full
Why Testosterone Levels Dropped 50% Worldwide | Shalin Shah
Testosterone levels have dropped by nearly 50% over the past 40 years, creating ripple effects in metabolism, mood, fertility, and longevity. In this episode, you’ll learn why hormones are declining across both men and women, the hidden role of endocrine disruptors, and how lifestyle, TRT, and new oral formulations are changing the conversation about hormone health. Discover the metabolic, cardiovascular, and brain benefits of testosterone and what myths need to be debunked once and for all.
TIMESTAMPS
[00:00] Testosterone decline over the last 40 years and why it matters
[03:27] Causes of low testosterone: obesity, endocrine disruptors, poor sleep
[06:09] Symptoms and metabolic consequences of testosterone deficiency
[09:45] Can lifestyle changes restore testosterone without TRT?
[15:09] How low testosterone shows up in women and its health impacts
[17:01] History of testosterone therapy, stigma, and FDA regulation
[22:16] Current TRT options: injectables, pellets, gels, and compounded creams
[33:06] Innovation in oral testosterone and SHBG reduction
[42:00] Fertility, LH/FSH suppression, and pilot study data
[55:33] Testosterone’s connection to longevity, chronic disease, and healthspan
[58:23] Myths about cardiovascular risk, prostate cancer, and testosterone use
[01:00:51] Hormones as a foundation of health and how to get tested
Guest: Shalin Shah
Website: https://kaisertrex.com
Instagram: https://www.instagram.com/themetabolicceo
🌐 LET'S CONNECT 🌐
Host: Orshi McNaughton
Website: https://www.optimizedwomen.com/
Podcast Links: https://optimized-women.captivate.fm/listen
YouTube Channel: https://www.youtube.com/@optimizedwomen
Instagram: https://www.instagram.com/orshimcnaughton/
Enjoying the podcast? ⭐️⭐️⭐️⭐️⭐️
Don’t forget to subscribe and leave a review to help spread the word!
Transcript
So this has been a decade over decade serious decline.
Speaker A:Actually, we mapped the rates of testosterone deficiency against other common conditions of today, whether it's cardiovascular disease, obesity, 2 diabetes, and testosterone deficiency is actually rising at the fastest rate.
Speaker A:The amount of young males, you know, 30 and younger that are coming in with testosterone deficiency is shocking.
Speaker A:And they are surprised every day by how many folks that are coming in there with low testosterone levels often, say today.
Speaker A:If testosterone was discovered today and didn't have the baggage or the stigma, it would be the most valuable molecule in the world.
Speaker B:Welcome to the Optimized Woman, the podcast for high performing women ready to take back their health.
Speaker B:Hi, I'm Orshi vangnaughten, a board certified holistic health practitioner and functional nutritionist.
Speaker B:If you are tired of feeling stuck, you can't lose the weight.
Speaker B:No matter what you do, your energy is in the toilet and you lost the spark you once had, then you are in the right place.
Speaker B:We are here to unleash the unstoppable force you're meant to be and give you the tools to fix what's holding you back.
Speaker B:So if you're ready to own it, start thriving again, and live the life you deserve, then let's get to it.
Speaker B:I'd love to kick it off with why are testosterone levels declining so dramatically across both men and women worldwide?
Speaker B:What are the contributing factors?
Speaker A:So this has been a decade over decade serious decline.
Speaker A:Actually, if you look at we mapped the rates of testosterone deficiency against other common conditions of today, whether it's cardiovascular disease, obesity, to diabetes, and testosterone deficiency is actually rising at the fastest rate out of most of these major common diseases.
Speaker A:So I think that's a fact that most people are unaware of today.
Speaker A:And if you look at the reasons behind this, why testosterone levels are dropping so dramatically, it's really multifold.
Speaker A:So testosterone deficiency is a comorbidity with a number of other diseases.
Speaker A:So it's bidirectional.
Speaker A:We whether that is obesity, type 2 diabetes, these are again bidirectional.
Speaker A:So there is that decline due to that.
Speaker A:If you look at other factors though, that are some out of our control, like endocrine disruptors, this has played a major role over the last few decades that have seeped into whether it's our water system, our food, you know, plastics and microplastics being everywhere in, you know, things like scents, cleaning products, et cetera, things.
Speaker A:These have all led to serious disruptions.
Speaker A:In our endocrine system.
Speaker A:So that's a big one.
Speaker A:Sleep is another big one.
Speaker A:And this, this seems like a very simple topic, but if you really look at lifestyle factors and the way our sleep patterns have changed over the year, that is driving a major disruption in our hormone production.
Speaker A:We produce our hormones at night naturally.
Speaker A:We're getting a lot less sleep these days.
Speaker A:We're getting less quality sleep.
Speaker A:We're in front of screens significantly more.
Speaker A:So that's a big driver that I always like to highlight because it's something that you can try and work on pretty quickly, but again, it's multifactorial.
Speaker A:So some of the things you can work on and try and control.
Speaker A:There are some underlying factors that, that make it very difficult to restore our levels to what healthy adults had two or three decades ago.
Speaker B:Can you quantify a little bit more?
Speaker B:Like, what kind of decline are we really seeing?
Speaker B:First, maybe in men and then in women and over how many years or decades?
Speaker A:I would look at the last 30 to 40 years.
Speaker A:Testosterone levels are approximately one half of what they used to be.
Speaker A:50% lower on average.
Speaker A:And what's, what's unfortunate about this as well is if you look at lab normal ranges, lab normal ranges really reflect the current state of our population.
Speaker A:So the normal range has continued to decline through this period.
Speaker A:And now a male, let's use a male, for example, is going and getting their blood work done, and maybe they come back at 300 nanograms per deciliter, which is the standard unit measurement for testosterone that's deemed as normal today.
Speaker A:So you have this sliding scale that is reflective of an unhealthy population rather than what's really optimal.
Speaker A:That's doing a disservice from an information perspective with patients.
Speaker B:So if you go back maybe 30, 40 years, what would you say a normal level was for men?
Speaker A:6 to 800.
Speaker B:And now we are down to like under 300 as a normal.
Speaker B:And then how about for women?
Speaker B:Is that also about half or what.
Speaker A:Do you see for women, the female decline?
Speaker A:There's not as much good data, to be honest, which is a whole other issue aside.
Speaker A:I think you're seeing similar types of declines, but some instances, maybe more.
Speaker A:And I think a driver of that has really been birth control usage, which is pretty high here in the US and birth control drives a protein called SHBG higher.
Speaker A:SHBG binds to testosterone and makes it unusable.
Speaker A:So then, then we're talking about free testosterone now, but that sort of being a little bit of an X factor on the female side, you may see declines that are as big, if not a little bit greater than the male side.
Speaker A:Look at the bell curve.
Speaker A:And the majority of younger folks, again, their average is low, is lower than it was previously.
Speaker A:But the number of men, and I talked to a lot of providers, right?
Speaker A:I mean hundreds and hundreds, not thousands of providers in all different medical settings, from cash only concierge to longevity to traditional endocrinology and urology practices.
Speaker A:The amount of young males, you know, 30 and younger that are coming in with testosterone deficiency is shocking.
Speaker A:And they are surprised every day by how many folks that are coming in there with low testosterone levels symptomatic as well.
Speaker A:So it's not just that their T level is low and there's a lot of, again, other things happening there, whether you, you know, look at the fertility scenarios of a lot of these men and so forth.
Speaker A:So the health ramifications are quite large.
Speaker B:You mentioned that testosterone affects health and then health affects testosterone levels.
