Men's Health Doctor West Palm Beach Florida

Men's Health

What you would call a hyper- responder? To testosterone. So, someone who responds really well to it versus a hypo responder or in the world of bodybuilding, they would say a responder and a non-responder. We've all seen the people that take a lot of things and don't really look that great. And you see the people who take a little bit and they respond really well. You see it., but there's always a reason. The reasons why people are responders versus non-responders, in other words, is always a cause. It's either one of three things.

One, nutrition is poor or it's suboptimal for them. They're not following their prescribed macros. Training intensity in the gym stinks. They're not giving themselves, their muscles the adequate stimulus or they're overtraining, they're not sleeping. There's no such thing as a testosterone non responder that works. That doesn't make any sense. So, from a genetic standpoint, really no differences with androgen receptors between individuals? No, I've never heard of that before. Was that may be something that's set-in gyms and things like that. Oh, I tried to testosterone. I didn't get I didn't get any bigger or stronger.

Really. So usually that's pointing to something else. Like you said, of. Course, it's pointing to some. Nutrition. Of course. Then you watch these people train. It's exactly what it is. An androgen receptor is an androgen receptor. We all have them. To say that somebody is doesn't respond to testosterone.

Well, what do they respond to? Does it make any sense? We're not talking about bodybuilders here. Bodybuilders yeah Who knows what's going on at the receptor level in them? I have no idea. But it could be all sorts of weird, you know, downregulation because, you know, there also is going to be a, you know, a saturation point. I don't know if that's what you're going for. You know, once you continue to inject, inject, inject, in other words, the pharmacokinetics of it or not, they're not linear.

You just can't keep injecting, injecting, injecting because you're going to downregulate your receptors and it's going to become over time, to a great degree, you're going to be less responsive to higher and higher doses. We know. That. That's actually, I think, really good clarification. Naturally, under normal

circumstances, no such thing. Someone who's using abusing over a long period of time, there's going to be a downregulation and so that person could essentially be a non-responder, not a non-responder, not as a responsive. Less responsive sure and I have no issue with that. That's sort of a standard principle in pharmacokinetics. Now from a genetic standpoint, some people probably build muscle easier than others if all things are equal.

Differences in genetics and androgen receptors for testosterone

I would agree with that. I think that there is a predisposition. Like as an example, I can't be a professional basketball player. I'm five foot nothing. So, there is some sort of genetic predisposition for me not to be a pro basketball player. But as far as you saying to me, Hey, Brett, I'm a testosterone non responder, I just can't. No matter what I would say, no, there's another problem. Come train with me. Let me put you through that workout. Okay. You want to grow and grow?

How long you sleeping tonight? 2 hours. Don't blame the testosterone on you sleeping 2 hours and then saying, oh, I'm not putting on any muscle. When you're not giving your time to grow, don't blame the testosterone when you're doing CrossFit six days a week. I'm not putting on any muscle. You're not going to grow. Is it the testosterone molecule? It's not working. It's you're running around with cortisol levels that are detracting from the effects of testosterone.

Effects of cortisol levels on testosterone

When we're talking about things that influence the results that we get or the benefit that we get from testosterone. Cortisol levels are obviously huge, huge. Huge. I would say if you were to ask me, call me up and when they Brett, what is the number one thing that probably counters the effects of testosterone, high cortisol levels? I want to shift gears a little bit bloodwork, total testosterone levels, free testosterone levels, SHBG, estradiol and start talking about blood work. What are some of the things obviously, besides and we're going to dive into total testosterone versus free testosterone and even bioavailable testosterone, which not everyone talks about. But before we do that, what are some things when someone's looking at their blood work, they go to the doctor, they get their blood work done. What are some of those other things related to their testosterone levels that they should be looking for? Right. So, albumin levels, albumin is total testosterone vs free testosterone - SHBG and albumin levels

just a protein or a globulin that is secreted by the liver, binds up various molecules in the blood, one of which happens to be testosterone. Sex hormone binding globulin is another thing to check to be another lab value, to check sexual one binding globulin again, another globulin, another protein that's floating around in the plasma that has a very, very high affinity for sex hormones.

So, it's sex hormone binding globulin SHBG binds testosterone. It binds estrogen with high affinity. If you have high levels of sex hormone binding globulin, it can be problematic because it's going to sort of hold on to any testosterone that is released from the liver and make it non bioavailable.

