Episode 170 - Dr. Dwayne Jackson: Do We Truly Need to Replace Testosterone? - D&D Fitness Radio Podcast

Episode Transcript
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Speaker 1 (00:14):
Welcome to the D and D Fitness radio podcast, brought
to you by your hosts Don Saladino from New York
City and Derek Hanson from Vancouver, Canada.

Speaker 2 (00:31):
How you doing, dude? Look did you get a haircut?

Speaker 1 (00:35):
I got a haircut. I still got hair.

Speaker 3 (00:38):
It's a wicked hairline.

Speaker 4 (00:39):
Yeah, I.

Speaker 3 (00:43):
Love it.

Speaker 2 (00:44):
I love it, love it.

Speaker 5 (00:45):
And that said complete uh jealousy behalf minh.

Speaker 1 (00:51):
Yeah, I'd be like, oh God, I think I'm getting
a few gray hairs. I think I'm like losing a bit,
and people are like, fuck you exactly.

Speaker 2 (01:02):
Though, all right, so this is this is.

Speaker 6 (01:10):
I don't want to say I'm frustrated, right, I don't
want to use that word. I don't know if it's frustration.
But I also think it becomes a bit of a
cop out at times. Right now, so I'm completely I
understand pro bodybuilders, world class power letters are going to
take things to compete at a specific level, right, Okay,

(01:35):
it's going to happen. And though it's not something and
I think everyone realizes that you can attest to it,
I've never taken I'm not ever going to claim that
I think I'm any better than anyone else Okay.

Speaker 2 (01:45):
So I want to go on record to say that,
but and.

Speaker 5 (01:49):
I can go on record well to say that I've
taken everything okay, And I've been an open class bodybuilder,
and I also have a kidney transplant as a result.

Speaker 3 (01:58):
And I've said it.

Speaker 6 (02:00):
Sport okay, and thank you for, thank you for. But
I never want to go and try and well I'm
better than anyone. No, I'm not saying that this is
a choice. I buried my best friend of my head
training back in twenty ten, came addicted.

Speaker 2 (02:14):
We couldn't get off specific.

Speaker 6 (02:17):
Substances that were not recreation that we're performers enhancing. And
when we found him dead and we had an autopsy
done in his body because I had to claim rights
to his body because he had no family, otherwise they're
going to bury him in the plotter's field.

Speaker 2 (02:29):
His testas was north of three thousand. Okay.

Speaker 6 (02:32):
So these are things that I needed to know and
find out about as peace of mind. What I think
is where I'm really scratching my head now. In the
industry are people who are just immediately going to this
with no real I don't want to say plan, but
no real reason. I just want a bodybuild, Well, do

(02:53):
you want to compete at a high level? No, I
just want a bodybuild. I'm going to get on drugs.
Or I just want to look good and I'm having
a tough time putting.

Speaker 2 (03:01):
On muscle, so I want to take drugs.

Speaker 6 (03:03):
Or I have been I feel worse and worse because
I'm aging, and I just want to take drugs. Or
how do you categorize it and how do you separate
like hormone replacement therapy testosterone, Well, it's testos, it's not
a drug.

Speaker 3 (03:21):
What is it like?

Speaker 6 (03:22):
Can you first, doctor Jackson and the reason why I'm
not doing in drugs.

Speaker 2 (03:25):
Everyone knows DJ.

Speaker 6 (03:27):
He's been one of my close buddies and he's been
on this podcast plenty of times.

Speaker 2 (03:30):
Can you please start breaking down the categories first, so.

Speaker 3 (03:34):
People on what these things are?

Speaker 6 (03:37):
Some stuff that's oh, but it's this I'm just taking
a little bit of tea.

Speaker 2 (03:42):
You know you're laughing, but right, actually on this not
long ago. Let's go So.

Speaker 3 (03:47):
There, there's there's TRT, right, and there's TRT what does
that mean?

Speaker 5 (03:53):
Right?

Speaker 3 (03:53):
And so so for you.

Speaker 5 (03:57):
Know, medically, there is testosterone replacement therapy. It's got guidelines
that surround it. There's you know, hallmarks in lab or
that tell us that you know, you're hypogadal. There's behaviors
they tell us that you're hypobanatl so you know, we're
low tustosterone. Some people will experience symptoms of lotustosterone at

(04:21):
a different level of tesoscone the blood than others. But
there's been a real mandate in the last probably five
years or so with online you know, prescribing and whatnot
that what.

Speaker 1 (04:33):
Are those symptoms, doc? What are those symptoms? Because like,
I'm fifty five and some days I'll feel low and
like and I'm like, well, maybe it's my testosterone. What
what should I be looking out for?

Speaker 5 (04:41):
Yeah, So the symptoms generally are and they're kind of
ubiquitous with a lot of things that happened to us
around the time when you know, we go through andropause
or whatever is, we're going through a lot of them's
you know, lethargy when we wake up, you know, not
feeling that drive.

Speaker 3 (04:56):
The first symptoms really for most are lack of sexual desire,
lack of sex driving general.

Speaker 5 (05:05):
And then when men start to feel that, then they
start finding oh, yeah, I'm having trouble sleeping, you know,
I'm having trouble focusing at work. My workouts are, you know,
feel much more intense when they really aren't.

Speaker 3 (05:19):
In my recovery is much less.

Speaker 5 (05:21):
And it's really just a kind of a mixed bag of.

Speaker 3 (05:27):
Symptoms that we feel that make us feel basically less energetic.

Speaker 5 (05:32):
In several aspects of our life, whether it's sexual energy,
or training energy, or just being able to focus at work.
The problem is that within all that, there's also the
fact that our stress and everything over time, as we
get older and in this phase of our life, becomes

(05:55):
a little less easy to manage. So we have, you know,
kind of a couple of different things coming into place.
So a lot of people jump on the testosterone wagon
ring over that.

Speaker 1 (06:06):
Would uh, excessive delayed on set muscle soreness after workouts.
Would that be another one too, Yeah, and that.

Speaker 3 (06:12):
Would be like that lack of recovery.