Speaker B:So my question is, what are the downstream sort of metabolic and systemic consequences of low testosterone?
Speaker A:You can look at these in a, a few different phases, right?
Speaker A:Again, symptomatically you're going to see at the top level, you're going to see fatigue, you're going to see inability to put on muscle mass, increased fat and adipose tiss.
Speaker A:These also manifest in, in things like depression, right?
Speaker A:So these are symptoms that, that do occur.
Speaker A:But testosterone is a molecule.
Speaker A:There's an androgen receptor on every organ in the body.
Speaker A:Tons on your heart, brain, et cetera.
Speaker A:So this actually works even down to a mitochondrial level and how your mitochondrial function at a cellular level.
Speaker A:So that's really where then the cascading effects happen.
Speaker A:So, so again, you're gonna see, you know, under those symptoms, what are you gonna see?
Speaker A:You're gonna see higher inflammation in the body.
Speaker A:Testosterone helps control inflammation.
Speaker A:You're gonna see more insulin resistance.
Speaker A:Testosterone helps control insulin sensitivity.
Speaker A:This is a major concern of today.
Speaker A:So metabolically, it will show up when we talk about bone density, right?
Speaker A:Like testosterone plays a role in osteoblasts.
Speaker A:So it's gonna show up in almost every function that you actually care about across the body systems.
Speaker B:So what happens when a man is clinically low in testosterone?
Speaker B:How would a man recognize?
Speaker B:You already mentioned a few things, but let's dive a little bit deeper.
Speaker B:So they may have fatigue, they may have lower sex drive, they may have higher levels of inflammation, maybe they not putting on muscle enough.
Speaker B:What are the things that they are feeling and experiencing that should be a red Flag that, hey, I should get my levels tested.
Speaker A:So two things I point out.
Speaker A:Each male is going to respond differently naturally.
Speaker A:You mentioned libido.
Speaker A:So sex drive is a big one and often a big red flag for men anyway.
Speaker A:So, so that's usually kind of why they get into the doctor because there's not a lot of reasons that they like to go there, but that's something that they want to make sure is working properly.
Speaker A:But cognition, brain fog are, is a, is a clear symptom of testosterone deficiency.
Speaker A:Again, that muscle mass is definitely big, the central adipose tissue.
Speaker A:So those large bellies are quick indicators.
Speaker A:There's actually a large, large study done, this is actually interestingly out of Brazil, that predicted testosterone deficiency to a very high degree in men with waist circumferences over 38 inch waist circumference.
Speaker A:And the rate of testosterone deficiency was off the charts.
Speaker A:So you know, these things are very clear for a patient to go in and get checked out.
Speaker A:Right?
Speaker A:So I think if we can help educate the population to say, okay, if you, if you are obese, if you're a type 2 diabetic or you have these other symptoms, go get checked.
Speaker A:And on the flip side, if we can also encourage the medical establishment to be better about offering a testosterone test.
Speaker A:This should be standard in the blood panels today because you check your cholesterol, you check your glucose, you check your A1C.
Speaker A:But a testosterone level is the single best marker of overall health in a male.
Speaker A:It can tell you if you're, you know, inflamed and so on and so forth.
Speaker A:So a lot of things and it's, it's not expensive, right?
Speaker A:It's, it's a $10 test.
Speaker A:Why is it so difficult to have this included on a blood panel?
Speaker B:Men that have the big belly, insulin resistant sex drive is low, it's probably very likely have low testosterone.
Speaker B:Is it possible to reverse it by losing we going on a low carb diet, exercising lifestyle changes, how often men are successful reversing that with lifestyle versus trt?
Speaker A:The percent that are successful in reversing with lifestyle changes is very close to most other common metabolic conditions.
Speaker A:Think about high blood pressure, high cholesterol, obesity in general.
Speaker A:These can be reversed with lifestyle at large.
Speaker A:So I'm not saying pharmaco interventions are not necessary.
Speaker A:But at large, if a person's able to do a lot of the lifestyle interventions, they can fix that.
Speaker A:Testosterone deficiency is not different.
Speaker A:I think there are these endocrine disruptors.
Speaker A:There are some things that are underlying driving these changes.
Speaker A:You can't correct for all of them as much as we want to think we can.
Speaker A:You know, I'm not going to touch plastic.
Speaker A:I mean there was a, there was a paper that came out said there's more plastic particles in glass bottles than, than some plastic bottles.
Speaker A:So you know, this, this chase to try to toxin from our environment is impossible.
Speaker A:Right?
Speaker A:Like, let's not kid ourselves.
Speaker A:So those things are not going away and those will still affect your T levels.
Speaker A:But I am a full advocate for, you know, taking care of the interventions you can diet, sleep, stress, exercise, nutri.
Speaker A:There will be differences that can show up in your levels.
Speaker A:So again, I encourage it.
Speaker A:But a lot of guys need to get on an upward spiral, right?
Speaker A:And testosterone really helps with that.
Speaker A:So say you do need to get into the gym and you want to lose, you know, 10, 20 pounds, but you don't have that motivation because your testosterone levels are in the tank.
Speaker A:What about restoring them, getting out there, becoming active, shedding the weight and then checking where you are?
Speaker B:I think the problem is that people want this like single magic bullet solution.
Speaker B:And, and it's not one thing, it's, it's a tool in a toolkit like a lot of other things.
Speaker B:It's also like a chicken or an egg.
Speaker B:Like what comes first?
Speaker B:Do we want to use testosterone to have better insulin resistance and have more motivation to go to a gym or do I do those first and then I have higher testosterone levels?
Speaker B:It's kind of like you, you probably want to do it, do it all.
Speaker A:But I think it's interesting to know why is, why is testosterone really singled out when it comes to this?
Speaker A:Because I've heard the same thing from clinicians themselves.
Speaker A:They understand the value of testosterone or should to a certain degree, but they still kind of, I want to say force some lifestyle interventions first as, as a incentive for the patient to get to TRT versus you know, I, I am a fan of what GLP1s can do, but if you look at the way that they've been treated, it's very different.
Speaker A:So the ACC, the American College of Cardiolog also came out with first line recommendations for GLP1 therapy.
Speaker A:So they're saying as, as, as a weight loss intervention that can be first, you don't have to do diet and exercise so well.
Speaker B:But, but it's true, true for GLP ones too, that that should also just be one tool in a toolkit.
Speaker B:I think, I think just like hormone replacement therapy, super powerful GLP ones are very powerful, but they all going to be Augmented my.
Speaker B:Better nutrition, better sleep habits, circadian habit, managing your stress, all those things that are important from the lifestyle's perspective.
Speaker B:So the problem is when people use GLP1s or TRT just as a single lever, like, I'm going to do this and it's going to be.
Speaker B:Everything's going to be fixed.
Speaker B:Right, Right.
Speaker A:No, that's.
Speaker A:And that should not be as.
Speaker A:It's a.
Speaker A:It's a fair point.
Speaker A:Right.
Speaker A:That's how anything should be.
Speaker A:I think what's amazing though is again, traditional medical establishment as wholeheartedly embraced this and with zero sort of question or, you know, thought behind it and said, you know, let's go to first line, this is fine.
Speaker A:And has really thrown testosterone historically, has thrown testosterone out.
Speaker A:And that's a shame again, mainly because who's the biggest loser?
Speaker A:The patient?
Speaker B:Yeah, I definitely.
Speaker B:In the health optimization space, we need to look at all the tools in our toolkit and where I think lifestyle interventions need to be the foundation for everything you do.
Speaker B:Sometimes it's not enough for people to move the needle and, and you need to start adding in these tools and see what works.
