AM Show Hr 1 | From Below the Belt to Ta-Ta’s: Health Talk Gets Real

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Episode Transcript

Speaker 1 (00:04):
It's that time, time, time, time, luck and load. So
Michael Verie Show is on the air. Today's show is

(00:27):
sponsored by Peanut Butter.

Speaker 2 (00:31):
For pure versatility of application, ability to make anything it
touches better, and shelf life.

Speaker 1 (00:42):
I don't know that there's anything better that comes in
a bottle. I really don't. I really don't. Let's just
take a moment and think about your best peanut butter moment. Ramon.
Your peanut butter moment should not involve sex.

Speaker 3 (00:58):
But my urologist, doctor Mohit Kara is our guest. Welcome
to the program. Good sir, Thank you Michael. Everyone has
a lifespan, Ramon. You know that you have a lifespan.
We talk about our lifespan. Doctor Mohitz Kara is writing
a book called Or about the sex span. How long

(01:19):
can a human being have a functional, fulfilling sex life,
Doctor Kara? Why does that matter?

Speaker 4 (01:28):
Well, Michael, the first, thank you for having me on
the show. You know, everyone where you go, everywhere talks
about lifespan and health span. That's the big buzzwords in
the community. And I'll give you an example. Everybody wants,
I assume their health span to last as long as
their lifespan. But in the United States, the average health
lifespan is seventy seven years old. Women live typically seventy

(01:50):
nine years old, men live typically seventy five years old.
But the health span in the United States is roughly
sixty seven years old, which means most of us, for
the last ten years of our life are not going
to be living in a healthy condition, which is very unfortunate.
And all these countries talk about how they're expanding their
lifespan and getting people to live longer. In my mind,
that is not what I want do, not expand my

(02:12):
lifespan without expanding my health span. But this concept of
sex span is also important because many men would say, look,
I said, if you're going to live till eighty, but
you can only have sex till fifty, that's a problem
for many men. And so what we want to do
is try to expand our sex span and our health
span as long as our lifespan. And I think that's

(02:35):
a really important point.

Speaker 1 (02:38):
I know.

Speaker 3 (02:39):
One of the things I like about you is that
you don't just rely on what you learned in medical
school and then mail it in every day. You're constantly
reading studies, you're constantly performing research and publishing and speaking
literally around the world, because you're always somewhere else when
I call you to see what you're up to giving
a speech on this or that. How important is sex

(03:01):
to the human body in terms of purely physically, Yeah.

Speaker 4 (03:06):
It's it's extremely important. So I want to just clarify
one thing. A rectile dysfunction is not a disease. It's
a symptom of other underlying diseases. Right, So ED does
not happen in healthy men as they get older. If
a man gets a rectiled dysfunction, it is a symptom
of his diabetes, it's a symptom, it is Cardiovaskar disease,

(03:26):
it's a symptom of his radical procestectomo surgery, or it's
a symptom of depression or anxiety. So when someone develops
a rectile dysfunction, the second question you should be asking
is what else is going on that's causing this condition,
because if he was perfectly healthy, that would not happen, right,
And so the best example I can give you is

(03:46):
this is that if did you know that if a
man walks in today and has a rectile dysfunction, fifteen
percent of them will have a heart attantic earth stroke
within seven years fifteen percent. It's an underlying marker of
cardiovask disease. If man and walks in with ED today,
thirty percent of them have a cult diabetes thirty percent,
which is a lot. And if a man walks in today,

(04:09):
thirty percent of them will have depression or anxiety. So
the biggest mistake I can do is give this man
viagra and send him on his way, because maybe he
has that occult cardiovask disease, maybe he has diabetes. Maybe
he's suffering from depression or anxiety. So it's really important
to figure out what is causing that ED. And what's

(04:29):
so nice about this is that there's a bi directional relationship.
So if I treat a man's ED, that actually improves
his depression. If I improve a man's depression, it actually
improves his ED. So I think the paradigm is shifting.
No longer do I want to just hand the man
the pill. You've got to figure out what's going on underneath,
because this is what I call the canary in the
coal mine, and you can actually save someone's life. I mean,

(04:51):
imagine if I catch someone's cardiovaskar disease today or diabetes today,
or I catch it ten years from now. It's a
total change trajectory in terms of their house span in
their life.

