Mark Bell's Power Project - Mark Bell's Power Project EP. 218 Live - Dr. Lester Lee

Episode Date: June 10, 2019

Dr. Lester Lee is a physician at Lee Regenerative Medical Institute and has over 30 years of private practice in Huntington Beach, CA. He has treated world-class Olympic athletes, health and fitness professionals, and individuals dedicated to achieving their bodies' full potential with hormone replacement therapy. He did his residency in Internal Medicine at University of Southern California and is a medical educator in the field of Hormone Replacement Therapy. Find Lee Regenerative on: Facebook: http://facebook.com/leeregenerative Instagram: https://www.instagram.com/leeregenerative/?hl=en Online: https://leemedicalinstitute.com/ ➢SHOP NOW: https://markbellslingshot.com/ Enter Discount code, "POWERPROJECT" at checkout and receive 15% off all Sling Shots Find the Podcast on all platforms: ➢Subscribe Rate & Review on iTunes: https://itunes.apple.com/us/podcast/mark-bells-power-project/id1341346059?mt=2 ➢Listen on Spotify: https://open.spotify.com/show/4YQE02jPOboQrltVoAD8bp ➢Listen on Stitcher: https://www.stitcher.com/podcast/mark-bells-power-project?refid=stpr ➢Listen on Google Play: https://play.google.com/music/m/Izf6a3gudzyn66kf364qx34cctq?t=Mark_Bells_Power_Project ➢Listen on SoundCloud: https://soundcloud.com/markbellspowerproject  FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell ➢ Snapchat: marksmellybell Follow The Power Project Podcast ➢ Instagram: https://www.instagram.com/MarkBellsPowerProject Follow Nsima Inyang ➢ Instagram: https://www.instagram.com/nsimainyang/  Podcast Produced by Andrew Zaragoza ➢ Instagram: https://www.instagram.com/iamandrewz

guess my microphone's on yep microphone check one two one two i think it's all working yeah yeah we're good to go all right today we got dr lee in the house and uh we're just going to dive right into all this um i guess basically to keep it simple you're like a steroid guru in some way performance enhancing drug guru of some sort. Well, we try to optimize, let's say the, uh, hormones of men and women who are sub-therapeutic deficient and have a lot of symptoms. And, uh, I'm not sure about guru, but, uh, um, I've educated a number of physicians throughout the United States on hormone optimization in terms of the science that I do. hormone optimization in terms of the science that I do.

Yeah. And I mean, what just an interesting thing to get into. How did you kind of land in this spot? Well, I've always had a strong interest in pharmacology. Even having going through being in pharmacy school locally here, as a matter of fact, at the University of the Pacific in Stockton, where I was born and raised. But leaving pharmacy and entering medical school, I've always had a strong interest in not the internal medicine aspect, which was great, but it also gave a great foundation for sports medicine, which I did a fellowship in also. So along with the fellowship sports medicine, of course, musculoskeletal injuries are part of it, but nutrition is a very strong part of it. And aside from just the nutrition aspect,

but I always get the questions from more male than female athletes. What about anabolic agents? What about performance enhancement drugs? Which I don't necessarily condone for PED purposes, for performance enhancement, but certainly if an individual has low T, as you see the commercials, they have symptomatic of, let's say in men, andropausal symptoms. They have a lower libido, poor recovery, more belly fat, decreased cognition,

have a lower libido, poor recovery, more belly fat, decreased cognition, decreased motivation, quality of sleep, grumpy old man syndrome. A lot of that grumpy old man syndrome is not because it's age-related, but it's because their testosterone as, let's say, a hormone, one of the many hormones, is becoming more deficient. So my background, having worked with a lot of Olympic athletes, Olympic teams with USOC, I learned a lot, let's say, from my athletes too. Not necessarily that all of them were suboptimal in their hormones, but some of them were for different reasons. My interest came that I see remarkable changes in people's lives, men and women, with optimizing their hormones. In women, it's estrogen, progesterone, testosterone, DHEA, which is dihydroepiandrosterone, which is a precursor to testosterone, estrogen production in women and men.

Pregnenolone. Pregnenolone is a hormone too. It's a fatty acid made from dietary cholesterol. So pregnenolone, we consider like the mother hormone because downstream it makes other hormones, including progesterone and testosterone and estrogen and cortisol. So like with, you know, cholesterol, I'm actually hearing more people talk about it. I guess, you know, a while, like a while back years ago, people would think, cholesterol, I'm actually hearing more people talk about it. Um, I guess, you know, a while, a while back years ago, people would think dietary cholesterol, you know, too much dietary cholesterol can make your own cholesterol, uh, go up and you can have, um, some maybe, you know, bad symptoms and maybe end up with some heart disease. But now we're kind of seeing a shift where people are having some different thoughts and maybe, maybe sugar is a little

bit more of a problem and maybe cholesterol is actually pretty healthy for us. I mean, you're kind of saying that cholesterol ends up helping us with the hormones in our body. And Stan Efferding, a good friend of ours who has a diet called the Vertical Diet, he suggests having a good amount of dietary cholesterol for performance enhancement. What are some of your thoughts on that?

You know, Mark, I agree that one should not totally eliminate fat cholesterol from their diet. Again, cholesterol is important for part of our cell membranes. It helps with our mitochondria support cell membranes. So we have to have some. It's the quantity and the quality of the fats that we take in. So we're not necessarily talking about eating lard out of a can like they did back in the Atkins diet back in the 70s. And things like French fries or something like that, right? We're talking about maybe like omega-3 eggs and things like that might be better, right? Correct. It's not the trans fat. Again, it's not the French fry fat, potato chip fat, deep fried things that you find from fast food industry. It's the quality ones, like you're saying, Mark. Again, I'm a strong advocate of having adequate fats in your diet, especially if we think about the keto diet, the paleo diet. A lot of it is

having to do with quality fat, olive oil. Again, it's a fat, but it's a good quality one, or even coconut oil, almond oil. So we're not, again, talking about just go for the gusto and just eat all the fat you want, and you'll make a lot of natural hormones and you won't have to you have to worry about being deficient your hormones forever as long as you eat a can of lard every day well it's not quite like that you know i'm curious about this because when i'm back in 2015 i cut down and i got really really lean i was working with an individual and i was at a certain point during that cut he had me eating around 35 to 40 grams of fat per day and i could feel like my libido was gone. Like it literally was gone. My girlfriend there too with bodybuilding. Yeah. Yeah. The libido was totally gone. I felt totally tired. Um, and more recently I, I got lean again, but I made sure to have a much higher fats in my diet and I felt great. So in terms of men dieting, is there like a minimum number or gram of fat per individual that they

want to maybe think about having? It depends on the person, the intensity and the frequency of your training, because the average individual probably doesn't train as intensely and frequently as both of you do. So their amount of fat that they have in their diet certainly is going to be much less because they don't want to have coronary disease too. So again, I can't say specifically how many grams of fat you should have because it depends on what kind of fat you're going to be taking in too.

As an example, you're talking about what kind of fat, what kind of cholesterol. As an example, you're talking about what kind of fat, what kind of cholesterol. For women, that's a difficult one because they think about that if I eat fat, I'm trying to lose fat. It doesn't quite work that way. So if I don't eat any fat at all, then I won't get fat. Well, the fat weight doesn't come from the cholesterol. It comes from the carbs.

Because if we do a lot of cardio, we utilize that for form of energy. Stored in the liver, releases glycogen, triglycerides, fatty acids. So the difficulty explaining, let's say, to a female patient is that you have to have so many grams of fat in your system. One, because if you don't, you can't make a hormone. You can't make estrogen progesterone. You won't have normal cycles. If you don't have normal cycles, you are more likely to get osteopenia osteoporosis earlier in life. In a sense, putting yourself into early menopause. So we find in women who are long distance runners, who are in the aerobic sports, but don't get enough fat in their diet, they burn off all the fat. Their fat content of their body is so low, they don't have a normal estrogen, progesterone production, and they don't have a cycle anymore and not just that but if

you're contemplating having children well you got to have cycles yeah so for health purposes i always advocate you have to have a proportion amount of fat in your system i i can't say i give them an exact number because it's based on the intensity of their workouts and based on whether you don't work out at all. Would you say probably the number one place to start when you do have an individual that has some of their hormones off base would be with nutrition and sleep and things like that? I'm sorry, I missed the question. Yeah, well, would you kind of say like, you know, we're going to get into diving into talking about, you know, performance enhancing drugs and drugs to help manipulate your hormones. But in your opinion, do you think the best place to start might be with just like nutrition and sleep, daily habits to help change your hormones? No, I agree.

I agree, Mark. your hormones? No, I agree. I agree, Mark. A good, sound nutritional program helps you make, assuming your age is not in the 80s or 90s, an adequate amount of hormones. Exercise, strenuous exercise stimulates growth hormone production as well as testosterone production in men and women. In terms of proper sleep, very, very important. It's a critical part of any athlete who wants to optimize to the best of their ability. Let's assume we're not talking about specifically hormones optimization because they're sub-therapeutic. But those individuals who don't get adequate sleep don't make actually adequate testosterone production or growth hormone. So in a sense, if you have an abnormal circadian rhythm, if you have sleep apnea, you have

interrupted sleep, fractionated sleep, you actually have more cortisol production, higher cortisol, harder to lose weight. And you'll also be tired the next day because you haven't had adequate quality REM sleep, delta-way sleep, deep sleep. So in answer to your question, yes. As a foundation, when my staff evaluate a patient, the first thing we ask about, it's not actually even diet and exercise. We always ask that. How's your sleep?

If your sleep is fragmented, we try to find out why. So before like even prescribing, you want them to deal with these habits first. Correct. Okay. Yeah. I think a lot of, a lot of the people that I know that are trying to be as strong as possible in strongman competitions or powerlifting, even some bodybuilders, you know, they're basically kind of pumping themselves up with all these things, and especially years ago, it was a lot more reckless, and they're not thinking about the basics, you know, these things that you might think are, you know, I think people are thinking, I'm going to get on steroids, I'm going to get, you know, big and strong, and I'm going to train really, really hard.

And they're not really thinking about the sleep. They're not thinking about, you know, this day off could, this day off could set me so far forward. They're not thinking about that. They're not thinking about if I can just stack up a bunch of nights in a row or like people aren't pumped to sleep for eight hours. You know, some people really enjoy their sleep, but it's not something you get like hyped for. You know, like you might get hyped for a good training session or a good deadlift. And so I think a lot of us are thinking like intensity, intensity, intensity, and we're not thinking about how important that sleep is. And so I think that's a critical thing.

And I think a lot of people are kind of burning a candle from both ends because now if we're not getting the proper sleep and we're starting to implement testosterone and the testosterone is adding to our muscle mass, maybe even potentially adding to our sleep apnea, now we might be really fighting a lot of different things. Now we might have to take something else to kind of counteract the cortisol. True. something else to kind of counteract the cortisol. True. There are individuals I've seen in dozens, if not hundreds, in over the past decades of being in practicing that an individual didn't have sleep apnea before, decide to self-medicate above and beyond recommended doses. Let's say it's not the transdermal rub on testosterone. Usually athletes, competitive athletes, Sunday athletes, injectable. So if I tell them one thing, you only need 100, 200 milligrams per week,

a little bit good, double, triple, whatever Lee said is better. So let's do 600, 800 milligrams a week. And now they have sleep apnea. Now they have a difficulty sleeping period and they're always tired during the day. So they're equating and thinking that, you know what, I must not be using enough testosterone because I'm still tired during the day. So I'll go ahead and check even twice as much more now up to a thousand milligrams a week. I'm not exaggerating because I've had a number of patients do that,

not because they were competitors, but that's the thought process. And along with that, of course, the more you use, the more potential side effects because testosterone converts to estrogen. Estrogen makes you retain water. Then they wonder why I'm getting puffy. I'm having a harder time losing weight. I'm getting, well, gynecomastia. I'm getting acne, water retention.

My prostate is outstandingly large now. I can't pee anymore, or if I have urgency frequency, early prostatic enlargement. Again, the part I emphasize with them is that, above all else, you have to pay attention not just to your hormones or your cycle, because you can oversaturate the receptors. They're just not going to work and function as well anymore when you hit a certain level of saturation. And that applies to men and women. So I always emphasize that less is actually better.

If you improve the quality of sleep, if you improve the quality of the diet, you decrease the amount of carbs, you have better quality fats and proteins, and you have not fragmented meals and more consistent meals, you'll get better gains. Have you seen in your practice that athletes respond really well to more moderate usage of carbohydrates? Because you mentioned carbohydrates a couple times now. When we think about the Barry Sears diet, the zone diet, we think about the keto, paleo, even eat for your blood type.

The premise of a lot of that is decrease the carbs, increase the protein and the quality fats, and you'll lose weight, and you'll actually put on more lean mass too with a similar amount of intensity of workouts and frequency. Yes, I have seen more. And when an individual, man or woman, let's say a female patient comes in, one of the main things they're coming in for is not necessarily the hormones. That's part of it. It's because I gained a lot of weight over the past year or two ever since my cycles became irregular. I'm now 40, 41, 42, and I'm getting cellulite.

I'm having more fatigue. I'm having lower libido. I'm having irregular cycles, heavy cycles. My breasts are swollen. I have premenstrual migraines. I have incredible mood swings now. Just ask my partner, which they bring their partner along and they agree. They'll shake their head, yeah, yeah, yeah.

She needs hormones. That's part of it. But whatever you say, double it up. But, you know, that's not always the answer. But back to your question, you know, the carbohydrates part, when we think about it, we don't want to decrease it too much. Carbohydrates, okay, breads, pastas, let's say good quality, the yams, the potatoes, cruciferous vegetables even, they stimulate serotonin. Serotonin is a transmitter in the brain. That's how Prozac, Paxil, the mood alteration,

antidepressant, anxiety medications work. When you have a higher amount of serotonin, you have that pacifying effect, less anxiety. That's why, let's say at lunch hour, you have a big carbo meal. When you go back to work, you feel like taking a nap. Well, part of that is because you stimulate more serotonin. And serotonin stimulates more GABA, gamma-immunobutyric acid. That's how Xanax Valium tranquilizers work. You get a massive rush of GABA. It tranquilizes you. You're more mellow.