But so, albumin, sex hormone binding globulin, another one obviously, which is on everybody's radar is your E2 level. So your estradiol levels because testosterone is aromatased more so in females and males but even in some males – genetics to estradiol and you don't want to have too much of an imbalance because you can end up with gynecomastia, etc., etc... So those are the sort of the three big ones that we actually the four big ones that we that we check here.

So, testosterone, estradiol, sex hormone binding globulin albumin and of course you always have to check your lft is your liver function test because you also want to make sure that whether it's the testosterone or whether it's just, let's say, an aromatase inhibitor, just let's call it anastrozole, you want to make sure that they're not bumping or causing elevations in your liver function tests. You're not hurting your detoxifying organ, your liver by polluting it with chemicals. and Anastrozole is a known offender to cause bumps in LFTs So going back to liver health being. One of the important factors there,or our testosterone levels are a utilization of testosterone therapy. Sure.

So obviously important to look at our liver function and our blood work, like you said, albumin, sex hormone binding globulin and then estradiol, which is, like you said, a lot of people, whether it's gyno or sensitivity in the nipple. Sure. Absolutely. Let's talk about total testosterone, right, versus free testosterone versus bioavailable testosterone, because that goes back to these proteins.

Sure. It's tightly bound to sex hormone binding globulin, Correct. Not available for tissues to use. Correct. So, it's not being cleaved off of the sex hormone binding globulin molecule. It's done, which is in distinction to testosterone that is bound to albumin. Which is loosely bound. Very loosely bound and will float in and off, in and out depending upon. It's almost like a a suck effect. As. There is demand, you know, in the tissue. You injure, you electively injure your muscles. Training, which there is demand for recovery. Right? There's demand at the cellular level. Testosterone is going to get bound. More is going to be pulled off. Of That reserve for the albumin based reserve pool. So, there's an equilibrium there. So as more of the free testosterone is being utilized at the receptor level on the cell, you're going to create like a sump effect more is going to be pulled off the albumin molecule. Typically, we don't see a lot of variations in albumin in well-nourished, healthy individuals. So for the general population, sure, it's just a I look at it real, real quick. But for the most part, albumin is is albumin is albumin. It's pretty much normal in in most people it's the same sort of thing as do I measure in the clinic. Bioavailable testosterone. No, for what? most people's albumin output from their liver is normal. So, I don't need to measure it. But it's a good it's a good thing to understand the difference between high affinity SHBG So here's the SHBG molecule. You put testosterone on it, it's not coming off, it's gone, it's over. Okay. You're not going to cleave that. Okay. And get that to join the albumin pool. Certainly, these two things are not going to fight with each other because the affinity of SHBG for testosterone relative to albumin, they're orders of magnitude different. This is loose. Like you said, albumin goes like this and sort of holds it. Okay. But you can knock it off really, really easy.

Sex hormone binding globulin. Once it's got it, it's done. The affinity is too too too high. So, we don't measure bioavailable. And that means the free testosterone floating around. Okay. So not protein bound, plus that which is bound to albumin. We don't measure it because you don't need to measure it. But I think an important distinction for most people because the focus ends up on total testosterone versus just free testosterone. And that's only a partial picture. So that which is bound to sex hormone binding globulin, like you said, is gone, Right? That's a waste. Right. Write it off the books. Right. But the amount that is bound to albumin can still be used. And I think that's where there is an importance, not necessarily on testing bioavailability. Right. But knowing that it's not just the free testosterone by itself that matters, the amount that is bound to albumin matters as well, because that is the testosterone that is in reserve in times of higher demand.

That's correct. So, we will see this a lot. Somebody comes in, they have a total testosterone that's pegged to the edge. I'll just call it 1100. Okay. And then the free testosterone is eight. Okay. Almost by definition, the sex hormone binding globulin is high. You don't see it any other way because you can't really you can't really account for that. That's really the only explanation for something like that. So what really is important is that percentage of total testosterone, not just that is free testosterone, but that ratio that is bound to sex hormone binding globulin. Yes. Versus what's bound to albumin.

So that's what's important. Correct. So, when you see high SHBG, right. That means less of that total testosterone is going to be bound to albumin and available later. That's correct. So, you want to see lower sex hormone binding globulin levels? That's correct.

And like I said, the albumin, even if you try to move the needle in that regard, there's no reason to do that. You could it okay, aside from giving somebody telling them to eat more protein, eat more protein, you may see it bounce up a point sex hormone binding globulin. If we see at high octane, I'm just going to use the number 50. We want it typically somewhere around 20 to 30.