Speaker 3 (05:03):
Well, it goes back to viagra originally being a cardigo
vascular disease in a off label benefit being.

Speaker 1 (05:11):
The ability to get erection.

Speaker 4 (05:14):
Yeah, Michael, that's a funny story because remember this one.
But they were trying to make a blood pressure medication
and accidentally everyone in this study was getting erections, and
they figured it out because people were not returning the pills.

Speaker 3 (05:31):
I had a friend, I was a baby lawyer at
the time at a firm called Jakins and Gilchrist and
I worked with a guy named Darren Alt who was
my best friend there. And his wife, Tracy, was the
head of viagra in Houston, which was the top market
for viagra in the country, and they were taking a
trip every other week with their sales reps, and they
had all sorts of stories of people and at that
point it was still you'd go to your cardiologist to

(05:54):
get viagra, So everybody was faking a heart problem to
go in and get this medication. And the story goes
that the doctors were getting calls from the wives going, hey,
knock it off, take him off.

Speaker 4 (06:06):
Of that, right, right, right right? Yeah, absolutely, And so
you know what the issue is is that ED back
then was not considered a very serious condition. People used
to make fun of it, and oh he has ED.
ED is a very serious condition. Someone gets erected on dysfunction.
Take it seriously. Something else is going on.

Speaker 3 (06:26):
Well, and to oversimplify this, that is because it means
you're not getting proper blood flow or you're not pumping
your blood properly. And that's I guess as good a
way as any for us to check, maybe the easiest way.

Speaker 4 (06:41):
Yeah, and so think about this. I teach their medical
students this knew monic called vent vascular, meaning there's not
enough blood flow coming in or there's too much blood
flow coming out. And too much blood flow coming out
is the most common cause of ED. So the guy
will tell you I can get the direction, but I
just can't maintain it. He's telling you the blood flow's
coming out too quickly. The number one call of ED
in the world. But VENT stands for a vascar E

(07:03):
means androcrine. It's testosterone. The testosterone goes low, ED goes up.
Neurologic meaning nerve injury and then trauma. And don't forget medications.
Medications are notorious, for example, beta blockers. How many people
are on beta blockers shuts down the erections. Antidepressants shuts
down the directions. So you got to look at all
the different causes for ED. And I just want to

(07:26):
stress one other thing. Sexual dysfunction is a couple's disease.
You know, we're so fixed on these silos. I got
to take care of the woman, I got to take
care of the man. You got to look at both
of them. I'll give you an example. Back in two
thousand and seven, I finished my fellowship and I was
so proud of myself. I was able to get these men,
these amazing erections, amazing libido. And one day a woman

(07:46):
called me and said to me, she said, everything was
great with our relationship until he met you. We never fought.
We fight all the time because every day he wants
to have sex with me and I don't want to
have sex with him. And you've ruined our relationship. And
I thought to myself, she's right. What is the point
of raising one libido without raising the other? Either leave
both libidos low. It's fine leave them both low or

(08:10):
raise both, but you don't raise one without the other.

Speaker 1 (08:12):
Doctor Mohitera at the Better College.

Speaker 3 (08:14):
Of Medicine and myroologist and friends coming up the book
will be are going to get the name of it.

Speaker 1 (08:20):
It's about the sex Ben. Maybe callver sex Ben. A
moment a hard problem. Everyone listens the Michael Verry Show.

Speaker 5 (08:37):
Today's show was brought to you by peanut Butter for
pure versatility and application ability to make anything get touches
better in shelf life. I don't know that there's anything
better that comes in a bottle. I really don't. Let's
just take a moment and think about our best peanut

(08:57):
butter moment.

