In this episode, Dr. Mistry and Donna Lee are joined by Urology Specialists' own Dr. Christopher Yang and special guest Dr. Billy Franklin, founder of Victory Medical. Dr. Franklin is a pioneering primary care physician who focuses on both disease prevention and treating the underlying causes of disease. His practice utilizes next-level testing to measure factors that affect longevity, such as blood sugar metabolism, inflammation, and sleep disturbances. Today, Dr. Franklin explains the risks and benefits of hormone therapy and its impact on health span, or the number of years you remain healthy and free from disease. Listen in to learn how adding simply adding testosterone supplements to a balanced diet and targeted exercise can help you live a longer, healthier, happier life! To contact Dr. Franklin, call 512-462-3627 or visit Victory Medical online today!
Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Phone: (512) 238-0762
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:16):
Oh , and welcome to the Armor Men's Health Show.
This is Dr. Mystery , your hostjoined as always by my
wonderful co-host Donnel Lee .
Speaker 4 (00:23):
I'm liking these compliments these days. Thank
you.
Speaker 3 (00:26):
Donnel Lee is very popular. A lot of our listeners
get to , uh, call in and talkto her. Uh , if you do that ,
uh, you can sweeten her up andshe'll send you a shirt. It's
true. One of our amazingshirts, I really like the Make
America Pee again shirts.
Speaker 4 (00:38):
Yeah, those are really popular. I thought they
would not be for some reason. Idon't know why, but they are
. Even some of our staffwho I'm sure would not agree
with some of those ideas, wantthe America Make America Pee
Again shirt.
Speaker 3 (00:50):
It's a wonderful logo. Uh, we can't wait to put
on our Make America pee again.
Um, uh, events , uh, aroundtown , uh, which we hope to
have once a quarter, where ,uh, it's kind of like a
prostate carnival. That'swhere's , right , where you get
to learn more about all thethings that we do for urinary
health, not just in men, butalso in women , uh, when it
comes to their incontinence andother kinds of issues. Mm-hmm .
. So we'relooking forward to putting
(01:10):
those events together. Uh ,Donna, if people want to become
patients of ours at N A UUrology Specialists, how do
they do that? That's
Speaker 4 (01:16):
Right. If you wanna make America pee again, call us
at (512) 238-0762 our website,armor men's health.com, where
you can see our shining littlefaces there. We're located in
Round Rock, north Austin, southAustin in Dripping Springs,
Texas.
Speaker 3 (01:29):
Uh, a big part of what we do in Men's Health is
to testosterone management andhormone management. And I have
two wonderful guests with ustoday, Dr. Christopher Yang,
one of our urologic partners atN A U Urology Specialists, and
Dr. Billy Franklin, founder ofVictory Medical, one of the
most progressive and , uh,forward-thinking men that I
know , uh, primary careprovider and really created an
(01:49):
amazing conglomeration ofmedical , uh, services , uh,
here in Austin. Uh, BillyChris, thank you for joining me
today. Glad
Speaker 4 (01:55):
To be here. Thanks
Speaker 5 (01:56):
For
Speaker 3 (01:56):
Having us. So , uh, I thought I would , uh, talk a
little bit about the differenttypes of testosterone options ,
uh, that patients have and ,uh, uh, Chris, maybe you could
talk to us about like the moretraditional ones. And then
Billy , I'd love to hear yourthoughts on some compounding
options and other kinds ofthings like that. So what ,
what are the most traditionalways that people are getting
testosterone nowadays?
Speaker 5 (02:15):
Yeah, so the, the easiest ways, the ones that
have been out the longest isprobably the topical
testosterone. Typically that'slike a gel or a cream. And then
there's patches as well. Thereare testosterone injections,
testosterone ate . That's theone that you can get at your
retail pharmacy. And then thereare pellets , uh, the one that
is covered by insurance,sometimes it's called testopel
(02:37):
. And then there are a coupleof newer ones on the market,
oral testosterone pills. Uh ,there's one called Denzo and
there's one called Tolando .
Speaker 3 (02:45):
There's also like a nasal cream is in there.
Mm-hmm.
Speaker 4 (02:48):
Nasal gel. Right.
Speaker 3 (02:48):
That's kind of an
Speaker 5 (02:49):
Interesting one.
Yeah. That's another type of,it sounds weird to me. Topical.
You have to, you have to smearit on the inside of your
nostril
Speaker 3 (02:55):
Twice. A twice a day. Yeah .
Speaker 4 (02:57):
Doesn't it feel like something smeared on the
inside, inside of your nostrilat
Speaker 3 (03:00):
That point?
, we use it, but the
commercials make it look likethe guy's, like a cocaine user
because he's like sneaking s inthe bathroom and like putting
into his nose doesn't
Speaker 5 (03:07):
Sleep for three days.
Speaker 3 (03:08):
But, but there are some, some different ways that
testosterone can beadministered. If somebody
didn't wanna take testosterone.
What are some other ways thatwe can prove pharmacologically,
somebody's testosterone level?
Speaker 5 (03:17):
Yeah, so we can look at their, their estrogen level
and sometimes if too much oftheir testosterone is being
converted over to estrogen, wecan block that conversion with
, with a pill.
Speaker 3 (03:26):
Dr. Franklin, you , you've been doing testosterone
replacement therapy for a longtime. What are some of the
considerations that go intodeciding what's the right kind
of therapy for the person?
Speaker 6 (03:36):
Well, I think a lot of it is what works for the
person. I've always had sort ofa predilection to use H C G
simultaneous to any other kindof testosterone therapy. 'cause
it
Speaker 3 (03:46):
Keeps , what does H C G do?
Speaker 6 (03:47):
It basically keeps your own autonomous production
active. 'cause what wouldhappen ordinarily and take
testosterone is it suppressesthe pituitary in a way that it
doesn't release hormones tostimulate you to produce more
testosterone. But if we give ac g , you continue to produce
no matter what the kind oftestosterone replacement that
you use.