You're less anxious. And you can sleep better. But again, we don't advocate having patients, if they have insomnia, go straight to a tranquilizer. We try to adjust the diet, the carbohydrates, the transmitters in the brain with different what they call nutraceuticals that will help stimulate GABA. Melatonin, 5-hydroxytryptophan, 5-HTP, St. John's wort. Again, the common denominator here, again, is that we're making more serotonin, serotonin to melatonin. Melatonin stimulates GABA. Magnesium. Why does Epsom salt help

muscle relaxation and quality sleep? What's the active ingredient of Epsom salt? Magnesium sulfate. So you sit in a tub, it's absorbed through your skin, it relaxes your muscles because magnesium is the muscle relaxer and a vasodilator, and you have a better quality sleep because you've stimulated more GABA too. So those individuals, I always tell them, hey, you ever take an Epsom salt bath? Take one, see how you feel. Magnesium could potentially, I guess, be really good for somebody who's got some injuries. So somebody's banged up, right? Because now it's going to kind of relax the muscles a little bit, right? Yeah.

And those individuals, let's say they don't sit in a tub every day. Like guys, they don't have some salt baths in general, especially every night, women maybe. So I just have them take magnesium. And it's also not just the magnesium. It's the kind and quality of magnesium. The inexpensive one called magnesium oxide doesn't absorb as well. Usually we like magnesium glycinate, G-L-Y-C-I-N-A-T-E, threonate.

They're better absorbed. They're chelated. So they're going to work better in your system. So individuals who, again, have difficulty with sleeping, besides looking at the magnesium level, testing for it in the blood, if they take magnesium, guess what? Take the 400 or 500 milligrams at bedtime. Why? Because we're trying to stimulate inhibitory transmitters for you to sleep better. Of course, keep in mind that if you take too much magnesium, and some people are sensitive to it, it gives you diarrhea. So the active ingredient of Maalox, Mylanta, is an antacid, is what? Magnesium. So if you chug the whole bottle because you have bad indigestion,

well, the indigestion might be better, but then you'd be going to the bathroom a lot. What type of levels have you seen, you know, really help people a lot in terms of prescribing, you know, something like testosterone and not really necessarily like performance enhancing, not anything really over the top, but, you know, a lot of the men and women that listen to this show, they just want to like be in better shape, you know, so can someone go to a doctor and get, they check the hormones, hormones aren't great. They get a little stuff prescribed to them. You know, what kind of levels can really make a big difference? Because you're talking about usually a smaller amount, right?

We're going to start with a male or female patient first. Male, I guess. Okay. Let's say a male patient comes in the office. I'll give you a typical male patient. He sees the commercials, low T on television. He said, that's me. I have all those symptoms. What are the symptoms? Well, I got more belly fat. Maybe it's because I don't work out as

much. I don't train maybe at all. Maybe my diet needs improving, but I also have lower libido, lower drive. My memory is not as good. My quality of sleep is not as good i just lost that zest for life i feel like depressed sometimes too if testosterone goes low enough uh you'll have men talk about male menopause it's called andropause is the medical terminology as the counterpart to menopause for women so the andropausausal symptoms are grumpy old man syndrome, irritability, depression, mood swings, low libido. So when we check a blood test, it's not always a blood test. Sometimes we check by a saliva, but let's say for insurance purposes that most doctors would check would be a blood test. And it's a wide range depending on

what lab that they utilize. For round numbers, even numbers, I use 300 to 1,000 anagrams. Again, it's a wide range. So you see your primary care doctor. You request a testosterone level. He said, well, you're a 350. It's in the range. You're okay. So it's not your testosterone. Well, one, it's a wide range. You're on a low side of normal. I like to see between 650 and 750. Keep in mind 300 to 1,000. You don't need 1,000. You don't need 1,100. 650 is 750. Now, the more important part is how much of that baseline testosterone you were initially checked for was free bioavailable testosterone. And what's that part? That's the part that's not bound up to blood protein. Because when it's bound to blood protein, it's not available to

do its anabolic effect, recovery effect, muscle building effect, overall sense of well-being effect. So most physicians forget to check the bioavailable free testosterone. And it's a formula calculated in the computer by the lab that does that. So I've seen individuals with 550, 600, total testosterone, not bad, not bad. And then you look at the free testosterone.

Well, the free testosterone is like a 30, 40, 50. What are the normal ranges? Men feel better 120 to 200. So if you're a 30, 40, 50, your total may be okay, but the big picture that you may be missing from your primary care doctor is the free testosterone is sub-therapeutic. So there are different ways of optimizing it.

One, as we spoke about before, transdermal like Androgel, Fertesta, Axaron, those are commercial based. Insurance companies usually cover them. But a lot of men don't absorb very well. Thick skin, hairy skin. If they don't absorb very well, the next option would be, say, injectable testosterone. So just to cover the different protocols

that I go through with patients, if you want to be like a man of science, like a lot of male doctor patients of mine, well, my level's like three, 350, 400. I'm getting more, I have to take more naps. I'm only 42, 43 years old, but I'm busy. I just attributed I'm a busy doctor. Well, I also offer them,

how about if we try to stimulate your own production, which be by HCG, human chorionic endotropin. It's a product of a pregnant mare's urine. It acts like LH, which stands for luteinizing hormone, which is produced in the brain in men, stimulates the testicles, and produces testosterone. Another medication that's used for fertility in men and women is called Clomid, clomiphene citrate.

It's a tablet. It's a standard 50 milligram tablet. So I'll offer that to some male patients. What about Clomid and HCG? Or just Clomid, if you just don't like injecting with HCG. And HCG, you can administer with a small needle or even an instant syringe. And a lot of male patients say, you know what, my level went from 300, it went to 600, 700 just with HCG and or Clomid. If you're happy with that, that's all we do. I don't have them use it nonstop. We have to pulse cycle it so you don't

burn out the latic cells down below. You have to give them a chance to regenerate the testosterone. the latex cells down below. You have to give them a chance to regenerate the testosterone. The other option that has come up in a lot of offices now offer is pellet implants for men and women. Let's say in a male patient. Yeah, this kind of blows my mind. Yeah. I was excited to talk to him about this actually, because I just discovered the whole pellet thing, but please keep going. So the question comes up in my patients a lot of times, you know, I heard I can get pellets. He said, what's a pellet? I said, well, it's exactly that. It looks like a granule of a granule grain of rice and they come different strengths, 25, 50, a hundred milligrams, 200 milligrams,. Let's again talk about the men's side. And usually,

I would numb the hip area with a numbing agent, Marcane, Xylocaine. And then we would go ahead and make with a trocar, like five different little prongs, introduce the trocar underneath the skin. And behind the trocar, with the sterile tweezers, put in the little granules of grain, anywhere from 600 to 1,500 milligrams, let's say, of the pellets. And then either put just a little Band-Aid on it or one stitch, and off they go. So the idea with the pellet is it's a slow release. It'll last anywhere from three to four months.

You heard about this before on SEMA? He was telling us about it earlier. Yeah, it's crazy, right? And every time you have a pulse of blood, the pulse of blood would just be water over the pebbles in a stream, wash over the pellet, wash off some of the testosterone.

It circulates throughout your system, and you have a slow-release testosterone pellet system. So it works well for a lot of men and male and female patients. For some, they don't like the pellets because it's either one, let's say a male patient, it's not enough. I still need, I want more. Well, then added cost comes in because it's not inexpensive. They're $600 to $800 to insert the pellets versus injectable.

It's once a week, bottle of testosterone, 10 CCs lasted 10 weeks on an average to 12 weeks. It's like $80, $85 compared to paying somebody $800 for the pellets. But again, the convenience is it's in there for three to four months and you only do it maybe three times a year.

You know, when you're talking about how literally blood rushes over it and just, you know, it has a steady stream. How about an individual's extremely active cardiovascularly, right? And they have moments in their days where, you know, their heart is pumping much more blood. Does that mean that the pellet would last a shorter amount of time, or does that really matter? That's a good question because a lot of these patients are athletes. They do cardio. They want to get that rate up 75%, 80%, 85% above the maximal.

So the question is, one, will they get a lot more that they didn't want to have by having increased heart rate, therefore a greater amount of flow of water over the granules, over the pebbles. And two, if it's washing it off, it's only going to last you a month instead of three or four months. The science is such that it's regulated how much you can wash off in a day's time, you can wash off in a day's time because the pellets are like a slow-release pellet that it's not as much based on the amount of quantity of flow as much as just it's programmed to release up to three, four months' worth. But I think it's a good observation that I do notice this in my intense training athletic male patients. They do seem to, four to six weeks, the pellet doesn't last three or four months.

It lasts them two to two and a half months. So I think a great observation. My thought is, as much as the manufacturers who are trying to sell you these pellets, oh, that doesn't matter. My thought is, I as the manufacturers who are trying to sell you these pellets, oh, that doesn't matter. My thought is I think it does matter because if you have somebody seven days a week who is drowning, you know, the little pebbles with water, I don't think the pellets are going to last as long. Yeah. So with the average individual though, who let's say doesn't train that intensively, three to four months is usual customary. And are all of the pellets, are they all bioidentical? Or is that just a type of prescription? Well, one, they are prescriptive. They are made from a compounding pharmacy.

They're usually soy-based, which is natural. That's why they call them bioidentical, because it's similar to your own production from your own testicles and women, their own ovaries. It's more natural in a sense that it's plant-based. Therefore, the argument or the, for those who promote pellet, it's more natural. And it's easier on the liver, less likely to cause any kind of liver enzyme

elevations, less likely to upset the lipid picture of driving up your bad fats LDL and driving down your HDL, which we can see in high dose, potentially long-term usage of injectable testosterone because this is synthetic. Testosterone, cyprpanate, nanthate, and propionate are synthetic. They're not from natural cactus juice or from a soy-based or plant-based or yams. So then in theory, the body should accept the pellets better than a synthetic injectable. They should, unless you're hypersensitive or allergic to soy. And there are people who are hypersensitive or allergic to soy, which we do testing in our office too. We do a blood allergy test to determine,

to make sure that they're not to egg, which is supposed to be healthy, egg white. But there are some people who are highly reactive to egg white. They just don't know it until we test them. And then they wonder why they have achy joints, foggy memories, swelling, puffiness, abdominal problems. But I eat so healthy. I eat cruciferous vegetables. I eat kale, eat ginger, soy, egg white, not even the egg yolk because that's where all the fat is.

And then we do a blood test on them with a specialty lab that says, guess what? Everything you love, you eat. It's in the red column. You're highly reactive. You have to eliminate all the healthy things you're eating in this column. And some individuals, I've seen 30, 40 items there and they eat every 30, 40 items weekly. And you eliminate those 30, 40 items. They lose weight five, six pounds in the first week. Mental clarity is better. Skin quality is better. Aches and pains are better. Fatigue goes away, but that's kind of off the

tangent. Maybe another subject down the road. Yeah allergies yeah yeah and then so in regards to the pellets um like one of the benefits that is promoted is kind of like the steady stream of testosterone going through the through your system correct do you is that um like do you put a lot of weight in that as opposed to like the injectables where you know the test level is going to go up then drop and then it's time for another shot is there a lot more benefit to that? Or is that kind of just like hype in regards to like trying to promote the pellets? Well, that is a good argument on behalf of pellets.

I'm not opposed to pellets because you used to do thousands of them years ago. But the steady stream is an advantage. No injections. It's only every three or four months, whether it be a man or woman. More natural. It's not synthetic. It's plant-based. In terms of injectable, yes, when you inject within the first 24 hours, there's a rapid rise, whether it be sipping air or

nantate. And then it starts decreasing your system about six, seven days afterwards. arinanthate. And then it starts decreasing your system about six, seven days afterwards. But if you're a rapid metabolizer, you may find by the fifth day that you feel kind of a lull and you start craving that seventh day when you get another injection so you can kind of feel the anabolic effect, the androgenic and anabolic effect. So for those individuals who are not opposed to injections, if they're a rapid metabolizer, let's say you inject 200 milligrams a week. Instead of injecting all at once, I haven't split the dosage up. Do a half cc or 100 milligrams twice a week. You get a smoother curve.

You avoid a roller coaster. Now, those individuals who, let's say, have the pellets, they just say, can you give me twice as many pellets? In other words, I don't want just 800. I want two or 3,000 level. So I'll pay you $3,000 to just load me up full of pellets. Let's go, doc. So again, we're trying on behalf of the patient, the well-being and the health of the patient. So I don't advocate, you know what, you want a more anabolic effect, I'm not going to give you pellets unlimited. The other part I do notice that you don't quite get the great amount of anabolic effect, the free testosterone effect with the pellets

as you do with injectable. And certainly I don't- So that's why we got to do both. Yeah. And we need the cream. And I do have a number of patients, they may have a pellet in, and if they're getting ready for whatever competition, they may give themselves an additional little injection, 50, 100 milligrams for a couple of weeks to get that level higher because they have something coming up that they want. Maybe they got a honeymoon coming up or something.

I don't know. Yeah. But they're not uncommonly, someone may be on injectables. They're traveling. They don't want to carry the bottles with them, the paraphernalia because of customs on international travel. Those individuals, either one,

if they're gone for a extended period of time, I may put in some pellets. If they're gone, they live in dual residency. They live six months here, three months here, different parts of the world. Or two, if they're on injectable, I'll give them a script for a gel, a compound gel or a cream

to carry them for one or two months while they're elsewhere other than home base. How have things changed over the years? Because you've been doing this for a long time, but it seems like over the last maybe five years or so, it seems like it's a little bit more acceptable for people to go. There's commercials on TV and things like that. Were people doing this, you know, in the early nineties and eighties and stuff like that as well? Well, I've been working with hormone replacement therapy since the mid eighties. I introduced it to Orange County when it was not really heard of. And I'm talking about the injectable part, but the transdermal rub on stuff from compounding pharmacy. It was difficult, of course, at that

time to find a reliable, consistent compounding pharmacy to have a good mixture with a good base for release into the skin. It was, at that time, it was a little more taboo, I have to admit. Lee's giving everybody heart attacks, strokes, and cancers by putting them all on hormones. All his female patients, male patients who are low on estrogen, progesterone, testosterone, women, testosterone in men, growth hormone in men. You know what? He's going to give them all heart attacks and strokes and cancers. Of course, we find out now in the last 15, 20 years in the medical literature, just the opposite.

in the last 15, 20 years, in the medical literature, just the opposite. These are more healthier people with healthier metabolic profiles, healthier lipid profiles, have a greater amount of zest for life. They aren't grumpy old men and women. They actually have a lot of vitality in their 60s and 70s.