Speaker 3 (09:15):
The only downside to having doctor Mohit Kara on the
air as our guest is then people it's me how
to get in to see him because it takes so
long to see him because he is so insanely popular.
Everybody I know is now his patient after hearing my

(09:35):
experience with him.

Speaker 1 (09:38):
He's just fantastic. I think the world of him.

Speaker 3 (09:40):
Doctor Mohit Kara is at Baylor College of Medicine, where
he is a urologist. He has a forthcoming book is
the book called the sex Span moment, or what.

Speaker 1 (09:50):
Is the book called.

Speaker 4 (09:52):
It is called sex Span and it's a proactive approach,
a proactive approach to prolonging your sex span.

Speaker 1 (09:59):
So we were going into the break.

Speaker 3 (10:01):
You made a statement about if you help a man
build his libido and his sexual function, but you do
not concurrently do that for the woman, you end up
causing problems for them. Let's take the physical out for
a moment. In your opinion, how important is sexual relations
to a couple and to an individual emotionally? You tied

(10:23):
it to the antithesis of depression, but talk about that
if you would.

Speaker 4 (10:28):
It's extremely important. If you look at couples that engage
in regular sexual activity, that tend to be happier overall,
satisfied with their quality of life. These tend to be
healthier and easily tend to live longer. So there are
numerous aspects. There's one study that I saw that talked
about couples that engage in who do not engage in
sexual activity typically can have a twofold attraction from their relationship,

(10:52):
but if they do engage sexual activity, it actually can
add four x to the quality of relationship. So I
mean let's be honest. I mean, it does bring intimacy
and closeness to the relationship. It does strengthen the quality
of the relationship, and in many cases people find this
extremely important. So I do think that there is a
medical benefit psychological benefit in patients engaging in sexual activity.

Speaker 3 (11:14):
I have had friends over the years when they put
their parents in old folks homes.

Speaker 1 (11:19):
They talk about.

Speaker 3 (11:20):
How how it is surprising how much activity there is
in the old folks home. And when I did that
for my dad earlier this year, that was one of
the things that everybody consistently across the board talked about.
I don't know if if there's anything to that, but
we're talking about these and nineties, and.

Speaker 1 (11:36):
I have heard this story consistently.

Speaker 4 (11:40):
You're actually so one of the highest levels of STDs
do occur in nursing homes. So you do know that
there's increased sexual activity that does occur in those in
those nursing homes. And so, but part of it is
because there's a at some point, there's an inflection point.
As you live longer and longer, those patients that are
the healthiest tend to live the longest, and those patients

(12:02):
who are tend to be healthier, tend to be more
the ability to engage in sexual activity.

Speaker 3 (12:07):
When you and I talked about the book the first time,
you said that one of the things that the book
is going to cover is the importance of screening for
testosterone and how a rectyal dysfunction is a marker of
other underlying major medical conditions, such as a heart attack.
The screening for testosterone, why is that important?

Speaker 4 (12:25):
So, Michael, I am very passionate about this topic because
you know, everyone thinks about testosterone as energy and sex
drive and erections. And yes, it's true if you have
low energy, low lebido rectal dysfunction, giving a man testosterone
can improve these symptoms. But now we're in an era
where it goes way beyond that. So did you know
that a man who has low testosterone is much more

(12:46):
likely to have a heart attack, non negotiable, much more likely.
A man who's low test also is much more likely
to break a bone. A man who's low tests also
is more likely have diabetes obesity Metabook syndrome. A diet
man who's low test also is much more likely to
suffer from depression. And giving a man back his testosterone
can help mitigate improve these conditions. So it's not just

(13:06):
about sex, it's about your overall health. The problem I
have is that when I walk into my primary care
doctor's office every year and he checks my blood, he
does not check an annual testosterone. He'll check a thyroid.
He'll check a TSH. I say, why are checking at TSH?
He said, well, we do that every year to make
sure you're not hypothyroid. There is not a better marker
of a man's overall health than a testosterone level. It

(13:28):
gives you a marker of what his health is today,
and it gives you a marker of what his health
will be in the future. And so every man over
the age of forty, every single man, should be getting
a testosteral level every single year after the age of forty,
because I do think it's the best predictor of his
overall health currently and in the future. And it's modifiable
because there's things I can do to improve his testosterone

(13:49):
if he's low.