Speaker 3 (04:07):
And I think that gives some comfort to , um, to
patients to know that whatthey're taking is not
necessarily like irrevocablyaltering their , uh, own own
physiology. What is your dosageof H C G that you use?
Speaker 6 (04:18):
You know, we base it on the response a lot of the
times. 'cause it doesn't justkeep things going. It also has
a summation effect and createsa higher testosterone level .
So, you know, we'll use 500units three times a week or
something along those lines.
Again, it kind of depends onthe , the patient and, and
their response. And also it's acost issue. Some people really
can't afford it. Like you saidthough, if if someone's using
(04:40):
the , um, IM injection form oftestosterone, they don't use H
C G , they're gonna be turnedoff forever once they start
that process.
Speaker 3 (04:47):
And I think a lot of our younger listeners need to
be reminded that that turningoff of your autonomous system
can negatively impact , uh,your ability to have children.
Uh, Dr. Yang, what are some ,uh, common complications or
risks that testosterone , uh,supplementation can have?
Speaker 5 (05:03):
Yeah, so one thing that, you know, I'm sure any
testosterone provider does is,you know, we wanna make sure we
don't overshoot your level. Iftestosterone gets levels get
too high, patients canexperience more anger, more,
you know, moods changes. Andthat's something that they
might not necessarily notice,but their partners, their ,
their coworkers might notice.
We also keep an eye on theirestrogen level, like we talked
about earlier. That can makeyour estrogen level too high
(05:25):
and that'll make thetestosterone not work as well.
We also monitor their bloodcount. Uh, the hemoglobin
hematocrit taking testosteroneis one of the oldest ways to,
to juice for , uh, performanceathletes. And , uh, normal
people like me and you , uh, weprobably don't need very high
levels of oxygen carryingcapacity. So, you know, and
that increases risk of , um,blood clots among other things.
(05:47):
So we do keep an eye on yourblood count.
Speaker 3 (05:49):
So , um, you know, in practice I've noticed that.
And , and so if you're alistener out there and you're
taking testosterone and thensomebody told you to go donate
blood because your blood countgot too high, that's the risk
factor and the complicationthat we're talking about. And ,
um, uh, we do a lot of sleepapnea testing in our office
because I have found that themajority of those patients that
(06:11):
have high blood counts ontestosterone actually have
underlying sleep apnea. Uh ,Dr. Franklin as a primary care
provider, what would you say?
Like kind of the undiagnosedlike amount of sleep apnea that
is out there? There's
Speaker 6 (06:23):
A, he , I'm glad you brought that up. 'cause there
really is a huge amount ofundiagnosed sleep apnea. And we
were talking early about howsleep is a major determinant of
longevity as well. So sleepapnea is something that puts
you at greater risk for heartdisease, stroke and, and early
death as well. But it's anunderdiagnosed phenomenon along
with blood pressure. Bloodpressure increases frequently
as patients get older. We'retalking about the over 70
(06:45):
patient . It , it's probably asfrequent as 50% of patients in
that age category, but mostpeople don't look for it or
test for it. And it's anotherthing that can cause a lot of
risk. Interestingly enough,there is an association of
higher blood pressure in olderpatients with low testosterone
levels.
Speaker 3 (07:01):
Well, I think that , um, uh, you know , uh, we've,
we've talked about what thegeneral population thinks about
when it comes to risk for , uh,testosterone replacement. Uh,
in terms of your own reading ofthe literature, do you think
testosterone replacementincreases , uh, cardiovascular
risk or risk of prostatecancer?
Speaker 6 (07:17):
I actually think it reduces cardiovascular risk.
Um, and although there's not alot of random control trials,
which just sort of the goldstandard that we use here
sometimes, unfortunately,'cause those can take decades
sometimes and can only look atone factor. But I I'm pretty
confident it actually probablyextends your lifespan along
with making you feel better andbeing stronger.
Speaker 3 (07:38):
I I , I think that , um, you know, for years , um,
hormone replacement has beenreally considered more of a, a
female kind of like issuebecause , uh, some of those
signs are a little bit moreobvious. Chris ,
Speaker 4 (07:49):
What are you trying to say?
Speaker 3 (07:50):
We're saying
, we're saying that we can tell
that you look old
Speaker 4 (07:54):
Or she's a hormonal.
She's a hor in the mornings.
.
Speaker 3 (07:58):
That's exactly right. I hear you. Thank
goodness my wife doesn't listento the show.
Speaker 4 (08:01):
.
Speaker 3 (08:03):
Dr. Yang, what are some symptoms that men , uh,
might start experiencing ifthey think they have low
testosterone?
Speaker 5 (08:08):
Yeah, so low libido is definitely a very common
symptom. Uh , just feeling moretired, more fatigue, poor
concentration , um, lowerenergy levels. All of those are
fairly common for patients whohave low testosterone. Now ,
there are other things thatcause those symptoms, but you
know, if you have some or allof those, it might be, you
know, low testosterone that'scausing
Speaker 3 (08:28):
It. So , uh, Dr.
Franklin, sometimes patientsmay be concerned about cost
when it comes to managing theirhormones or maybe they have
some kind of, you know, falseimpression of what's going to
be happening from an insurancestandpoint. How do you advise
patients that might beconcerned about cost for
evaluating and treatingtestosterone?
Speaker 6 (08:44):
Well, it , it , it can cost money. And I think
there's , um, a tendency towant insurance to pay for
everything when sometimes theyjust don't. But from my
perspective, you know, for theprice of what a moderate priced
car, you know, you can extendyour life and feel better and
happier and be stronger. It iswell worth what a car might
(09:05):
cost. We compound ourmedications so that even if
insurance doesn't cover it, youcan get it a reasonable price.
And we, and we do someinteresting mixes with our
compounds, you know, we'll,we'll throw in an estrogen
blocker or we'll throw in ansteroid to try to help your
hair with the testosterone.
There's all sort of cocktailsthat we can create on a
compound, and by putting themtogether, it makes it a little
(09:26):
less expensive than having tobuy individual components of
that therapy.