I have, I think my youngest patient on hormone replacement therapy is probably 18, and that's a female patient who just happens to have female hypogonadism. My most elderly patient, let's say on transdermal testosterone, is I believe 102. Wow. And he still is, um, he has a very young, I just call him young cause I'm older, very young 53 year old wife. And as she says, I can't keep up with him. Keep in mind he's, he's a centurion and he still likes to brag about, he can still bench 275 he can squat 380 damn i need to have him on the podcast too seriously who is this man he just beat my numbers

that's but that's uh that's definitely uh very impressive now you know taking anabolics and uh just kind of you know going off on your own and doing them and maybe not having great nutrition, not having great sleep, that's when it can cause problems, right? Correct. And in large dosages and things like that, it can have, especially cardiac, right? It can have effects on, you could really knock your cholesterol and your triglycerides and things like that out of whack quite a bit, right?

Yep. A great observation, Mark. Blood pressure as well, right? If you're going to be on hormone optimization therapy, it should be supervised not just by your regular doctor who may not have much knowledge and training in it, but somebody who has formal training. And I train a lot of physicians in my office throughout the United States, they come rotate through the office. I train them on hormones besides hormones, thyroids, adrenals, cortisol, transmitters in their brain. So it's not just hormones. But back to your question is, just because a little bit is good, you felt great,

you double, triple, it doesn't mean it's better. What will happen is you'll negate the positive effects by overdoing it. In other words, I have a headache. I took a Tylenol. I felt better. What'll happen is you'll negate the positive effects by overdoing it. In other words, I have a headache. I took a Tylenol. It felt better. So I'll take 10 Tylenols at once. Well, the difficulty is now you're rotting your liver and your kidney. So it's going to negate the positive benefits. Similarly with testosterone replacement therapy, hormone replacement therapy, do it under the supervision of a knowledgeable clinician. Again, there is a proper way of doing it, an improper way of doing it.

There's even a proper way of cycling. Most physicians don't realize that. You will develop tolerance. You develop resistance. If you do testosterone nonstop, you'll saturate the receptors. You won't get quite the same response. So I will cycle them even off their rub-ons or on their injectable. In your opinion, is it hard for, because I think that a lot of people think, I have a

lot of friends that would probably be, you know, very interested in trying something out, but I think they're kind of scared. They don't know where to go. They're not sure, you know, how does somebody like kind of get this whole process going and are there pretty good physicians out there or what's your opinion? Um, how would you find a good physician besides myself? Okay. Um, they do have a number throughout the United States. Um, I've trained a lot of them. That's why I know they're from throughout the United States. I'm not quite sure how you would find, other than call the office, does the doctor train

through the American Academy of Anti-Aging Medicine as he has special training in hormone replacement therapy, other than the fact that he himself saw it on TV and he's going to prescribe the usual commercial brand stuff. The other part that I let doctors know, or I shouldn't say I let them know, but for those who come through my office, that there are pros and cons, okay? If you don't monitor them correctly, if you're just going to dabble, don't do it. You do more harm than good. You can potentiate, back to your question mark, coronary disease, okay? If you don't dose them correctly, if you overdose them, it will drive down the HDL good

fats and drive up the LDL bad fats. So if you optimize it and they're low, let's say your level is 100, 200, that's pretty low. Keep in mind 300 to 1,000 is normal. Those individuals are more likely to have coronary disease, more likely to have heart failure because keep in mind the heart is a muscle, it's a striated muscle. So it has anabolic receptors also on it. If you optimize the hormones, again, not abusive pharmacologic levels,

the heart is stronger. When you train, it gets stronger, more effectively and efficiently. As far as the coronary arteries, the coronary arteries get plugged up if you, let's say, overdo testosterone. It's not just the testosterone. It's the stacking that athletes sometimes do. And these are, let's say, the counterfeits, the ones that come from other countries. They're not U.S. drugs. And they'll

stack it with this, this, this, this, this, this, and this. Yes, they will have more propensity for coronary disease. And one of the number one killers of, let's say, bodybuilders who go for the gusto, it's not necessarily the coronary disease. It's what they call polycythemia, too high a blood count, because testosterone and... It's mainly red blood cell count, right? Yeah. It's the red blood cell count, the hemoglobin matricrate. It's part of blood cell count, right? Yeah. It's the red blood cell count,

the hemoglobin matriculate, it's part of your CBC, complete blood count. So the red blood cell count will go up really high. It's great for more oxygen carrying capacity, but it gets too high. What'll happen is it thickens the blood like Pennzoil. You're prone to clotting events, heart attacks and strokes and abnormal rhythms.

So what'll happen is athlete looks great, working out hard, just drops dead because they precipitated a severe abnormal rhythm from sluggish blood causing the abnormal blood flow. They just dropped dead. And I've seen that happen in the news. I've seen that happen recently that you hear about certain athletes. I think that's important to point out because, you know, you know, a lot of people that take them, they're just like, yeah, they're not dangerous. And, you know, and they'll, they'll, you know, wave their fist in the air. They're not dangerous, not dangerous. They're fine. You know, you can inject them and you don't feel anything right away from it and things like that. And it's,

I, I've always thought that that's reckless. It's like, no, they certainly can be. And, you know, to your point, you know, they, they can increase blood pressure. Uh, it could clog up your blood as you're, you're mentioning, uh, make the blood sluggish. And then in addition to that, some of these guys are on like stimulants, you know, some guys will take some men, some women will take, uh, things like clenbuterol and they'll take things to kind of speed things up, um, have caffeine and stuff like that. So now you've got like, one thing is racing, right? Your heart's trying to race, but you got this blood that's not moving through your body very well and could cause irregular heartbeats and all kinds of things.

Yeah. The other thing that some individuals don't watch out for, keep in mind, testosterone converts to a couple of end products of metabolism. Estrogen, DHT, dihydrotestosterone. The DHT is the anabolic effect, the recovery effect, the motivation effect, the sexual libido effect, muscle building effect, okay? Now, some individuals, men and women,

are more prone to hair thinning. That's where the hair thinning comes from with an anabolic agent. So DHT inhibits follicle hair growth. That's how propesia finasteride works when you take an anabolic agent. So DHT inhibits follicle hair growth. That's how Propecia finisteride works when you take a long-term to inhibit DHT. Of course, let's assume you're not on testosterone replacement therapy

and you're taking it for hair growth purposes. So the downside potentially is it knocks down DHT, then it knocks down DHT and knocks down your libido. So you want more hair or you want more libido. It's a kind of a trade-off. Two, if you don't control the estrogen with an estrogen blocker, okay? Water retention, puffiness, breast tenderness,

best swelling, gynecomastia, enlarged prostate. So testosterone can cause, yes, enlarged prostate. It's not the testosterone itself. It's the estradiol estrogen that is produced as a breakdown product that stimulates prostate tissue enlargement. Individuals who are on testosterone replacement, whether it's injectable, transdermal, or pellets, if they have high estrogen, when you measure it after they've had so many injections or so many months on rub-ons or so many weeks on the pellets, you look at the estrogen level, and it's skyrocketing high.

I put them on an estrogen blocker like either Arimidex or Femara. If somebody wants to be a little more natural, you can put them on DIM, di-indole methane, salt palmetto. It's like found in broccoli or something like that, right? Correct. Yeah. And cruciferous vegetables. But you can only eat so much.

Yeah, yeah. Unless you just love the stuff. You're on the toilet all day. And then even the anti-estrogens, I just want to kind of, before everyone gets all excited and goes diving into jumping on a stack haphazardly after this podcast, it's complicated. And sometimes even the anti-estrogens can cause problems as well, right? Correct. Because we need estrogen. Iens can cause problems as well, right? Correct. Because we need estrogen. I mean, even men need estrogen, right? Yeah.

Well, if you drive the estrogen down too much, cognition long-term can be impaired because we have estrogen receptors and neurons in our brain. We also need adequate estrogen for bone mineralization in men and women. for bone mineralization in men and women. So usually we think about Irimidex, Femara, for women's breast cancer, to drive the estrogen down to zero. The idea of course, is not to re-stimulate breast cancer. Again, unfortunately, when we do that, it puts them into pharmacologic menopause. They're more likely to gain weight.

They're more likely to have early pathologic fractures because of poor bone mineralization. In men, they can become more irritable because the androgenicity of estrogen helps with normal functioning of cognition, helps with the memory, helps with emotional stability. Now, if it's too high, just the opposite occurs. They become emotionally labile. Be careful there, Doc. They cry at chick flicks even when the chick's not even crying and he's crying. I do that.

We know why now you know uh having the uh estrogen get too low can that mess with the cholesterol and things like that as well or um if it if it gets too low yes there is a an adverse reaction with your cholesterol profile yes it can right dr lee there seems to be like there's so many red flags for individuals that like want to take like want to take this route. And first off, obviously, we want to make sure, you know, if we're going to a doctor, find out if they're trained by you or that, you know, company. that someone needs to pay attention to that might be red flags that the doctor says that isn't a good idea or that's maybe this is a sign that I need to get out of here and find somebody else because there doesn't seem to be much oversight with a lot of individuals that are in this practice these days. True. How would you know? Actually, you wouldn't know, but usually it's by experience. Let's say you're receiving an injectable testosterone because your level's low.

The doctor agrees it's low. Let's replace it. You have to do the correct dosage, the correct frequency interval, and when to take a break. So again, testosterone starts decreasing your system about six, seven days after the injection, unless you're a rapid metabolizer.

So your injection is not every two weeks or every four weeks. It's usually weekly. If you're a rapid metabolizer, it's probably half the amount twice a week. So the part I see patients coming in, you know, I saw my regular doctor. Then I saw another doctor. He almost once gives me a shot, one cc, 200 milligrams every month. Well, I felt great for five, six days, but you know what? By the second week, I was crashing. I felt irritable. I felt lethargic.

I started getting lower libido. I couldn't think as well at work. So again, usually you'll, just by your experience with your clinician that you're seeing, will tell you, no, this is not the right guy to see. Now, how do you find the right guy? That part I can't say because different states, different cities have different physicians who are trained. There are a fair number of them are trained

by different hormone replacement therapy societies. A great one that's been around since 1992 is the A4M, American Academy of Anti-Aging Medicine. And they can make a referral in your state. Specifically, again, a lot of our patients come from out of state. I like to see them at least once a year, good faith examination.

And most of the times we can handle that just by phone call. They tell us about the symptoms. I email and draw a slip. They go to a lab of choice. Usually it's LabCorp or Quest. They're international. And when we get the results back, email them back to them.

Then we just have a phone discussion wherever state they are regarding here are labs, where you should be. And this is the protocol I recommend. And again, it's not always hormones. Keep in mind, insulin's a hormone, thyroid's a hormone, cortisol's a hormone. So DHA's a hormone, pregnenolone's a hormone. So it's not just about estrogen, progesterone, testosterone. We look at the spectrum of it. So. Are you able to prescribe other things other than testosterone in terms of of performance enhancement? I guess maybe growth hormone may be in there, but there's a lot of other different types of anabolics, a lot of different types of steroids.

Are you able to prescribe other things? Well, not a whole lot that's commercially available. The old Anovar made by Syntex many, many decades ago. The generic of that is Oxandrolone. That's about the only one that's available that's reasonably safe, let's say. Anodrol you can find, but it's hard to find in the pharmacies, but it's much harsher on the liver and in the constitution. I usually don't recommend that to patients. I had a friend that got Anodrol from a doctor. I'm like, what kind of doctors is prescribing that? It's pretty strong, pretty powerful.

What about something like ibutamorin, a.k.a. MK-677? That's a peptide. That's compounded. So back to Mark's question, too. That's a great question, Andrew, that one of the peptides, MK-677, is a good, great, it has an anabolic effect by stimulating like a SARM, like a selective anabolic receptor modulator. So it's an oral. I like it. I prescribe it also. The difficulty very, the difficulty is there are very few pharmacies

that can compound it and make it pure and sterile. Um, I only found maybe three in the United States that can do it. The difficulty here is finding a compounding pharmacy in the United States that can ship to California because the California pharmacy board doesn't allow a lot of outside compounding pharmacies to ship stuff to California. But growth hormone-releasing peptides, we'll just call them peptides, Cermarillin, Ticamarillin, Ipamarillin, the SARMs, MK-677, PT-141, which is supposed to help with libido for women. And you can either inject it or take it orally. So those are anabolic agents, but they are not fatty acid derived. They are protein peptides. You can prescribe SARMs as well?

Yes. Didn't know that. That's interesting. So, I mean, let's take it there. What is your take on SARMs? I think they're effective for those it works on. You've seen it maybe not work that well on some? I would say my experience with the SARMs, it's not quite as effective, let's say, as something as strongly anabolic as testosterone.

let's say, as something as strongly anabolic as testosterone. For those individuals, male or female, I think they're effective. If it works for you, you want to give it a try for 30, 80 day or 90 days, by all means. What about the safety? Any safer or more damaging? I would say they're pretty safe.

Usually this arm is like a half milligram capsule. Woohoo! But of course, you tell a bodybuilder, I'm in the killer party. Half milligram, they'll take two milligrams. Of course.