Speaker B:And everybody's so bio individual that what works for one person might not work exactly the same for another person.
Speaker B:Although for men in general, I would have to say testosterone will probably help in general.
Speaker B:I mostly work with women where it's a little bit more nuanced for, for testosterone supplementation.
Speaker B:So I want to get to women right now.
Speaker B:How do we, how do these symptoms differ for women that experience low testosterone?
Speaker B:And it may be different for a younger woman, as you mentioned.
Speaker B:For example, if they're on birth control, that could suppress their like, endogenous testosterone production.
Speaker B:But there are some women that are not on, on birth control and still have low testosterone, even younger women.
Speaker B:And then once women go into perimenopause and menopause, it's a completely different ballgame too.
Speaker B:So what are the symptoms that women see with low testosterone?
Speaker A:So you do see a fair range of similar symptoms.
Speaker A:The fact that there are androgen receptors across the body is really equal for male and female.
Speaker A:So going back to the brain cognitive function, whether that's brain fog or.
Speaker A:And frankly there's a role for this actually in dementia.
Speaker A:So if you look at hormones and the role that it's needed in the brain, both testosterone, estrogen, that's a separate conversation, but that's a huge, huge again.
Speaker A:And that's why I go back to medical society.
Speaker A:You have something here that's neuroprotective and it's not talked about, but nonetheless, from a symptom perspective, that cognition and those brain functions, same muscle and fat metabolism, I think those are very, very common and key.
Speaker A:And you know, females, that's why it's good that the discussion, the health and wellness discussion for females is moving into a lot of more strength training and muscle.
Speaker A:Right.
Speaker A:How muscle being an endocrine organ and the role that it plays.
Speaker A:But that's certainly a big one.
Speaker A:Bone is another big one.
Speaker A:Not that you're testing for that.
Speaker A:So that's not really a symptomatic thing.
Speaker A:But I think females are much more commonly screened for osteoporosis.
Speaker A:And you know, in there you'll kind of, you can reveal testosterone deficiencies as well.
Speaker A:So again, a lot of the symptoms are very similar.
Speaker A:Even this, the, the libido question.
Speaker A:Right.
Speaker A:You know, you'll see it in this extra drive.
Speaker A:Although.
Speaker A:And that's actually, I think, I believe if you look at the society guidelines, the only thing that they've sanctioned testosterone for so far is female sexual dysfunction.
Speaker A:Right.
Speaker A:Even though uses are, are definitely broader and they have those impacts.
Speaker A:That was the only, that's the only thing that they've clearly said, yes, this is, this is useful for.
Speaker B:Whereas there's so many other benefits as well.
Speaker B:So I would love to dive in a little bit about sort of the history of how testosterone was used in the US So when was it first used therapeutically?
Speaker B: a controlled substance in the: Speaker B:What impact did that on prescribing practices of testosterone?
Speaker B:And why do you think there has been such a widespread sort of misinformation and fear mongering about testosterone over the last two decades?
Speaker B:As you mentioned, it's sort of not part of the standard of care whether for men or women right now to check, which is kind of mind blowing.
Speaker A:Right?
Speaker A: synthetic form first in like: Speaker A: ly enough, as, as far back as: Speaker A:Testosterone is a molecule because there was so angina, which is heart, heart pain in hospital settings.
Speaker A:They were actually using testosterone injections to alleviate angina.
Speaker A:So this actually made it to its cover, the COVID of Time magazine.
Speaker A:Testosterone for angina.
Speaker A:Which is really ironic because if you fast forward 70 odd years, there became this tremendous controversy around the cardiovascular risk of testosterone.
Speaker A:Right.
Speaker A:This was.
Speaker A:There were a couple of faulty studies that even the FDA debunked.
Speaker A: ascular risk to the labels in: Speaker A:So, you know, kind of full circle there, right?
Speaker A:This is a, this is, we're injecting this into the heart muscle.
Speaker A:And now we think, okay, there's some risk here.
Speaker A:And again, in that time period you did have the Controlled Substances Act.
Speaker A: So that was: Speaker A:And this was, this was Ben Johnson, Canadian sprinter, won the 100 meter and then tested positive two days later or one day later.
Speaker A:And that, that, you know, global outcry.
Speaker A:So the US and Congress at the time basically said, okay, we're going to ban and make this a controlled substance.
Speaker A:And that did have ripple effects because even at the time, hormones, including testosterone, were really not taught in medical school.
Speaker A:Right.
Speaker A:If you talk to providers that were educated in those times, very little time was spent on this.
Speaker A:Now you have it as a controlled substance, has this stigma.
Speaker A:You know, again, steroids, cheating, et cetera.
Speaker A:Why would we study this and why would we include this in medical curriculums if it's bad, right?
Speaker A: it of an opening in the early: Speaker A:There was beginning to be research done around testosterone and diabetes.
Speaker A:I think that started to help unlock what testosterone is really for Androgel.
Speaker A:So gels were introduced then and naturally had a large pharma, big pharma push behind them.
Speaker A:So you did see quite a bit of growth there and awareness.
Speaker A:You know, again, people who were, you know, middle aged at that time would likely remember the commercials around low T and so forth.
Speaker A:And now those campaigns got pretty big at the time.
Speaker A:Then the FDA asked the pharmaceutical industry to run what would be the largest randomized controlled trial in testosterone space in history.
Speaker A:And that was almost a decade worth of research that went in over 5,000 patients, double blind randomized placebo controlled.
Speaker A: And that study read out in: Speaker A:This was the Traverse trial.
Speaker A:Testosterone therapy does not increase cardiovascular risk.
Speaker A:These are all older men with pre existing cardiac conditions that were put on TRT and they did not have, they actually had less cardiac events and less deaths than the placebo groups, which again I do believe is the case.
Speaker A:Hands down, agency will want data for that.
Speaker A: But that read out in: Speaker A:And in February of this year, the FDA finally removed the black box warnings.
Speaker A:So Marius, our company played a large role in that.
Speaker A:Finally get those warnings off that shouldn't have been there to begin with.
Speaker A:And now we've come first, full circle, where we can really ask not is this safe?
Speaker A:What's the benefit?
Speaker B:Is it still a controlled substance now or just the warning got removed, but it's still correct, a controlled substance and it's just still for the reason of sports to make sure that it's not abused.
Speaker A:Yeah, and two things there, right, no other hormone is controlled, estrogen is not controlled, insulin's not controlled.
Speaker A:Testosterone really again, it should not be controlled, especially oral testosterone, which you can't abuse.
Speaker A:But secondly, you gotta really think about what these athletes were doing.
Speaker A:And it's not just testosterone, it's sort of the most mild anabolic.
Speaker A:If you think about it, they would be doing a whole lot more in their protocols than simply injecting testosterone.
Speaker B:So what can you describe sort of the current landscape of TRT that exists both for men and women?
Speaker B:So what are the available delivery methods and the pros and cons to them?
Speaker B:And then we can sort of dove into the oral testosterone after that?
Speaker A:Absolutely.
Speaker A:So I'll start on the male side.
Speaker A:The by far the dominant form today is injectables.
Speaker A:This is relatively cheap.
Speaker A:Luckily this has moved from protocols that often dosed every two weeks, intramuscular injections, this has moved to often one week is the most common.
Speaker A:And a lot of folks sub Q inject testosterone today, again, this is the dominant form just because it's the most well known, tried and true if you will, but it does come with its fair amount of side effects because at a baseline the human body produces its hormones every day.
Speaker A:So the circadian rhythm is a daily circadian rhythm for testosterone and hormones.