Speaker 3 (09:29):
I continue to be amazed every day at the
innovations that , that you do . I mean, you were one
of the first medical providersto have your own pharmacy. Uh,
you have cardiovasculartesting, a real focus on , uh,
the person making them feelbetter, live longer, and , uh,
know everything about theirhealth. I, I really have to
take my hat off to , uh, the ,the innovations that you've,
(09:52):
you've created , uh, Dr.
Franklin at Victory Medical.
How do people be part of thatinnovation?
Speaker 6 (09:58):
Well, they can call us at (512) 462-3627 . Thank
you for being so generous.
Speaker 3 (10:03):
And what is your website? Our
Speaker 6 (10:05):
Website is www.victorymed.com.
Speaker 3 (10:10):
I know that , uh, our guests are old when they
have to say the www
Speaker 4 (10:14):
stop.
Speaker 3 (10:15):
How do people get ahold of us? Don ,
Speaker 4 (10:17):
You can call us if five , if you say
Speaker 3 (10:18):
Www,
Speaker 4 (10:19):
You can www dot armor men's health.com. Our
phone number's (512) 238-0762.
Speaker 3 (10:26):
Hello and welcome to the Armor Men's Health Show.
This is Dr. Mystery , yourhost, board certified
urologist, joined by my co-hostDonnel Lee .
Speaker 4 (10:33):
Hey everybody.
Welcome to the show.
Speaker 3 (10:34):
We handle everything from the nipples to the knees
in our urology practice. Uh ,very , we are very fortunate to
be growing and being able tooffer , uh, you as potential
patients, shorter wait times tocome see us. We would encourage
you to make an appointment forthat primary or second opinion,
especially if you've beendiagnosed with prostate cancer
or kidney stones or lowtestosterone, or you want to
(10:57):
have your hormones evaluated oryour life improved. We also
love taking your questions onthe show. We , uh, give advice
all the time to patients whoare looking for new primary
care doctors or orthopedicsurgeons. And we think we have
a wonderful stable of excellentcollaborators that we can
advise you on. Mm-hmm.
, Donna, how dopeople get ahold of us?
Speaker 4 (11:17):
Uh , first let me say, I was listening to this
radio station in K L B J theother day and they have a
testosterone clinic where youcan go right there and have
your labs done right on site ,but it's just testosterone. So
continuing the hormonediscussions we've had, you
might wanna consider adifferent clinic, but that's
why we're here. Our website isarmor men's health.com and our
phone number is (512) 238-0762. We're in Round Rock, north
(11:38):
Austin, south Austin andDripping Springs, Texas, where
we will be more comprehensivethan any low T clinic that you
might encounter.
Speaker 3 (11:44):
We are very fortunate to join
Speaker 4 (11:46):
Today . Did you hear that shade? I threw? Yeah, I
hear it .
Speaker 3 (11:48):
Alright . I hear, I hear it . . I didn't ,
I didn't hear you talk aboutany negative comments about
pop-up shockwave clinics for Oh, that , that's the next
segment. That's our nextsegment, , we're joined
by Dr. Billy Franklin, founderof Victory Medical, a
pioneering primary carephysician who focuses more on
prevention than, I guess youknow, the other one, which is,
(12:09):
you know, . What's theother one? The other one. The
other thing. So , um, you know,more and more I um , uh, meet
men who are on the oppositeends of the spectrum when it
comes to their health asthey're getting older. You
know, what is the difference,you think, between the 70 year
old guy that comes in that'srobust and full of life on no
(12:31):
medicines and the guy that hashas 12 medicines. Like at what
point did their trajectoriesstart deviating in their lives?
Speaker 6 (12:39):
Well, I think you mentioned the other ones, which
would be conventional medicine.
And unfortunately we've sort ofleaned toward using
pharmaceuticals instead ofgetting healthy. And medicine
just treats symptoms. It , itnever cures anything for the
most part , um, in terms oflongevity. But we've gotten to
this place where we think youhave a problem, you take a
(13:01):
medicine and a lot of peoplewill give lip service to things
like exercise and diet, butexercise and diet can actually
cure 90% of what we treat. Andexercise in particular is an
extremely potent preventativeof disease. And people that eat
right, people that exercisedon't have to take a whole
bunch of medication to treatthe symptoms of disease. 'cause
they won't develop thosediseases.
Speaker 3 (13:23):
I mean, it's rare to find a sedentary, overweight,
70 year old man not on meds.
Right.
Speaker 6 (13:30):
. Right. And
at that age particularly , um,
a lot of terrible things startto happen physiologically to
those who haven't taken care oftheir body. And that's when
disease really makes itselfknown in the seventies. So
Speaker 3 (13:40):
Let's talk about various , uh, age ranges. So if
somebody's out there in theirtwenties and thirties, what are
some steps that they shouldstart taking? Um, to think
about either testing or lookingfor to, to kind of , uh, to try
to get a longer life, a longer,healthier life? Because we both
know nobody wants to be hookedup to machines till they're
150. Right.
Speaker 6 (13:59):
I mean, the whole idea is to have a, a health
span, which means not so muchas just grow life life , right
, right. But in the healthspan, you're healthy to a
certain age and then, then youdie. And to do that
Speaker 3 (14:10):
Speaker 6 (14:11):
To do that, then it's over. If you wanna start
testing early, I think there'sa movement toward looking at
early metabolic dysfunctionbecause that's where it starts.
Once you have metabolicdisease, insulin resistance,
inflammation, that all beginsvery early in the process. And
that can be looked at. Um,these days people will do
(14:32):
things like get continuousglucose monitors, wear them,
become acutely aware of whatthings cause insulin to be
irregular. For example, youmight find that you didn't
sleep one night, you'll seethat your sugar shoots up
'cause sleep is very importantto longevity. You'll find that
if you exercise, the sugarremains stable also. And so you
can use these vi thesefluctuations while looking at
(14:54):
your sugar as sort of areflection on how well you're
doing toward your future andhow long you're gonna last.