Speaker 1 (13:50):
You suggested testosterone for me ten years ago.

Speaker 3 (13:53):
I know you weren't going to talk about it because
you're the doctor, but I can, and obviously it changed
my life. It made a huge difference for me. But
when you do that for folks, what kind of differences
do you typically see?

Speaker 4 (14:07):
Well, the first thing you have to ask yourself is
are they young and do they want to have children?
Because most people don't realize that giving testosterone actually shuts
down your fertility. So I can't tell you how many
patients I see in my practice every week they said, look,
I was started on testosterone or no one told me
that the test also could make me infertile. Now we
want to have kids? What do I do? So there's
the ways I can reverse it. So the reality is,

(14:29):
if you're in the reproductive years, if you're planning on
having children and your tea is low, don't take testosterone.
But let me give you medications that make you make testosterone.
That's safe. So I can give you medications to make
you make testolstone and that will enhance your fertility. But
if you're older and you're you're not trying to have children,
then there are many ways to give a man testosterone.
We now have oral testosterone, which is fantastic world test

(14:51):
asinal is very new in the United States. It's only
been out for five years. And that we have a pill,
we have injections, we have pallets, we have patches, but
I will tell you that I do think that this
medication can have a profound effect on the quality of life.
And many patients, I mean many patients come in. They're
thanking you, they're telling you that they have a significant
improvement directions or libido muscle mass. Not everybody, I mean,
there are patients that don't respond, but the majority of

(15:14):
patients who start out low do see a significant improvement
in their quality of life.

Speaker 3 (15:20):
I was talking with one of our show sponsors, Wayne Wilson,
who owns Synergenics, and.

Speaker 1 (15:26):
He said, hey, you're urologist.

Speaker 3 (15:28):
Is the one who came when we started, I guess
with pellets or whatever, and came and talked to them
about testosterone and obviously that's what they do all day
every day, and he went through the various things that
you talk about.

Speaker 1 (15:44):
He took note. He's a physician's assistant by training. But
it was amazing to me.

Speaker 3 (15:48):
You were the god of testosterone as far as Synergenics
is concerned, and.

Speaker 1 (15:53):
I didn't know you had an association with them.

Speaker 4 (15:56):
No, I appreciate. I mean, I've been very passionate about
this for about twenty five years. So all my basic
science work, all my lab, all my clinical trials are
around this topic. So when it comes to teaching and
education to others about Tessaucer, I'm all in one moment.

Speaker 3 (16:12):
Doctor Mokara is our guest. He's at Baylor College of Medicine,
and I'm going to start with the question everyone always asks, well,
am I more likely to get prostate cancer?

Speaker 1 (16:20):
Mike, aren't you worried about prostate cancer? We'll ask him
that coming.

Speaker 6 (16:23):
Up with his finger on the pulse, The King of
Teing continues on the Michael Berry Show.

Speaker 3 (16:35):
Doctor Mois Kara my urologist and friend of Baylor College
of Medicine and international renown as a speaker on issues
of sex urology, testosterone. Forthcoming book is called sex Span,
which talks about the length of tom in which a

(16:58):
person has a functional sex life that will be out
relatively soon. Doctor Kara, I received an email from a
fellow named Doug who writes three minutes ago. I figure
your interview is pre recorded, but if not, I'm curious
about blood clots.

Speaker 1 (17:18):
I had a.

Speaker 3 (17:19):
Pulmonary embolism and they told me to stop taking testosterone.
I used to go to the Low T Center and
had a great experience experience with the treatment. I miss it.
I hate that I can't take it anymore. Does doctor
Kara have a thought about that?