Speaker A:When you're injecting yourself on a weekly basis, the analogy could be, okay, on Monday morning you wake up and have 10 cups of, of coffee for the week.
Speaker A:That doesn't make any sense, right?
Speaker A:You gotta, you gotta kind of go with what you need at that time.
Speaker A:You can't store it up, you're gonna lead to a high peak, you lead to a super physiologic level and then you have a crash three or four days later and you go to a trough level.
Speaker B:Right.
Speaker B:However, I think they are in this oil based solution that almost like a.
Speaker A:Slow release is a long ester, but it's still, it's still causing super physiological spikes and troughs.
Speaker A:There's no way around that.
Speaker B:So when you women do the injectable, do they do once a week or can they like divide the dosing?
Speaker A:So you can divide the dosing?
Speaker A:If I were to be on injectable testosterone, I would inject it every day, because that would be the best way to mimic my circadian rhythm.
Speaker A:It's a big ask.
Speaker A:Right.
Speaker A:So I think it's tough for folks to actually do that.
Speaker B:And before we move on to the other forms, I just want to mention that that's.
Speaker B:So the challenge with women is that the dosing is available, the injectable is available for women, but the dosing is so tiny that it's very, very hard to precisely dose for women because it's.
Speaker B:They don't dilute the formula enough for.
Speaker B:There's really no female versions available.
Speaker B:I mean, you can use the male versions, but very hard to dose it.
Speaker A:Yeah, it's typically a tenth of the dose.
Speaker A:Right.
Speaker A:So, yes, if you're, you know, if you're pulling this into an insulin syringe, it's very, very hard to do it consistently.
Speaker A:And then if you think about how this is grown in certain populations and certain circles, it introduces a significant risk of misdosing.
Speaker A:And that's problematic in a lot of ways as well.
Speaker A:So, you know, it's difficult for females to inject.
Speaker A:But again, I think what happens with that, at least on the male side, is that's really what, that's why I think testosterone has a bad rap for the most part, is that that's when the side effects occur, right?
Speaker A:So you get high hematocrit, just elevated red blood cells, and doctors are really wary of that.
Speaker A:You get higher estrogen conversions.
Speaker A:So, and this is really a result of being at high supraphysiological peaks because then your body's saying, we got too much of this going on.
Speaker A:Let's start all the other processes that we would do, right?
Speaker A:Let's convert it to estrogen.
Speaker A:We gotta, it can't just float around.
Speaker B:And that's why I like the shbg.
Speaker B:Like the sex hormone binding clubbing gets.
Speaker A:Pushed up so much, so you're, you're kind of fighting against yourself.
Speaker A:So your free tea is actually coming down potentially.
Speaker A:And that does.
Speaker B:You have more like ups and downs because you have these large peaks and then, and then you feel depleted, I'm assuming.
Speaker B:So unless somebody will dose it daily or every other day, that may be more evenly.
Speaker A:You can even out.
Speaker A:Yes, absolutely you can.
Speaker A:But again, so there's a trade off there and you just, you just have to be compliant.
Speaker B:And I think this is even more of a problem with pellets because pellets give you a really super physiological.
Speaker B:Can you talk about how that works?
Speaker A:And there are, there are strong advocates and a lot of people that are on the other side of it.
Speaker A:So yeah, pellet therapy is even longer acting and you'll have, so you have longer sustained peaks and longer sustained troughs.
Speaker A:Even though they're supposed to be, you know, time released.
Speaker A:There's no clinical data, there's not much clinical data on these time releases given that most of these pellets are compounded.
Speaker A:So they have no data whatsoever.
Speaker A:No data.
Speaker A:And, and that's what's being used both in males and females.
Speaker A:Obviously the scarring is, is a bit of an issue and expulsions from, you know, these are done mainly in the, in, in the butt.
Speaker A:So you know, having an expulsion or not being able to exercise for a week, 10 days is, is kind of a hamper on, on our current lifestyles.
Speaker A:So there's a lot of issues there.
Speaker A:I think again they, they've kind of been been born out of the provider community that, that have kind of added these to the practices and, and it's been a bit of a revenue generation tool.
Speaker A:But there are better ways.
Speaker B:I think it's special can be a huge problem for women because if you're not getting the right dose, you could be stuck with this super physiological dose of testosterone or either too much or too little, but most likely too much because you're going to start with this huge peak.
Speaker B:And for women it can have a lot of negative side effects that could be very unpleasant and then you can't really just take it out.
Speaker A:Yeah, that's what so, so a number of providers that we work with, you know, they, yeah, that's kind of the last resort in a lot of ways and certainly not the first modality that they're trying with a female.
Speaker A:Right.
Speaker A:You want to understand what, how they respond to T and what their dosing may be.
Speaker A:So you can, you can get there and not be stuck for yeah, two, three months.
Speaker B:And then you also have the jails and the compounded formulations and tell, tell me how I, I know that there are some gels that are available fairly inexpensively for men, but again the same issue for women is the dosing.
Speaker B:How do you dose that for women?
Speaker B:Because again the concentration and the, the way they are, if they are in little pouches that they're, the doses are really large.
Speaker B:So really like the only, only thing that seems to be precision dosed is the compounded formulations.
Speaker B:And I'm also curious like what you, what your thought is on the compounded testosterone creams, what you're like.
Speaker A:So yeah, so I think at large, you know, male Gel usage is, is dropped dramatically.
Speaker A:So, you know, it's very seldomly used.
Speaker A:Absorption is definitely an issue.
Speaker A:Transference is an issue.
Speaker A:Right.
Speaker A:Truly, when you think about, okay, how does this fit into my lifestyle?
Speaker A:Actually I'd rather inject myself than slather the gel on, wait for it to dry and, and you know, not shower all those things that just, it's not conducive to, to daily life.
Speaker A:On the female side, yeah, using the male products is very difficult because again of the dosing conversion, but you have compounded products which do allow for that much smaller dosing.
Speaker A:I think that helps.
Speaker A:The good thing is I think it helps females that need testosterone start testosterone because it's an approachable solution in the scheme of things.
Speaker A:It does have its drawbacks.
Speaker A:Again, applying it to, you know, hairless areas and then letting it sit there for 30 minutes.
Speaker A:And it's not like it fully absorbs.
Speaker A:Right.
Speaker A:So it's not like you rub this on and like it's invisible, it's still there kind of absorbing into the skin.
Speaker A:So it's, it's still kind of a rudimentary solution to, in, in the grand scheme of things.
Speaker A:But again, as a, as an entry point for a female that needs testosterone, at least it's there.
Speaker A:And, and in the scheme of, hey, look, there are thousands of compounding pharmacies out there.
Speaker A:There will be people that do a good job.
Speaker A:Right.
Speaker A:So I think having a provider that knows its compounding pharmacy is extremely important.
Speaker A:So you are getting a high quality product versus you can't just send it to any pharmacy and expect the same product.
Speaker A:There's no, you know, there's no guarantee of consistency there.
Speaker A:And that's something that patients need to be aware of.
Speaker B:Yeah, I think it's really important like what basic compounding pharmacy uses, as you mentioned, I think the, the gels are, I think still the best because they absorb very quickly versus creams.
Speaker B:As you said, you have to kind of rub it in.
Speaker B:And, and then there's transference issue that you mentioned.
Speaker B:So people can transfer it to their pets, their children, to their spouse.
Speaker B:And that is not where you want to share your testosterone.
Speaker B:And then what you mentioned, that you have to put it in a hairless area of your body because it can grow hair.
Speaker B:Right.
Speaker B:So for women, women don't like to grow hair in weird places.