Speaker 3 (14:59):
I think that sugar metabolism, as you mentioned,
and inflammation are probably ,uh, two of the biggest like
future predictors of , uh,abnormal health. And, and you
mentioned somethingfascinating. So those of you
out there that are really, arehealth freaks and really wanna
pay attention to your health, I, I love the continuous glucose
martyr, you know, experimentfor a week. See which foods
(15:21):
make your in , you know, your ,your sugar spike. See what
again, you said sleep patterns, uh, see if your job stress is
causing you to stress.
Speaker 6 (15:29):
Absolutely .
Speaker 3 (15:29):
Absolutely. Have , uh, have , have , you know,
more cortisol and , and poor ,uh, sugar metabolism because
it's, it really is a veryrealtime, you know, indicator
of h h h how our bodies aredoing. So let's say somebody in
their forties and fifties. Whatdo you think are important kind
of , uh, in , in that age rangethat people need to do to kind
of avoid later term problems?
Speaker 6 (15:50):
Well, I don't wanna sound superficial or cliche,
but really exercise iscritical. And, and I think the
way it got driven home for me,'cause I've heard it so many
times over the years, I'veexercised a lot myself. But it
got driven home for me whenthere's a Austin physician who
specializes in prevention bythe name of Peter Attia . And
he was pointing out that thebenefits of exercise in terms
(16:13):
of health would exceed thebenefits of discontinuing
smoking. In other words, it'dbe better to smoke cigarettes
and exercise than the other wayaround
Speaker 3 (16:23):
. But the
ash keeps getting on my
treadmill.
Speaker 4 (16:26):
, it's so
hard, it's so hard to be
healthy . That's right.
It's a dirty place to
Speaker 3 (16:33):
Be . My cheeseburger keeps getting on my
Speaker 4 (16:36):
on
Speaker 3 (16:36):
My treadmill
Speaker 4 (16:37):
Too . The dripping of the cheese, the dripping of
the
Speaker 6 (16:39):
Cheese . Well, and , and there's been so much
conflicting diet information, Ithink people get confused.
There's a million differentideas about what you should eat
and protein's probably underrecommended pretty
significantly in, in theliterature these days. You, you
have to eat enough protein tomake things work for your body
and you have to do not justaerobic exercise, but
weightlifting resistanceexercises just important in
terms of longevity. Well ,
Speaker 3 (17:00):
Uh, when it comes to testing , uh, you had mentioned
previously that there are teststhat people can take to kind of
understand, you know, and, andthese may not be offered by a
traditional primary carephysician. What, what do you
guys do at Victory Medical thatcould be considered kind of
next level testing for factorsthat might impact longevity?
Well,
Speaker 6 (17:17):
What we used to do things like the G SS P , which
is a real sensitive test for ,um, glucose irregularity. But
now I think the continuousglucose monitor is gonna be
what we start going to. There'salso some, some ways to test,
if you're in the zone ofexercise that really puts you
in a preventive mode , you haveto reach basically zone two for
a certain period of time orzone three for a shorter period
(17:39):
of time.
Speaker 3 (17:39):
What does that mean?
Speaker 6 (17:40):
It's about how hard you're exercising and it's
different for each person toreach their sort of peak
exercise.
Speaker 3 (17:45):
Is it managed by, is it measured by O two or is it
managed by blood pressure? Howdo you know what zone you're in
Speaker 6 (17:51):
It ? It's by O two.
Okay.
Speaker 3 (17:53):
So, so when you , um, are your heart rate's at a
certain rate , uh, then whenyour O two kind of your , the
use of oxygen is a certain ratethat gets you into a , a higher
rate of exercise. So a briskwalk would get you into what
kind of zone you say that'd
Speaker 6 (18:06):
Be ? Well it depends on how fast you're walking .
Mm-hmm. , itdepends on the person too.
'cause uh , people responddifferently. For example, you
know, an Olympic athlete riskwalking isn't gonna be doing
very much exercise. Right. Butif you're a completely
sedentary person and you gorisk walk, that's a heavy
amount of exercise. And sothere, there are actually
tables to calculate whetheryou're in zone two, which would
be moderate exercise likebriskly walking or jogging
(18:29):
versus running, which might putyou into a zone one. Reaching
your actual peak exercise givesyou like more credit. If you're
physiologically or young enoughcapable of exercising to that
degree , you get sort of morelifespan credit for doing that
as well, but not you have to doit to a certain amount of time.
There's studies that have beenreally actually carefully
(18:51):
performed. It can suggest thedegree of exercise and how, how
much of an impact it make onyour life and health.
Speaker 3 (18:57):
So as a primary care provider, you've, you've
probably seen so many people asthey're aging just on so many
medications, I feel like a lotof the patients that I see just
feel resigned to the fact thatthey're gonna be taking all
these things forever and don'ttry to make any effort to try
to get healthier and getbetter. And that's always a
little disconcerting. Do youthink it's reasonable for me to
(19:17):
continue to tell my patientsthat if they started eating
right and exercising, thatmaybe they could lose some of
those medicines?
Speaker 6 (19:23):
Absolutely. And I think unfortunately it's not
just patients that are resignedto that, it's physicians too
that are resigned to that. Andthe reality is you can get most
people off their diabetesmedications and most people off
their hypertension medicationsin terms of primary care.
That's what we see masses of .
And , and the reality is notever getting to the point where
you need those medicines is thekey to prevention That's a
(19:44):
super healthy 70 year old .
Speaker 3 (19:45):
I think that , uh, too often patients think that
getting a preventative medicinedoctor is going to be way too
expensive or well out of theirreach and that these kinds of
things are only for otherpeople. But you've created a
practice in which that is nottrue. I mean, you see everyone,
you take almost all insurancesand your approach, I think to
primary care is somethingthat's filtered down to the
(20:07):
tremendous providers that youhave. So , uh, I really
congratulate you on , uh, allthat you've done. How do people
become patients of VictoryMedical? Well, you
Speaker 6 (20:15):
Just have to call us up . (512) 462-3627.