That's we're probably the sweet spot for most people. We can knock it down. We use various supplements to do things like that and we actually use a medication and I can go into that. Okay, if you want to. Your sex hormone binding globulin straight down, and then the test free testosterone goes right up. I think anyone watching this is going to say, yes, I want to know.

Supplements to lower SHBG levels and increase free testosterone

So sure. So, let's start with supplements. What kind of things can your average person do maybe over the counter, go to a supplement store to knock down their SHBG So we used to and we started obviously supplements first and then medications. If it proves refractory, we use two in the clinic. One is nettle root extract or stinging nettles and the dose it varies. Okay. Why does it very well. Everybody's a little bit different like we talked about. Plus you don't really know with regard to these supplements, you know what's in them. You assume that things are per the label, but as you know, a lot of them are, you know, sort of they don't follow suit and they may tell you that there's a gram of stinging nettles. Depending upon the preparation, you may only get 300 milligrams or you may get more. So, you have to figure out which one works best for you.

And there's a whole host of stinging nettle root extract out there so you can buy those. And the dose typically is a gram to two grams per day in divided doses. A lot of them are 900 milligrams, some of them are a thousand. I'm talking about one capsule. So, one or two, you can even go up to three days. It's not going to hurt. You take them with meals. The other one that we use is boron. So elemental boron starts out of MG, you can go up to three milligrams, maybe even five. Yes, I often get this question. Can I use both? Yes. Check your sex hormone binding globulin before, do it for 12 weeks. Check it thereafter. Those are the two big ones. I would say at least 50% of the of the people will respond to them and free testosterone will go up. And again, you don't have to change your testosterone dose. Just add the supplement, knock the sex hormone binding globulin down. Shoot for 20 to 30. So when it comes to this, let's call it a perception of being a non-responder. Right. That could be a factor. If someone's SHBG is high, they could be on a higher dose of testosterone. And obviously, if their doctor is not telling them, well, here's the problem. Their perception is going to be, well, I'm not responding to this the way that maybe someone else might be. That's correct. Hopefully their doctor is talking

Effects of synthetic steroids on SHBG levels and testosterone production to them about that. And again, these are these are sort of, you know, loaded questions because you also don't know what else they're taking You know; they can be on 40 synthetics. So, you have you have no idea.

That being said, synthetics, one of the ways that we know that people are on synthetics, so we don't have a lot of bodybuilders in the clinic because I sort of weed them out is drives your sex hormone binding globulin straight down so you can get somebody who says, oh, you get this guy who's really, really big comes in hearing those, oh yeah, no, I just take 200 milligrams of test a week. I know you're 4% body fat, you're monstrous. What else are you taking your sexual Your sex hormone binding globulin is 5 You know, something else is going on. That's right. The telltale sign is when somebody comes in there, there on nothing and their sex hormone binding globulin is 5 Then they're taking let's say Anavar Okay. And their testosterone level is, you know, zero. Okay. We oftentimes see people that come in here and they have very, very low levels of both. And the reason why sex hormone binding globulin goes down is one that's probably a direct inhibition, but it's probably secondary to the fact that they're driving. A lot of times they by a feedback mechanism, they're starting off their natural testosterone production. Okay. We know that that happens when you take synthetics in isolation. That's why if you're going to take synthetics, you always take both.

Right. And their body. If you make the mistake of only taking one, anavar don't take testosterone. Your sex hormone binding globulin goes down because your body is trying to free up as much of that testosterone as possible because the production is being suppressed. So, it's the body's natural response to free up testosterone. So, it lowers sex hormone, binding globulin Does that make sense? It does. It's it's you know, it's Legality of Anavar being prescribed for lowering SHBG not a topic that I know a lot about. And listening to you, I'm now in my head seeing these questions that were popping up where people are going to their doctor and these physicians are prescribing anavar and that's what they're telling them, is that we're trying to knock down your SHBG level. And that's true. Okay. And that's the way that doctors get around the law. How do you get it from your. I thought the synthetic was cracked down on it. Oh, no, my doctor wrote it for me because I want to drive my sex hormone binding globulin down to free up more testosterone.

Hopefully they're also giving them testosterone. Right. And not just the anavar unto itself. Otherwise, what ends up happening is that you find out after the fact that, oh, I haven't been able to have sex with my wife in six months ever since I started the Anavar. Well, you know, go figure. Right. Push your testosterone levels plummet. They plummet. Your sex hormone binding globulin goes, Oh, my God. You know, his testosterone level, you know, went from, you know, 400. Now it's down to 50. So, my sex hormone binding globulin. My liver is reacting and going, oh, my God, this guy has no more testosterone floating around in the body. I'm going to cut the production of sex hormone binding globulin off to try to salvage the situation, but it can't. In other words, it's too they're oftentimes too far gone.

