Low T and What Men Should Know and What They Can Do About It

Medical disclaimer, please note that the information shared on this podcast is for educational and informational purposes only and should not be considered medical advice. Always consult with your healthcare provider before making any changes to your health regimen, including starting new therapies, supplements or treatments. While we discuss cutting edge research and advancements in cellular medicine, individual health needs vary and professional guidance is essential. By listening to this podcast, you acknowledge that neither Dr. Seeds nor the podcast team is providing personalized medical recommendations. On today's episode, we're going to talk about hormones and males. Hello and welcome back to Redox Revolution with Matt and Maddie. Hello. Hello, Maddie. Welcome back. Welcome back, Maddie. How did my seat feel? Warm. Thank you. That was uncomfortable. I'm so glad to have you back so Matt can't ask me any more questions about myself. After those sessions, I was like, you know, Matt, maybe you need to not put this in and he's just like, look at me smiling. I go, I'm so screwed. He's going to put some of these things in there and I let my guard down, but then, you know what? Like I said, I'm old enough I can take it. People want to know the real you. They want to know the man behind the bow tie. This is just me working smarter, not harder. I get asked all the time all of those questions about who he is and now I'm just going to have a video. I can just send the link. Yeah. You want to know Dr. Seeds? Here you go. I did that. A patient asked about NAD and what Dr. Seeds thinks. I literally just sent the podcast link. I love that. Well, that's what these are for, right? Mm-hmm. That's what these are for. I wish you would ask me more about skiing and stuff. That would have been fun. We could have Captain PepTide do a drive-by episode with us where he, you know, is kind of mobile. Has his camera, has his little gurney set up. What's it called? Gimble. It's called a gimbal. Whose gimbals are fine? As long as he can keep up with us, I know he is pretty slow. You know he has a new board, right? Yes, he does. You think? We're detection about it this week. He thinks he's a new man because of his new board. He is. He is. He rips on that thing. But yeah, Drew could record an episode of us while we're going down the hill. If he can keep up with us. Mm-hmm. No, I don't think it's, I don't see that happening. Yeah, I don't see either. So let's just move on then to today's. For Captain PepTide. I honestly enjoy this part of the episode the most, I think, because he never knows what the topic is. And we kind of just get to hit him with it. Mm-hmm. Today, and by the way, this is the start of a two-parter. Ooh. Today, we are going to talk about low T. What men should know, what they can do about it. And it's a two-parter because next week we will be diving in to women specifically. Thanks for including us. Oh, now you're giving me a heads up. Okay, thanks. Yeah, no, I want to give you that heads up because you may, I know a big point at the PepTide World Congress this year was like, Hey, a lot of these protocols have been frameworked around men. And some of the people like Dr. Fitz and Kelly and they've really been trying to put the word out that, Hey, we need to get a little bit more specific in terms of women's health. Mm-hmm. So we will have an entire episode dedicated to that. So you don't need to dive down any rabbit hole split in the difference here. We are specifically talking about men today. Tough job to not go down any rabbit holes. Do you think you can do it? We're going to see. I guess it depends what he asked me. So low, low T in males also known as hypogonodism. What? Hypogonodism. There you go. It can be associated with a wide range of conditions that affect physical health, mental health, metabolic function, sexual performance. These causes and consequences of low testosterone are associated with aging. So how do you first go about approaching these interrelated effects of low T in your male patients? I'm not really sure where to start with this, but let's just go somewhere. Ooh, can I say a place where we don't really start with a patient with low T is by giving them testosterone. And that's that's that's a great beginning. So let me go back to what she said in a second, but just I think we do diligence here is to define what's hypogonodism. And today, if we follow the biochemistry of testosterone, it's defined by a number. Hypogonodism. And it's typically less than 300 is considered hypogonodil. It used to be 250 than it was now up to 300. So it's defined by a number, but it's it's typically just if you're defining hypogonodism. And I think it's a we're really doing it at just service by by stating that it's just low testosterone and not producing an adequate amount of testosterone. And there can be primary hypogonodism and secondary primary where there's some type of injury to the testes. It's specific to the testicles or secondary where there's some inflammatory process or toxin that's affecting the lady cells of the gonads or something in the brain with the HPA axis. A lot of things can define secondary and primary, but Matti hit it on the head in really thank you for starting this off because I think this is this is the misconception of, you know, if you if you think about testosterone and we we know it's produced for males for the in the lady cells of the testicle. There the this the production of testosterone depends on cholesterol getting into the cell and then with and then getting into the mitochondria where it's into the mitochondria powerhouse of the cell. Yeah, and signaling of the cell where then it's converted into pregnant alone and then converted into a bunch of other hormones one being testosterone. So that should tell you right there that if we're in the in the mindset of cellular medicine and looking at testosterone production. Shouldn't we be looking at why someone