Yeah. So you would cycle it though as well, just like you would anything else. Yeah. Usually with the SARMs, usually it would do like maybe four to six weeks on, maybe a month off, but you want to do it nonstop. Similarly with the peptides, I usually recommend something like six to eight weeks with the peptides, but take a month off. Anything interesting or cool that you've seen

with the peptides? I hear all kinds of people talking about how it's healed this and that, and I don't know a ton about them. What have you seen? Some great results because depending on the peptides, they have some for gut health. They have some for tissue healing. They have some for mental cognition. They have some for libido.

So it depends on the peptide. The constitution of the amino acids linked together dictates how it would be working. Excuse me. As far as with efficacy, in other words, does it work? Like anything else, it doesn't work on everybody. But I've had some great results on patients who have tried these. these. I have a patient who we tried the MK-677 because he cannot have testosterone injectable. He can't have a growth hormone. He has an autoimmune disorder. He has a demyelinating disorder like a multiple sclerosis. And he has a lot of hypersensitivities to a lot of things,

a lot of medications. So he lacks the benefit when he tried a growth hormone prescribed by his UCLA doctor, but he swelled up and had a reaction. He lacked the testosterone, even at low dose, but he swelled up, water retention, had a reaction. I said, what about peptides? So I educated him about peptides. We tried it around. He swelled up, retained water, couldn't take it. We tried Ipamiralin. He swelled up retained water, couldn't take it. He tried Ipamiralin.

He did the same thing. So he tried three different peptides. And we even tried the MK-677. Same thing. Nauseated and threw up. So yes, there are side effects. Usually they have to do with gastrointestinal intolerance. If it's an oral with some of these peptides i've been feeling great on mk677 like my digestion and everything i've had issues for a really long time and it could potentially

be just because i'm not having like any cheat meals of any kind but for the most part as soon as i started taking i started feeling way better so it it's been, if you want to call it a side effect, it's been, I haven't been- It can increase your hunger, right? Oh yeah, definitely. It raises the ghrelin big time. Ghrelin, leptin, that balance. So for those individuals who have difficulty keeping weight on, it's a great one. So I've seen great results with it. Again, it's very clear in the literature, the medical literature about the positive aspects of it. Very little negative. Usually again, if it's negative, it's a gastrointestinal problem.

We hear a lot of people say that steroids really aid in recovery. What's your kind of opinion on that? What's your take on that? And what does that even really mean? Recovery from surgery or recovery from workouts? Usually people are talking about training. Well, yes. That's why it's called an anabolic agent because it helps with tissue synthesis.

More specifically, muscle synthesis. It positively increases your anabolic effect of protein anabolism into amino acids to protein, protein to muscle, and it shortens the recovery period between workouts and intense workouts. That's why, let's say, athletes from different sport disciplines, if they can, they would go on different cycles for purposes of recovery as well as performance.

That's why they're considered PEDs, performance enhancement drugs. But I agree, they do, they are effective. Aside from that, note two, individuals undergoing surgery, fact of life, when you train intensively, you compete intensively, injuries do occur. fact of life, when you train intensively, you compete intensively, injuries do occur. If they're going to have to have surgery, there are a number of athletes who pre-op and post-op would go on, let's say, a cycle of anabolic agents. Not necessarily from me, but they find it somewhere. A lot of athletes or a lot of people will kind of point out that muscle tears are a little bit more common amongst people that use performance enhancing drugs. Have

you seen that to be the case? You know, in powerlifting, we see like a lot of pec tears and things like that. And sometimes in bodybuilding, we see some pretty big muscle tears. We don't really, from my experience, I haven't really seen that as much from the guys that are natural? Much more common among athletes who are on anabolic agents. So biceps tears, pec tears, Achilles tendon tears, depending on your sport. The idea, of course, when you're using an anabolic agent, you recover faster, you're stronger, bigger, stronger, faster, as the film said in 2008. But the difficulty here, you lose the compliance elasticity of that muscle tendon. So it recovers faster, it's stronger, but it loses, as a trade-off, compliance elasticity. It's like a rubber band. It's not as stretchy.

So if you have a fast twitch ballistic movement, it'll snap easier. And is that why you felt up in Seema's shoulders over here? And you said, I think you said mostly natural, right? That was the analysis, the official analysis. But what were you feeling, like, you know, as opposed to somebody who's maybe like on anabolics? What would be the difference in the feel of the muscle? Well, individuals, let's assume,

equally training intensity and frequency athletes in bodybuilding, as an example. Somebody on anabolic agents is going to have a much more effective, efficient, rapid development given similar genetics, similar diet, similar training regimens. But the density, the tone, the separation, the cuts are much more noticeable in somebody who's on an anabolic agent. Somebody who is not, they're going to have tone, they're going to have the bulk, but you're not going to get the same definition separation of the muscle groups. So usually I can kind of tell, especially someone

who has been on a recent cycle. Certainly when you go off cycle or post-cycle therapy, you're going to lose a little bit of that tone and that size and bulk and mass. An individual who is, back to your question, how can you tell? Well, vascularity is another one too. Individuals who are on anabolic agents, their peripheral vasculature, their vessel is the size of fingers rather than noodles or threads. Again, you can be naturally, you work out and you have very thin skin, you're going to be pretty vascular. But somebody who is, let's say, on an anabolic agent for whatever reason, okay, whether it be for optimization, performance, recovery, because they're sub-therapeutic. Mostly in my patients, you can tell when they're not on,

when they're on, they're softer when they're not on, they're not as vascular. If we're drawing blood, sometimes harder to find the vessel when they were on. It's like, God, no problem.

It's easy. I can do this blindfold and find the vessel and do a venipuncture for our testing. Are, are some of these reasons in SEMA, like reasons why you've chose to never, to never do them? Like,

because of like, uh, what he's mentioning, you know, like you're, you've chose to never, to never do them? Like, because of like, uh, what he's mentioning, you know, like you're, you're bigger and stronger when you're on them as opposed to not on them. Or have you just never really considered them for other reasons? Um, I think I was just lucky because I started training when I was young. So I kind of had the, and I didn't have social media. Like when, when I was 13, I didn't have Instagram, right? So I'm not comparing myself to individuals that are super big and are super strong. I can't when I was 13, I didn't have Instagram. Right. So I'm not comparing myself to individuals that are super big and are super strong. I can't say that if like, maybe when I, let's say I started working out when I was 21, 22. Right. Um, and I see everything that's around me,

seeing everyone around me and just seeing how, like how people get big, really, really fast. I may have done that, but I was lucky enough to start young, put in a large amount of training before I get introduced to a whole new world of lifting. Right. And I was just lucky enough to be a little bit naive, you know, so I see why a lot of individuals, especially when they start later. Right. They have the means. They have money to potentially pay for things that can allow them to get bigger a bit faster. get bigger a bit faster, I can see why they want to take that route because they can't and they can, but they don't want to put in eight or nine years of training and get to a certain point when they're 30. They'd rather just get to it maybe by the time they're 24, 25 with three years of training. So I can understand it. But my curiosity, Dr. Lee, is if someone, let's say a young man, he wants to do this. Have you ever seen cases? Because we talked about you can increase your testosterone by getting more sleep, getting better nutrition, increasing, like starting to actually work out rather than being sedentary. You know,

your hormonal levels can go up to a positive level. But let's say you're doing all these things. Have you ever seen an individual get on this? And is there ever cases where it can increase their levels and keep them increased even when they don't take this? Or do they have to continue doing this for the rest of their life? So an individual who started on hormone replacement therapy for whatever reason? Yeah. Okay. Well, when they do go off, the unfortunate part is they're going to drift back down to their chronologic natural level. Now, if you've been on testosterone, one, we don't just cut you off

when you're taking a break. We normally do a post-psychotherapy, it's called, or PCT, which consists of HCG again to stimulate your own production down below as much as possible. There's some who can and some who cannot because they just can't

because things don't work downstairs anymore. Or we put them on Clomid, which is a capsule used in men and women for fertility purposes Some who can and some who cannot because they just can't because things don't work downstairs anymore. Or we put them on Clomid, which is a capsule used in men and women for fertility purposes to stimulate in men, sperm production and testosterone, in women, estrogen. So let's assume that they went through a post-psychotherapy. They decide, you know what, I'm not going to be on this stuff anymore for about a year or for whatever reason. So you'll find those individuals will lose tone.

They'll lose the definition. They'll lose even motivation, the recovery. It's just not going to be as effective or efficient. An individual like yourself, for instance, who hasn't been on any performance enhancement medication, genetically gifted because the nature of your genetic gene type is that you have the predominance of fast switch type 2 fibers for strength ballistic sports compared to type 1 fibers for like long distance runners who can take a slow, long pace. Yours would be better for somebody who's a power lifter,

somebody who's a sprinter, 100, 200, even 400 meters, because you have that genetic ability that just got given that you can have with intense workout, of course, and proper diet, which you do. And even my levels, like, because I got my levels tested last year, my testosterone, my free testosterone, from the numbers you told me minor lower. I think my total test was 585 and my free test is 97. So, I mean, that might be something I consider maybe on like 40, right? And those levels are going down. Maybe that's going to be a good idea then. Yeah. And that's when I see a level like that's, that's normal. That's a normal level. Okay. It's in the middle. Let's round the number out. Let's call it a 600. That's, that's, that's okay normal level okay okay it's in the middle let's round the number out let's call it 600 that's that's that's okay it's it's even okay for your age group

if somebody was 40 45 and see 600 that's usually not an average they're closer to 400s would you also say that maybe uh somebody like himself um might get a little bit lower reading just because he's always training too. So like, let's just say like he had a couple of days where he didn't train and he got some good sleep and came in and got a blood test. Would the levels maybe be higher or not? Well, one, we'd like to check the blood test when you have not trained intensively for at least 24 hours. Two, we'd like to do it early morning, eight, nine o'clock in the morning, because testosterone is peaking in early morning.

If you check in the afternoon, it's going to be lower than it was in the morning. So one, depends on when you checked your test level, was it morning or afternoon? That kind of thing. So that's going to make a big difference. Because I've seen in the same patient, drawn in different days,

but totally different times, it is a matter of 300 points sometimes, or more, or more. I definitely train, I probably trained the day 300 points sometimes or more. I know, I definitely train. I probably trained the day before. Yeah. So keep in mind, strenuous exercise,

pulse strength training stimulates both growth hormone and testosterone output. Intermittent fasting also can stimulate a little bit, not a tremendous amount of testosterone production positively. People are on keto diets, hydroxybutyric acid, acetic acid, they take ketones in their diet for intentionally, can positively modulate testosterone production too. How have you gotten into the bodybuilding world? How have you crossed paths with Charles Glass?

How has some of that happened? Well, I met Charles, you know, I didn't, I never met Charles personally. It was over 20 years ago. And I remember having a phone call conversation with him and introduced himself that he had a patient that he liked to, it was a female patient, as a matter of fact, that he liked to refer over. I'm in Huntington Beach, California.

He's in where he trains with Gold's Gym in Venice. So she was having difficulty losing weight. She was having difficulty with cellulite. She's having difficulty with fatigue. She couldn't finish her workout, but she's paying all this big money to Charles to train her to get her in shape. Not because she wanted to compete. She just wanted to get in shape. And, of course, Charles has a great, fabulous reputation. So I had met Charles back in the mid-'90s via phone call, but I never met him until about three years ago. I mean, we've been on the phone with mutual patient athletes, I'll call them. patient athletes, I'll call them. And we were going to do a tour together about, I think, about two years ago. He would handle, of course, strength conditioning. I would handle things

as with questions about Q&A with anabolic agents and nutrition. So it didn't work out where I had my own cardiac event, December of 017. So I had to essentially take a year off to get things organized with my own. They told me I had heart failure of all things. I said, me? I can't possibly have heart failure. I'm way too healthy. I take no medication.

I don't have hypertension. I don't have coronary disease. I don't have high cholesterol. So anyway. Just being around these steroids messed you up. Vicariously. I got coronary disease just from talking about it. Proximity, yeah.

But as such that, again, we have a relationship where if he has a client athlete, I call them patients because they are patients. If I can help them with their program, I can help them with their hormones because they're low. Usually, actually for women, they are low. And for men, they may be okay, but okay low side. Or they would just tell me, well, they're low because I use some prohormones over the counter, which is very damaging. It suppresses your LHFSH, which suppresses your own sperm production and testosterone production naturally.

And if you didn't do it correctly, and pro-arms usually are not the safest, you may have done some damage when you were younger. And now you're an adult, and they're still low. So if he's referring somebody to me, usually they're pretty low because they received the results from their primary care doctor already,

so they'll come in with their labs. So we'll work our magic, optimize them, and they get better results when they're training with Charles. That's how I met Charles actually two decades plus ago. You know, in powerlifting, we're starting to see an explosion of women coming into the sport and they're really kicking ass. They're really doing great. They're lifting some big weights, but you know, we're at powerlifting meets sometimes and we're, we always yell for each other. We always encourage each other. And every once in a while, you know, you'll hear someone's voice and I'll turn and I'll be like, that's probably smoky behind me or something. And it's, and it's not, it's a girl, you know? So what are, what are girls supposed to do? You know, when it comes, like they want to be

enhanced too. A lot of these girls want to be big and strong. Can they get enhanced without, you know, going overboard and getting their voice changed and things like that? Well, depends again, duration, dose, frequency, frequency of cycles. And with anabolic agents for women, voice enhancement, best way to describe it, is a potential side effect. Hirsutism, hairiness is another side effect. Clitoral enlargement, another potential side effect. Acne, another potential side effect. Hair thinning because of the DHT, another side effect. Again, similarly, polycythemia, high blood count, liver enzymes, similar as men do. So is there a safe way, you're asking, Mark, for women if they were to? The most common things I hear from female competitors, not even say which sport disciplines,

but female competitors who do it seriously or professionally, the old wind straw, stenozolol, and oxandrolone. Again, usually these are not available for women, but if they are able to find them, they would use a lower dose. Now, if they overdo it, yeah, you're going to get masculinization. Testosterone is maybe too strong? I have women on testosterone, usually transdermal, unless they're allergic,

hypersensitive to the cream base, or they just don't absorb. I've been to multiple doctors. They always give me this transdermal cream, compounded or otherwise. My level's always low. So low dose, men, let's say they do somewhere between 150 and 300 a week. Women would do somewhere like 10 milligrams with an insulin syringe every 10 to 14 days. So I caution them, you might get hairier, you might get acne, but we'll control that with an estrogen blocker or DIM or cruciferous vegetables or salt palmetto, you might get clitoral enlargement. Again, all the side effects potentially. So a lot of women say, you know what? The way I feel and my body weight and my skin just hangs on me, I got sarcopenia, a medical terminology for muscle wasting for different reasons,

or because they do have a musculoskeletal disorder, they have a neurologic disorder, they have MS, they have Lou Gehrig's. Again, I have a number of female patients, really low-dose testosterone, whether it be rub-on or injectable, they do fabulous. Of course.