Today, the big burly guy, all on his synthetics. Right. He's on anadrol or whatever reason, he's big and burly guy, kind of sexual. His wife has that possible both because of negative feedback. Right. And then your sexual and binding globulin is 2. Right. They're trying to free up all that testosterone, whatever the whatever, whatever, whatever is being output, but they're too suppressed. Right. So the sex hormone binding globulin and you can't get low enough to compensate for that very, very, very

low testicular output of testosterone. And again, that's happening because of the inhibition at the level of the hypothalamus that the synthetic is causing. So, if you're going to use anavar you must use testosterone, you can't just be on anavar otherwise you can. You're going to be this big guy and you're not going to able to have sex with your wife seen in a million times. You personally you recommend starting with the supplement approach first to try to knock that down as opposed to this alternative. route? I do not use anavar in this clinic. It is very, very, very heavily scrutinized by the DEA. Okay. I'm not going to start fiddling around and, you know, using these anabolic agents. Okay.

In in, you know, under the auspices or under the guise of I'm trying to lower his sex hormone binding globulin No you're not, you're trying to turn this guy into a bodybuilder. So, what do we use? We use Danazol Danazol works fine. It's another synthetic agent.

Okay. Doesn't have any of these, you know, you know, anabolic androgenic properties and it drives your sex hormone binding globulin straight down. You give them a six-week course. They're typically done for six months. Even out to a year. Works beautifully, and there's no nothing with it. Well, you present it to a lot of guys, the anavar approach, right? The added anabolic effect of it, of course, it seems appealing. Not interested. Right. Right. But absolutely, that's from an aesthetic perspective You can see why a lot of people like it, of course. Okay. But I'm not here to lose my license. Right? Not so. It's a way. Not necessarily the right way. Correct.

Half-life of testosterone in different forms: Cypionate, enanthate, propionate You hear a lot of people talking about the half-life of test, different forms, right? cypionates etc. Sure. Is that important? Should people be worried about that or how does that affect them? So that's a good question.

Testosterone dosing schedule

And we hear about this a lot from our patients who are obviously are on on the Internet and things like that. For me, I like just simple once a week, 160 milligrams or so of cypionate and I'm good and the enanthate and proprionates we just stay away from Proprionate is heavily scrutinized again by the DEA. Why because it is a short acting agent it clears from your system quickly a week a week about a week but it is fast. So as an example, if you are going to be in a bodybuilding competition or powerlifting competition, you know, and you wanted to fiddle around with the drug testing Proprionate So the government is watching Proprionate prescriptions for that reason. I stay away from it Do I have any issue with the ester itself? Nope. An enanthate also shorter acting a little bit longer than proprionate I don't see much reason to write for enanthate for me cypionate once a week. Great. Some people insist on doing it twice a week. So they're on just let's say 0.4cc maybe 0.5cc So 80 or 100 milligrams of cypionate twice a week. Why? It's because a lot of these folks, men and women, are concerned about their hair. This was long gone. My hair was long gone. Okay. Before I was ever on testosterone.

DHT levels and hair loss

But I do. Concerned about a bigger peak, potentially higher DHT levels. Exactly. I was just going to say, because a lot of it gets shunted over to DHT and that's bad for your prostate health. It's also bad for your hair follicles. So, there are people who are very, very concerned. Obviously, they have full heads, hair, so they go twice a week. Sure. In that context, we also used finasteride asteroid, so we use a lot of finasteride in the clinic because people are concerned about their hair and they don't want their DHT levels going up.

When a person is taking testosterone, maybe to unwanted side effects could be elevated estradiol levels on one side or on the other side, elevated DHT levels, Correct. So one that dial estrogen affecting maybe gyno, nipple sensitivity, whole slew of other potential things. Correct. The DHT for probably most. Common concern being hair loss. And prostate. And prostate health.

So let's tackle estradiol first. If a person has total testosterone in a good range. OK Free testosterone is in a pretty Estradiol, estrogen and aromatase inhibitors like anastrozole good range, but their estradiol is high. Is it better to take an aromatase inhibitor to lower that since all their other levels look good?

