be like, that wasn't that bad. And you're like, what? And if you can figure this thing out, if you really know what you're doing, it's not just about like all the weight cutting tricks. It's about this stuff too. It's like, if you can figure out how they work on this side, the body will just do everything for you.

If you don't, it goes the opposite direction. Andy, do you know any fighters that have ever tried to kind of hit their weight, their, their ideal kind of fight weight that they would cut from like three weeks out that way they can be, or maybe in a little bit below it that way they can be in a caloric surplus for like the three weeks leading up to the fight. That would be a bit aggressive. Um, but you want to, you want to do that exact on a smaller scale. So in other words, if you come limp, let's say Monday of fight week on a Friday weigh-in, if you come limping into Monday already at a caloric deficit, problems happen. But if you can come in on a little bit of a rise or a pretty good amount of rise, the whole thing changes.

So you can't do it three weeks out, but you can certainly do it like five days preceding that Monday. So if you go like basically overshoot it a little bit, a couple of weeks out and then run into fight week coming up in calories, it can be a big, big change, but there's a lot of things you have to do correctly for that. But yeah, they're going to gain the fluid weight,

but then they're going to sauna that out anyway oh they're going to have to sauna it if you do it right they'll have to sound some but most of that won't actually it'll just auto correct so once you then drop the calories last couple of days they'll just dump all that water Ben's talking about they'll just they'll just kill five to eight of water without touching the sauna or bath and And all of a sudden they'll start waking up three pounds lighter, three pounds lighter, three pounds lighter. And you're like,

what the, and you haven't even really dropped that many calories yet. So yeah, there's lots of tricks if you really know what you're doing. Like how much weight are you sitting in a bath with rubbing alcohol all day? Like that's, that's just the idiot way to do it. How much are your fighters losing on average?

8% 8% of their body weight. Yeah. It's just the idiot way to do it. How much are your fighters losing on average? How much weight? 8%. 8% of their body weight? Yeah. And what are they fighting at? 10% higher. 10% higher. Then they weighed in or 10% higher than normal? Then they weighed in.

So they're netting too. 10 to 12 is a very good number. 24 hours post, yeah. It doesn't scale perfectly across the board. What would you think about a weightlifter? Do you think that is that too much? You can't do those numbers because you've got 22 less hours. Yeah.

And in our case, the main event guys, we've got 30 to 35 hours. Oh, yeah. So you're talking about like power. Okay. Yeah. It's not even the same thing. Yeah. I would lose 10 kilos easily in a week when i was powerless so yeah yeah um yo fellas what in your mind what's the difference between doing like a test at lab core or wherever else versus like an at-home testing kit

i don't know the i don't know the accuracy of those in-home testing kits. I know the accuracy of quest and lab core. Uh, so in 2005, uh, so pre 2005 they used immunoassays and those could have a 10 to 30% variation on the draw. Like that's insane. Yeah. Uh, now they use mass spec, with high liquid performance chromatic yeah there you go uh uh yep and then so they use that and that has a they have to be under they have to be under 6.4 percent um so it's pretty good now from a lab but i will say this so your your average pool like most people can think of like like i live in north carolina we

got a lot of above ground pools like let's just be honest there's just some like there's some like so your average five thousand five thousand gallon above ground pool um most people can see that right you're you're talking about legitimately um like i don't feel like i've ever heard like a like a hyper local north carolina joke that was awesome it landed hard right here for my newly minted north carolina self on the above ground pool joke. So I'm back calculated. I'm back. So in that above ground pool with 5,000 gallons of water, I just want to put this, put this in perspective for people.

Point one, a 10th of a Cheerio. You would dissolve that in that pool and you would go find it with science. That's what we're doing. Like legitimately that serum testosterone, that serum testosterone, which is at like whatever, 400, 500 nanograms per deciliter, which is 10 to the negative ninth nanograms per deciliter. That was a beautiful analogy. Estrogen, estrogen 0.0005 grams in that 5,000 gallon swimming pool. Go find that shit with science. Like, it's insane.

It's insane. So, like, a regular estradiol value, like, I got no faith in. Like, I'm just going to tell you, like, I don't care. Like, you show me your irregular estradiol value went up by 20. I'm like, Ooh, I got no idea what that's doing. Um, so, but that, and, and people who know what they are doing, know this, they know that free testosterone, they know that they, these values have gotten better, but they still have air. So my faith in that at-home test, probably going to be pretty low unless they can show me that they have really good precision and then really good accuracy to those other values.