Speaker B:So it's really important to put it somewhere.
Speaker B:And, and then you could still start growing a little bit extra hair and can also have a higher, like DHT conversion for women and cause hair loss.
Speaker B:And other side effects, especially the dermal subdermal delivery, is what I heard.
Speaker B:Do you have any other information on that of how, what your experience is?
Speaker A:What from my discussions with clinicians, providers, while these side effects are real, I think at the right dosing, the majority of females don't have issues.
Speaker A:So I will sort of advocate for not.
Speaker A:Don't worry about it.
Speaker A:Right.
Speaker A:To the listeners audience that I wouldn't be overly concerned.
Speaker A:Right.
Speaker A:I think your benefits far outweigh some of those downsides.
Speaker A:And the downsides or, you know, side effects like increased hair or a deepening of the voice are less common than maybe it feels.
Speaker B:I know a lot of women that are so sensitive to testosterone, even the tiniest dose causes acne and all kinds of like almost immediately.
Speaker B:So women are very tricky because we do have a lot of hormonal fluctuations and a lot of different types of hormones.
Speaker B:So.
Speaker B:So I would always advise women to get your estrogen progesterone dialed in first.
Speaker B:Once those are on point, then add the testosterone in starting with like all.
Speaker A:Then to start at smaller doses.
Speaker A:Right.
Speaker A:Don't go 100% on your first month.
Speaker B:Start slowly and watch out for, for any, any side effects.
Speaker B:So I'm curious, what made you create this oral formulation and is your testosterone formation the first oral formula or is there any other ones out already and is that already available?
Speaker A:What really encouraged us to create this was, you know, twofold.
Speaker A:One, how important testosterone is as a molecule.
Speaker A:I often say today, you know, if testosterone was discovered today and didn't have the baggage or the stigma, it would be the most valuable molecule in the world.
Speaker A:So really the breadth and depth of the importance is the first driver.
Speaker A:The second one is, if you look at the market, you know, oral was the holy grail.
Speaker A:There again, you just had injections and gels.
Speaker A:And we live in a society that's used to taking capsules or pills.
Speaker A:And that's the solution, right.
Speaker A:Anything but is sort of subpar.
Speaker A:So that was.
Speaker A:That again was the holy grail.
Speaker A:If we could crack that, then again you can solve a massive metabolic issue at point some scale because again, right, Even today there's 25 million on the male side.
Speaker A:There's at least 25 million males that are hypogonadal or low testosterone.
Speaker A:Only 2 million are being treated today.
Speaker A:Right.
Speaker A:How do you close that gap?
Speaker A:It's not going to be via injection.
Speaker A:It needs to be an oral.
Speaker A:Old formulations of oral, and that's actually something we're still correcting, is that old versions of oral Testosterone were liver toxic, so they went through the liver and it was toxic to the liver and that's why they were never used.
Speaker A:Our formulation is absorbed by the lymphatic system, so the small intestine, so it bypasses the liver and that really is the innovation here.
Speaker A:So it's a formulation and then being able to obviously formulate in a way that it becomes bioavailable and usable and then we can deliver the metabolic benefits that that testosterone is known for.
Speaker B:I think that's something I just want to highlight.
Speaker B:Make sure people are hearing that, that your product bypasses that first, first pass metabolism challenge.
Speaker B:Like we have that same problem with estradiol for women and that's why it's not really prefer to take oral estradiol because we have that first pass metabolism issue.
Speaker B:But the way you formulated it, you said that it absorbed by the lymphatic system.
Speaker A:Correct, the lymphatic system.
Speaker B:So that is a huge innovation.
Speaker B:How is the absorption different compared to injections and jails and all the other delivery if you take it orally?
Speaker A:Yeah.
Speaker A:So ultimately, you know, we will restore testosterone to normal ranges.
Speaker A:Right.
Speaker A:So we have to use more testosterone to ultimately have what's needed as bioavailable.
Speaker A:So it's, it's single digit percent which becomes bioavailable.
Speaker A:But ultimately like for example our, in our phase three trials, our C Max was still 1,000 nanograms per deciliter.
Speaker A:Right.
Speaker A:On average across all of these patients and so forth.
Speaker A:So we used an average dose in that trial would be 600 milligrams.
Speaker A:Well actually for that C max it'll be 300 milligrams of TU, which again, so you really can't compare a dose by dose to what an injection would be.
Speaker A:Right.
Speaker A:Because we're taking 300 milligrams so say in the morning time versus people are taking 100 milligrams of test sipionate a week.
Speaker A:So.
Speaker A:And you're going to see the same thing actually play out here in GLP1s very shortly because right.
Speaker A:We're used to injection doses 2.55 milligrams, 10 milligrams, 15 milligrams a week.
Speaker A:When these things go oral, you're going to be taking double that a day or triple that a day.
Speaker A:So you're going to see the same sort of thing play out.
Speaker A:But ultimately at the end of the day what matters is what's available in the system and something unique that we've been able to DO is lower SHBG.
Speaker A:So we lower SHBG by 30% on average and that increases free testosterone by 2x and we've seen even higher in investigator led studies.
Speaker B:So sex hormone binding globulin, normally when people are in some sort of an exogenous supplementation tends to go up.
Speaker B:Do you know why?
Speaker A:Your formula, the mechanism is unknown.
Speaker A:Actually, it's okay.
Speaker A:It's a byproduct that, that, you know, we happily accept in, in the scheme of things because this is really, you know.
Speaker B:Or is it maybe the fact that you're dosing it daily so it's a more consistent dose versus having these peak peaks?
Speaker A:Well, even other products that dose daily don't see the same SHBG effect that oral does.
Speaker A:But being able to lower that SHBG, which is historically high for both male and female today because of lifestyle, say alcohol, again female on this, on the birth control side, we do need to bring those down.
Speaker A:But being able to increase free testosterone to really good levels without going super physiologic on total T hasn't been done before.
Speaker B:Yeah.
Speaker B:And just for our listeners that may not fully understand what we were talking about, we measure the total testosterone and the free testosterone and some of the total testosterone gets bound up.
Speaker B:That's what we call sex hormone binding globulin.
Speaker B:And really what your body can use is the free testosterone and that's really what matters and that's really what is available for your body.
Speaker B:So when you're able to reduce shbg, you're really allowing your body to have more free testosterone, which is the usable form.
Speaker A:Absolutely.
Speaker B:Right now Kaisertrex is your product.
Speaker B:Is it now available through prescription or how does it work?
Speaker A:So yeah, Kaisertrex, it's indicated for men with low or no testosterone due to certain medical conditions.
Speaker A:So that's the indication on label.
Speaker A:It is a prescription product.
Speaker A:It is available broadly here in the US today.
Speaker A:Whether it's your traditional provider, we do work with, as I mentioned, a lot of longevity docs and concierge and even TRT clinics.
Speaker A:I think again, we're giving a really innovative tool here to help address this massive population that does exist or for testosterone deficiency.
Speaker A:So yeah, Kaisertrex is widely available today, even available through digital channels.
Speaker A:Telehealth is an avenue that we decided to make available as well.
Speaker A:So patients have options at the end of the day and we've very importantly made Kaisertrax a cash product.
Speaker A:So we've not gone through insurance companies and we've not gone through PBMs.
Speaker A:And while that may sound counterintuitive to begin with.
Speaker A:We've done that to increase access for patients.
Speaker A:We've kept the costs, you know, as low as possible.
Speaker A:Kind of like a high end supplement in a lot of ways.
Speaker A:It's around that $200 price point, which is what a lot of people pay for a lot of supplements today.