Or is it potentially better to maybe lower the testosterone a little? To your question in we we do both. You almost have to take into account an individual's goals, things like that. And you also sort of have to look at their at their DHT levels. Right. That's what really gives  your testosterone its real oomph Okay. So, if somebody is, you know, looking to have that, you know, that virility, I would tell you that driving down your total testosterone levels may not bode well with them. You really have the the options. If they don't care so much about that, you can, you know, drop their total testosterone level so that that answer is heavily dependent upon where that individual wants to sort of live. So, another surgeon colleague of mine at the hospital.

Effects of estrogen being too low or too high - gyno, nipple sensitivity and erectile dysfunction Total testosterone free. Testosterone, good. But he has, E.D. And that's a whole other. There's a difference between erectile dysfunction and libido. Yes, I remember I told you the E.D. itself, it's almost a vascular phenomenon. In other words, you have poor blood flow down there, whereas libido and the two can be interchanged. But that's erroneous. Okay. Libido is your drive You're calling me and you have ED problems, which he really doesn't. He's a very healthy guy. Okay. No medical problems.

I'm just on a little bit of test. I said it's probably your libido, you know, What's your estradiol level? I don't know. You better go check it. And the text was be careful, because when you're on an aromatase inhibitor and he was he was on Anastrozole and he was on half a milligram a week. So be careful because with estradiol, men are probably best at 20, 25, 30, 35. But the window, if I can get one point across, is extremely narrow. You're outside of the window on the low side to low. It doesn't matter if you've got the hot wife or the hot girlfriend, you are not going to work. It's not happening.

Okay. You know, estrogen has these profound effects on the brain. If you're outside the window, you're done. We see that all the time. So almost without knowing his numbers, you're on too much anastrozole. So admittedly, I used to make this mistake because the way I was trained was go on Anastrozole Point five, three times a week. The phone was ringing off the hook as I was telling my patients they can't sleep at night. I'm feverish, I have hot flashes, can have sex with my wife. So you know what we do with the anastrozole? Now we start people out.

If we start people out. So, if they come in and they have very, very low in estradiol to begin with for whatever reason. Okay. So, they're sort of on the low end. Just let's say they're ten. Don't even start them on anastrazol Maybe put them on some zinc oxide which has aromatase inhibitor properties like Chrysin and zinc. Those are good ones. And we wait and we see that 12 weeks gynecomastia doesn't happen in 12 weeks. Okay. Nipple sensitivity typically doesn't happen in in 12 weeks. But when I used to start people on aggressive doses of Anastrozole, it was a disaster. So very, very, very narrow window. And if you're going to error on one side, leave the anastrozole out. Take zinc every day, 2550 milligrams. It has a nasty tendency to make people nauseous, so you got to be careful with it. But watch out. Okay. More so for low estrogen than for high estrogen.

That's my sort of soapbox speech on estradiol. How do I learn? Thousand patients or more, whatever it is. Can you have Can you have low testosterone levels yet still have a high libido? low testosterone levels yet still have a high libido? Oh. See that old time I saw a guy last week Free testosterone of six. How's it with your wife? I'm good. Sure, it could have been better. He'll say something like, oh, you know, wasn't as good as when I was 18, but he still passed. But I see that all the time. And the other key, key, key component to libido is also how you are between your ears if you have a significant amount of stress on the job. Your professional life, your personal life, whatever your financial, whatever it is. And you are bad there, right?

Okay. Even despite because I know this question is coming, even despite you being up here. Okay. In other words, your free testosterone is 18. You're good. Some of those people are just. No. So that was the question. That was the follow up. Yes. And you have high testosterone and low libido. See that?

Effects of stress on libido

And the first thing that I usually go after is what do you do for a living? How much stress do you have in your life? Are you sleeping well? Those two things are very, very tightly coupled, as you know. So we do see that, you know, people that are CEOs with good levels of testosterone, they have zero drive, zero drive. So, a lot of that stuff comes between their ears. And I always talk to them and counsel them about you got to get your stress down. You got to get your stress down. It's not purely an effect of testosterone levels. So, switching gears, going to the other side of the conversation, DHT levels.