Yeah. I'd say even my trust in a lab core blood draw, like it's, it's only like for so many layers, the accuracy of the actual measurement being much better. Okay, fine. But then at the beginning of the talk, like we still have the diurnal variations.

We still have the day-to-day. We still have influence of acute stress, sleep. Like all these things are going to play small. Like they're not going to jack your numbers up that much, but they're going to move it, right? The diurnal for sure will jack it up, depending on the time of day. 30% potentially within 30 minutes of waking. No question, right? All over the place. going to move it right the diurnal for sure will jack it up depending on the time of day 30 percent

potentially within 30 minutes of waking no question right all over the place um independent of that now we have the conversation of well is even free testosterone this example the right metric and we know the answer is no it's not right so like if the broader conversation is stemming back to the real purpose right of like why are people even interested in testosterone? Because they have this perception that it does A, B, C, D. Okay, fine. I just don't know how one could be that fixated on that particular number, given all the limitations, if we're trying to solve that problem we talked about before. So I think you have to take a broader, and I don't know exactly what Ben does in his practice, but I guarantee I know, right? Without knowing anything, I know, right? Which is that you're going to have

to take the actual physical assessment of the metric, but you're going to have to combine that with symptomology, with questionnaire, with other things, right? And you have to have somebody who really has done a lot of this or spent time thinking critically about the literature, thinking critically about the individuals they've been around about their training their schooling to really help you understand what you need to do direction right so like is trt the answer potentially maybe in some cases i'm with ben i don't have a problem with it but i think the vast majority of people have been around it's like do you have a mechanical problem is there something physically wrong like a pituitary probably not do you have to simply a lifestyle issue if so like the

correction of the lifestyle is going to auto correct he just talked about it could be energy auto correct could be sleep auto corrects like all these things will auto correct you don't need to go to the exogenous testosterone now because what are you trying to solve are you trying to solve the sensations the feelings you're having are you trying to solve the testosterone well if you're solving for testosterone you're going after the wrong part of the equation almost sure right like if you take some tea are you going to feel better yeah you know i solved my problem that was my root cause probably not like really strongly probably not so a longer-winded answer depends on even something like a home testosterone kit. You buy it, whatever, and it comes in.

You spent $80 on it. I just don't know if you tell me that. I don't think you should do it. I don't think anyone should do that. Okay, more than me. Yes. The literature says that we should not do that. We should not cast that net out because you're going to get fish. And then

those you're, you don't, they're not going to know what to do. And so my, my big, this, I have a, I'm going to speak really bluntly. I have a huge problem with this shit because it's all over Instagram because they can't direct market. They can't direct market TRT. So what are they direct market? The testing. So they're, you're going to come back low and they're like, oh, well, here I got a solution for you. And the Endocrine Society says bluntly, testosterone should never be used as a first line therapy. It should not be the first thing we do. So that was actually a question that I wanted to ask is, is there any benefit to taking it in a low dose as like a simple like ramp up to get started? Or is that the exact opposite process? Because I know people that

have the problem, they feel like it, they go, I'll just get a nice little dose so that I feel better. Yeah, I feel like Shane Andrews. So I'm going to start off with a little bit of pump of cocaine. That'll fix my problems. I don't have energy. I don't think it's the right way, but I'm wondering if there is any – I would never recommend somebody to do that, but is that train of thought completely off? Because you're going to go to the tea store, and they're going to be like,

oh, well, if we just get you a little bit of energy, we can start burning fat faster. We can start feeling better. You're going to have better workouts. And all of a sudden, they're fixing the problem in a way which should be something way down the road. I'll dance with you. I'll fuck it. I'll dance with you.

I'm not the first person that's like presented this to you of like, what if I just take like a little hit to get this thing started? Yeah. In the hypogonadal range, if someone is diagnosably hypogonadal, absolutely. Absolutely. You will get big hits in muscle. You will get big hits in actual, we're talking about percentage changes in hemoglobin A1c, like 1.5%. If someone is actually diagnosably hypogonadal, then TRT is the right choice, generally. But they've had to gone through a gamut of testing where you know that it is functional, where you know that it is actually diagnosable hypogonadalism. That's the big key. Now, could you use it in another way? Could you just say, okay, I'm going to honor that there are some risks here and I'm going to start TRT and I'm going to just use it as like a stopgap?