Speaker 5 (06:15):
Yeah, you know a lot of us find that I'm
fifty two, and I'll find that my DOMS starts two
days after but it seems to kind of stay in
the heavy DOMS period for three or four days instead
of it kind of incrementally going down over three or
four days. And so that is another one that can

(06:36):
you know that that could be a symptom of a
you know, low testosterone level.

Speaker 3 (06:43):
So but what does that what does that mean? What
is low to stosterone? Right?

Speaker 5 (06:48):
And so we can't really say that we have low
testosterone without actually getting blood to stosterone measure. And generally
it's it's the free to stosterone or the bioavailable to stoscrone.

Speaker 3 (07:02):
It's really doing the job. And so there's a lot
of things that.

Speaker 5 (07:06):
Happen as we age that can decrease that free bioavailable
to stosterone. And one of these things is SHBG or
serum hormone binding globulin, and it kind of just basically
binds it to stosgroone and it can't do it asoscone
thing at the stosterone receptors.

Speaker 6 (07:25):
All right, So now we have and you have not
categorized all the different you know what I want to say,
substances that you can that someone can take you where
they can enhance themselves with. Right, this is where this
is where my question is. Many people are immediately going

(07:48):
to this as their immediate solution, right, immediate and media
am using the word of media. A lot people are
going to this as their solution, like They're immediately like,
I don't feel good, and I'm going to go take
this right.

Speaker 3 (08:02):
Yeah, or go get some blood work done.

Speaker 6 (08:04):
Get or go get some blood work done, and the
doctor is going to say you need to take this now.
There are many doctors out there that are looking at
this as oh, well this can this can help improve things.
But isn't it just abandoned.

Speaker 5 (08:20):
Well it really depends, right, Okay, So and this and
this is where kind of the the real probably the
meat potatoes of this this podcast sit is that when
we age, first of all, there's a natural progression for
us to you know, have t stosterone get lower number one.
But buried within that are the lifestyles that are really

(08:46):
hard on our free to stosterone levels. And so what
I with any of my clients that I work with,
you know, that are in this age group, which are
mostly you know, forty to sixty, say, generally, you know,
it starts blood work and we take a look at
things like lutinizing hormone, which is the signal from the
brain to the testes to produce the stoss grone, thebollicle

(09:09):
stimulating hormone, which is how we get sperm, and everything
else within that ejaculate. But then we also look at
our free and our total test estrogen, progesterone and other hormones,
and then we.

Speaker 3 (09:25):
Look at this SHPG.

Speaker 5 (09:27):
And the key here really is when we look at
these signals, we have to understand is it a problem
that the brain's not telling the testicles to do their job.
Is it the testicles are doing a great job, but
the serum hormone binding globulin is really high, and it's
making our total test that looks perfectly fine, our free

(09:48):
tests bubble or and or is it the fact that
we actually have hormone balances by having say, high levels
of estrogen, despite the fact that you stostrom looks relatively normal.
And when we look at the big picture, in most cases,
when men are complaining about this andropause and they want

(10:10):
to go into your t they probably haven't optimized their diet.
So they'll say, well, I've been dieting for years, well,
very low calorie diets.

Speaker 6 (10:21):
Drive down to stostras I and I have to jump
in there because it's fascinating and I've been doing this
now almost thirty years, meaning trainers, right, It's fascinating how
people will turn around and think that they're eating well
or because they're eating the right foods, are making the
food choices, But that is such a small portion of

(10:44):
the equation. If you are in this consistent colork deficit,
which we're all told to be in by the letter,
every nutritious who comes on is saying, you want to
lose fat, You've got to be in a colork deficit.
So now we're telling society that you have to deprive
yourself of calories, energy and day out. And the thing

(11:05):
that I look at is like, well, let's look at
the volatility and how they're feeling.

Speaker 2 (11:09):
Where's their blood sugar at, where's their fiber at.

Speaker 6 (11:11):
Where are their three micro macro nutrients protein, carbs and fats,
and then where's their fiber?

Speaker 2 (11:16):
Are they satiated?

Speaker 6 (11:18):
And when they're always you know, feeling like they need
to binge or the evening's coming around, they're overeating like
this is yoyo diving, this is traditional yo yo dieving.
What we are telling not us, but what we are
telling society today to do is if you want to
burn fat, you need to be in a CLOrk deficit,

(11:39):
which in the long run can do.

Speaker 4 (11:42):
What to us.

Speaker 5 (11:43):
Well, if we're in if we're in CLOrk deficit into perpetuity,
then the body's natural response actually is to lower the stosterone,
especially when in fact gets really low.

Speaker 3 (11:54):
Need we need you know, a relatively good amount of that.

Speaker 5 (11:59):
Very at least in order for us to produce, you know,
with the right amount of testosterone. But where the biggest
issue comes in is that all these things happen at
the same time. So the person is working with a trainer,
they're in a very low calorie diet for a sustained period.
They lose their first seventy pounds, they're very, very excited
about that, and then all of a sudden weight loss halts.

(12:21):
Then you know what, the coach says, well, let's get
some labs done. If you look at testosterone, it's in
the tank. They're like, well, there you go, that's why
you're not in any weight. And then put them on testosterone.
Now things start to feel better because just there's a
natural feeling of wellness when testosterone levels become more normalized

(12:42):
or a little high, and then they start and metabolism
goes up, and then the body starts looking good. And
then it's like this fit Dad sixty nine sixty nine
lost thirty pounds and you're looking at them and you're like,
that's what they look like now months ago. Now they're
all there's veins coming out of their crotch into their abdomen.

(13:04):
And so the question really is it's a chicken or
egg thing. Is it the you know, the way that
we're stressing the.

Speaker 3 (13:12):
Body in the gym on LITW calorie diets.