Speaker 4 (17:33):
I do, Michael, so listen. There was a concern for
that in twenty fifteen and the FDA asked to conduct
a large trial. It was called the Traverse Trial. I
was fortunate enough to be involved in that trial with
myself and eight other physicians, and we designed this trial
with several hundreds of millions of dollars and the goal
was to see if it caused increasing cardiovascar events and

(17:53):
prostate cancer. What it did find with there was no
increase in heart attack in those men taking testawsin versus placebo.
We had over five thousand patients. We followed them for
four years, and there was no increased risk in DVT.
But there was a slight increased risk in pulmonary embolism.
And the difference was a difference of between point five
percent and point nine percent, So there was a slight signal.

(18:17):
And I think it's very important to counsel patients when
they ask about that. So I guess again, you know,
I don't believe that I personally don't believe the test
alsa increases the risk of DVT in pulmonary embolism. I
think the difference was small, but the Travers trial showed
what it showed. Also, I just want to mention it
showed no increased risks in prostate cancer and no increased

(18:40):
risk of worsening of urinary symptoms. Great study, Traverse trial.

Speaker 1 (18:45):
Why do you think this is out there?

Speaker 3 (18:48):
Because I have a friend who started on testosterone, heard
me talking about it. He starts on it, three months later,
he gets prostate cancer. He text message says, hey, just
I want you to know I just started on testosterone
and I got prostate cancer.

Speaker 1 (19:04):
You need to be careful.

Speaker 3 (19:05):
And my immediate response was, you haven't been on testosterone
long enough. Even if it did cost prostate cancer for
it to have caused that, if there was no testosterone
supplement out there, men still got prostate cancer at rapid,
at large rates.

Speaker 1 (19:20):
You can't blame every one of them on testosterone.

Speaker 4 (19:23):
I absolutely agree with you, and I got to tell
you where it started from. It started in nineteen forty
one when Huggins and Hodges published the famous paper I'm
showing that when you give a man testoser increases a
risk for prostate cancer. If you and I go to
the library right now and pull that paper, you're going
to find something very interesting. It was based on one patient,
one patient, nineteen forty one, and we had instilled fear

(19:45):
in us for so many years. The good news is
in twenty eighteen, my society, the American Neurologic Association, said
testosterone does not increase the risk for prostate cancer, strong recommendations.
So we do not anymore have a concern that testoscer
increases the risk for prostate cancer. I'll tell you a
very interesting story. If I had metastatic prostate cancer all

(20:07):
over our body and we walked into Johns Hopkins University
of Today, they would there's a trial where they put
us on high doses of testosterone to reverse the prostate
cancer and it works. It reduces the PSA, reduces the metastactacy.
So we're learning a lot about testosteron prostate cancer. And
this concept that testoster increases the risk, I think to

(20:28):
me is a myth. Michael, I want to bring up
one other important thing. You talked about this earlier about testosterone,
and you said, when you give testosterone, does it make
people feel better. But I tell patients that you know,
you've got to understand there's something that's just as important.
It's lifestyle modification, diet, exercise, sleep, and stress reduction. I
don't have a pill on the planet stronger than diet, exercise,

(20:50):
sleep and stress reduction. And every day when we wake
up or when we go to sleep, we should ask
ourselves what are we going to do on diet, exercise, sleep,
in stress reduction. I call that offense like four things
on offense, and then I call it four things on defense.
Only four ways you and I are going to die.
We're going to get cancer, we get a heart attack,
we're going to get metabolic disease meaning diabetes, obesit, or

(21:11):
we're gonna get parking center Alzheimer's. So on the defense,
every day we should ask ourselves how are we going
to keep those four things away? And our offense? How
are we going to move our health forward with those
four that? I think is a really important point I
wanted to get across. We have a big program on that.
I mean every time someone comes in, I have a
program for their offense and defense. It's really important.

Speaker 3 (21:33):
The four on offense, which you have preached since the
day I met you, diet, exercise, sleep and stress reduction,
and do you have four on defense?