Speaker 4 (20:20):
I always wanna jump in and go 4 6 2 docs,
Speaker 3 (20:22):
4 6 2 docs,
. And, and you know, don't sell
yourself short when it comes toyour doctor. If, if , if
they're not doing what youthink is , um, next level care
for you, then you need to findsomebody else. And that's
something that we agree with atime and time again. Donna, how
do people get that next levelurologic here with us? That's
Speaker 4 (20:39):
Right. You can call us at (512) 238-0762 . Our
website is armor men'shealth.com. We're in Round
Rock, north Austin, southAustin, Austin in Dripping
Springs. And don't forget tolisten to our podcast wherever
you listen to free podcasts.
Speaker 2 (20:51):
The Armor Men's Health Show is brought to you
by N a U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:16):
Oh , and welcome to the Armor Men's Health Show.
This is Dr. Mystery , your hostjoined as always by my
wonderful co-host Donnel Lee .
Speaker 4 (00:23):
I'm liking these compliments these days. Thank
you.
Speaker 3 (00:26):
Donnel Lee is very popular. A lot of our listeners
get to , uh, call in and talkto her. Uh , if you do that ,
uh, you can sweeten her up andshe'll send you a shirt. It's
true. One of our amazingshirts, I really like the Make
America Pee again shirts.
Speaker 4 (00:38):
Yeah, those are really popular. I thought they
would not be for some reason. Idon't know why, but they are
with some of those ideas, wantthe America Make America Pee
Again shirt.
Speaker 3 (00:50):
It's a wonderful logo. Uh, we can't wait to put
on our Make America pee again.
Um, uh, events , uh, aroundtown , uh, which we hope to
have once a quarter, where ,uh, it's kind of like a
prostate carnival. That'swhere's , right , where you get
to learn more about all thethings that we do for urinary
health, not just in men, butalso in women , uh, when it
comes to their incontinence andother kinds of issues. Mm-hmm .
(01:10):
those events together. Uh ,Donna, if people want to become
patients of ours at N A UUrology Specialists, how do
they do that? That's
Speaker 4 (01:16):
Right. If you wanna make America pee again, call us
at (512) 238-0762 our website,armor men's health.com, where
you can see our shining littlefaces there. We're located in
Round Rock, north Austin, southAustin in Dripping Springs,
Texas.
Speaker 3 (01:29):
Uh, a big part of what we do in Men's Health is
to testosterone management andhormone management. And I have
two wonderful guests with ustoday, Dr. Christopher Yang,
one of our urologic partners atN A U Urology Specialists, and
Dr. Billy Franklin, founder ofVictory Medical, one of the
most progressive and , uh,forward-thinking men that I
know , uh, primary careprovider and really created an
(01:49):
amazing conglomeration ofmedical , uh, services , uh,
here in Austin. Uh, BillyChris, thank you for joining me
today. Glad
Speaker 4 (01:55):
To be here. Thanks
Speaker 5 (01:56):
For
Speaker 3 (01:56):
Having us. So , uh, I thought I would , uh, talk a
little bit about the differenttypes of testosterone options ,
uh, that patients have and ,uh, uh, Chris, maybe you could
talk to us about like the moretraditional ones. And then
Billy , I'd love to hear yourthoughts on some compounding
options and other kinds ofthings like that. So what ,
what are the most traditionalways that people are getting
testosterone nowadays?
Speaker 5 (02:15):
Yeah, so the, the easiest ways, the ones that
have been out the longest isprobably the topical
testosterone. Typically that'slike a gel or a cream. And then
there's patches as well. Thereare testosterone injections,
testosterone ate . That's theone that you can get at your
retail pharmacy. And then thereare pellets , uh, the one that
is covered by insurance,sometimes it's called testopel
(02:37):
. And then there are a coupleof newer ones on the market,
oral testosterone pills. Uh ,there's one called Denzo and
there's one called Tolando .
Speaker 3 (02:45):
There's also like a nasal cream is in there.
Mm-hmm.
Speaker 4 (02:48):
Nasal gel. Right.
Speaker 3 (02:48):
That's kind of an
Speaker 5 (02:49):
Interesting one.
Yeah. That's another type of,it sounds weird to me. Topical.
You have to, you have to smearit on the inside of your
nostril
Speaker 3 (02:55):
Twice. A twice a day. Yeah .
Speaker 4 (02:57):
Doesn't it feel like something smeared on the
inside, inside of your nostrilat
Speaker 3 (03:00):
That point?
commercials make it look likethe guy's, like a cocaine user
because he's like sneaking s inthe bathroom and like putting
into his nose doesn't
Speaker 5 (03:07):
Sleep for three days.
Speaker 3 (03:08):
But, but there are some, some different ways that
testosterone can beadministered. If somebody
didn't wanna take testosterone.
What are some other ways thatwe can prove pharmacologically,
somebody's testosterone level?
Speaker 5 (03:17):
Yeah, so we can look at their, their estrogen level
and sometimes if too much oftheir testosterone is being
converted over to estrogen, wecan block that conversion with
, with a pill.
Speaker 3 (03:26):
Dr. Franklin, you , you've been doing testosterone
replacement therapy for a longtime. What are some of the
considerations that go intodeciding what's the right kind
of therapy for the person?
Speaker 6 (03:36):
Well, I think a lot of it is what works for the
person. I've always had sort ofa predilection to use H C G
simultaneous to any other kindof testosterone therapy. 'cause
it
Speaker 3 (03:46):
Keeps , what does H C G do?
Speaker 6 (03:47):
It basically keeps your own autonomous production
active. 'cause what wouldhappen ordinarily and take
testosterone is it suppressesthe pituitary in a way that it
doesn't release hormones tostimulate you to produce more
testosterone. But if we give ac g , you continue to produce
no matter what the kind oftestosterone replacement that
you use.
Speaker 3 (04:07):
And I think that gives some comfort to , um, to
patients to know that whatthey're taking is not
necessarily like irrevocablyaltering their , uh, own own
physiology. What is your dosageof H C G that you use?
Speaker 6 (04:18):
You know, we base it on the response a lot of the
times. 'cause it doesn't justkeep things going. It also has
a summation effect and createsa higher testosterone level .