isn't producing enough testosterone I mean that only makes sense to me and and that has always been. I think how we do things differently and do them very effectively and actually looking at the efficiencies of. How that process works but then also realizing that the mitochondria plays a role and also oxidative stress or. And I'm sure state of stress you know can affect the gene activation and production of androgen receptor so there's receptors that receive that have to work with testosterone. And then there's also the testosterone production so there's a lot that goes into this and I and I think if you're not working on efficiencies of and so I think it all leads back to the premise of what we're all all about and that's what it's improving cell efficiency and flexibility because if we're making the cell more efficient. So we're doing a better job of that cholesterol conversion and to pregnant alone and then the conversion to the hormone itself and we've we've actually I mean and I'll stop and let you continue to ask questions because I need direction on where you go with the question to. Let me finish let me finish yeah guy just had a great thought and you stop me again it's like said questions all right now I forgot it's I just think there's so much importance oh we've seen these people with that have been on this you know this 300 number or 400 and they're told they have low T and this is the reason and then we work on. Work on root causes and what do we see improvement in libido improvement in fatigue improvement in muscle function all these things that people they believe it's all based on this low T number and it's got so much more to to do with the oh she's just waiting to ask this question. So I feel like a statement and a question so two things I'm gonna stop and let you let you go at it one thing when you had said the number. I feel like it's important to for people who get like fixated like my testosterone 400 it's low I need to address it but someone with 400 can feel perfectly fine. Not fatigue still gaining muscle and then 400 for someone else they can be feeling it so it's not about going after the number you need to go after the patient and what the patient's feeling yeah and you've seen it you've you've witnessed that in our practice and how and I used to you you remember in meetings earlier and I catch so much from hormone docs you're like you just got to go right at this first and I'd be like how does that make any sense I mean especially if I want to make things even more effective you know what what so let's say they do need testosterone and they do need some replacement well I want to make sure I've done everything to increase the density of energy receptors so I can use less. I want to do everything to prime the system to make this stuff even work better and not and to use less of it because we know there are issues with this and if we get into the discussion but I really believe that cellular medicine is changing that thought process it certainly is in women. For men in women more so because of the metabolism issues with estrogen and so forth but but now with males you're seeing this we're having patients that are getting smarter about it and are like a little on the fence like do I need to do this you know what there's got to be some some answers here so I love that Mattie that you've seen that you've seen it you witnessed it you know it's possible because you have to work on those those aspects of the mitochondria and and and we can go through I can get through the mechanisms of my question before I forget my question so sorry okay so hypothetically and it might be a dumb question but it's just how my brains working right now. hypothetically a patient's on statins since that like destroys your cholesterol our patients on statins more likely to have low testosterone. Yes absolutely that's it so so statins SSRIs but yeah low cholesterol absolutely is related to lower testosterone there's there's a clear correlation with that and we've seen it we can actually we will we'll go through that as we look at some of our patients here going forward just so you see that you just have never correlated it because I've never brought it up but but you asked the right question and and it's it's very true and and we see that happen so yeah my next question was just going to be based on some of the stuff you were saying let's get into the cell like what are some of the cellular inefficiencies that are leading to this low tea production or under utilization of these androgen receptors. Well it could be anrogen receptor so so it's a multitude of I'm just reaching but yeah it's a multitude of factors that can have an influence on on testosterone and one of them is to remember let's let's define this now a hormone test that's a lot of the way that we're going to see that the testosterone has to get into the cell and then it's it goes into the nucleus to start transcription whereas peptides they reach they they handle their signaling through receptors on the membrane. So if we're talking about low cholesterol or low DHA or low plasmologens or certain phospholipids those have a significant influence on structure of cell membrane. If the cell membrane is not fluid and it's more fixed and stiff then it doesn't matter it's the testosterone isn't going to get through that membrane and into the nucleus to do its job to to activate that energy and receptor aspect of the nucleus it's not going to happen so that's why that part is so structure is is so important to understand in in influencing the the process of of the use of testosterone so that that should resonate very so that should resonate above all else for everyone if if I can make it clear that let's say we use let's say we're going to use testosterone or we're not going to use it. If we're not using it and there is this membrane issue if we fix this membrane problem and make it better then we're helping testosterone natural testosterone production get into the cell and do its job and