Speaker 4 (21:44):
The four on defense are absolutely so it's cancer, which
means it's a heavy cancer screen CALLINGOX could be PSA.
Sometimes we'll do imaging as well. There are new tests
that come out called gallery. There other is called the
liquid biopsy test. I mean there's ways to image into
look for patients who may have potential cancer I have.
Cardiac screening is extremely important. You can sometimes you know,

(22:07):
you'll get certain labs like APO b LPLYTLEA. Sometimes we'll
get a corniny calcium score to look at the heart
to make sure there's not increase calcium metabolic disease. You
want to make sure that patients are watching their sugars.
It's a silent killer. Sometimes we'll put a CGM, which
is a continuous glucose monitor on them to help them
look at their sugars to make sure that they get
the feedback to say these are the foods I should

(22:29):
stay away from. And then you know, there's not a
lot you can do. With Parkinson's and Alzheimer's. There are
certain tests that you can look at some genes, you
can look at the see if you're a higher risk.
But you know, if you are at a higher risk,
you can start altering your behavior, exer, you know, and
doing things. So it's really important to keep the bad
things away and use the diet, exercise, and sleep and

(22:50):
stress to move your health forward in that paradigm. Most
people get the concept of offense and defense four and
four and it's really worked well for a lot of
my patients.

Speaker 1 (23:01):
I don't know if I've told you this. Doctor Mohit
Kara is our guest. K H. E.

Speaker 3 (23:05):
R A Baylor College of Medicine. I don't know if
I've told you this, but on Christmas Eve, Ramon got
a CGM, a continuous glucose monitor, and he started monitoring
his blood sugar and he keeps his blood sugar at
a very steady between one and one thirty, usually about
one point fifteen. The first thing I do when I

(23:26):
walk in the studio every morning is he's already here.
Is I ask him for the number he sees me
coming up the stairs and he will write it down
and show it on a sheet of paper or open
the door and tell me, and he has. It has
absolutely changed not only his health but his mood. I
mean he is consistent, he can work harder, he can
work longer by just stabilizing blood sugar, which obviously for

(23:50):
most people is fluctuating with great volatility.

Speaker 4 (23:54):
I love that story. I think that's that's the see
and I see that all the time because the reality
is there a foods that you're eating that you think
are healthy and they're not. And the fruits that you
think they are not that healthy are you know? And
you know, I put a CGM on my wife and
we went to the same restaurant once we ate the
exact same thing, and we got totally different numbers. Because
part of it's also genetics, right, So that can play

(24:15):
a role in it as well. But learning more about
what is bad and what to stay away from is
extremely important because if you give yourself feedback, and those
who take feedback very seriously, you can really alter the
quality of their life because that sugar is just pounding
the blood vessels, just pounding them.

Speaker 3 (24:35):
My dad's a lifelong diabetic. Was nineteen when he got diabetes.
He's eighty five now. It's amazing. He has all ten
fingers and toes, but he has monitored he I've had
doctors tell me your dad knows more about diabetes than.

Speaker 1 (24:45):
We do because he had to treat it before. They
was awesome.

Speaker 3 (24:48):
But I take ramon to see him last week and
all they talked about was their cgms and their dex
Colm CGM and what the reading was and what this
was and what that was it was. It was pretty
funny to watch Home with Me for one more segment
if you can.

Speaker 1 (25:01):
Doctor mohitz Kara is our guest.

Speaker 3 (25:03):
The book is The Sex Span and we will double
back to that subject coming up.

Speaker 6 (25:21):
From Portland to Walbany at all Greek cities in between.
Michael Berry Show is nationwide.

Speaker 1 (25:36):
Doctor mohitz Kara is our guest k H. E.

Speaker 5 (25:39):
R A.

Speaker 3 (25:39):
He is my friend and my urologist and an expert
in matters of sex and testosterone. I will read to
you an email from one fellow says, uh, well, let
me go back to that. Another fellow, actually several fellows said,
my wife's libido is way lower than mine.

Speaker 1 (26:01):
How can he increase a woman's libido?