So, you know, we'll use 500units three times a week or
something along those lines.
Again, it kind of depends onthe , the patient and, and
their response. And also it's acost issue. Some people really
can't afford it. Like you saidthough, if if someone's using
(04:40):
the , um, IM injection form oftestosterone, they don't use H
C G , they're gonna be turnedoff forever once they start
that process.
Speaker 3 (04:47):
And I think a lot of our younger listeners need to
be reminded that that turningoff of your autonomous system
can negatively impact , uh,your ability to have children.
Uh, Dr. Yang, what are some ,uh, common complications or
risks that testosterone , uh,supplementation can have?
Speaker 5 (05:03):
Yeah, so one thing that, you know, I'm sure any
testosterone provider does is,you know, we wanna make sure we
don't overshoot your level. Iftestosterone gets levels get
too high, patients canexperience more anger, more,
you know, moods changes. Andthat's something that they
might not necessarily notice,but their partners, their ,
their coworkers might notice.
We also keep an eye on theirestrogen level, like we talked
about earlier. That can makeyour estrogen level too high
(05:25):
and that'll make thetestosterone not work as well.
We also monitor their bloodcount. Uh, the hemoglobin
hematocrit taking testosteroneis one of the oldest ways to,
to juice for , uh, performanceathletes. And , uh, normal
people like me and you , uh, weprobably don't need very high
levels of oxygen carryingcapacity. So, you know, and
that increases risk of , um,blood clots among other things.
(05:47):
So we do keep an eye on yourblood count.
Speaker 3 (05:49):
So , um, you know, in practice I've noticed that.
And , and so if you're alistener out there and you're
taking testosterone and thensomebody told you to go donate
blood because your blood countgot too high, that's the risk
factor and the complicationthat we're talking about. And ,
um, uh, we do a lot of sleepapnea testing in our office
because I have found that themajority of those patients that
(06:11):
have high blood counts ontestosterone actually have
underlying sleep apnea. Uh ,Dr. Franklin as a primary care
provider, what would you say?
Like kind of the undiagnosedlike amount of sleep apnea that
is out there? There's
Speaker 6 (06:23):
A, he , I'm glad you brought that up. 'cause there
really is a huge amount ofundiagnosed sleep apnea. And we
were talking early about howsleep is a major determinant of
longevity as well. So sleepapnea is something that puts
you at greater risk for heartdisease, stroke and, and early
death as well. But it's anunderdiagnosed phenomenon along
with blood pressure. Bloodpressure increases frequently
as patients get older. We'retalking about the over 70
(06:45):
patient . It , it's probably asfrequent as 50% of patients in
that age category, but mostpeople don't look for it or
test for it. And it's anotherthing that can cause a lot of
risk. Interestingly enough,there is an association of
higher blood pressure in olderpatients with low testosterone
levels.
Speaker 3 (07:01):
Well, I think that , um, uh, you know , uh, we've,
we've talked about what thegeneral population thinks about
when it comes to risk for , uh,testosterone replacement. Uh,
in terms of your own reading ofthe literature, do you think
testosterone replacementincreases , uh, cardiovascular
risk or risk of prostatecancer?
Speaker 6 (07:17):
I actually think it reduces cardiovascular risk.
Um, and although there's not alot of random control trials,
which just sort of the goldstandard that we use here
sometimes, unfortunately,'cause those can take decades
sometimes and can only look atone factor. But I I'm pretty
confident it actually probablyextends your lifespan along
with making you feel better andbeing stronger.
Speaker 3 (07:38):
I I , I think that , um, you know, for years , um,
hormone replacement has beenreally considered more of a, a
female kind of like issuebecause , uh, some of those
signs are a little bit moreobvious. Chris ,
Speaker 4 (07:49):
What are you trying to say?
Speaker 3 (07:50):
We're saying
that you look old
Speaker 4 (07:54):
Or she's a hormonal.
She's a hor in the mornings.
Speaker 3 (07:58):
That's exactly right. I hear you. Thank
goodness my wife doesn't listento the show.
Speaker 4 (08:01):
Speaker 3 (08:03):
Dr. Yang, what are some symptoms that men , uh,
might start experiencing ifthey think they have low
testosterone?
Speaker 5 (08:08):
Yeah, so low libido is definitely a very common
symptom. Uh , just feeling moretired, more fatigue, poor
concentration , um, lowerenergy levels. All of those are
fairly common for patients whohave low testosterone. Now ,
there are other things thatcause those symptoms, but you
know, if you have some or allof those, it might be, you
know, low testosterone that'scausing
Speaker 3 (08:28):
It. So , uh, Dr.
Franklin, sometimes patientsmay be concerned about cost
when it comes to managing theirhormones or maybe they have
some kind of, you know, falseimpression of what's going to
be happening from an insurancestandpoint. How do you advise
patients that might beconcerned about cost for
evaluating and treatingtestosterone?
Speaker 6 (08:44):
Well, it , it , it can cost money. And I think
there's , um, a tendency towant insurance to pay for
everything when sometimes theyjust don't. But from my
perspective, you know, for theprice of what a moderate priced
car, you know, you can extendyour life and feel better and
happier and be stronger. It iswell worth what a car might
(09:05):
cost. We compound ourmedications so that even if
insurance doesn't cover it, youcan get it a reasonable price.
And we, and we do someinteresting mixes with our
compounds, you know, we'll,we'll throw in an estrogen
blocker or we'll throw in ansteroid to try to help your
hair with the testosterone.
There's all sort of cocktailsthat we can create on a
compound, and by putting themtogether, it makes it a little
(09:26):
less expensive than having tobuy individual components of
that therapy.
Speaker 3 (09:29):
I continue to be amazed every day at the
innovations that , that you do
of the first medical providersto have your own pharmacy. Uh,
you have cardiovasculartesting, a real focus on , uh,
the person making them feelbetter, live longer, and , uh,
know everything about theirhealth. I, I really have to
take my hat off to , uh, the ,the innovations that you've,
(09:52):
you've created , uh, Dr.