Speaker A:We didn't want to have this as a high priced drug that was going to go through typical insurance channels rebating and then ultimately only a small patient population would have access to it.
Speaker A:We really came in with a goal for as broad access as possible.
Speaker B:Now, do you have different doses of it?
Speaker B:So depending on your current level or how do you figure out how much.
Speaker B:Obviously this is male right now, approved for males primarily.
Speaker B:Can you walk us through, does it require lab testing first or what are the.
Speaker A:We would recommend.
Speaker A:Yeah, so it would require lab testing.
Speaker A:Although your, your levels don't dictate your dosage, this is really a function of how you respond to Kaisertrex and two seemingly same individuals, height, weight, etc, they may respond very differently to Kaisertrex and one may be a super responder and need a lower dose and one may be a poorer responder and need a higher dose.
Speaker A:On average, in our trials the most number of patients were on 300mg bid.
Speaker A:Right.
Speaker A:So this is kind of our mid dose.
Speaker A:They started at 400 bid and moved up to 600.
Speaker A:So in real life that's where most patients end up.
Speaker A:Within two hours your levels are starting to rise.
Speaker A:So like when we recommend testing for your levels, it's somewhere between the three and five hour time point and then again you are taking it twice a day, so you are taking a second dose to sort of sustain throughout the day.
Speaker A:There is a lot of variability though.
Speaker A:I will say this in terms of that, so timing of your lab testing, this is why it's important to follow symptoms and see how you're feeling.
Speaker A:Because if you take it between, say you took a test at three and a half hours versus five hours, your T level is going to be quite different because again, it's kind of rising during that period or if you miss that five hour mark, you might be slightly declining.
Speaker A:So this is what we've seen in practice, following the symptoms is really important and once you know you're doing better and then you can become a little less, I'll call it obsessed about sort of lab timing per se.
Speaker B:Now, does oral testosterone supplements, do they suppress your endogenous testosterone production, the LH fsh, and is that suppression reversible?
Speaker A:So really interesting point.
Speaker A:And again, I think this is going to be a future like the future of trt.
Speaker A:LH and FSH remain in the normal range on Kaiser tracks.
Speaker A:And, and this is a big shift, especially kind of that.
Speaker A:As we were talking earlier in the discussion around patient types and younger and younger patients that are testosterone deficient, nobody likes suppressing their natural production at all.
Speaker A:Even if you're an older man, you really don't love the concept of suppressing your natural production.
Speaker A:So there is some.
Speaker A:Right.
Speaker A:LH and FSH will decline, but again, they will stay in the normal range and theoretically that should lead to faster rebounds for patients.
Speaker A:If you were to stop therapy right now.
Speaker B:Does it affect fertility for men?
Speaker A:Big question.
Speaker A:And right now we're running a pilot study, so we're doing a pilot study out of Baylor and it's looking at sperm counts in young men that are on Kaisertrex.
Speaker A:So this is being done.
Speaker A:Dr. Mohitkera, you know, leading urologists across the country.
Speaker A:So this is going to be really interesting.
Speaker A:He did read out the first five patients last fall and four out of five did not see sperm count suppression.
Speaker A:So this was really interesting to see.
Speaker A:I think that number is continued to trend in that direction.
Speaker A:And, you know, hopefully he'll, he'll read out that data later this year.
Speaker A:But again, I, I think this is probably one of the biggest questions that we can solve for with oral TRT and, and really a game changer if, if shown to not reduce sperm.
Speaker B:Yeah, I mean, if you have a population that we have both men and women, 50% of testosterone than before, people are not having sex, they're not having babies, and it definitely impacting fertility, I'm assuming.
Speaker B:But then the catch 22 as well.
Speaker B:We are giving men potentially injectable testosterone, but then it impacts their fertility.
Speaker B:You're not really solving the problem.
Speaker B:But if you can have a product that allows people to optimize their levels and still preserve their fertility, that would be really a game changer.
Speaker A:And what's interesting too is, you know, a lot of the young males that are infertile actually have low testosterone.
Speaker A:And so the question also goes to, does that, is that low testosterone affecting that?
Speaker A:And can you provide enough exogenous testosterone that does not suppress further, that actually stimulates potentially.
Speaker A:That's a big outstanding question too.
Speaker A:So we're actively supporting research to try and answer these.
Speaker B:And you mentioned that the sex hormone binding globulin doesn't go up as much as on other forms.
Speaker B:But how about conversion to estrogen or dht, because those are sort of the problematic things both for men and women.
Speaker A:So yeah, conversion to dh, I mean, sorry, estrogen is normal.
Speaker A:Right.
Speaker A:So the balance level, so the ratios will remain the same as they were at large pre therapy.
Speaker A:Very small movements there.
Speaker A:So you don't have any excess conversion to estrogen.
Speaker A:DHT conversion is there.
Speaker A:You probably see about 20% conversion to DHT.
Speaker A:So you're inside two times normal levels is what the data shows.
Speaker B:What's that compared to like injectables?
Speaker A:So it's probably, it is higher than what you'll see in injectable.
Speaker A:That is there what's positive based on what we, what we gather from a lot of our clinicians is again the short acting nature of it.
Speaker A:Right.
Speaker A:So you're out there, it's floating, but then it returns back to baseline.
Speaker A:So these quick pulses, anecdotally we have seen, you know, to be beneficial rather than detrimental.
Speaker A:So we'll continue to kind of monitor them.
Speaker A:We haven't had any reports of, of you know, adverse events even.
Speaker A:Again, like kind of going back to the suppression like we didn't have reports of testicular atrophy in the study either.
Speaker A:Right.
Speaker A:That's a big issue for a lot of men on injectable testosterone.
Speaker A:And again a nice to.
Speaker A:Maybe it doesn't, it doesn't matter per se, but it's definitely a nice to have.
Speaker B:Definitely.
Speaker B:That's.
Speaker B:I'm sure men will appreciate that.
Speaker A:Exactly.
Speaker B:The biggest thing for women that I see just issues with testosterone in general is the DHC conversion.
Speaker B:And there's that there's again very.
Speaker B:By individuals, some women can tolerate really high levels of testosterone.
Speaker B:Some women, even the smallest amount can cause a lot of side effects.
Speaker B:And that what matters is do you have those side effects or not?
Speaker B:So everybody's so different that they have to try the different forms and see how their body do with it.
Speaker A:Correct.
Speaker B:So first of all, women really cannot take this product yet because the dosing is a little bit too high.
Speaker B:There's no way to, there's no smaller dose available.
Speaker B:Or is, is it scored?
Speaker B:Can you like.
Speaker B:So it's divide the tablets.
Speaker A:So two things.
Speaker A:One is yes, Kaiserrex is not indicated for females.
Speaker A:Yeah.
Speaker A:That is my full disclosure.
Speaker A:It's a soft gel capsule.
Speaker A:So it's not a tablet.
Speaker A:It's again, it's more like a fish oil.
Speaker B:Okay.
Speaker B:Oh, because it's oil based.
Speaker B:Is that for delivery?
Speaker A:Correct.
Speaker A:Correct.
Speaker B:So better absorption with the oil base.
Speaker A:Exactly.
Speaker B:Gotcha.
Speaker B:And so I guess my natural next question is when when are you going to have a product for women?
Speaker A:The program is in active development.
Speaker A:I will say that this is a very important project for Marius.
Speaker A:There is no testosterone product approved for females, full stop.
Speaker A:Whether it's injectable gels, etc.
Speaker A:So this has never happened before.