Speaker 5 (13:15):
And little fat and everything else leading to lotustosterone or
is it all these guys are coming to the gym
work working out with lotustosterone, reaching some you know, pinnacle
of their fitness that they can't move through and then
they take to stoscroone and that gives them the push
on the edge. And so really, if you haven't got

(13:39):
you know, to use Down's terms, your side of the
street cleaned up, so you know it's going to be.
Is your diet color uh colorically abundant enough to support
the work you're doing in the gym so that you
can push the needle on your training, especially resistance training

(14:00):
and hit style training, sprinting, these kind of things, because
those drive to stosterone. Are you supplying the substrates for
energy and to stosterone production, Because if you if you aren't.
Then there's the first place we start. Second, are you
doing copious amounts of cardio and running and running and

(14:20):
running while in very low calorie diet on a very
low calorie diet, especially a little fat, because we know
also that's going to drive it down. So if we
just back off a little bit, rest a little more,
can we recover splings? Something as simple as vitamin D levels,
Vitamin D three levels or twenty five hydroxy vitamin D
in the blood, is.

Speaker 3 (14:42):
That sitting in the normal range.

Speaker 5 (14:44):
A lot of times we're going into winter right now,
people forget, you know, they're keeping their D three at
a nice high level at two thousand and I use
a day with the whatever it is they're using for
vitamin D three, go into the dark winter a little
more cooped up, and then they start feeling that that
that testostomo stuff him in D three, he's a miracle
a lot of times when it's low.

Speaker 3 (15:04):
So there's a lot of things just within.

Speaker 5 (15:06):
That lifestyle, stuff, alcohol, sleep, everything else that if you
don't have that, I hate to use the term optimize,
If you don't have that in check, then really starting
a series of testosterone replacement therapy isn't where.

Speaker 2 (15:24):
But that's my that. But this is where I wanted
to get to.

Speaker 6 (15:27):
This is why I'm shutting up right now, Derek, I'm
gonna kick it over to you.

Speaker 3 (15:30):
No one does, No one does.

Speaker 6 (15:35):
I want to find out what percentage of people have
gotten on some form of hormone replacement therapy, who is
honestly maximized all these other categories that we talked about
or came close to it or then listen, I am
not saying for a second that there aren't certain people
that need it. Buddy, Lonnie's a war hero who was
on stage the other day. He's been promoting it. He's

(15:56):
blown up in Afghanistan, you know, shot whatever it was,
nine ten, eleven times.

Speaker 2 (16:02):
Yeah, I would say he's a candidate for it, right
like the guys you know in his mid to late forties.
He's a candidate for it.

Speaker 5 (16:08):
Well, it's totally legitimate, but let's let's let's let's delineate
between clinical testosterone replacement therapy and testosterone replacement therapy because
there's a there's kind of a disconnect, and it's actually
they've been connected and what's happened is that you can
do TRT testostro replacement therapy by either buying illegitimate sources

(16:32):
underground for your distostroone and do it yourself, or you
can go into some clinics and there are lots that
are great out there that are for this, but there
are some other ones that really are just up front
for pushing high levels of disosterone and TRT. True TRT
generally sits around you know, fifty milligrams of testosterone sacipient

(16:55):
eight per week up to say one hundred and fifty
milligrams testosteronecipienate per week. A lot of guys are on
TRT and they're sitting at two hundred and fifty to
three hundred milligrams per week of testosterone.

Speaker 3 (17:07):
And this is super physiological.

Speaker 5 (17:09):
It's what I put my pro bodybuilders, or at least
they put themselves on, and I watch them when they're
in the off season, so it's quite it's a big jump,
and you see it in the lapse, so you know,
if their body fat levels are high to start with,
they're going to be chewing up a lot of that
testosterone anyway, because there's a lot of aromatase in the
body fat and that then takes testosterone and then creates

(17:33):
estro dialpha. And so what we find a lot of
times is people that are on TRT or non clinical
TRT tend to actually be on bodybuilding in sillery drums
also where they're taking estrogen inhibitors and all kinds of
other stuff. So really it's become kind of a buzzword
for I'm not on the stuff, I'm just doing TRT.

(17:55):
And then that's kind of the people that the groups
that we're talking about in here, because yes, it's a
clinical issue in OBCD, it's a real problem, and it's
really hard for people, you know, who are carrying a
lot of body fat to be able to push the
needle on their weight loss and everything because they're they're
tytosterone such in the tank.

Speaker 3 (18:17):
So they do you truly have these.

Speaker 5 (18:18):
Issues, right or even you know, people just can have
protuitary issues or testicular issues or anything else.

Speaker 3 (18:26):
So thank god we.

Speaker 1 (18:27):
Have sure sure, yeah, a lot of information. They're very helpful.

Speaker 3 (18:34):
Now.

Speaker 1 (18:35):
The reason that we aging males have reductions into the
testosterone naturally is basically part of the aging process so
that we don't develop tumors. Other thing is that true?
Like would you say we're down regulating as we age
for health reasons, not just it's just disappearing, but there

(18:56):
is a evolutionary reason why we produce less testosterone.

Speaker 3 (19:01):
So evolutionary but not there's no clock.

Speaker 5 (19:06):
Okay, okay, So the answer, the answer to that is
is still like, you know, we can't give you a
perfect answer to it. But the point is when we
think from an evolutionary perspective, rights as we age, our
propensity to move will go down unless we you know,

(19:27):
force it to go up, and with that then our
propensity for lean muscle mass is down. Cyclopaenia is something
that occurs, you know, around fifty that is, you know,
a loss of muscle mass that's not explained by anything
else but age. And I studied it for like three
years at Yale trying to explain it, and there's really

(19:50):
not much of an explanation that we can find for it.

Speaker 3 (19:54):
So we also have this loss of muscle.

Speaker 5 (19:56):
Mass that occurs in the face of the distosche grone,
but it's not just explained by by you know, this
andropause that we go through. So when we look at
the aging factors, what we're really thinking about when we're
talking about like, is this an evolutionary thing is prostate.

Speaker 3 (20:12):
Cancers, for example, is one of them?

Speaker 2 (20:13):
Sure?

Speaker 3 (20:14):
Right?