Franklin at Victory Medical.
How do people be part of thatinnovation?
Speaker 6 (09:58):
Well, they can call us at (512) 462-3627 . Thank
you for being so generous.
Speaker 3 (10:03):
And what is your website? Our
Speaker 6 (10:05):
Website is www.victorymed.com.
Speaker 3 (10:10):
I know that , uh, our guests are old when they
have to say the www
Speaker 4 (10:14):
Speaker 3 (10:15):
How do people get ahold of us? Don ,
Speaker 4 (10:17):
You can call us if five , if you say
Speaker 3 (10:18):
Www,
Speaker 4 (10:19):
You can www dot armor men's health.com. Our
phone number's (512) 238-0762.
Speaker 3 (10:26):
Hello and welcome to the Armor Men's Health Show.
This is Dr. Mystery , yourhost, board certified
urologist, joined by my co-hostDonnel Lee .
Speaker 4 (10:33):
Hey everybody.
Welcome to the show.
Speaker 3 (10:34):
We handle everything from the nipples to the knees
in our urology practice. Uh ,very , we are very fortunate to
be growing and being able tooffer , uh, you as potential
patients, shorter wait times tocome see us. We would encourage
you to make an appointment forthat primary or second opinion,
especially if you've beendiagnosed with prostate cancer
or kidney stones or lowtestosterone, or you want to
(10:57):
have your hormones evaluated oryour life improved. We also
love taking your questions onthe show. We , uh, give advice
all the time to patients whoare looking for new primary
care doctors or orthopedicsurgeons. And we think we have
a wonderful stable of excellentcollaborators that we can
advise you on. Mm-hmm.
Speaker 4 (11:17):
Uh , first let me say, I was listening to this
radio station in K L B J theother day and they have a
testosterone clinic where youcan go right there and have
your labs done right on site ,but it's just testosterone. So
continuing the hormonediscussions we've had, you
might wanna consider adifferent clinic, but that's
why we're here. Our website isarmor men's health.com and our
phone number is (512) 238-0762. We're in Round Rock, north
(11:38):
Austin, south Austin andDripping Springs, Texas, where
we will be more comprehensivethan any low T clinic that you
might encounter.
Speaker 3 (11:44):
We are very fortunate to join
Speaker 4 (11:46):
Today . Did you hear that shade? I threw? Yeah, I
hear it .
Speaker 3 (11:48):
Alright . I hear, I hear it .
I didn't hear you talk aboutany negative comments about
pop-up shockwave clinics for Oh, that , that's the next
segment. That's our nextsegment,
by Dr. Billy Franklin, founderof Victory Medical, a
pioneering primary carephysician who focuses more on
prevention than, I guess youknow, the other one, which is,
(12:09):
you know,
other thing. So , um, you know,more and more I um , uh, meet
men who are on the oppositeends of the spectrum when it
comes to their health asthey're getting older. You
know, what is the difference,you think, between the 70 year
old guy that comes in that'srobust and full of life on no
(12:31):
medicines and the guy that hashas 12 medicines. Like at what
point did their trajectoriesstart deviating in their lives?
Speaker 6 (12:39):
Well, I think you mentioned the other ones, which
would be conventional medicine.
And unfortunately we've sort ofleaned toward using
pharmaceuticals instead ofgetting healthy. And medicine
just treats symptoms. It , itnever cures anything for the
most part , um, in terms oflongevity. But we've gotten to
this place where we think youhave a problem, you take a
(13:01):
medicine and a lot of peoplewill give lip service to things
like exercise and diet, butexercise and diet can actually
cure 90% of what we treat. Andexercise in particular is an
extremely potent preventativeof disease. And people that eat
right, people that exercisedon't have to take a whole
bunch of medication to treatthe symptoms of disease. 'cause
they won't develop thosediseases.
Speaker 3 (13:23):
I mean, it's rare to find a sedentary, overweight,
70 year old man not on meds.
Right.
Speaker 6 (13:30):
a lot of terrible things startto happen physiologically to
those who haven't taken care oftheir body. And that's when
disease really makes itselfknown in the seventies. So
Speaker 3 (13:40):
Let's talk about various , uh, age ranges. So if
somebody's out there in theirtwenties and thirties, what are
some steps that they shouldstart taking? Um, to think
about either testing or lookingfor to, to kind of , uh, to try
to get a longer life, a longer,healthier life? Because we both
know nobody wants to be hookedup to machines till they're
150. Right.
Speaker 6 (13:59):
I mean, the whole idea is to have a, a health
span, which means not so muchas just grow life life , right
, right. But in the healthspan, you're healthy to a
certain age and then, then youdie. And to do that
Speaker 3 (14:10):
Speaker 6 (14:11):
To do that, then it's over. If you wanna start
testing early, I think there'sa movement toward looking at
early metabolic dysfunctionbecause that's where it starts.
Once you have metabolicdisease, insulin resistance,
inflammation, that all beginsvery early in the process. And
that can be looked at. Um,these days people will do
(14:32):
things like get continuousglucose monitors, wear them,
become acutely aware of whatthings cause insulin to be
irregular. For example, youmight find that you didn't
sleep one night, you'll seethat your sugar shoots up
'cause sleep is very importantto longevity. You'll find that
if you exercise, the sugarremains stable also. And so you
can use these vi thesefluctuations while looking at
(14:54):
your sugar as sort of areflection on how well you're
doing toward your future andhow long you're gonna last.
Speaker 3 (14:59):
I think that sugar metabolism, as you mentioned,
and inflammation are probably ,uh, two of the biggest like
future predictors of , uh,abnormal health. And, and you
mentioned somethingfascinating. So those of you
out there that are really, arehealth freaks and really wanna
pay attention to your health, I, I love the continuous glucose
martyr, you know, experimentfor a week. See which foods
(15:21):
make your in , you know, your ,your sugar spike. See what
again, you said sleep patterns, uh, see if your job stress is
causing you to stress.
Speaker 6 (15:29):
Absolutely .