Right. Again, probably same approach. First thing is lowering total testosterone, correct? Correct. Is there anything else someone can do if their DHT levels are high? Sure. From a supplement standpoint, Lowering DHT: aldactone (spironolactone), finasteride and DHT blockers what you can use is you can use supplemental. So that's the prostate that's typically billed as the prostate. Go get some saw palmetto. Right. Because DHT untoward effects on the prostate causes the prostate to grow . Hair follicles to, well, basically die in people that are androgen sensitive. Okay. So, there are a lot of people on testosterone who have no problems with their hair. Right. There are a ton of people who are not sensitive toit. There are a subset of  us who happen to be so Saw Palmetto is a good one. From a pharmaceutical standpoint, things that work really well. So five alpha reductase takes testosterone and goes to DHT. So five alpha Reductase inhibitor is like Finasteride Any of the hair loss medications that end in "ide" like different "ides" and there's a million of a million other ones Propecia, things like that. And that's obviously the brand name, but things like that, Aldactone. So that's a potassium sparing diuretic. A lot of a lot of bodybuilders use it, particularly during the contest prep that interestingly, despite the fact that it is a diuretic, it's used for acne and it's also used for hair loss and prostate, that'll drive your DHT down to zero. Okay. If you use it in a reasonable dose, they actually have shampoos that have like an aldactone in them that you can use on your hair. So, it gets into the follicles. So yeah, yeah. So, it does that does work.

How low is too low for DHT?

Estradiol we know we don't want to drive it to zero, right? We don't want it too high but we don't want it to zero. What about DHT? So same sort of thing. Great question. What's the main side effect of people that are on hair loss medication? What do you think. Some effects on the androgenic properties? So how do you feel when those things are not circulating in your body?

What's the main complaint that you hear? I don't feel like myself anymore, so I sort of feel more and this is not an name, this is not a misogynistic comment, but I sort of feel more like like effeminate You are. We've taken away your virility. We've taken away your manliness. Your manliness is from your DHT.

That's what gives you your virility. That's DHT. So little little's good. That's good. Okay, great. Right or great. Okay, But. But, but. But too little is a problem. Too little is a problem. Okay. And that is the main complaint. That's why we always tell our guys here, you let us know and you're even on testosterone. You let us know if you're having any of those symptoms. And you know, when you get them back, they'll say, you know, you may get a phone call. My testosterone. It just doesn't make me feel like it used to. Right. That's why we use James. That's what we use a very, very small amount here.

We don't use standard dose, a milligram a week, which I used to take. Okay. Just as a sort of a soft sort of blood pressure medication I used to use. You know, I take my card is okay and then I'll use you know, sometimes I use some spironolactone if I happen to have a, you know, a bad meal, I check my blood  ressure or something like that, and I have a little bit of extra water on me. And I just sort of very sensitive to sort of what you look like in the mirror, maybe just sort of sliding scale, a little bit of l doctor, a sort of soft. But if I'm using it. Okay, and I check my blood work. Okay. Within a week of a dose, my DHT goes down to nothing. Okay. From one or two doses of aldactone So be careful. You do, you can, you do and you don't feel you don't feel as just as good. You just don't look when your DHT levels are low. So, yes, it's a double-edged sword of sort. You know, you have to stay in sort of that window. That's good for James or good for Brett or good for good for Mike. It's not nearly as tight as estradiol, but you do need to have some DHT. So, it's a fine line. It is a fine line and you can just measure it. And we see those numbers go down. Sometimes we see those numbers go down too much. We back the finasteride off. It will back the dark down off a little bit so that a person has a little bit more oomph. And since these parameters are so tight, obviously why blood work is so important. Regular blood work. Correct. So now we talked about high testosterone, low testosterone with libido, where he really kind of answered this question, but I'm going to ask it anyway. Sure. So, people that have high testosterone levels that still have a challenge building muscle versus people that have lower testosterone levels that are still able to build muscle, I think a lot of it goes back to the other variables that we talked about training, intensity, nutrition, etc... But are there other factors.

Top 3 causes for not getting good muscle building results from testosterone

95% of people. Okay. Or having problems? You can always, always pinpoint something. I have a friend lean, lean, lean guy, but he comes back here every year and says, it’s just not doing much for me. You know, this testosterone, maybe it's given me a little energy, maybe it's helped me from a sexual standpoint a little bit. But, you know, I'm not really amassing muscle mass. And I say to him, how are you training? Well, you know, I go on bike rides three times a week. I trail ride. Please don't play in the testosterone molecule. Don't you have to do the other 50%?

The testosterone does not work alone. All right. So, there you have it. Hopefully that answered all your Sharing my own bloodwork questions. Now, a lot of people ask me what I take or what my blood work looks like. So next video, we're going to sit down with Dr. Osborne and go over my blood work. Now, he happens to be the doctor that I first visited when I was considering taking testosterone. So we're going to go do my original blood work, get his take on that, and then also some of the changes and adjustments that we made over time. So, if you want to check out that video, make sure to turn on your notifications and all that crap and I'll see you next video.

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