Oh, sorry. The other thing I always caution them, if you're on oral contraceptive, you increase your chances of clotting, deep vein thrombosis, legs, legs to lung or your arm. So we have to watch out for the side effects too if they're on other medications and makes them more prone to clotting disorders.

How about fertility? And the reason I ask that is because I actually know a man, I used to train him back in the day and he was saying he did something because he was from Dubai. So he did something there and he was young, he was like 20, but this doctor recently said he can't have children. So what do people need to think about in that realm when doing a lot of this stuff? How can it affect their fertility and what should they stay away from? Well, any anabolic agent suppresses the feedback loop from brain to testicles, LHFSH.

Luteinizing hormone stimulates the cells down below to make testosterone. FSH, follicle-stimulating hormone, stimulates sperm production. Together, they make the man whole and fertile. Now, when you use an anabolic agent, it suppresses that feedback loop. That's the causation for shutting down your own testosterone production as well as sperm production. The higher the dose, the longer the frequency, the more suppressive. Again, that's why we cycle. That's one of the reasons why, especially if somebody is young, they want to have children in the future. I just let them know, if you're going to, now you're low,

so here's an option. Are you contemplating to, now you're low, so here's an option. Are you contemplating having children like within the next one or two years? You don't need testosterone. Let's not do testosterone. Let's do HCG and Clomid. It acts like a fertility agent. It enhances sperm production and your natural testosterone production. So it doesn't suppress. Two, if you are going to be on a cycle, you tell me when you're going to anticipate starting a family, take you off your testosterone, put you on HCT Clomid, a certain dosage for a period of time to see how much we can stimulate. So in men, we'll go in and get a baseline evaluation semen analysis to look at that part. We'll look at a blood test to look at the testosterone part

and other factors too. So I've never had over the decades any male patients who were on testosterone replacement therapy for optimization sub-therapeutic reasons. And then, you know, I want to start a family. Great. Follow this program.

You're still going to be fertile. So I would say every quarter, there's always two or three male patients Great. Follow this program. You're still going to be fertile. So I would say every quarter, there's always two or three male patients, taking them off, put them on post-psychotherapy. And when they're ready to start their family, they do. And when they said, you know what? My wife is expecting now. Can I get back on testosterone?

Because now they drifted back down to a low level. And there's not necessarily a correlation between low testosterone and low sperm count. You can have individuals with really low testosterone levels, but they have adequate sperm count and motility and size and viability, pH. They check multiple things on a semen analysis. And that's also like, I mean, similar with women too on taking this stuff,, they need to be careful because it will affect them being able to give birth, too. Yeah, same feedback loop, LHFSH. Got it. Estrogen and eggs.

Do you think these hormones should be allowed in Olympics and professional sports? Well, certainly a controversial question. In other words, should the best chemist win? Well, I guess kind of the question is like, um, you know, somebody's 40 years old and they are 270 and they want to be, you know, 220 and they want to be healthier and stronger and look better naked and things like that. They want to get to results faster. Um, if that person kind of reserves the right to go in and say, Hey doc, I need some help because, uh, you know, I don't know much about this. And I feel that, you know, if I take, uh,

some, uh, if I take some, uh, hormone therapy, uh, it can assist my assist my, uh, you know, assist me along a lot faster versus, uh, somebody else who is my, uh, you know, assist me along a lot faster versus, uh, somebody else who is like, Hey, you know what? I want to do this professionally. I want to be the best in the world at this. And I want to, you know, I don't want to rip apart my body. I want to recover from these workouts. Let's say you're an MMA fighter. It's like some people say, well, if somebody's cheating and they're using them, uh, well, it's easier for the guy who's taken them to, you know, knock the crap out of the other guy and potentially like injure the guy, kill the guy, maybe even who knows. But if we're both taking them, maybe it's kind of even. Stephen, what are some of your thoughts on some of this?

So in other words, Mark, we're leveling the playing field when whoever wants to take if they want to take. Yeah. Because just like Olympic sports, we level the playing field when whoever wants to take if they want to take. Because just like in Olympic sports, we level the playing field. In terms of a code of ethics and standards, PEDs are not, they're on the ban list. Yeah. By IOC, USOC, WADA, World Anti-Doping Association, different national governing sports. WADA, World Anti-Doping Association, different national governing sports. The question to me is, should we allow? I guess I'm supposed to say no because I'm a doctor.

But the other situations that have come up with me a lot over the decades is somebody who is an Olympic athlete, somebody who's going to be tested because of the fact of the nature of the national governing body in which they compete, from hockey to basketball to football. We do a test and say, wow, you're pretty low. So we can do this. We apply for a TUE, a therapeutic utilization exemption, with that specific national governing body, whether it's cycling, USOC, NHL, NFL. Of course, it's up to that national governing body, and their medical people say, well, here's John Doe, who's an all-star quarterback,

all-star hockey, this, what have you, and his doctor's saying that he has a really low T-level. The patient athlete is applying for a therapeutic utilization exemption. In other words, that national governing body says, okay, he's low, we agree, he can have. So those are allowed. In the past, for the...

In the Olympics, even? Yes yes but not that often that's the difficulty you can apply for one doesn't mean you're gonna get one so what'll happen is how do you know that a little bit's good not a lot better in other words yeah i was low now like super high so where do you draw the line what's the most recent one? The female athlete from South Africa? Kastor Semenya, the 800-meter runner. Female lady who has naturally gifted to have really high test level. Was she also, but when she was born, was she a biologically female or? Supposedly she's a biological female and competes with females at the world-class level, Olympic level.

So have you heard the latest one is that to be able to compete in the future moving forward, effective now, you have to take medication to lower your testosterone or have a surgical procedure to lower your natural testosterone. Isn't that something? So back to your question, Mark, should it be allowed? Go for the gusto. I call it may the best chemist win. I can't say to do that because of the fact that, and there she is. So again, she is one of the best female sprinters in her event.

I think it's 800 meters. And now, can she compete anymore? She's appealing it now to the world governing bodies in track and field so i guess like uh so bodybuilding you know doesn't they don't have a regulation on it power lifting uh there's non-dread drug tested federations i don't feel like uh i still feel like it's the guy with the most genetics that puts in the most amount of work do you feel the same for for bodybuilding or powerlifting i feel like it's the guy with the most genetics that puts in the most amount of work. Do you feel the same? For?

For bodybuilding or powerlifting. I feel like these guys, these men and women that are winning these shows, I don't feel like it's necessarily the best chemist. Do you feel differently? Well, are they natural that we know? No, no, I'm not saying, I'm saying that they're not natural. I'm saying these are like, you know, uh, you know, professional bodybuilders, like the guys that, you know, whoever won last year's show, for example, and whoever won previous shows. Um, and same thing with powerlifting. Some of these guys that are setting, you know, all time world records and stuff. Uh, obviously they're, I'm sure they're taking a lot of stuff and I'm sure they're being kind of reckless with it, but,

uh, I don't know if it's, uh, if they have a doctor like yourself in their corner necessarily. Well, addressing that question, Mark, is that a lot of these world records are set because they were on a performance enhancement medication. To be one of the best in the world, one, you have to have certainly the consistency, the discipline, the perseverance, all those factors, the diet, the regimen, the genetics. And then the part that, if you don't have that, it's called the pharmacology.

So I would say the majority of people have all the above okay pharmacology makes the difference of gold silver and bronze and world records in power lifting let's say right is it possible that some of the records because i think uh they didn't really have a lot of stringent testing until like the mid early 80s or something like that. Somewhere around that time. Is that right? About mid, mid late 80s. And then in your opinion, like, you know, I guess I won't even use any names, but in your opinion, are some of these records in the Olympics legitimately being beat? Maybe these records were previous set by somebody who did have good genetics, and on top of that, they were on stuff.

Are these potentially getting beat by people that are clean? Without knowing the specific athlete, I can't say were they. Like a Hussein Bolt or someone like that. He's just absolutely crushing the competition and breaking world records, you know? Yeah. And how do I address that without sounding biased? I really, because I don't have the evidence,

like let's say we had with, you know, back in 88 with certain athletes in the sprints. Even again, not naming names. But it's just a matter of sometime in the future that something positive comes up in a drug testing retroactively to 8, 9, 12 years ago, like we've seen with who's. It's very bitter news. Marion Jones, as an example, because I'm not violating confidentiality there. So I'm not picking on a Jamaican government at all in any way.

Let's say their testing protocols are looser than USA. Maybe as loose as Russia. I can say that because it's been in the news too, hasn't it? Right? Yeah, they had like 70 or something, right? And you're always... Some outrageous number. Very, very few, let's say Russian athletes,

are flunking drug tests in Russia. Right? Or China. And the reason I can kind of say that because many in the past decades from previous 88 92 olympics let's say um some some athletes were my patients patient athletes and they would confide in certain things, and since they were really young, groomed. How do I say this without sounding too biased? But in certain countries, you're groomed at six, seven, eight years of age for certain sports because of your genetics, your abilities, your musculature.

And then along the grooming, your training, the government's behind it. They foot the bill. They pay for your training. They pay for the family. Because you're going to be the next gold, silver, or whatever for the world in that sport discipline. A lot of pressure.

And before the wall came down, Berlin, I know there were a lot of athletes who were encouraged to be pharmacologically enhanced or don't make the team china the same way so if you think about back in 2000 or 92s 96 um from caterpillar juice to whatever caterp Caterpillar juice? I never heard of that. Is that a thing? Remember that one, Andrew? Caterpillar juice?

No. It's one of the strongest anabolic agents known to man. What? Why is the power going to reduce? That's what the Chinese said. It was caterpillar juice. Why all the female swimmers are breaking world records out of nowhere. Oh, that's great.

Because they had this magic caterpillar. That's like do-turn-into do turn into butterflies, don't they? We got to get some damn caterpillars in here. Yeah. So you've been on both sides, though. You've been on the side where you're assisting the athlete to do the best possible job they can in the particular sport that they're in, and you've been on the drug testing side as well, right?

Correct. What's harder? Which side's harder to be on? There's a lot of rules to follow. There's a lot of banned substances, right? The list is enormous now. The athletes, I always tell them because they know my position as a clinician too, you ask the questions, my role is education.

them because they know my position as a clinician too. You ask the questions, my role is education. I'm not going to tell you how to beat a system, but you ask the questions, I'll respond to your questions. So I'll be a good scientist. I'd be a good clinician. I can't condone, endorse you trying to, let's say, beat a drug testing. But you tell me what you're going to do, what you're trying to accomplish. I'll give you the rationale of what you're trying to do and whether you are doing it the right way or wrong way. So my role is more education. Some hacker breaks some federal internet website, right?

And they sometimes will bring this person to court and then they'll kind of like work it out. And actually in some cases, like I've seen in movies before, but I think the movies are based on some truth. The person ends up, end up working for the government to block, you know, hackers, right? Is that kind of how your position happened where you ended up on both sides of things where you you you knew so much internally or knew so much from the athlete side that you ended up uh you know working for the ioc well the um the um you have another question we can move on certainly we can move on um that was a complicated one yeah yeah yeah well it's just it's just interesting to me too because you ended up on on both sides of the spectrum there where

it's well again my role is education uh on behalf of patients patient athlete physicians physicians, governing bodies, from even boxing federations, MMA, certain legal entities representing certain athletes said, you know, they're accusing so-and-so after he won this at Arco Arena or whatever arena that he made weight, had to lose nine pounds, lost nine pounds in a matter of 10 hours. They said it's not possible. I said it is possible. They said without diuretics, because, you know, that's a banned substance.

I said, well, I've seen it happen where they wear a sweat outfit, don't drink any water. They sweat up a storm. Yes, you can lose eight to 10 pounds in one session. You've probably done that, seen individuals training hard cardiovascular-wise, not advocating, but if you're trying to make weight, you put on a sweat outfit, you know, and then you put yourself on a song on top of that with the risk of having heat prostration and dropping dead before the competition.

But you know what? You made weight right so on behalf of let's say the legal representation i said yeah it's possible he said okay i don't want to know because we're going to defend this so he can keep the title i said okay right right yeah and when you're um you know who better to to like uh you know perhaps uh investigate on whether someone is clean or dirty than somebody that has dealt with athletes. You know the psyche. You know the mindset. You know what they're looking for.

I find the whole topic just super interesting because one person is born with a certain set of genetics, one person is born with like a certain set of genetics. Another person's born with what they got. And I guess everyone's just trying to do the best with what they got. And so, you know, maybe one person feels they need to and one person feels they don't need to. You know, someone like Barry Bonds is fascinating to me because he never really retired from the sport. As far as I know, he never tested positive or anything, and it's just such a weird, that whole era has such a weird stigma to it.

That was the era during, if you call it a Balco investigation, Bay Area Lab Cooperative, out of Burlingame. But again, that's what they call non-analytical evidence. It's all over the lab that was rated. Didn't flunk a test. Any of these athletes, and there were like 37 athletes who fell one by one. But none of them ever really tested positive

because the certain individual knew how to cycle and have masking devices during the urine drug screen. So at that time, they didn't have blood testing, but they allow blood testing now if you want to compete at the world-class level with the various national governing bodies. Back then, natural excretory product was only allowed. Snot, poop, and urine.