then we've we've actually fixed a root cause problem without giving them testosterone now let's say this patient has is in a state of where they need testosterone. Because of some reason from the HPA axis of where they're not making it or other issues with the synthesis of cholesterol. And then we're going to have a pregnant alone from cholesterol or you know from the enzyme aspect let's say for instance you need to use testosterone well even if you need testosterone if it's not going to get through the membrane or it's going to have a hard time you're still going to have problems and that's why you have to you're going to have to use these higher doses that then can have significant negative effects so so that's one issue. The other issue is the mitochondrial issue which is I think the the big one of efficiencies of the mitochondria where if we're losing the ability to produce ATP and NAD efficiently NAD is a big is a big part of this process of production from the NAD. And then the production from from the standpoint that NAD is converted into NAD pH and NAD pH is this key co factor nuclear co factor in the the production of testosterone. But getting NAD is not going to increase your testosterone just letting people know correct. But but having the cell do it appropriately so NAD pH is a is a very significant factor which is all about cellular medicine and redox so if they're reactive oxygen species are abnormal. If there's reactive nitrous state of species which is when when there's nitric oxide on coupling which is another process of inflammation these all have an effect on the enzymes that are trying to convert the final production of either cholesterol to pregnant alone or pregnant alone on to testosterone. So there are many steps there where this this can take effect so you've got you've got the issues with the mitochondria which are I think significant you've got the issues with structure with cell membrane and and you've got some of these higher issues with the HPA axis which is the hypothalamic pituitary stimulation to the mitochondria. To the testes to signal you know you the pituitary can also be affected by inflammatory problems too so it's fascinating when you start to look at all of these things and and then you can. And then it's even the transport of cholesterol into the cell itself not the not the testosterone into the cell to do its job on the receptor but actually star protein is something that's important in transferring cholesterol into the cell that can be just just disrupted and so redox plays a role. Memorand structure plays a role there's all I mean I could just keep going plays a role yeah stress on it can get it can get large cumbersome confusing and I mean it gets even more confusing right because in 2015 if you remember I'm sure you do the FDA released a warning statement about testosterone replacement therapy TRT and it's potential risk. Yeah regarding cardiovascular health so that was the beginning that started that process of really changing the communities evaluation and understanding of HRT it it sparked a lot of debate so yeah what those those were poor studies because they didn't the inception cohort of those studies was ridiculous I mean they had people with type one diabetes type two diabetes they had obesity it there was so many other. Fair it was a terrible it was one of those things where the media you know it's like when they pull a study out and say the world's going to end and it's based on the study it's the same thing and it it was it's terrible because because testosterone itself and it's been you know now that it's been more validated. I think that that box was removed correct oh yeah that it's just been removed this year you didn't hear it on the news though of course not but but testosterone itself is is as a hormone you know don't don't don't let me under sell it as a hormone it is. It it improves endothelial cell function it improves mitochondrial function it improves cert function cert protein function so it has it improves. Can you improve anti-inflamm it has anti-inflammatory it works again at it against NFKB can you like take all those things that it improves and just. Bring it down to very basic level because okay listeners might not know yes so it in fact testosterone. Helps in physiologic in a physiologic amount which is what we're talking about not super physiologic we're talking about physiologic is what your body knows how to do with an in range. How to work with that's in range of normal for people that we determine normal normal so good question so it improve it actually improves vascular health it it improves muscle function. And and that's something that's a bigger role than we really appreciate because it makes if you're making good muscle remember if we go back to working out training. Smet of all occurrences muscles yeah muscles are endocrine gland that are very big in producing myocytes and in fact irisin and GF 15 are very important. Are very important in in the regulation of the HPA access in helping with testosterone product and it it ladies. A lot of people who are not what is what activates that lady sells to make testosterone so there's so much there. And this should just keep resonating that why wouldn't you want to look at these mechanisms and improve them. Before you even jump into this world of hey you need this because your numbers low that's that's insulting. So let's walk through that process then how should a patient approach their provider if they want to be treated for low T. Well I think they just they explain their symptoms like they typically do and say hey I just want to look. I you know I appreciate this could have something to do with testosterone as a male. But I want to look more into the cellular aspects of what could be contributing to this and I think that opens the door that cellular medicine doctor or functional doctor and aging doctor is going to like to hear that you know that they want to hear that from their patient because they're like