Speaker A:It's been studied to a certain degree, but during a time where there was a lot of fear and misconception.
Speaker A:Now we have an FDA commissioner that fully understands the importance of female hormones.
Speaker A:And I think that's a very good win for the female population.
Speaker A:And we want to be able to work proactively with the agency to develop a program that fits, that's reasonable.
Speaker A:I think the two words that they're.
Speaker A:The two phrases that they use is logical and gold standard science.
Speaker A:So if we can achieve those things, I think we can be successful at bringing Kazotrex to the female population.
Speaker B:It's super upsetting that hormone replacement therapy is still so hard to get even estrogen, progesterone, although it's available and more accepted, most doctors don't know how to prescribe it correctly.
Speaker B:They are not trained in it.
Speaker B:Even endocrinologists, obg vians have no idea.
Speaker B:The vast majority of them, unless somebody really specializes in hormone replacement therapy, women especially as they're going into perimenopause and menopause and hormone replacement therapy becomes more important.
Speaker B:We really need practitioners that are trained understand how these hormones work.
Speaker B:They are understanding the most current research and not research that's been debunked like the Women's Health Initiative.
Speaker A:Whi.
Speaker A:Absolutely.
Speaker B:Research that you mentioned on testosterone that were incorrectly performed and created this fear mongering.
Speaker B:The science is there, but somehow the newest information is not being thought and disseminated in the medical community and the standard of care needs to change.
Speaker B:Do you think that it would even go through the FDA if there was a product for women?
Speaker B:Or why can we get it approved?
Speaker B:Like I don't understand the law.
Speaker A:So there's no reason it shouldn't, right?
Speaker A:Like again, like clinicians prescribe lots of things off label, right?
Speaker A:So there's no stopping clinicians from doing what they think is right in their clinical judgment.
Speaker A:Fine.
Speaker A:But like you're saying, why not?
Speaker A:Because then maybe this does become something that's covered by insurance.
Speaker A:Right?
Speaker A:Because again, it's a product that's been approved for that indication and females have more access.
Speaker A:So then it's.
Speaker A:There shouldn't be a socioeconomic divide between those on hormone replacement therapy and those not.
Speaker A:Right.
Speaker A:Because there's 50 million plus women in Peri or menopause, you know, every year.
Speaker A:So that number's staggering, right.
Speaker B:It's.
Speaker B:It's half of our life, basically, right, as women, right.
Speaker B:And we want to have a good quality of life, continue to have good quality of life.
Speaker B:We want to age better, we want to have longevity just like men do.
Speaker A:Well, that's why, honestly, that's why this discussion as a couple, couples is so important, right?
Speaker A:Like don't fit.
Speaker A:And I have this discussion all the time, like, you can't fix one, Right.
Speaker A:So the males can't get in and get their testosterone fixed and feel great and have their partner suffering.
Speaker A:Right.
Speaker A:Because that's going to create an even, you know, there's a mismatch and then an even bigger mismatch.
Speaker A:So I wholeheartedly believe that, you know, couples should be treated together in this sense and solve these together and that you're gonna have a happier relationship.
Speaker B:The easier part with men, that testosterone itself is a game changer.
Speaker B:Whereas women, it's a lot more complicated, multi level, Right?
Speaker A:Yeah, absolutely.
Speaker A:You know, males, pretty, you know, males are dumb.
Speaker A:She just give one thing, it's gonna work.
Speaker A:Females are way more.
Speaker B:Exactly.
Speaker B:And that's why you have like an amazing product that can help a lot of men and hopefully women in the future.
Speaker B:So why is it still in your opinion, so difficult for the average men or women to get a comprehensive testosterone test ordered or interpreted?
Speaker B:Because I am a functional health practitioner.
Speaker B:I tell people like, you should get tested.
Speaker B:And oftentimes we have to have people just order their own testing because their doctor is not willing to order a basic blood panel for them for testosterone.
Speaker B:And then usually for women, we order all the hormones.
Speaker A:Right.
Speaker B:What's the reason?
Speaker A:The twofold one is, you know, not all insurance companies cover it, you know, without sort of those that coding and reasoning, Right.
Speaker A:Whether it be fatigue, sexual dysfunction and so forth.
Speaker A:So you kind of have to justify it to the insurance company.
Speaker A:So that creates this downstream effect where a doctor, you know, they don't love justifying tests.
Speaker A:And then patient gets a bill, they call the office, they're angry.
Speaker A:Then it creates this whole, you know, thing, Right.
Speaker A:So that's, that's something that most doctors are trying to avoid, is creating office headaches.
Speaker A:So that's one.
Speaker A:The second is again, because most practitioners or clinicians, doctors, however we want to refer to them, don't have the training and don't actually treat it.
Speaker A:They don't want to know.
Speaker B:Yeah.
Speaker A:Because if they know, they have to do something about it.
Speaker A:Yeah, that's yeah, unfortunately that's, that is.
Speaker B:The biggest issue is like, okay, I get the labs, but I don't really know how to evaluate it as a doctor and I wasn't really trained how to prescribe hormones.
Speaker B:So why, like, what am I going to tell you?
Speaker B:So it's better.
Speaker A:I don't have time to create another problem.
Speaker A:I got seven minutes with you.
Speaker A:If I create this, I'm going to need a whole half hour and I don't have it and I don't get reimbursed for this.
Speaker A:So I can't spend that time with you.
Speaker A:Our system is so broken that.
Speaker A:Think about it just from this, you know, root fact.
Speaker A:Our system is so broken, clinicians are afraid to order lab tests that would be indicative and helpful to a patient's overall health.
Speaker B:Yeah.
Speaker B:And for our listeners, just remember, you can go online and order your own labs.
Speaker B:Yes, it's out of pocket, but at least you'll know where your numbers are.
Speaker A:So what we did, honestly, so we put up at home testing kits on the kaisertrex website at cost.
Speaker A:We contracted with a provider with a lab, does the whole at home kit test and we actually test total T, free tea, shbg, LH and fsh, psa, hematocrit.
Speaker A:Right.
Speaker A:All the, at least on the male side.
Speaker A:And we just, look, we're going to give this at cost because people need to know, forget like, yeah, solution is later, that's fine.
Speaker A:But like at least understand if there's a problem so you can start asking some of the right questions and start doing your homework, research so you can become an advocate for yourself.
Speaker B:Very important.
Speaker B:Can you mention your website, like how do people get those tests?
Speaker A:Kaisertrex.com K, Y Z A T R E X.com and amazing right there.
Speaker B:Go and find out because what you can measure is what you can improve and at the point you're just guessing.
Speaker B:So you need to really quantify that and really understand it.
Speaker B:At the end of the day, what matters is how you feel.
Speaker B:But, but at least you could see is testosterone a big factor in how I'm feeling, my fatigue, my libido, my insulin resistance.
Speaker B:Is this a big piece of health puzzle or not?
Speaker A:Right.
Speaker A:And I will say, I will say my prediction on that, which, and I absolutely agree, you know, how you feel is the driver.
Speaker A:If I fast forward on where this space is going 5, 10 years, especially back to this inflammation point, right.
Speaker A:Having testosterone deficiency even asymptomatically will be viewed as a health detriment.
Speaker A:And I do believe it will be addressed.
Speaker A:Just like you don't feel your blood pressure necessarily, you don't feel your cholesterol, but they're treated today, I think you're going to see something very similar happen to testosterone.
Speaker B:Yeah.
Speaker B:And we mentioned the most common signs of testosterone deficiency and how you feel.
Speaker B:But I want to touch on the impact of quality of life, mood, energy versus long term health span and longevity.