So, but if you have what they call non-analytical, it's all over this guy's lab. This name, this name, with this cycle, with taking the clear, versus this, versus this. Well, that's non-analytical. Versus urine test, I flunked a urine test, that's analytical. It's a good program until somebody decides to say, hey, this is what's in the clear. Tetrahydrocannabinol, tetrahydrogestanol. But anyway, something like that. It goes in and out of your system really fast or something like that?

It was called the clear, and it's actually sublingual. You can just put it under the tongue. And it was short-acting too, developed by a chemist. So the question was? I was just like, I don't know, like I said, I find it fascinating. I find the whole thing fascinating of one person just maybe not having the genetics but wanting to pursue it. A lot of times we see a lot of athletes, they take stuff and they hang on to a pro team, but they're not Michael Jordan.

They're not the best player on the field. They're the jacked guy who's riding the bench, and that's where it got them. And sometimes even we'll see a high school athlete will want to take something just to kind of get to college, but they won't be a star in college. And, you know, people, it's like a card that someone can play at a certain level, and it can help level them up, you know.

And I just find the whole thing fascinating because we should never really be surprised because a lot of athletes are striving to want to be the best and do the best. And a lot of these people are so highly competitive. It should never really surprise us that, you know, any one person is going to do them or not. Yeah. But doesn't that also make you wonder, you know, if, for example, you look up a picture of Kai Green before he got on anything. He was still much better than every single natural bodybuilder. I thought he was natural. No, like back in the day, like Kai Green prior, like when he was 16 years old,

we had Kai Green at like 15 or 16. Did you just out Kai Green? Okay. Anyway, you look at these athletes that have great genetics, right? And if, for example, let's just say all substances became legal or a certain amount of substances became legal for certain sports, those athletes are still going to be ahead of every other freaking athlete. It's just going to like every athlete gets a little bit better, but the ones at the top are going to stay at the top. So, I mean, it's, it gets difficult to wonder like, okay, if we let everybody on, what's it really going to make in terms of a difference? Okay. People aren't getting banned, but the guys at the top and the women at the top, aren't they still just going to be the people at the top? Yeah. I mean, when we had branch warren on that was kind of like the question i had asked him like okay well what happens if we

pull all of the you know anabolics out he's like the same top five people will still be the top five people he's like well shit i guess you're right and then records just won't be yeah it just won't be as big the records won't be as high the times won't be as big, the records won't be as high, the times won't be as fast, but the same genetic that God gave in genetic, the same discipline, intensity of workouts, the same five, six will be there. So a number of athletes will actually, will ask questions about performance enhancement drugs

because it's an insurance policy. Now they've been on top of the game. Best in the world in that sport discipline. They'll have a question. Well, what about, I know where you're going with this. What about if I got a little bit, I know, little bit. I said, well, you asked the question. So here's, has to do not with the ability

is waxing and waning. They're a little more mature now. The younger troops are coming in their 20s. This person may be later 20s, 30s now, still wants to be atop of the game, but thinking, I can't keep up, recover like those 20-year-olds 10 years ago like I was. So it's an insurance policy when they start asking questions. Do you think it would help me? What if I said, well, let me explain to you the mechanism of actions, the pros and cons, just like we're discussing here. So it's not because they're looking actually to be bigger, stronger, faster.

They're already big, strong, fast. They want to maintain psychologically because they're 10, 12 years older now. Yeah. Some of these athletes are put up on such a pedestal and we love and admire them so much. We're thinking like, nah, they wouldn't do it that way. A lot of times that's what people are thinking. And if you look at someone like Michael Jordan,

that's probably the most highly competitive person to maybe walk the face of the earth. And it's like, did he beat the Detroit Pistons? Um, just cause he decided to start working out harder or, you know, uh, you know, or was because he's so highly competitive. He's like, you know, I'm tired of getting the shit beat out of me by the Pistons. I'm going to train. And maybe he trained and maybe he stumbled upon some stuff. I'm not saying he did or didn't, I have no idea. But it definitely could be possible. I mean, somebody like him did get bigger as his career progressed. I think Barry Bonds is in the same position where Barry Bonds is already headed to the Hall of Fame regardless. And then he got bigger and stronger later in his career. And

he wasn't even really a home run hitter. He hit a lot of home runs beforehand, but he really started smacking the crap out of the ball later on. I actually think it's... The B12 injections. Got him swole. Made his neck really big. All those BCAs that he was taking. Made his head really large.

But you're right, Mark. It is super fascinating. I was just reading an article. I think it was a college player from Clemson, football player. He got caught with Osterine. So he was suspended the whole year. It's like, oh. It's a sarm, right?

Yeah. So it's like, oh no, like his career's over. Drafted 17th overall. So it's like, you know, kind of like what Encima was saying, like, okay, well, what's going to happen if we open it all up? It's like, okay, he probably still would have been picked anyways because the NFL just know him getting caught and even without playing the rest of the year he still got drafted in the first round

it's like what the hell i guess some people are maybe worried about what it might do to the psyche of the youth right what are your thoughts on that like if it was just like hey just have at it you know you think our youth might get caught up in that as well? Well, a lot of them already are. Yeah. Because the idolize our home run sluggers. They idolize the different NBA stars. They idolize the MMA star.

So I have parents coming in with little Missy and little, little Mr. And these people are these, these students sometimes are high school. They're, they're 16, 17. Um, uh, one, um, my kid's short, get them on some growth hormone. That's come up a number of times and we don't want to have him, this individual, he or her have a self-esteem problem when they're 20 years old, and they're still only 4'9", 4'10", or 5' even. Or two, he's a great player, he's a great football player, great lacrosse,

but he's only 5'4", 5'6", not even that short. But, you know, do you think he'd get the extra edge if he had a little more bulk, and was quicker, faster, and recovered faster? Because I think it's potential, according to his coach, to get a four-year ride. That'd be great if he said four-year ride. You're kind of like, what are you trying to say? They're like, nudge, nudge. Come on, doc. Hook him up.

And these are parents, okay, who come in with a teenage daughter or son. And it doesn't happen a lot. And these are actually doctors. Two doctors, husband and wife, came in many years ago who asked about, you know, my offspring. I'm not going to say man or woman. Offspring is finishing at, you know, high school, and the schools are looking at him. And I said, well, what's the sport? I'm not going to name the sport. So it has to do more with speed, let's say, than hitting people.

Okay. So I said, well, if you're a little bit taller, you would start this now. You would see a pediatric endocrinologist to see if he's a candidate by the growth plates. Are they closed yet? Not closed. How much can he get? Can he get an extra three, four, five inches by high dose growth hormone? And the growth hormone actually is much higher than just optimization for an adult. Adults anywhere from one unit to two or

three units. So for individuals have pituitary stature short from, let's say, lack of growth hormone, those are 12 to 14 units a day, okay, for three or four years non-stop. Probably be extremely uncomfortable in more ways than one, right? They get acro... Interestingly, the young individuals may get the water retention, but they get over it. Can you imagine you and I doing 13, 14 units a day of GH? We get acromegaly. We look like certain people we know. And we have heart failure cardiomegaly. But these individuals adapt really well. And they get that maybe extra two inches. How do we know? And plus they're lean. I mean, phenomenal shapes as little Missy and little

Mr. kind of thing. Little science experiments, huh? So it does come up often enough. Again, my role is education. I'm not going to endorse, especially a teenager, to go on stuff, okay? I said, if you were, this is something you would consider with a pediatric endocrinologist.

If you are high school, your test level is really low, I don't advocate you be on testosterone. Let's see how much you can stimulate your own production again, back to HCG, corneal aconitotropin injections, and Clomid. Works well, really well. Especially if you're going to be

in a dorm situation in college. I mean, you don't want to be like shooting up steroids or whatever. So not even HCG, which is usually injectable. Just take Clomid Oral. So it's effective. We don't do it nonstop. Pulse cycle it.

So allow the latex cells to regenerate the testosterone. And so a lot of, a number over the past decades of young, let's say male patients, entering college who just are hypogonadal. Or maybe they abused anabolic agents when they were younger. They abused over-the-counter prohormones. They've done some damage now. So they come in with parents and I said, you know what, this is what's happened. We look at the LHFSH. We do the endocrinologic evaluation. So here's a recommendation. And usually it works out well. we do the endocrinologic evaluation.

So here's a recommendation. And usually it works out well. Somebody just wants to be jacked. They just want to be in great shape and they're not in a professional sport and they don't have as many of the worries of testing positive or anything like that. They just want to be strong and they just want to be in good shape.

How have you seen this kind of stuff? Uh, what you do at your practice, uh, help people in terms of, uh, you know, you checking their blood, getting their sleep, going the right way, getting their nutrition head in the right direction and getting them on some therapeutic dosages must be a huge turnaround. It must be fairly fast too, as well, right? For injectable more so than the rub on testosterone, I always tell them when they ask, when am I going to see results? I said between the second and third week, between the second and third week of injections. And I don't advocate, go for the gusto. Start low, go slow. So it's anywhere from 75 to 200 milligrams per week of injectable testosterone.

Okay. Depends on how low they are in symptomatology. But remarkable changes in the metabolism, remarkable changes in outlook on life, the body, habitus, the physique in a short period of time, in a month. Again, I let them know, you don't just sit around eating what you like and playing with the remote. Oh my God, I'm on juice. When's it going to happen?

It doesn't work that way. So you're still going to follow, which is part of our protocol, common sense eating, whatever program you want to do about eating, eating cleanly, eating healthily, you know, the balance of the fats and the proteins and the carbs. And if you have a trainer, great, but you got to work out too. The stuff doesn't just make you shredded six, eight pack with defining deltoids and traps just by having testosterone replacement. It works with your metabolism and your anabolism. So when they really get into it, because one, the motivational,

that's the other thing that most people don't know. Testosterone has a positive modulation on our brain for excitatory transmitters. Dopamine, epinephrine, norepinephrine. That's how stimulants, Adderall, Ritalin work. So when you stimulate the excitatory transmitters, that gives you the upward, wow, overall sense of well-being, the focus, and also the motivation.

If you have more motivation, you're going to train a little more religiously and intensely and come back for more. But if you don't have the motivation, you don't even feel like going to the gym. In a lot of ways, I wish this was like a little bit more out in the open because um you know i've seen trainers you know take on clients um and you know with like you said like within a month two months you're like that's the same guy that's the same girl like whoa holy crap

you know and you and i knew what was going on, you know, I'm like, okay, well, you know, obviously the guy probably has them on a little bit of stuff, but it's just like a bodybuilding guy or just a guy would not that bodybuilders don't have tremendous knowledge because a lot of them do. Um, but man, wouldn't it be great if it was like, you know, the safest route route possible. And like someone like my dad who's 70, who's just like, you know, Hey, I want to And like someone like my dad, who's 70, who's just like, you know, hey, I want to be in better shape. Yeah, he walks and he, you know,

he's on a nutrition plan and stuff, but not everybody wants to be like so tied down to their nutrition and so chained down to, you know, I'm going to, I need to exercise, you know, four days a week for, you know, two, three hours at a time. And I think if people were allowed to get a, and I know they are allowed to, but it's a little complicated on just, you know, finding the right person and stuff like that. I think it's, I think it would be

great option for a lot of people. It is. If there are appropriate candidates after proper testing, again, there are a number of clinicians, especially in what they call the HMO system, Health Maintenance Organization, not to name the different groups, they don't believe actually in hormone replacement therapy. It's not for their members. We get a lot of those patients from the HMO systems.

They said, Dr. Ronin, check my testosterone, male or female. He said, the doctor won't even check my testosterone, male or female. I said, so we check it. I got to pay out of pocket. And I said, well, that's really low. He said, the doctor won't prescribe for me. He did check it. My level is like 185.

He said, suck it up. I said, okay, that's why I'm here. So again, it's just a matter, because the other comment is this. The doctor said it'll give you heart attacks and give you cancer. Nor in the literature, testosterone replacement of anything,

it prevents prostate cancer. I kind of thought that way back in early 90s, that chronically low testosterone, you're more likely to get chronic prostatitis, inflammation of the prostate gland. Chronic prostatitis, more likely to get prostate cancer. If you optimize the testosterone levels, okay, then they're less likely to have chronic prostatitis, therefore less prostate cancer. And the PSA doesn't go up, which we measure prostatic specific antigen as a measurement of prostatic enlargement or prostate cancer,

or both, but actually goes down. That's in the literature now, but it took how many years later, 10 years later, 15 years later before that comes out in the medical literature. So now the advocacy now to even mainstream, they didn't teach me that in med school. It was just the opposite. High testosterone, high incidence of prostate cancer. Now they're teaching the med students and residents a little bit differently. It's up to you if you want to deal with it and do the testosterone replacement, let's say in men or women, because the literature doesn't bear out. De novo doesn't create prostate cancer. Now, if you get prostate cancer, that's your genetics.

Yes, it can make it more aggressive and grow faster. So I normally monitor the PSA for men, not once a year, twice a year. I also start when they're 40, not 50, because prostate is very slow growing. If you pick it up when they're 50, 60, it's been there years. So I want to know if your PSA, the velocity, in six months, six months, six months, not one or two or three years at a time, because if it's all of a sudden rapidly increasing,

well, is that prostatic enlargement, prostatitis, or prostate cancer? So I'm looking for prostate cancer. Now, I pick up a lot of prostate cancer. Why? Because I'm looking for it. And not because they're on testosterone. The majority of prostate cancers I pick up,

they're not on testosterone. I pick it up because the fact, well, let's go ahead and look at a baseline PSA. You're 40, you're 45, you're 50, whatever the age is. Boy, PSA, normal is zero to four. You know, you're already a three. You're only 41, but your testosterone is really low. Let's do this.

I want you to go see a urologist, get a digital exam, or I'll do it, and maybe depends on that, get an ultrasound of the prostate gland, make sure there's no abnormal lesion that needs to be biopsied. So I've picked up a lot, a number of prostate cancers. They don't have any symptoms. You won't have symptoms for years, but by then that means it's spread. So I'm looking for it before I put you on a hormone program. That's men and women. For women, I want to make sure they're up to date on their female exams, their PAP, and their mammograms.