okay. This isn't another person just coming to get testosterone this person who wants answers. Maybe they're giving themselves some of the treatment without the treatment what I'm saying is you know we just talked about muscles. What are some of the other ways that men in particular can increase their testosterone. Exercise. Yeah it's all it's all strength training. Yeah that's the that's number one. You're doing things to enhance the muscle cell to have more mitochondrial density which is all about making the muscle stronger. But also making it a better signaling agent. Remember muscles a endocrine gland sorry endocrinologist but it's the biggest endocrine gland in the body that produces significant signaling agents. So we want it on we want it doing its job to like signal the hypothalamus an area in the brain to do its job to signal the release of testosterone. So you can't get around that that's vital. But also keeping muscle healthy is just as important because that's going to keep that axis intact. And I think it gets that simple and sleep does the same thing. Good sleep helps the because you pulse the growth hormone. Yeah you'll pulse out growth hormone. You won't lose any pulses and you'll pulse them out because remember sleep if we look at the circadian clock is the anabolic state of the body. It's about recovery repair. So that's when more NADPH is produced which you need. It all falls into place. It's that master you know the more NADPH the more anabolic the more recovery and restoration of all the cells. So it all adds up. Yeah. And it's just it's fascinating when you get to look at all of this and you get to go down the road because what do we find everybody's different to some degree right? I think it's important for people to know to like just because you have low testosterone a lot of clinics will just be like here here's your testosterone injection. Once you start that you're kind of stuck to it or it's hard to get back off of it. Does TRT need to be continued forever? If you are doing injectable pretty much because you shut off your own production of testosterone. It's a it's a difficult place to be when you're trying to work backwards when people are already taking injectable because we find most of them are super physiologic to start with there and they got used to it. Or that some some are in the higher range and it's hard to it's it's hard to get them away from that because it takes it takes I'm going to just say it takes years. If not a year years you know to work on structure work on really the androgen receptors because they're they're desensitizing receptors and messing those up and they're messing out the mitochondria. It takes a dedicated patient that really wants to do that to and it could be less than a year but to get them off of an injectable and do things it really takes a dedicated person because when you do that you're going to lose right away it's a hard road because they lose that feeling. They feel like shit yeah and and so I can do things to get that a little bit better and I can give them the picture and we've had a few that. That's ticket out and and they end up doing very well but you have to be it takes incredible dedication and understanding and some people just don't have that they don't want to lose that and. And we've seen two some people they try and they really try to push themselves but there's it's just not turning back on their own production no matter what we do. So we need more we need more time and they just lose their patience and I understand that and so then you've got something you got to work around which is what we do and so it may it makes it very interesting with all of these with all the modale with all the different ways you can do that. So what are what are your thoughts about in clomaphon clomaphon good maybe maybe describe what it is first and what your thoughts are on it. So so in clomaphon is actually a SIRM it's a selective estrogen receptor modulator and what does that mean well. And it modulates selective estrogen receptors correct thank you and it works in it works in a way where estrogen is something that actually works in it inhibits it can inhibit the release of a banana tropon releasing or moment and so. And clomaphon is a citrate and there's clomid which is which is another SIRM but in clomaphon is just a little more refined and it works so it works by dis-inhibiting the banana tropon releasing or meaning it makes it work better. And so you're influencing more the pituitary is influencing more of the lady cell to what is the lady cell it's a it's a cell in the it's a there's the lady Excel and the serotonly cell the serotonly cell that that lady cells concerned with making testosterone and the serotonly cells were about spermatogenesis and so luteinizing hormone influence that it's released and influences testosterone production and the fSH it influences the production of sperm and spermatogenesis and so in clomaphon citrates a little bit better in the fertility side of improving fSH but it also what they do is they just let the bottom line is clomid and in clomaphon citrate what do they do they work on in helping you produce your own testosterone so it's a it's a step in a direction of trying to let you do a better job with testosterone based on your own production without introducing an exogenous source so what about hcg what's the difference between like hcg and clomaphin citrate so hcg is another way to influence the luteinizing hormone and fSH it's more luteinizing hormone it's more of production of and it's just another it's it's another potential way to improve that release of the pituitary so it doesn't cause like any negative feedback like testosterone does it doesn't shut any of your body's own production off no but it can no so you have to be it's it's one of those it there's definitely an art in using it and how much to use it it it's all about improving testicular volume and and and actually you know helping in your own production it test testosterone it's