Speaker 4 (26:06):
That's a really important point. So you know I told
you earlier that couple that got the woman that called
me that was very upset. So in two thousand and eight,
I actually flew out to California to the Many Fellowship
in Female sexual Dysfunction, and I started treating women for
the past seventeen years because you can't just treat one
person without treating the other. And when you improve both libidos,
you actually it's synergistic. So women, this female sexual dysfunction

(26:29):
is comprised of four components low libido for arousal meaning
poor blood floats of the genitalia, or gasmic dysfunction, or
pain it was sex. If she has any one of
those four and is bothered by it, she suffers from
female sexual dysfunction. And there are many treatment options out there.
One could be hormonal, one could be actually using new
Two FDA proved medications are out. One's called add ADDYI.

(26:53):
It came out in twenty fifteen. FDA proved strictly to
increase a woman's desire for sex. That's it. She takes
the pill every day, increases her desire for sex by least.
He came out several years later. It's an injection EpiPen.
She injects strictly to increase her desire for sex. Now,
I just want to want to be very clear. Libido
is more deeper than that. I mean there could be
a lot of other other factors. I mean it could

(27:15):
be her stress, it could be her physical condition, it
could be fatigue, so you can't. It could be the
quality of the relationship. So I mean, if someone has
a terrible quality and relationship, I can't. I can give
them all the pill they want, it's not going to help,
you know, So you just got to look at the
whole big picture. But I still also believe when you
improve a woman's diet, exercise, sleep, and stress, her libido

(27:36):
does go up.

Speaker 1 (27:37):
It also helps if you take them to the movies.

Speaker 4 (27:41):
Yeah, that's true.

Speaker 3 (27:43):
That's true for the most conversations. Alex writes zar, what
if you can't always afford the treatment for testosterone, is
there a safe supplement I can take that would help?

Speaker 4 (27:58):
So the good news is that you can get testosterone
even compounded compounding pharmacies, many of them are called A
five ZHO three B, which are regulated. They make testosterone
at a price of about thirty dollars a month without insurance.
Most people can afford thirty dollars a month without insurance.
If you look at even medications like cialis, if you
use a good RX cupon co order you use Mark

(28:19):
Cuban's company, you can get ninety days for roughly twenty
or twenty five dollars ninety days for cias, So these
medications are extremely affordable and price should no longer be
an issue.

Speaker 1 (28:31):
That's interesting.

Speaker 3 (28:34):
Several of the questions relate to hemoglobin blood thickness. I
know some people begin giving blood once they get on
testosterone because they're blood thickens. Your thoughts on that, is
that problematic or is that just a side effect?

Speaker 4 (28:50):
It can be and it all depends on what type
of formulation you're using. Injectables have the highest rate. Injections
up to sixty six percent, of pellets about thirty five percent,
a gel twelve percent risk, and a pillarge about five percent.
So if your hermaticrit goes up and the number you
want to remember is fifty four, if it gets above
fifty four, there's a slight theoretical increased cardiovascar risk. And

(29:13):
in my practice, we have these patients start donating blood.
We don't wait to fifty four. We haven't started donating
at fifty one because I don't want to wait to
fifty four. So it is real. And remember that many
of these patients have sleep apnea ac cult to sleep apnea,
and the testoscern is unmasking it. So send them for
a sleep study because you'll find that many of them
are just suffering from sleep apnea.

Speaker 3 (29:34):
You know, I find a lot of people are suffering
from some sleep disorder and they've just grown. They don't
even realize what a contributor to their overall health or
lack of it that sleep is. It's almost always accompanied
by the person being overweight, or maybe maybe the overweight
led to the sleep. But that's one of those things

(29:56):
that I find when I dig into people often have
bad sleep and they don't think that's they don't realize
how important that is.