Speaker 5 (20:15):
And again, did the body select for that, you know,
for us to have a less a less chance of
getting prostate cancer by lowering stostroone. I don't think that's
the case, but I do think that it's a really
nice evolutionary coincidence that are that the the mechanisms for

(20:35):
creating cancer cells go up as we get older because
genetic blips and bad photocopy errors in our RNA and DNA,
and our stostophone goes down naturally, so we don't stimulate
those prostate cells that then divide more rapidly and have
more chances of having bad ones growth. So yes, and

(20:57):
that's why part of any clinical regimen of TRT involves
you know, regular prostate checks, measuring prostate specific energen and
engigen storry and and also you know, doing some finger
poke assessments of the prostate itself.

Speaker 6 (21:15):
So when so, I want to break this down categorically now,
and I'm not getting right to the need of this,
but I'm just curious, when do you feel like it's
okay for someone to take or get on one more
replacement therapy And when should they be shying away from this?

Speaker 2 (21:33):
So maybe at least exhausting other areas, hees.

Speaker 3 (21:36):
Yeah.

Speaker 5 (21:36):
So, so if if someone is first off, you know,
going and seeing their primary care physician, they do some
lab work, and they've had depression, they've had a whole
bunch of issues that have just kind of reared their
head in the last year, and all of a sudden,
they see that the thoughts thrones in the tank and
like very low totals, low freeze, low shpg is high,

(22:00):
extra diols high, and progesterones all over the place. If
we have a situation like that, then this person is
definitely the perfect candidate for stowsprem replacement therapy.

Speaker 3 (22:11):
But it's their choice, right, we didn't have this available choice.

Speaker 6 (22:14):
Yeah, but what if what if someone is not exhausting
all the other avenues with their lifestyle. So let's say
they're out drinking alcohol, you know, four or five nights
a week. Let's say they're getting five hours of like
mediocre sleep. Let's say they're in a high stress environment.
Let's say they have a poor diet. Are you immediately
telling them to maybe consider this or are you telling

(22:35):
them that, well, maybe we should start exhausting these other avenues, right, yeah,
absolutely not telling it in my in my in my
coaching realm.

Speaker 5 (22:43):
I start by, you know, controlling all the variables that
we can so that if we have to do to
stosphrone therapy, it's going to be the least dose, like
the minimal effective dose, because then we're going to have.

Speaker 3 (22:57):
The minimum side effects, right, Right.

Speaker 5 (23:00):
And so you know, diet, like I said, gloric intakes
really important. And then obviously the type of diet that
you're eating, So you should be eating a mixed diet
that's got an abundant in the oxidants and everything else,
because as we age, it's not just just tossterone that
becomes an issue. It's you know, issues with oxidata status
and everything else. Is your training too heavy, too little,

(23:23):
too much? Is you know, how how is your training designed?
And are you feeding that training properly? Right? And then
obviously sleep and stress play the biggest roles. Like there's
very few men out there that aren't on TRT that
can undergo you know, multiple levels of stress at say

(23:43):
fifty years old. So they might lose a partner from divorce,
they might lose their parents, their job, might be getting on,
you know, on the edge, all those stresses become more
and more and more. Are we handling stress better? Because
by just you TRT, it's not going to help with
those stressful situations and creating stress resilience.

Speaker 3 (24:06):
And then and then are you a healthy body fat?

Speaker 5 (24:09):
Because if you're not a healthy body fat, if you
know you're sitting at thirty forty percent body fat, any
testosterone that you're taking is going to get chewed up
by that those aromatases that I talk about body fat,
and that means you got to use higher doses of
to stosterone in order to get the same desired effect.

(24:29):
So really, you know, health is key here if you
aren't focused on your health in all those aspects.

Speaker 3 (24:36):
We just mentioned.

Speaker 6 (24:37):
Yeah, but it's it's also kind of broad what you're saying,
right because in one sentence you're saying that, well, you
know what, like, yeah, you could be a candidate for this,
but we need the first leave by saying everything else,
like if you've exhausted these areas and you've really put
your time in, and it's someone like me, honestly, someone

(24:58):
like me who's been living this for years, and then
at a certain point, things are just tanking and there's
like no, like, Okay, maybe maybe you think about that.
But I've seen people in their mid to late forties
improve levels without taking anything.

Speaker 2 (25:15):
I've seen this improved.

Speaker 6 (25:19):
Like I was in what I think I was in Wait,
I want to say, I wasn't as good as hell
when I had drive open because of the three hour commute,
the lack of sleep, the level of stress, the commute.

Speaker 2 (25:32):
In and out of the city every day.

Speaker 6 (25:34):
And then when I exited from there and came here
and my lifestyle drastically changed from three am wake ups
to five forty five six thirty wake ups. Do I
think that's why my team drastically improved?

Speaker 2 (25:52):
Yeah? Would some people say, well, was the plug? Was
the sauna?

Speaker 6 (25:56):
Was it the fact that you were It's probably more
the sleep in the stress. Are those things maybe going
to be the sprinkles on the on the Maybe maybe,
but I'm not putting it on that.

Speaker 2 (26:07):
I'm putting it on these other things.

Speaker 6 (26:08):
So my frustration all this is that I feel like
the majority of the people out there are just using
this or they're just jumping on it like it's a
bid event, Like oh, it's it's a multi Like I
need that like multi, okay, let me just take it.
And I'm like, no, but you're not. You're not paying
attention to these other areas first.

Speaker 2 (26:28):
Now, why does this bother me so much? Why?

Speaker 6 (26:32):
Because we've seen a lot of people have health issues
when they've abused certain categories. There's certain areas they've abused that,
and what ends up happening is tell.

Speaker 5 (26:43):
Us, well, with cardivascular issues, you can get kidney issues,
we can have relationship issues, and things get a little
bit too far because it's you know, if you're not
if you're not dealing, you know, with a clinic and
you're dealing with the on the street. He also has
a whole bunch of other good stuff that you can

(27:03):
utilize too, right, other anabolics and these kind of things.

Speaker 6 (27:06):
I had a bodybuilder recently who who was she's on
her mission.

Speaker 2 (27:11):
She was diagnosed with cancer. And I am not saying this.
She said this. She said, no.

Speaker 6 (27:18):
Develop cancer because of the performance enhancing drugs that I
was on in my career.

Speaker 2 (27:24):
And how I abuse that? And I'm thinking of myself, well,
how do you how do you know is from that
maybe maybe she already had cancer? Did this multiply it.