Speaker 3 (15:29):
Absolutely. Have , uh, have , have , you know,
more cortisol and , and poor ,uh, sugar metabolism because
it's, it really is a veryrealtime, you know, indicator
of h h h how our bodies aredoing. So let's say somebody in
their forties and fifties. Whatdo you think are important kind
of , uh, in , in that age rangethat people need to do to kind
of avoid later term problems?
Speaker 6 (15:50):
Well, I don't wanna sound superficial or cliche,
but really exercise iscritical. And, and I think the
way it got driven home for me,'cause I've heard it so many
times over the years, I'veexercised a lot myself. But it
got driven home for me whenthere's a Austin physician who
specializes in prevention bythe name of Peter Attia . And
he was pointing out that thebenefits of exercise in terms
(16:13):
of health would exceed thebenefits of discontinuing
smoking. In other words, it'dbe better to smoke cigarettes
and exercise than the other wayaround
Speaker 3 (16:23):
treadmill.
Speaker 4 (16:26):
healthy
It's a dirty place to
Speaker 3 (16:33):
Be . My cheeseburger keeps getting on my
Speaker 4 (16:36):
Speaker 3 (16:36):
My treadmill
Speaker 4 (16:37):
Too . The dripping of the cheese, the dripping of
the
Speaker 6 (16:39):
Cheese . Well, and , and there's been so much
conflicting diet information, Ithink people get confused.
There's a million differentideas about what you should eat
and protein's probably underrecommended pretty
significantly in, in theliterature these days. You, you
have to eat enough protein tomake things work for your body
and you have to do not justaerobic exercise, but
weightlifting resistanceexercises just important in
terms of longevity. Well ,
Speaker 3 (17:00):
Uh, when it comes to testing , uh, you had mentioned
previously that there are teststhat people can take to kind of
understand, you know, and, andthese may not be offered by a
traditional primary carephysician. What, what do you
guys do at Victory Medical thatcould be considered kind of
next level testing for factorsthat might impact longevity?
Well,
Speaker 6 (17:17):
What we used to do things like the G SS P , which
is a real sensitive test for ,um, glucose irregularity. But
now I think the continuousglucose monitor is gonna be
what we start going to. There'salso some, some ways to test,
if you're in the zone ofexercise that really puts you
in a preventive mode , you haveto reach basically zone two for
a certain period of time orzone three for a shorter period
(17:39):
of time.
Speaker 3 (17:39):
What does that mean?
Speaker 6 (17:40):
It's about how hard you're exercising and it's
different for each person toreach their sort of peak
exercise.
Speaker 3 (17:45):
Is it managed by, is it measured by O two or is it
managed by blood pressure? Howdo you know what zone you're in
Speaker 6 (17:51):
It ? It's by O two.
Okay.
Speaker 3 (17:53):
So, so when you , um, are your heart rate's at a
certain rate , uh, then whenyour O two kind of your , the
use of oxygen is a certain ratethat gets you into a , a higher
rate of exercise. So a briskwalk would get you into what
kind of zone you say that'd
Speaker 6 (18:06):
Be ? Well it depends on how fast you're walking .
Mm-hmm.
'cause uh , people responddifferently. For example, you
know, an Olympic athlete riskwalking isn't gonna be doing
very much exercise. Right. Butif you're a completely
sedentary person and you gorisk walk, that's a heavy
amount of exercise. And sothere, there are actually
tables to calculate whetheryou're in zone two, which would
be moderate exercise likebriskly walking or jogging
(18:29):
versus running, which might putyou into a zone one. Reaching
your actual peak exercise givesyou like more credit. If you're
physiologically or young enoughcapable of exercising to that
degree , you get sort of morelifespan credit for doing that
as well, but not you have to doit to a certain amount of time.
There's studies that have beenreally actually carefully
(18:51):
performed. It can suggest thedegree of exercise and how, how
much of an impact it make onyour life and health.
Speaker 3 (18:57):
So as a primary care provider, you've, you've
probably seen so many people asthey're aging just on so many
medications, I feel like a lotof the patients that I see just
feel resigned to the fact thatthey're gonna be taking all
these things forever and don'ttry to make any effort to try
to get healthier and getbetter. And that's always a
little disconcerting. Do youthink it's reasonable for me to
(19:17):
continue to tell my patientsthat if they started eating
right and exercising, thatmaybe they could lose some of
those medicines?
Speaker 6 (19:23):
Absolutely. And I think unfortunately it's not
just patients that are resignedto that, it's physicians too
that are resigned to that. Andthe reality is you can get most
people off their diabetesmedications and most people off
their hypertension medicationsin terms of primary care.
That's what we see masses of .
And , and the reality is notever getting to the point where
you need those medicines is thekey to prevention That's a
(19:44):
super healthy 70 year old .
Speaker 3 (19:45):
I think that , uh, too often patients think that
getting a preventative medicinedoctor is going to be way too
expensive or well out of theirreach and that these kinds of
things are only for otherpeople. But you've created a
practice in which that is nottrue. I mean, you see everyone,
you take almost all insurancesand your approach, I think to
primary care is somethingthat's filtered down to the
(20:07):
tremendous providers that youhave. So , uh, I really
congratulate you on , uh, allthat you've done. How do people
become patients of VictoryMedical? Well, you
Speaker 6 (20:15):
Just have to call us up .
Speaker 4 (20:20):
I always wanna jump in and go 4 6 2 docs,
Speaker 3 (20:22):
4 6 2 docs,
yourself short when it comes toyour doctor. If, if , if
they're not doing what youthink is , um, next level care
for you, then you need to findsomebody else. And that's
something that we agree with atime and time again. Donna, how
do people get that next levelurologic here with us? That's
Speaker 4 (20:39):
Right. You can call us at (512) 238-0762 . Our
website is armor men'shealth.com. We're in Round
Rock, north Austin, southAustin, Austin in Dripping
Springs. And don't forget tolisten to our podcast wherever
you listen to free podcasts.
Speaker 2 (20:51):
The Armor Men's Health Show is brought to you
by N a U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
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