Because again, testosterone, estrogen does not create de novo, meaning creates brand new cancer. But if you get genetically prone in the family history of having uterine cancer, breast cancer, testosterone and its derivatives, estrogen, will make it more aggressive. So we're, in my office, Dr. Singer and myself, we make sure our patients are having their annual exam, female patients as well as male patients. And again, the PSA, most physicians don't bother looking at it until you're 50, okay? I start when you're 40. Even younger, if you have a strong family history of multiple cancers in a family on both sides. In the men, let's say you have prostate, colon cancer, pancreatic cancer. There are certain syndromes, genetic predispositions, you're more likely before you're 50 to get cancer.

In women, again, if they have a strong family history of cancers in there, I want them much earlier to get their mammograms and or their female exams. So in our office, we're a little more proactive, let's say. And the HMO systems don't like that. Why? Because it costs more money to be proactive. Have you been able to flip-flop the medications that people are on? You know, so someone comes in and maybe they're diabetic and they have, you know, cholesterol,

they're on cholesterol meds and blood pressure meds and they're on a medication for everything. I realize that you're prescribing medications as well, but maybe some of these medications that they're on, like, you know, aren't, they're not, they're not helping them long-term in terms of them being healthier. And in fact, maybe they're making them feel worse and maybe they're potentially going to accelerate some of their issues. Is that, is that some of the, some of the goal of what you do? Yes. Statins, as an example, statins as an example, Lipitor, Crestor, Provacol, the statins as a category. There's up to 10, 15% of patients who develop myalgia, achy joints, achy muscles,

rhabdomyolysis, fancy term for muscle destruction as a result of the statin. So if you have to be on it, you have to be on it. So I'm not saying that when you present and you're on a statin, we're going to take you off it. Our goal is try to optimize your metabolism to enhance the efficiency of you naturally, if we can, to metabolize and lower the fats. Lower the LDLs, increase the HDLs via higher dose omegas. Higher dose omega-3s, 6s, 9s balance, phytosterols, plant-based sterols, diet change. Assuming they're not reluctant

of making a drastic change in your diet, ketosis diet, intermittent fasting diets, paleo diets, Mediterranean diets. I'm not opposed to any one of them. They all work. Eat by your blood type diets. If it works for you, it works for you. People who are on diabetes medication.

Well, maybe if you aren't 100 pounds overweight, you wouldn't be diabetic because the more belly fat you have, the more adipose fat you have, the more insulin resistant you are. So it adipose fat you have, the more insulin resistant you are. So it's more difficult to metabolize fats and sugars. Therefore, sugar goes up in your bloodstream. We call that diabetes. And it's hard to lose weight too. So those individuals, we make drastic changes in their diets. We put them on different kinds of cleanse diets, botanical diets, protein supplement diets. Our goal is to get you off the medications. That's why you're here.

If you're on a antidepressant, anti-anxiety medication, Prozac in their families, the idea would be, is it because you really need to or is it because, is it hormonal? Again, you saw your gyne, you saw your primary carers, and I said I had these symptoms. They put me on an antidepressant. And I went back a month later.

I'm not any better. They doubled the dose. I got double the side effects, but I'm not any better. Okay, so let's look at hormones. Let's look at transmitters in the brain via urine. Let's look at the hormones by either saliva or blood. Let's look at the pancreatic function. Let's look at the hormones by either saliva or blood. Let's look at the pancreatic function. Let's look at the adrenal functions. Again, cortisol from the adrenal glands, thyroid

from your thyroid gland. They talk to each other. There's a relationship. If one is out of whack, it affects the other one. You have to have adequate cortisol to convert thyroid T4 to T3, the active form of thyroid. So your doctor says, oh, he said I had low thyroid. So he gave me thyroid medicine. I felt pretty good for about a month. Then I'm back where I started. I'm still tired.

So he doubled my thyroid. Didn't make a difference, but I got ampy. Okay, and I'm still tired. So they didn't look at the cortisol level because you have to have adequate cortisol to have adequate thyroid function. What'll happen is you keep increasing the thyroid, it steals from the cortisol. It plummets the cortisol even further.

You get even more fatigue and poor cognition. It's called cortisol steal syndrome. If doctors believe in that kind of thing. I do because I've seen it happen in hundreds of patients. I went off a tangent, but the question was what again, getting them off medications. Yeah, it's okay. It was good. That was good information. You know, when it comes to the aging process, um, you talked about that Centurion that's still, uh, active with his 52 year old, you know, lady, and you don't even look your age. I think she's trying to kill him. That's not good. But like, obviously it seems that this hormone or

hormonal replacement therapy kind of can slow down or even reverse the aging process. Is that kind of correct in saying that? In many ways it does. I can't use the term that it's anti-aging help you live longer. The idea is to optimize your fitness, your overall sense of well-being, your outlook on life, your metamorphosis, your physical type. So these individuals have a better quality of life before you die of something. If you still develop cancer, that's in your genetics, you will. But the idea, of course, let's say you're lucky enough to live till 90, 95. We want the quality to be really good, not the remaining five, seven years in a nursing home bent over on a wheelchair or in crutches.

So when patients come in, the idea is, you know what? Initially is, I got to lose weight. I have poor motivation. I got all these medications and my blood pressure is skyrocketing high. The doctor thinks he wants to put me on insulin now. I don't want to go that route. So our goal is to, one, indirectly,

back to your question mark, titrate you down, if not off the medication. During that process, your quality of life actually became better. Your outlook on life became, your sense of well-being became better. Your life-life became better. Your libido was better. You're a 100-year-old guy with a very young wife. I don't go there, but I said,

don't send me the DVD either. I don't want to see the DVD. How about stem cells? Because I've seen you talk about that like in interviews also. Do you still do a lot of that type of therapy with individuals? We do for the appropriate candidates from autoimmune disorders like rheumatoid to degenerative arthritis,

injections into shoulders, knees, spine, hips. For individuals who are type 1 diabetic, insulin dependent, that's an autoimmune disorder. It's in the literature where stem cells from umbilical cord, newborn babies, not an embryo, but newborn baby's blood called perinatal stem cell products does wonders. And the idea of course, is to re-regulate the immune system via the stem cells, intravenous or intramuscular. And most physicians don't even know this. It's not the stem cell itself, okay? There are different parts, which I won't go through, but there are different parts from the umbilical cord, Wharton's jelly, the chorion, the amnion, okay? But each has specific healing

factors, growth factors, regulating factors, immune modulating factors. The cells will secrete, regulating factors, immune modulating factors. The cells will secrete. I call it stem cell spit. It secretes what they call an exosome. An exosome is like the spit of a spider. It's not the bite of the spider that can kill you. It's the venom. So the exosomes will travel to a target, a pathologic tissue, and through their RNA, without going too fancy here, will send a message. The message will tell that pathologic tissue, best way to describe it, to heal itself, to upregulate, downregulate itself.

So I've seen wondrous results in my own patients too with stem cell therapy. And stem cell therapy is nothing new about that. It's been going on for decades, having to do with breast cancer, leukemia, that kind of thing. But only in the last maybe three years has FDA allowed in-office practices to order umbilical cord stem cells from mothers who don't want the baby's products. It's a newborn's baby's blood. And then they process it, take out the good stuff called the umbilical cord stem cell, and different portions for different reasons for different healing factors. I think from a biomolecular point of view,

it's the wave of the future. In terms of healing and curing, it's the wave of the future, even though, see, FDA does not allow us, the United States say, it can cure, it can heal, and it's for investigational use only. So the FDA law says this. If you're going to administer a stem cell to somebody, you have to sign a consent form that FDA does not approve us to heal anything or cure anything, investigation use only, but sign here and give us a lot of money and we'll give you the cells. It's a federal law.

And unfortunately, there are a number of clinics giving it a bad name because they're marketing it as cure-all. You can't say it cures anything. In the literature, it's fabulous. Wondrous. Through hundreds of articles I've researched over the last five years. So we do offer stem cell therapy to a limited number of patients in our office who I think are good candidates. As I tell them, I'm not saying it's going to cure your rheumatoid. It's going to cure your arthritis. It's going to cure your diabetes. It's going to cure your

Parkinson's and your depression. But you know what? Here's the literature. Read up on it. Google it. I'll give you a bunch of articles on it. If you want to continue, let me know. But you have seen it cure all those things. Again, I can't use the word cure. Positively modulated, where the symptoms used to be, let's say, 9 or 10 out of 10, down to 1s or 2s in terms of pain. Where they weren't walking before, they had to use a wheelchair or assisted ambulation, they're ambulating without the assistance. Someone who's had paralysis from a stroke, couldn't move the legs,

you inject IV down the road, interestingly, they're up and walking again, at least with a cane, where they were bedridden before. So again, I'm not the only one who's witnessed these miraculous transformations in terms of treatment with stem cells, but it is part of regenerative medicine

as the name of our clinic, Lee Regenerative Medical Institute. in terms of treatment with stem cells. But it is part of regenerative medicine, as the name of our clinic, Lee Regenerative Medical Institute. But it's not just hormones. Stem cells, it's not just that. But it's also diet, nutrition, lifestyle, functional integration of other aspects of medicine, mindfulness, transcendental meditation, to praying and chanting. I mean, we don't do all that. We have a nutritionist on staff full-time too.

So I have a pharmacist, Dr. Avni Shea. She is a PharmD and she also handles a lot of our compounding. And I have Dr. Singler who's a naturopath doctor. So we have four different areas of expertise and training and clinical experience to work with some of our more challenging patients. Let's say you get a bodybuilder that comes in and they want to push the limits. They want to be a professional bodybuilder. How do you handle that?

Do you have limits on what you can prescribe? bodybuilder. How do you handle that? Do you have limits on what you can prescribe or do you just try to give them advice towards, you know, Hey, I can't really advise this, but you know, let's go for it anyway, type of thing. I don't know how it works. I would say the latter, Mark. Again, my role is education. They'll come in themselves or the trainer or their coach or all of the above. or the trainer or their coach or all of the above. This is what I do. I'm coming to the competition. It's nationals.

It's the worlds. I'm trying to make an Olympic team. And I said, okay, what do you want to do? Well, I want to do double that. Okay, double that. And I said, well, in two weeks or four weeks. So again, I can't condone endorse. I'll do my blood test on you.

We'll do our diagnostic evaluation, okay? You tell me what you're doing right now, the medication you're on, and we'll test and see if you're healthy one, two, okay? So, well, okay, you're not an anabolic agent. Let's say the individual who's right now, like Mr. Natural here, okay? He's not on any performance enhancement medication. He likes to be called the natty professor. Again, ask the questions with you and your trainer or coach,

and I'm not going to prescribe it. I know you can probably find it without me asking. Don't even tell me where you're going to get it from. Okay. I don't want to know. So what you're trying to accomplish, whatever, let's, let's say it's not running football, basketball. Let's say it's powerlifting, right? Okay. All right. Cause a lot of those come through the office too. And some are like yourself, world record holders. And I said, well, tell me what, what can you get? Right. my trainer, my coach told me to take this. I said, is that because it's the right regimen for you?

It's because what they can find themselves from their source. The parking lot sale, I call it. So usually it's going to be an outlandish program. They're going to say, well, they want to do 1,000 milligrams of this, 5,000 milligrams of this every other day. I want to mix it with this, this, this, this, this. I said, wow, that's a lot of stuff. I said, well, right off the bat, I'd say cut it in half if you're going to do that.

And I'll give them my rationale why. And how long you do it, I don't know. I said, what are you going to do, 12 weeks, 16? Well, all the way up to competition, when's that? Next year. I said, well, you got to take a break. Again, my role is education. And you know what? Antibiotic agents, there are certain ones that have androgenicity too,

that form estrogen. They're not purely anabolic. You want something that's more purely anabolic. So you got to eliminate probably this one, this one, this one, this one. And if you're going to do a cutting cycle, you probably want to do a combination of these. He said, well, I can't get that one. I said, I'm just educating you. I'm just, you came out. Figure it out, bro. Yeah. I said, check with your chemist. That's right. So in answer to your question, Mark,

I can't condone, endorse, prescribe for purposes of performance enhancement, and I don't. If they have a regimen, they would bounce it off me, I would render an opinion. If a coach comes in with them and said, well, we're on this. He's on this. I said, okay. Said, well, what do you think? I said, well, it has a lot of androgenic policies. You ever notice when you

increase the dosage, you got puffy, but didn't get more results? And then that's because of the estrogen, one. Two, if you haven't had a break, that's saturation of the anabolic receptors. That's why you're not getting results. You double the dose, you double the side effects, but you're not going to double the results. So

you probably need a break. You probably need to change the regimen. The break could be an answer for somebody because it could be right it could get them back to making progress again right let's say it's not a power lift let's say it's not a competitor gee I felt great my libido was better

my recovery is better so you know a year went by my libido is really low I'm kind of sluggish at the gym and I got fatigued now. Is there something else wrong? I said, have you had a break? No. So sometimes all we do is, I tell you what, take four, six, eight weeks off. Let's look at your liver enzymes. Let's look at this. Let's look at that. And I'll give them a rationale. Okay. If you're going to saturate receptors, they don't get any better by double tripling the dose i noticed that in fact it made me cry a lot i said i know because you got your estrogen level

and now it's skyrocketing high he said i mean chick flicks don't even make you cry you just sit there and cry on your own don't you now he said yeah i said i asked my i asked my primary doctor for a prozac or select Celexa or a Fexor. So he gave it to me. I said, did it help? No. Maybe. We're dreams, though.