Speaker 5 (27:33):
Well, what it's always a predisposition because as soon as
you turn on metabolism, like the whole key to anabolic
steroids aren't like you take them and you grow right.

Speaker 3 (27:40):
And this is this is one of the biggest yes
you have to be able to.

Speaker 5 (27:45):
What they do is they provide a background of hormones
that allow the person to push harder in the gym,
eat more, and then turn more a higher rate of
cell turnover. And when we get high rates of cell turnover,
then we get a greater propensity for when that cell

(28:07):
turns over. The DNA can be like I said, photocopied wrong.
And as we get older that those photocopies get worse.

Speaker 3 (28:16):
And worse and worse. Think about it, like, you.

Speaker 5 (28:17):
Know, photocopy it's got you know, limited amount of toner.
You start it with a new photocopy, it's nice and fresh.
At the beginning, you're the same thing that you put in.
It was ther original copy. But by the end of
you know, seventy eight months in photocopy of your life,
you know, you're like, was this was this the one
that had the spelling here on or not? This happens
with our genes and so when we use any sort

(28:39):
of anabolic agent.

Speaker 3 (28:41):
It's anabolic.

Speaker 5 (28:42):
It's gonna build, it's gonna turn cells over faster so
that we can grow things quicker. And and that allows
us to go into our catabolic stimulus, our workouts and
everything else in a state that we can push harder,
tear more stuff up, repair it faster, and build. And
so yes, there's no question that you know, everything from

(29:06):
testosterone through the growth hormone can exacerbate an underlying condition
that's going to be sitting there or in the case
like Derek was saying, you know we're talking about prostate
it can actually beat the catalyst that drives prostate cancer.

Speaker 3 (29:20):
And that's known.

Speaker 5 (29:21):
Because what's the therapeutic a strategy for prostate cancer. Well,
it's you know, it's basically a chemical castration or pharmacolodronal castration.

Speaker 3 (29:31):
So you so you reduce your distosterone.

Speaker 5 (29:33):
So so really at the end of the day, you know,
is is it a healthy practice for those that need it?

Speaker 3 (29:41):
Well?

Speaker 5 (29:42):
I do believe that under the right supervision and everything else,
And by right supervision, we're talking about clinically prescribe TRT
under monitoring of your physician with great of the blood
work it can make a big change in people's.

Speaker 3 (29:56):
Lives and actually done some people.

Speaker 5 (30:00):
You know, the actual effects of the side effects of
having a distosterone are so great that they're in the
depressive state. You know a lot of depressive symptoms.

Speaker 3 (30:11):
So it can help a lot. The problem you're talking
about is there's.

Speaker 5 (30:15):
A lot of twenty thirty thirty five year olds that
are on TRT to optimize their testosterone, and I don't
know if they know where their optimization sits because the
range for testosterone is so wide. It's crazy, because each
human has a different I guess a phenotype for being

(30:39):
able to utilize the testosterone. So that's where the issue
really lies is in those those people that are trying
to optimize testosterone and you know use utilizing it in
for most of the wrong reasons, and those would be esthetic.

Speaker 3 (30:55):
More than any not even performance, but aesthetic.

Speaker 1 (31:00):
Talk about when people like because I know a lot
of people are who are in the situation where they
maxed out. I mean basically things shut down when you
provide exogenous testosterone. Your normal production just is eliminated and
then they can't start it up again once they go off.
Can you talk about that and how people will lose

(31:20):
their ability to produce their own testosterone.

Speaker 5 (31:23):
Yeah, And actually I work with a lot of people
that have to get off TRT because this is the
other interesting thing. Even if it's clinical, there comes a point,
you know, decade in or so that you know, their
hematocrits going up too much because so the amount of
red blood cells and their blood goes up too much,
and it's happening too fast that they're constantly getting full
of botomy and giving blood to get rid of that,

(31:44):
and their prostates acting up, so you know they're yeah,
they probably should start worrying with that because their dad
had prostate cancer.

Speaker 3 (31:51):
Whatever. Cholesterol is another one, right, it decreases.

Speaker 5 (31:55):
HDL the good stuff, and raises LDL cholesterol.

Speaker 3 (31:58):
So when we start seeing those things happen, a lot
of times we want to come off. The young guys,
they want to come off when they want to have babies.
And I help a lot of bodybuilders with this.

Speaker 5 (32:09):
So there will be a refractory period no matter what
when you come off to stosterone therapy because or whatever
you want to call it, because you've shut down those
it's a feedback loop and you shut down that laganizing
hormone that drives the testes. There are ways actually for
us to be able to bring back to stosterone levels,

(32:32):
which involves a lot of dietary manipulation, but also utilizing
some innovative drug strategies to basically turn the testes back
on and allow for that that loop for lutinizing hormone
to start firing back up. And it takes you know,
anywhere from sixteen to twenty weeks. And generally speaking, if

(32:55):
someone has an abuse steroids for you know, decades and
they've just had Tierty, we can get it back real
relatively quickly and to really give numbers.

Speaker 3 (33:05):
So I've quite a few clients that I've worked.

Speaker 6 (33:07):
With all that stuff, So reference to a lot of
these clinics, there's there's so many clinics out there right
now that are I guess they're collabing with other coaches,
they're bringing people in their analyzing bloods, and they're making
a determination whether an individual needs to be on it

(33:29):
or not. So you would hope that this is something
that they're doing ethically. They're taking a very responsible approach here.
But like any other business, you need to optimize or yeah,
another like you need to make sales, so I'm starting
to hear that a lot of these clinics are there's

(33:53):
that line that's drawn on whether you need it or
not is really beginning to get blurbed.

Speaker 3 (33:59):
Yeah, yeah, it's actually really blurry.

Speaker 6 (34:01):
It's very burning in front when we and when we
say this, what do we mean Where if there was
a hard line of like you need it or you
don't need it, now it's become like, well it's okay,
but this will give you a nice little boost, and
they're putting people on And that's that's where I have
a problem.

Speaker 3 (34:18):
Yeah, And that's that's that's a stosstone optimization.