Speaker B:What happens to men and women that their whole life they are struggling with the low testosterone, they have all these other health issues as a result of it.
Speaker B:What happens to their health span, longevity?
Speaker B:And is there any sort of connection to testosterone levels and biological age or epigenetic aging markers?
Speaker B:What is the connection there?
Speaker A:We are doing a little work around that and we're in discussions with a few companies to kind of very directly correlate like testosterone to age and biological age and sort of your health span age.
Speaker A:But in terms of longevity, two very important points, and this data is clear as day.
Speaker A:Low testosterone.
Speaker A:These are studies with thousands and tens of thousands of patients.
Speaker A:Low testosterone leads to increased, all cause mortality, full stop.
Speaker A:So you will die earlier if you have testosterone deficiency.
Speaker A:So that's really clear.
Speaker A:I think the second bit that's really important to always make the connection to, if you look at what's often regarded as the Four Horsemen and people you know regard these as type 2 diabetes, cardiovascular disease, dementia and cancer, right.
Speaker A:These are the four things that are likely to get you if you're the average human being.
Speaker A:Testosterone is correlated to each one of these.
Speaker A:So again, type 2 diabetes and we look at insulin levels and sensitivity is right there, cardiovascular risk and endothelial function.
Speaker A:So testosterone improves the endothelial linings.
Speaker A:And if you look at ventricular atrophy and so forth, there's good data that discusses all these things.
Speaker A:Cancer.
Speaker A:There was a really good study a couple years ago that unfortunately no one talked about, looked at testosterone therapy and metformin for prostate cancer and colon cancer and you saw 25% reduction in prostate cancer and colon cancer on testosterone therapy.
Speaker A:Why?
Speaker A:Why is nobody talking about that?
Speaker A:Right.
Speaker A:And then dementia, you look at elevated SHBG levels being correlated to dementia.
Speaker A:And if we have the ability to modulate those, maybe we should.
Speaker A:So I like to bring those up because those, again, are very understandable, relatable.
Speaker A:Everybody at large knows these four conditions, but testosterone is related to each one of them.
Speaker A:So it's absolutely crucial when you have this health span and lifespan discussion, right, because you're going to have better quality years.
Speaker A:That's important.
Speaker A:But then Also, you won't have them cut short, hopefully.
Speaker B:Right, to wrap up the conversation, what are the most persistent myths about testosterone that you'd like to see corrected once and for all?
Speaker B:Maybe something that we haven't discussed yet.
Speaker A:So two, at least as it relates to risk is again, testosterone causes cardiovascular risk and causes prostate cancer.
Speaker A:These have been thoroughly debunked.
Speaker A:Right.
Speaker A:Both through the Traverse study.
Speaker A:As a final nail in the coffin, that 5,000 patient study that I mentioned and again that was published in the New England Journal of Medicine.
Speaker A:And again, the prostate cancer thing has been, it's been known for, for a fair amount of time that it does not cause prostate cancer.
Speaker A:But I think this myth still exists.
Speaker A:A lot of urologists really don't love treating for testosterone because of prostate cancer.
Speaker A:It actually went back to like that.
Speaker A: at myth came back from like a: Speaker A:One was female and two were male and they were both old and one got prostate cancer.
Speaker A:Right.
Speaker A:Because that's what happens if you think about prostate cancer.
Speaker A:It occurs in men who generally have low testosterone levels, not young men with high testosterone levels.
Speaker A:Very intuitive if you really just think about it.
Speaker A:So I think that's.
Speaker A:Those are two myths that are really important to put to bed full stop.
Speaker A:Because again, patients then defer therapy and suffer, which is bad.
Speaker A:And then the other one is just again, testosterone is only for muscle and sex drive and that's absolutely not the case.
Speaker B:What would be besides muscle and sex drive?
Speaker B:What we really like the top three things that would you say it's for?
Speaker A:I think it's for cardiovascular health, it's for brain health.
Speaker A:And I think your, your metabolism, like again, your glucose control.
Speaker A:Because type 2 diabetes is such an issue.
Speaker A:Again, Kaiser trucks is not indicated for these things.
Speaker A:I want to be very clear.
Speaker A:But testosterone is a molecule, is simply that important.
Speaker B:Hormones are signaling everything in our body and they are connected, as you said that we have receptors in every cell in our body, so they are connected to every function.
Speaker B:So while we may see it as a sexual dysfunction or low energy, but they are really connected to all the underlying metabolic functions in our body.
Speaker B:So it's really where.
Speaker B:And health optimization is not one thing, but when it comes to men's, men's health, this is a very, very big lever.
Speaker A:It's one thing I'll just, I can, I love to leave it there.
Speaker A:And if some sense, like it's foundational.
Speaker A:Right.
Speaker A:So like at the bottom you do.
Speaker A:And I believe these are non negotiables.
Speaker A:You know, Again, diet, sleep, stress, exercise, these things.
Speaker A:Can't ignore them.
Speaker A:But above that, then really are hormones.
Speaker A:So your hormone levels are there.
Speaker A:Then you can look at other interventions like peptides or recycle some old generic drugs like tadalafil and so forth or even metformin.
Speaker A:And then maybe you get to, you know, rapamycin of the world.
Speaker A:But your two biggest blocks are your lifestyle and then your hormones.
Speaker A:They're going to underpin everything.
Speaker B:Wow, that was such a thorough conversation.
Speaker B:Charlene, thank you so much.
Speaker B:Tell us, like, how people can connect with you.
Speaker B:How can people find these medications?
Speaker B:What is the easiest way to get a prescription?
Speaker B:Can people just go to your website and, like, interact with somebody there, or do they have to go to the doctor?
Speaker B:What is the process?
Speaker A:So, so in terms of Kaisertrek specifically.
Speaker A:Yeah.
Speaker A:Kaisertrux.com is your best resource.
Speaker A:K Y Z A t r e x.com There you'll find more information about the product.
Speaker A:You'll find either you can find a provider near you physically.
Speaker A:You can also find some of our telehealth providers.
Speaker A:So they can also help if you don't have a provider and get the labs done and go through the process to see if it makes sense for you.
Speaker A:You can follow me at the Metabolic CEO on Instagram.
Speaker A:So I'm fairly active.
Speaker A:I like doing podcasts like this and frankly, just educating, right.
Speaker A:Talking and bringing awareness to this space is the best thing we can do to empower people to advocate for themselves, whether they are in traditional medical settings or they are fortunate to have great functional providers like yourself.
Speaker A:Go to rethinktestosterone.com, so that's our disease awareness site and we really share a wealth of information.
Speaker A:It talks about all the research, all the studies that have been done in this space over the last 20, 30 years and show why it's such an impactful moment.
Speaker B:Thank you so much for tuning in.
Speaker B:This is Maya.
Speaker B:Our production team pours our hearts into this show because we believe women deserve better.
Speaker B:Better conversations, better tools and health strategies that are actually built for our physiology.
Speaker B:But here's the truth.
Speaker B:This show doesn't grow on its own.
Speaker B:It grows because you share it.
Speaker B:So if this episode hit home, do me a favor, follow the show, leave a quick review and text it to a girlfriend who needs to hear this.
Speaker B:And if you want to go deeper or connect with other women on this path, come join our free community@ optimizedwomen.com thank you for being here.
Speaker B:We appreciate you more than you know.
Speaker B:The views expressed on this podcast are solely those of the speakers and do not reflect the host's opinions.
Speaker B:The content is for informational purposes only and is not a substitute for medical or nutritional advice.
Speaker B:Always consult a licensed healthcare provider.