My caution there would be like, this could be a stopgap that you need forever. Like this is not creatine. This is, you are shutting down your own endogenous production of testosterone, taking that away. Cold turkey looks like you're adding very much increased risk of depression and even suicidal idolations. So like just dropping off cold turkey from testosterone is generally a really, really bad idea that needs to be handled by somebody. And so you're playing with a little bit of fire that I don't think people know about. And that's my biggest flaw. If there's informed consent there, testosterone is one of the only things, even at TRT dosages in hypogonadal males, independently causes body recomposition.

So you gain muscle, lose fat. I'm not aware of many other pharmacological things. I don't know of any other pharmacological things. I don't know of any other pharmacological things that do that. That sounds good to 100% of the people. That's one of the problems, but it's an over-promise. I'll be completely honest. It's an over-promise because you might gain five pounds of muscle. Normal TRT doses, and you go on metal meals, you don't lose fat. You gain about three to five pounds of muscle. And these are people who aren't training. And a lot of that is probably fluid. Um, so what I like to temper is

like, you're not going to turn into Arnold because a lot of people think they're going to take TRT and they're going to boom, I'm going to be, you know, whatever, die hard. Um, and so like, that's a, that's a misconception in a narrative that I think we can do a better job of, of, of explaining. Um, but, but I do think that I don't want to be negative on TRT at all, because I think in the, in the right, in the right settings, I think that can be really, really, really, really powerful. Um, and this stuff does exist. Like we're talking about 20 ish. It all depends on your diagnostic criteria, but probably five to 25% of the population is suffering from lower testosterone values, which would be diagnosable. is that living with obesity or living being, I don't want to use the word being because that infers a permanence,

but having too much adipose tissue on your frame, losing that adipose tissue, if you look at the bariatric surgery research, the people who lose the most amount of adipose tissue gain the most amount of testosterone, sometimes in the 200 nanogram per deciliter range here's the here's the kicker though weight loss maintenance seems to be very very difficult and so that's where can can you maintain that weight loss long term and does it does it lead to a progressively more testosterone fantastic you just you just hit the lottery. But there's going to be a

lot of people where that might not be the case. And this is a very new world problem. Yeah. I think another piece, and I'm glad you said new world problem because this is because of all things internet, whether it's social media articles, typing into Google low testosterone and 4 billion things show up. The idea that we're all supposed to, or that we could get to this place where we're like 1500 is our number. And then you go and get tested and it's like, oh, you're like 550. And you go, well, shit, I'm leaving like a third of my productivity on the table. I'm only a third as manly as I should be. Like when I got mine tested, I have another one that we're doing with Andy right now. Like I

can't wait to see the numbers. But when I got my T tested the last time I came back, it was like 580. You go, it's like, yeah, you go, oh shit. I'm like slightly above normal. Cool. Great. But average is such a thing that we don't associate like we're all in this giant thing and we all are probably within 500 to 600. Unless you get way down to the bottom or you really are trying to be, you know, four digits and absolutely crushing this thing. There's some sort of narrative where all of this gets lost that we're all supposed to be relatively normal in the middle and you don't have to be most olympians aren't over that range man like you look at the vast majority of olympians and their testosterone are in that range um so like i think we get it like they've been done i mean you know that to be certain i'd like to. Yeah, I can send it to you after the fact.

There's definitely blips on the radar, but the overall average testosterone for Olympians, it's not like they're outside of the bell curve. So I think what you touched on, Anders, is a really big deal. Your testosterone is not your bench press number because that's what we've kind of turned it into. There's so many other factors. There's clearance. There testosterone is not your bench press number. Cause that's what we've kind of turned it into. There's tone. There's so many other factors.

There's clearance. There's angiointerceptor sensitivity. Like the most Jack dude I know has a testosterone that's never went over 500. He's like natural lie detector, drug tested, natural dude. He had, for people who know he has FMI well above 27,

which is 25 is what they think is naturally possible um which is not true we know from football literature that you can probably be natural if you're offensive defensive lineman and get up in the 30s um yeah it's it's and so um i just would really really calm that down and the reason I would calm it down is because the placebo of this stuff is so huge. It's so big. Like even you tell people like you tell elite powerlifters that that they're going to get you give them a sugar pill and you tell them it's fast. Fast acting people get stronger right away. They PR that same day. There's no way that they PR.