Speaker 2 (34:20):
That's where right, that's and that that's.

Speaker 5 (34:22):
When we're optimizing to stosterone as opposed to replacing it
because it's missing. And optimization is based on the gas
gage I called the gas gage theory of our labs
that when you get her out everything to the top end,
you're you're optimized. But in actual fact it's you know,
a little more complicated and the Endercrons system is a

(34:43):
little more complicated than just the top and her all up.
And so one of the biggest things in the issuery
now is in order to kind of stay within the
realms of what we call medicine is.

Speaker 3 (34:56):
To you know, get to stostrone free, to stostrone at.

Speaker 5 (35:00):
Its peak as high as we can get it within
it going you know, shooting overshooting them.

Speaker 3 (35:05):
And one of the so what you'll see a lot.

Speaker 5 (35:08):
Of times is total tiestosgone is super duper high in
a lot of guys, but they're free testosterones just at
a really really high normal and that they consider.

Speaker 3 (35:16):
It optimized and that they can get away.

Speaker 5 (35:19):
With because that fits within the clinical guidelines of you know,
stostroone replacement, because some people run at that end as
long as you keeping keeping it between the lines. That's
when peptides and all that kind of stuff come into play.

Speaker 3 (35:33):
So a lot of times it's.

Speaker 5 (35:34):
Not just a testosterone a cestosterone cabinet, but it's a
testosterone cabinet. And then when that gets optimized, it's also
a look what else we have under the hood, And
that's when that's that blurred line that becomes very very
apherent between fixing your low androgen symptoms and going into

(36:00):
the athletic ped world. And where the problem is is
that a lot of times more testosterone is thought.

Speaker 3 (36:11):
Of as better.

Speaker 5 (36:13):
And if you're looking for performance and the feeling of
sex drive and feel like an animal, then yes, that
will be the case. You know, it's a dose response carve.
The problem is, though, is that when we cross over
that threshold, it's really hard to control the health factors,
and it allows the person to forget about a lot

(36:36):
of those important things like sleep, stress, food, intake, you know,
the important stuff.

Speaker 3 (36:44):
Alcohol, use drug use that stuff. You can get away with.

Speaker 2 (36:49):
Not getting enough calories.

Speaker 6 (36:51):
Not get enough calories just like something so basic that
a buddy of mine recently came to me and was
asking me questions about potentially getting on something, and I said,
could we.

Speaker 2 (37:00):
Just look at your die first?

Speaker 6 (37:01):
And when we looked at it, we saw he was
in about one thousand calory deafists of a day.

Speaker 2 (37:06):
So what do we do.

Speaker 6 (37:06):
We spend time driving his calories up and he's like,
oh my god, I feel really good. I'm sleeping better.
And he ended up actually body competitions.

Speaker 2 (37:15):
Started changing and he's not thinking about getting on this now.
So this is where I have a problem. Long term
effects from taking something.

Speaker 6 (37:26):
You're thirty seven years old, you start getting on hormone
replacement therapy, you become relyant upon this.

Speaker 2 (37:34):
Are we taking this into our sixty game? Look what's
the end game?

Speaker 6 (37:37):
Like I can understand if you know, my dad's turning
seventy nine this year in November. He's turned seventy nine
in November, which means next year he's going to be eighty.
If he turned to me and he was like, my
doctors considering put me on this, I'm like, dude, go
for it. Man, Like it's you're eighty years old, go
for it, right, but thirty years old, thirty five, forty
years old?

Speaker 3 (37:57):
Yeah, And I don't know a lot of these cases.

Speaker 5 (38:00):
What happens is I have a lot a lot of
bodybuilders that come to me with heart conditions and whatnot,
even like they've had heart attacks and stents put in everything.

Speaker 3 (38:09):
Now come to me.

Speaker 5 (38:09):
The first thing they'll say to me is my doctor
took me off test. I feel like shit, when.

Speaker 3 (38:15):
Can I get back on test?

Speaker 5 (38:18):
And I'll say, well, first, the mindset is completely wrong here,
because like, what what just happened to you was a
result of dyslipidemia that was likely driven from you know,
twenty years of dystosterone replacement therapy at a thousand wondering, And
so what I do with those clients is literally do
exactly to say, get everything else all in place, get

(38:39):
them good and healthy, let them, let them feel a
little shitty because they're just sosterones. And then see where
our tstosterone lies. When we've had several months of you know,
good healthy lifestyle and needing some if not most, will
need something, but it's definitely within the clinical realm which

(39:00):
stosstom replacement therapy constitutes. But they've done the damage. Like,
that's the damage that's been done. And I mean we
see it all the time. Guys that are in their thirties,
it's usually around thirty four to thirty seven started noticing it.
It's because it's been hyper aging. Right, We've been driving
those selves as hard as we possibly can for over
a decade yea, and now you know the system's starting

(39:23):
to break down. So honestly, it's, uh, there's no endgame.
If there's an When we're young, one of the biggest
problems is we're not thinking about the endgame. The endgame
is you know, Friday night at China Club.

Speaker 6 (39:39):
So it does some good times, man, I I'm not
gonna like it. Those are just some good times. But
I also remember when I was going to China Club.
I was twenty five years old. I was living in
New York City by myself. I was single. And there's
a reason why I'm getting to this right now. I'd
have to talk about China Club. But I could go
out and party all night on a Saturday or Sunday,

(40:00):
wake up, go to work, feel like shit, push through it,
and Tuesday would wake up and I would have veins
back in my abs.

Speaker 2 (40:08):
Yeah, that was quick and easy.

Speaker 6 (40:10):
Now there is a recovery component that is going to change.
I'm forty seven. It is going to change as you
get older. Do I believe body competition could be as good,
if not better?

Speaker 2 (40:21):
Yes? Do I believe strength could be as good, if
not better? The answer is yes. Do I think we
started using elasticity if I'm not doing things.