and it works differently in different people but it's it it definitely has its role for people that that that prefer to use something like that it's more of a bridge I think it's more of a bridge then in clomaphin or or clomid in people that have maybe had to go on testosterone and are trying to get back off of it or well I notice a lot of clinics like when looking up where patients go I'm nosy so I look up the clinic to see what they're all about and they'll do like courses of like six weeks of testosterone and hcg together and then maybe one day a week though so add in a natural all but then they stop for four weeks and then they'll do it again but the hcg is always with the testosterone so what they're doing is they're trying to maintain the stochular volume and to let to try to try to while you're you're you're causing that negative feedback with the testosterone to keep your test is still producing and so it's a way it's a way of cycling and continuing to be able to use all of those together and the astrosol is more are the people that produce more that convert more estrogen so so convert testosterone to estrogen and that that's to lower that air motace enzyme that that does that and is it good to do cycles like that though I think I do I think I think the people that do it that way it's just my opinion there you're going to find out there five million experts out there about all of this right I'm my approach is just cellular medicine let me give you the facts think about it and and I don't think you can argue the approach we take it all now I like the cycling that the that the people use there because they're there they're being responsible they're not trying to desensitize the energy receptors so it's a it's a and they're different type styles of cycling but I really appreciate those people are really trying to do it right and and that that that's keeping the testicles working in producing their own hormone and so sometimes you'll see when you put people on something like that yeah you and and hopefully when they're doing that they're doing the things we do to work on improving mitochondrial function and whole and then seeing when they get off of that and go back you know when they stop the test so to try to live on their own production they do it well and they do it better and then they don't have to go back on it so what's the length of time that they could be on a cycle before it's like your receptors are their toast oh boy that's a debate you know that that's a that's a that's a circle debate struck an earth of that one well there again so many experts that just think well I think he can be creative with that I think the time frame you can you know the people that do the six weeks and four weeks off or I think you can even I think you can go longer I think the energy receptors it all depends on what you're doing because nobody knows unless you're actually testing and doing doing biopsies to look at energy receptors and and looking for real deficiencies of the gene transcription all the things that you you potentially could do yeah it all depends on that and so it's it could be a multitude of cycling to to make that happen right six weeks three months but if you're working to make things better it's going to get better and then there's people that you you aren't and I think that's what most you know unfortunately these clinics that are just set up to give you your you know they take a number they give you the testosterone give you these other things right away but they they're not doing anything to correct anything and I think people are looking for that but you're doing a great disservice to your body we're doing a great disservice to medicine and to the holy well the cell of hey why not work on improving things before or or during that if you choose to go that route so I think I think we touched on a lot here because we could go and I think we'll have to dedicate another episode to actually the the treatment side yeah like how can you how can you approach this low T because because we have even we have more options than we've ever had and now especially with this oral the oral type of testosterone that we've been working on for 20 years to make it available where it's healthy and and it has it actually follows a half life and it's processed through lymphatic system so you don't get delivered toxicity yeah exactly and and and so those are things that I think would be make a great episode to follow this at some point if we can remember yeah because we we should spend the time on that to talk about the options and then but also talk about the the peptides and things we can do to make that work better if we need to but maybe not even do that so so I really like what you picked out today because there's and then there's so much to this that were we need we need to be more I feel we just need to be more responsible in improving the the improving the discussions that we have with our patients so they truly are given all the options and they can make their an intelligent decision on on where to go with this so again we've got a lot to discuss this was a great topic I really am enthusiastic about where we're going to go with this I'm even looking forward to next week now and I want to just hey thank you everybody for being part of this episode again Matt and Mattie Mattie some good questions again and wait a wait a follow up and fill in and Matt wait a wait a wait a pernounce and clomaphon yeah right that can be a tough one nailed it nailed it and actually oh boy actually now that I'm thinking about it we should bring up we should bring up charms also in the next when we do this discussion about because I've done a video on that that I think people should look into on the selective energy receptor modulators because those are big and young people and we see and they talk them up yeah Mattie said it we see a lot of bad things there thanks again for being with us on this redox revolution episode as I already thank Matt and Mattie I will be back