Speaker 4 (30:04):
Michael, You're so right. Listen, when I take care a
lot of CEOs, a lot of people, and I talk
about the four pillars diet, exercise, sleep, and stress. They're
all pretty good at diet, they're all pretty good at exercise,
that are lousy at sleep and stress. Right, and so
in sleep and stress are so critical, and you think
about sleep, it is a game changer. Even the way

(30:25):
you think about sleep. It's not the hours you sleep
that's multiplied by how efficient you slept. So if you
slept eight hours last night, but you were twenty percent efficient,
And I slept only four hours last night, but I
was eighty percent efficient. I'm going to feel a lot
better than you, right, So the reality is not just
lying there with your eyes closed. You have to get
good deep sleep, good rem sleep, and even thirty minutes

(30:47):
extra of either deep sleep or rems sleep every night
game changer for the next day. So I think people
need to be very military. Just find a way to
make sure that you go to sleep on time, wake
up on time. And best website I found was the
American Sleep Foundation. The American Sleep Foundation has twenty tips
on their website. They're awesome. Follow those tips. That makes

(31:08):
a big difference.

Speaker 1 (31:11):
Salt in the diet. So I've been reading a lot
on salt lately, and.

Speaker 3 (31:16):
I don't I have not run this by you yet,
so I'm curious to see what you think of this.
And the theory goes that we were told to stay
away from salt. Salt raises blood pressure, salt causes all
these these problems. And basically the point of the piece
was that we are now deprived of salt, and what
do you do to treat someone for a number of

(31:39):
things is you give them salt. Your thoughts on salt intake.

Speaker 4 (31:44):
So I think that I'm still a believer that salt,
particularly in patience who have hypertension, is a risk factor.
And so if someone has hypertension, which most many Americans
suffer from, that is going to be something that's the
first thing I'm going to ask them to stay away from.
As ayrlogist. The other thing we worry about is increased
salt intake significantly increases the risk for the kidney stones.

(32:08):
And so I am not a believer yet that we
should be increasing excuse me, increasing salt unless there's a
reason to do so. But I'm more concerned about the
hypertension and the stone risk.

Speaker 1 (32:20):
But on French Fries, it's okay, right.

Speaker 3 (32:24):
Sometimes sometimes, doctor moh Kara, you are the absolute best.
The four phases of offense he has outlined or diet, exercise,
sleep and stress reduction all things you can do yourself
that don't require spending a dollar. Diet, exercise, sleep and

(32:46):
stress reduction is four pillars of offense and defense. I
cannot help you get in to see him, so don't
even try, because I'm to be overwhelmed again.

Speaker 1 (32:56):
It's Baylor College of Medicine.

Speaker 3 (32:57):
It does take a while to get in to see him,
only because he's very popular.

Speaker 1 (33:02):
A lot of people like him.

Speaker 3 (33:04):
I was my own worst enemy in sending too many
patients to him at the beginning, and he only has
so many hours of the day. The book is The
Sex Span, which is not out yet but will be
hopefully soon.

Speaker 1 (33:15):
And when you let me know that is the case,
we will all go and buy it online.

Speaker 4 (33:20):
Will do. Thank you so much, Michael, You're the best.

Speaker 1 (33:22):
My friend. Doctor mohit.

Speaker 3 (33:25):
H e r a Baylor College of Medicine.

Speaker 1 (33:30):
Yeah.

Speaker 3 (33:31):
So I'm having dinner at Gringos, the new location at
ninety nine and two forty nine with Wayne Wilson, who's
the founder of Synergenics, and he was telling me about
we were talking about the testosterone replacement, but he was
talking about this doctor and he said.

Speaker 1 (33:52):
I think it's your doctor.

Speaker 3 (33:55):
He comes out and trains our people on testosterone in
the effects and why it's important and all that, and
it was doctor Kara and I did not know that.
I had no idea. Doctor Karatt was the first one
that put me on testosterone. We did the pellets for
a couple of years and then Low T Center, which
is also Synergenics, became a show sponsor, so I just
moved over there and started doing the weekly shots. I

(34:16):
liked the shot. I like the shots better than the pellets.
Some people like the pellets. I gotta tell you my
Pellette story.

Speaker 4 (34:20):
Hold on