Speaker 6 (40:27):
Like sprinting, Yes, we definitely begin to lose the ability
to throw in a lot of this frivolous work. Meaning
I'm squatting on a Tuesday or a Monday, and I
decide to go for a six mile run on Sunday,
my body might be a little sore the next day.
Where you know, when I was twenty five, it's like

(40:50):
there was no difference. It didn't make a difference. So
there are things you have to start thinking about differently now.
Now I I'm looking at how people prepare, like how
I prepare for my day and my training and my
recovery and my rest. And no one's gonna do this
like it like no one's gonna do what you did,
like no one's no one's going to do the things
that we find joy in doing. So when someone's like,

(41:12):
we'll live a little like, I am like, this is
how I want to live, This is why I want
to live. I find it irresponsible though, when someone you
know ten out of ten times is just bringing you
to that well.

Speaker 5 (41:24):
Well, and this is where I mean the the the
I guess the Canarian coal Mine of the acid text
for you know, if you're asking yourself, do I need
to stop storm replacement therapy? Is it a reason because
of a feeling you have? Or is it a reason
because you have body dysmorphia and you have a feeling?

Speaker 2 (41:43):
Right?

Speaker 5 (41:43):
So are you seeking to stop storm replacement therapy because
you want to have ABS?

Speaker 3 (41:50):
Eh?

Speaker 5 (41:51):
You probably should get the ABS first, because it's definitely
possible even with low distoster.

Speaker 3 (41:56):
But if it's affecting.

Speaker 5 (41:57):
Your life where you know you're no longer having sexual
intercourse with your partner. You are irritable and tired all day.
And the only explanation for this you haven't changed anything else.

Speaker 3 (42:10):
You're eating well and everything else is age.

Speaker 5 (42:14):
You go to the dock, you get tested, and if
your testosteronees, you know, significantly low, then it's probably a
good clinical reason to be taking it. But the problem
is that all of the like you said, the influencers
every and they are pushing it are esthetic based. These
are not influencers that are running around and being healthy.

(42:35):
And I've lived, like I said, I've lived the life
I've lived as a promotocrosser with a very very high
aerobic capacity bodybuilder with no aerobic capacity in two hundred
and sixty pounds in an open class and use it.

Speaker 3 (42:46):
A whole bunch of drugs, steroids and whatnot.

Speaker 5 (42:50):
And then now, the lovely part about having a kidney
transplant is.

Speaker 3 (42:54):
The governor that you get from having that.

Speaker 5 (42:56):
If you want to survive and live a full life
which you can perfectly be healthy, you now have to
put all of your ducks in line, and you can't
fuck your helf anything because you've got a beautiful gift
inside you. And that's when you know it becomes apparent
in a person like me who can train hard, still
go out and snowboard, surf, mountain bike, do all the

(43:19):
things I can do stay in shape. Yet you want
to what my stars room generally hovers on the low end,
and oid sure and the drugs I take they're m
tor and hippers. They actually stop animalism. So but you
just have to do what you need to do and
it still works out. And mentally I'm perfectly fine, right right,

(43:40):
But if there are times, and I will say this
to listeners because it's it's it's really good for them,
understand that if I go into the wrong atmosphere.

Speaker 3 (43:47):
So if I go into bed.

Speaker 5 (43:49):
Jim automatically my workouts changed my the way I look
at like, I start thinking like man says, And it's funny.

Speaker 3 (44:02):
So so it's not like you don't feel it, but
when you but you know that, oh that's that's that's
the ticket.

Speaker 5 (44:08):
Right. But really, at the end of the day, you know,
I'm in the best shape really of my later life anyway,
you know I was younger.

Speaker 3 (44:15):
It's a lot better shape. But I'm about shape my life.

Speaker 5 (44:18):
Yet I have this, you know, a three pound piece
of meat that my buddy gave me in my belly
that's controlling my hydration and blood pressure and everything else.
So you can do it without you know, the stosprary placement.
A lot of cases, if it's aesthetic, it's it's a
it's a escapegoat to get somewhere quicker than you need to,

(44:39):
and you'll pay for it.

Speaker 3 (44:39):
We always have to pay for the thing that happens fast.

Speaker 2 (44:42):
That's what I think. That's what dark O, right, I
have sorry about it.

Speaker 1 (44:45):
Well, yeah, I mean I am such a proponent now
because of obviously my relationship with don of You don't
leave any stone unturned, right, because when you're like, as
I'm aging, I I thought like, ah, I don't have
energy and I feel kind of low, and it's just
because I'm aging. Right when the actuality in actuality, my

(45:08):
training wasn't great, Like I would do I would do
the weightlifting and I would sprint and stuff, but I
was lacking a lot of the aerobic stuff because you're thinking, well,
you don't need to do aerobic stuff, that's for whissies, right.
But then I have a friend who used to work
in Major League Baseball, and he looks at injuries, and
he looks at muscle oxygenation technology, and he's finding that

(45:29):
all these guys that are getting injured have poor blood
circulation because they're not working on that. They're working on batting, throwing, whatever,
but they're not working on their energy system development. So
I'm like, oh, so I started doing two five K
runs a week, maybe five to seven k Zone two easy,
and guess what, My knee pain went away. I sleep better,

(45:52):
I have more energy in my weightlifting workouts. You know,
I just generally feel better and my compositions better. Right,
Because I was I wasn't diversifying my workouts enough, and
I was just out of shape as I got older.
But it wasn't because I was older. It's just because
I was lazy or whatever. I got stressed out or whatever.

(46:12):
I was busy with other stuff. So that that's a
perfect example of somebody who didn't analyze their training and
was blaming something else. I was blaming aging, right, And
so yeah, I'm fully on board with what you're saying.

Speaker 5 (46:27):
You hit the nail on the head with the you know,
the the zone ones on two training because and I I.
You know, I teach, I teach courses in this stuff
and energy systems, and I'm teaching them right now. And
it's really neat because this whole thing about don't do
aerobic exercise because it doesn't lose body fat.

Speaker 3 (46:46):
It's like, whoa, you forgot what you're doing here? Boys
train those slow twits. You what do they do?

Speaker 7 (46:52):
They chew up the lot eat and turn it to
approbate for you, and then you get some energy from it.
You can make some atp during those you know, those
sprints and those times with your priestyl I lacking an
what happens last week you did three rounds, this week
he did four, and next week you can do five
because you can do all that aroobic training between the
can they can.