So again, it's not all the answers by changing transmitters. They help, yes. But if that's not the answer, part of it has to do with other hormones. Then that's our role to evaluate that. You know, a real popular one that we hear all the time, and everyone says it on, you know, messes around on everyone's Instagram and YouTube. We hear people talk about Tren all the time. Why has this become such a popular drug and what's your opinion of it? You know,

I think it's a great agent, anabolic agent. It doesn't aromatize that much at all to estrogen. It doesn't aromatize that much at all to estrogen. Female athletes would consider, have considered utilizing it too, whether they are physique versus figure, depending on their genetics and how much they need to increase tone, bulk, not necessarily strength, because their role, of course, is to look good on stage. So one, I believe it's more accessible now, coming from where it's coming from. You probably know maybe more than I do about where it's coming from. I never ask.

I just know it's more accessible. It used to come from pellets back in the day. from pellets back in the day. But South America, Europe, Mexico even, there are individuals who women use it too. I think it's a great metabolic agent as part of their program. You know, I know in Mexico, well, at least I believe from what I've

heard that the trainers can, uh, like recommend, you know, the, the type of cycle that someone does. So someone comes in and they, you know, rather than, rather than just paying you, you know, uh, 200 bucks a month for training, it's like I pay you 400 bucks a month and I get the, the cycle and the training at the same time. It's a package deal. Forget the deluxe package. It's funny. I went on a cruise to Mexico like last year and there's a place where the boat stopped and we were like, we went into this, you know, a place where it has a bunch of like tents and stuff where they sell. There's this little pharmacia and this lady yells, Oh steroid. She looks at me. She's like steroid,

steroid. So I'll come over here. And it's just so easily accessible in those places like legit they wanted to sell it to me right there in developing countries well who's huge in mexico nobody right it's not a problem there well the heavyweight champ is yeah that's about it yeah yeah so a lot of it has again with training too because you got to train put and put in the hours and put in the discipline and the hard work. But I would say that it's popular because it's been around a long time, Trenbolone. And it's always been part of a favorite, let's say with the power lifters and the bodybuilders.

And I think the ease of accessibility in different countries is probably why where, you know, Parabon, Primabon, Mysteron, Finoplex, even Deca, things like that, are not as easily accessible now. There used to be a time where you can have a compounding pharmacy just in the past few years, but not as much anymore. You can have compounded Nandrolone, generic for Decadura bone, first inazolam, windstraw, windstraw V, and even equipoise. But the nature of FDA and the pharmacy boards, they didn't like that kind of stuff. So in the past two or three years, it's really difficult to find any compounding pharmacies

in the United States to make, to compound those kinds of ingredients. So if you do see them, they're usually from a foreign country, and are they easy to obtain? I guess so, because it seems like most athletes can find them. And then how would somebody know if they got fake stuff? I mean, years ago, I think people could get stuff tested, but I think even those laboratories are like illegal or something like that now.

Well, the labs prefer not to get involved. Plus it's very costly. You don't know if you're getting something that's fake. Watered down or whatever. Meaning that it's not the potency that it claims to be on the vial. And when you look at, there's a lot of great fakes out there. I mean, there are a lot of good counterfeits. You can't tell.

I mean, they look like real. And sometimes they're missing an expiration date. That's a tip off. Sometimes they're writing on smudge or crooked. That's a tip off. It doesn't mean it's bad. It just means it may not have the same potency it's claiming to have 25, 50, 100 milligrams in it

in the ampule or the vial. So how does an athlete know when you're getting, quote unquote, the parking lot sale? You don't. Sometimes you don't even know when you're getting a legitimate, quote unquote, legitimate source online or from a Canadian pharmacy. Well, how do you know that the Canadian pharmacy is real Canadian pharmacy, not somewhere offshore, somewhere else. Again, social media, or not social media, but internet, you can get a lot of stuff now. I've had patients say, you know what? I'm doing growth hormone. I checked IGF. How much are you doing? Five units a day. Oh, good dose. Look at the IGF-1 level. Wow, that's like an 85-year-old. If you're doing five units, you should be skyrocketing high. So that tells me right off the bat, you know what?

It's probably not what it claims to be. Well, how much did you pay for it? Oh, it was only $50 a vial. Well, get what you paid for. Expensive water. Or worse, maybe it's something contaminated, not sterile, and you got some kind of bacterial fungal infection from it, which can happen. I've seen it happen too. Yeah, there's definitely, definitely all kinds of weird

risks that you run. So what are, what do you think something that some people are missing, you know, that they just, you know, we went through quite a bit, so hopefully we covered a lot of things for people, but what do you think some people might be missing that are, you know, that are currently on a cycle, they're trying to get stronger or they're trying to get leaner? You know, is there a little bit of, uh, or some, you know, secrets that you got or tips that you got that might help? Well, digressing a bit, we talked about cortisol. We talked about thyroid intense training athletes over half. I find, are cortisol insufficient and thyroid insufficient. So what happens is they're your stress hormones.

Thyroid for hair quality, for memory, cognition, for fatigue, for energy, cutting fat. Cortisol, your stress, your fight or flight hormone. cortisol, your stress, your fight or flight hormone. Now, what happens is our adrenal glands can only crank out so much cortisol for intensity of the big game of stress, psycho-emotional or physical. There is a condition that we refer to, not that you're Addison's disease, that's pathologic where adrenal glands don't produce any cortisol at all. It's like adrenal fatigue, adrenal insufficiency. When we need it the most in the morning from six, seven o'clock in the morning till like three or four o'clock, it's not there. I feel flat. I'm fatigued. It just seems like I need to sleep all the time. But at nighttime,

I'm really tired. I can't sleep. Well, maybe you have an abnormal spike at nighttime when it should be lowest, but it's flip-flopped. So it throws your circadian rhythm off. Two, back to thyroid. Intense training athletes like yourselves, you know what? I thought it was my test, so I doubled up. I'm still tired throughout the day. Like, I feel like I need to take a nap. Well, your thyroid is a stress hormone too. Maybe your thyroid needs upregulating. And we don't want to just test your TSH. Most physicians just test thyroid stimulating hormone or T4. You need to check the free, like free testosterone, free T3, free T4. What do the three and four stand for? Three iodine molecules on thyroid and four. The reserve form

that's not as active is four. It converts to three. Again, you have to have adequate cortisol to convert the four to knock off to the three. Otherwise, you have an inactive form of thyroid. And you can't just keep increasing it because it's not going to work. So intense training athletes, not just the anabolic agent. I also pay very close attention to the cortisol. And it's the cortisol not by spot blood tests. It's a 4.1 with saliva, the active metabolite, seven in the morning, noon, five, 10. Most physicians don't even know how to order that.

Special labs do it. So we look at the rhythm. Highest in the morning, lowest at night. If it's not and you're flatlined through the whole thing, guess what? That's why you're tired all the time. It's not your testosterone. It's not your estrogen, that kind of thing. your testosterone. It's not your estrogen, that kind of thing. Other things that with, well, again, the break. Yeah. Most of the people that are going to you that are already on stuff probably aren't taking breaks, right? No. When they come from me, come to my office, they may have been treated elsewhere or another state, moved here, or just changing doctors. I said, have you taken a break? Most of them say no.

Why? Then I give them the rationale, the education of why you take a break. Or, you know what? I got this also from somewhere. So I'm also taking not just test propionate. I'm injecting that twice a week. And I'm also utilizing Samanavar. And I'm doing about 60 milligrams of that a day oral.

And I also happen to have, again, you know, they go through the list. I said, that's a lot of stuff. He said, well, I don't feel very good. Is it because the side of my blood pressure is up? Whoa, high blood count, polycythemia. Are you donating blood? Nope. Heart attack, stroke waiting to happen.

So we look at all these safety factors because they're pros and cons of anything. So we look at the liver, look at the lipid, we look at the blood count. Athletes who go way out of whack usually don't die of liver failure. They don't die of cholesterol abnormality. It's usually the high blood count that's going to cause a cardiac abnormal rhythm,

and they just stop heartbeat, and they go to cardiac arrest, and they drop dead. Unfortunately, recent athletes, bodybuilders, not knowingly what the cause of death was from an autopsy report, my guesstimation is probably the high blood count. What you got over there, Andrew? What you cooking up? Nothing. I was just curious going way back earlier,

you were talking about like how some parents will come in and kind of like hint like, oh man, they got people looking at them here and there. And then of course, this can be just alleged scenarios that may or may not have happened but have you ever had a situation where like a parent has come in and they're saying like um my child is in junior high and they're already getting looked at and you're like you know this is it's too soon it's probably a bad idea like you know just understand

like the risks but i i wouldn't recommend it And then they turn around and they get something off of the street. Yep. So it's exactly that scenario multiple times over the, over the years. Okay. So it is, um, cause I think a lot of people hearing this might've freaked out when they heard you say like you would, you know, kind of help guide them. And I think that's, um, I wanted you to, you know, at least, uh, tell us about that because again, if you don't tell them how to do it safely, there's a good chance that they'll do it totally wrong. And that's, yeah. So that's why I just wanted to kind of clarify that because that was kind of heavy on my mind because I'm actually getting the same thing with SARMs.

I'm telling people like, Hey, I don't know how safe or unsafe they are, so I can't recommend it. And then they turn around and say, Hey, look what I got. I'm like, Oh shit, dude. Like you have no clue what you're doing. So it's, it's like a, it's a weird, it's a weird, uh, it's kind of being stuck between a rock and a hard place. Right. You know, Andrew is a good question because yes, it does come up more frequently than not. Um, more frequently than not. They're going to go, they're going to find it. It's not the parents,

it's the child who's going to find it somewhere. Especially Orange County. You know, it's a rich neighborhood, affluent, that kind of thing. They can find anything they want. They can find cars,

you know, Beamers, and Benz is sitting around and all of a sudden a 16-year-old is driving around in fancy cars. But again, my role is education. If you're going to do this, this can happen. We should test for this. Make sure you're not rotting your liver. Make sure you're not, uh, um, uh, getting the high

blood count. Make sure you're not long-term doing damage to your cholesterol, your heart indirectly years down the road, and also fertility. My gosh, you're 16, 17 years old. You're going to want to have a family more likely than not someday. So the potential for you to sterilize yourself is because you're suppressing your own testosterone production and your own sperm production. You do it long enough, little guys downstairs, they just get shut down. They don't come back. So the proper way, let's say,

if you're going to do it behind your parents' back or with your parents' condolence, guess what? Parents actually are condoning it, but they want to do it safely as possible. I can't keep my child from doing drugs, but let them know what kind of harm they're doing to their body. They're going to do the drugs anyway. My daughter is 12, 13 years old.

I can't stop her if she's going to be sexually active at an early age of life, but at least educate her about birth control pill. So being judicious parents and concerned parents, our role is going to be education. So Junior is going to do this regardless of what we do. We just don't want him to hurt himself. So my role is educate the parents too. Well, my question is,

where are you getting the money from to get this stuff? Your parents aren't giving it to you. Well, maybe they are, but you're not using it to buy lunch money. Right. Yeah. And then so if somebody is taking injectable testosterone, like, is there a safe way to cycle off of that? Yes. Okay.

Because a question actually did had come in earlier. We just didn't get around to asking it. Because a question actually did had come in earlier. We just didn't get around to asking it. But yeah, it's like, what would a safe protocol be for coming off of TRT or injectable testosterone? Not uncommonly, let's say somebody is on injectable testosterone. Let's say they're on a four or five month cycle. And let's say they inject weekly. Okay.

So to take a break, PCT, post-psychotherapy, I let them know, one, let's do HCG. Let's do HCG 2,500 units three times a week. If you've got a really heavy cycle and you're really suppressed, let's add Clomid 50 milligrams every day for 30 days too. So the post-psychotherapy would be anywhere from four to six weeks. It allows resaturation of receptors. It allows the system a break. It allows the blood count a break. It allows the liver a break.

You get a better response when you start up again after the PCT. And they do. So they'll take the break, and then they'll go back on their replacement. Again, this is someone who is the usual customary patient male patient and even women who are on estrogen progesterone testosterone the transdermal the rub-ons i usually don't have them do non-stop too for the same reason they'll do a drug holiday i call it and they may take uh not totally off because they'll have all these menopausal symptoms back. But what they'll do is maybe take the weekend off or three days off every other month. And they still have good results and good cyclic rhythm.

And they feel good. Individuals who are really heavy cycles, again, not that I'm condoning that at all. They just do. They're a little more difficult because they may already have done damage to the latex cells. Let's assume fertility is not a concern because the majority of our patients are, you know, 40s, 50s, 60s. They're not concerned about starting a family. They're more concerned just about, I want to do it safely as possible because I'm low. So I'm going to be honest. I feel great. I'm working out well. My cognition, my memory is better. So I may have them do even a higher dose of HCG if they're

really suppressed, up to even 6,000 units, three times a week of HCG injectable. And I may have them on 50 to 100 milligrams a day of oral clomiphene citrate. So the individuals who, let's say, don't want to be on any testosterone, same thing. They may only be on clomid from 50 to 100 milligrams. But again, pulse cycling, one month on, two to four weeks off, depending on how they respond and the competence of the latex cells down below. And so with HCG, I might be mistaken, but is there also a sublingual or like under the tongue type of, is that as effective as injectables? There is sublingual from compounding pharmacies, more commonly utilized for HCG weight loss program. I don't find it as effective for purposes of both weight loss as well as for post-psychotherapy.

Okay. Because part of it is not all of it is going to be absorbed through the mucous membrane, right? And then when you swallow it, well, the gastric juices will destroy it. So you really don't have the benefit of the whole sublingual 10, 20, 30 milligrams, whatever you're doing. For those on HCG diet programs, usually it's anywhere from 150 to 200 units a day, days one through 42 for men and women. And then we use an instant syringe. And then of course they also follow a 500 calorie diet. So that alone, you'll lose weight. But the idea with the HCG is to mobilize the fat stores in the lymphatics. So when you go back to a regular diet, you'll keep the weight and the fat off.

Yeah, what a weird diet protocol. Not sure how anyone figured that one out. Anyway, Dr. Lee, thank you so much for your time. Really appreciate it. It's great having you here at Super Training. Thank you. And it's going to be great having Charles Glass in here tomorrow. And that's all the time we got.

Strength is never a weakness. Weakness is never strength. Catch you guys later.