They're never got testosterone. Nobody ever got testosterone. Everybody fucking PRs. You take it away and they do worse than they originally did. So there's huge, there's huge placebos

around this stuff that I, that I really do want to temper. I mean, I know people who took, you know,

drugs back in the 90s and were taking lots of drugs, got a lot stronger, found out they were all fake, 100% fake. It had all been a placebo effect, 100%. When you get into just over-the-counter supplements, there are things that show up like ashwagandha is is most of that stuff just lowering inflammation lowering stress helping you sleep a little bit better and therefore shows up on test as clinically proven to help boost testosterone and and the claims are there things that people can take that you know they don't have

to go as far as going to a clinic or is is there a way that they can get kind of like so much of what i view in supplements is like that's like the fancy new driver to make you good at golf it's like i'm gonna hit the ball 10 yards farther if i take this if i buy this new 400 driver it's like yeah but your swing still sucks it's just 10 yards further into the woods we gotta align all align all these things to actually aim the club in the right direction. But is there a way that we can get people to take some sort of supplement or what supplements can they take to aim the club in a better direction so that maybe there is some sort of increase in performance, even if it is some sort of placebo effect?

I don't know. Are there things off the counter that we can take? I mean, I'm down to use placebos. It's just who's making money on placebos? So how I would kind of explain this, there's a cool study by Vidic et al in 2021, just came out. And so what they did was they put people on a ketogenic diet and so it was 30 grams of carbs and i'm gonna it's gonna make sense why i'm kind of using this story

um and so it was ketogenic versus non-ketogenic so 30 grams about 30 26 grams of carbs versus like 80 ish grams of carbs eight week study eight week study testosterone went up serum testosterone went up 200 nanograms per deciliter 200 nanograms per deciliter statistically significant from pre to post those individuals didn't gain muscle they didn't get stronger i don't i don't think i don't think that you even getting a... So number one, here's the thing. On the individual level, I can share this. There's a BMJ calculator.

50 nanometers per deciliter, non-significant. Guarantee you that. 100 nanometers per deciliter, non-significant. 150, maybe significant. So that's the problem is like, there's no way to even know if this supplement actually significantly increased because none of them are going to do that because if they did that, they'd be illegal

in the, in the, in the, in, in the IOC. So they might, they might give you, and this is, there are, there are some supplements that potentially raise things nominally, like, like single digit percentage points and things. Maybe Maka does it, things like that. Most of them are adaptogens. potentially raise things nominally, like single digit percentage points and things. Maybe maca does it, things like that. Most of them are adaptogens. So I think you could, your hypothesis may be somewhat right. Also, we know that inflammation will directly knock down testosterone production. This is from mechanistic data of injecting people with inflammatory compounds like TNF alpha. And so if it's anti-inflammatory,

it could potentially increase testosterone. Um, and so, but we're majoring in the minors. Yeah. That's kind of the problem here is that we really are majoring in the minors and we're not focusing on those big rocks. So the problem, the problem with functional medicine is generally, you're just losing, you're using less effective things. You're using a supplement that is less effective than a pharmaceutical. Maybe it has a different side effect profile, but ultimately it's less effective. You're better off going after what is the potential cause. And if you can't find that and it's just there, this is where I see people waste a ton of time

and they just spin their wheels because maybe it is an issue. Maybe it is an issue that needs to be addressed by conventional medicine. Dr. Ben Howes, where can people find you? You can find me at broresearch.com or deconstructnutrition.com. I love your new website, by the way. Thanks, bro. Travis Mashed at MashedLeapPerformance.com. Make sure you hang out with Andy Galpin, Dr. Andy Galpin on the Instagrams. Doug Larson, tell the people. Doug C. Larson on Instagram. I'm Anders Varner at Anders Varner.

We are Barbell Shrugged at Barbell underscore Shrugged. Make sure you get over to DieselDadMentorship.com where all the busy dads are getting strong, lean, and athletic. And get over to Walmart. We are incom where all the busy dads are getting strongly in an athletic and get over to Walmart. We are in 2200 stores starting November 9th. That means you can go over to the performance nutrition section. You can find my face on three boxes in the store, in the pharmacy performance nutrition, start November 9th,

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