Speaker 5 (47:12):
Tune those blood vessels, tune the mitochondria and this is
this is another one. Mitochondrial health.

Speaker 3 (47:18):
Right, everybody's looking for NMN.

Speaker 5 (47:19):
Everybody's looking for all these things that help with want
to condria health. Go out and run around, yeah, for
a longer, longer time, Yeah, and then you'll get the
mitochondria health and that helps aging.

Speaker 3 (47:31):
Then we start seeing the diestosterone.

Speaker 6 (47:34):
And we can put on we could put we can
put on size if we if you have better mitochondrial health, right,
and well, you.

Speaker 3 (47:40):
Can put harder in the gym.

Speaker 6 (47:43):
You just at the end of the day, you really
need a well balance of training. Okay, you need when
it comes to nutrition, you need a well balance of
different types of foods for your gut, different textures, different colors.
It's just like it's like, come on, like, let's let's
but this is for me. What I want to ask
you is what is health?

Speaker 2 (48:03):
Right? Like, I think that's that's a big question because.

Speaker 6 (48:06):
I have a lot of people I'm friends with that
are very heavy in this area and their body compositions
looking great. But you're seeing things with their skin, You're
seeing things with how they're aging. They're just seeing how
they carry themselves and it just doesn't look healthy.

Speaker 2 (48:25):
So what is health?

Speaker 6 (48:25):
Just because you get on something, does that necessarily mean
you're going to be healthy?

Speaker 5 (48:30):
No, it actually actually kind of means the office, right,
So so funny, right, Health's pretty easy to define when
we talk about spinning.

Speaker 3 (48:39):
So you know, we talk about life span. Oh, you know,
fumans will live to eighty years old.

Speaker 5 (48:43):
Or whatever like that, right, But health span is you know,
live into eighty and then you know your on your
eightieth birthday, you ran an Ultra is sprinted a nine
point five second hundred meter and you had I'm not

(49:03):
gonna say what else, but you had the best time
in your life with a bunch of people that you
want to have phone with, and you die of a
herd attack. Do it, And that's health spin right. We
all want to live right to the end, doing everything
that we possibly can, and then die in our sleep.

Speaker 3 (49:20):
And so that's what.

Speaker 5 (49:21):
Everybody should be aiming for, is being able to perform
as a human until that day they fall off the cliff.

Speaker 3 (49:31):
But the day they fall off the cliff.

Speaker 5 (49:33):
Is not the threes or forties and saying, well, you know,
I lived a really good one.

Speaker 3 (49:37):
Because it was a lot packed into a small period
of time.

Speaker 5 (49:40):
But rather, you know, and I see it all the
time where I live because I live on the far
side of I don't Derek if you know this, but
I moved to Uclue Lid like, so I'm on the
far side right and we did that on purpose. And
it's really cool because when you walk around there and
you're on the trails, you'll be behind a couple and
be like Wow, they're bait. They must they must be
sixty years old and you need to buy them. And

(50:02):
they're two, you know, Scandinavian people with poles, and they're
and the wife's got a tight button and the husband's
got perfect posture. They're not huffing and puffing.

Speaker 1 (50:11):
It's like dumb and dumber. He must work out.

Speaker 3 (50:14):
Right, exactly exactly. But there it is, right there it is.

Speaker 5 (50:19):
And anybody who denies that that's where they want, like
if they say, that's not where I want to be
when I'm eighty or ninety.

Speaker 3 (50:25):
Years old, of course, of course, and.

Speaker 5 (50:28):
So so denial is the biggest thing in our aesthetic
sport world.

Speaker 6 (50:32):
When no one's thinking about the long term though they're
really most not no one.

Speaker 2 (50:36):
Most people are thinking about the moment. How do I
get here?

Speaker 4 (50:40):
Now?

Speaker 2 (50:41):
Let me deal with it?

Speaker 3 (50:42):
And it's not me.

Speaker 5 (50:43):
It's mostly as right. And I know this from doing
aesthetic sport for so long, because now I want a
zig left and fake a left and go right, and
it feels like I left my knees and hips over
here because I haven't done the healthy moves.

Speaker 3 (50:59):
That's what I do now.

Speaker 5 (51:00):
You're the first one too, notice that you're like, you're
super strong, but you aren't conditioned.

Speaker 3 (51:03):
And that was like a year ago, and I went
home and I started running.

Speaker 5 (51:06):
Traditioning is great now, right, and I feel fifteen years younger. Yeah,
And that's like I said, with kidney transplant on board,
handfuls of meds every day to keep my immuna suppressed,
immune system suppressed, and I'm you know, living healthier and
more vibrant.

Speaker 3 (51:22):
Than anybody I know.

Speaker 5 (51:24):
Actually it's in my crew, and so it's really it,
really and that's because I've you know, cleaned up my
them die and everything else. So it's your If your
propensity is to be on TRT for aesthetics to look
in the mirror, then you bought it right off the
bat made the obviously, because that's not the reasons that
are clinically why we need to have that, right.

Speaker 1 (51:45):
Yeah, it's so I'm going through this phase now, don
and it's called delayed gratifications. So I bought an eight
millimeter movie camera where I take the film, I have
no idea what it looks like, and I got to
send it away and maybe three weeks later I'll see
what it looks like. Right, So I'm going back to

(52:06):
film with the still camera and movie camera because I want,
I want to be patient and I want to see
the effect of my work later on. Right, So that's
what that's what I think people need to embrace the
laid gratification.

Speaker 3 (52:19):
Where are you getting it developed?

Speaker 1 (52:21):
I have to send it either to Toronto or California.
So and it's fifty dollars, fifty dollars per cartridge three
minutes of film, and it takes another fifty bucks to
get it developed and scanned, and so like, yeah, it's
three minutes per hundred dollars.

Speaker 2 (52:40):
I took.

Speaker 6 (52:41):
I took a photography course in college and I loved
it and I miss and I missed film.

Speaker 5 (52:45):
Derek, that is that is actually a brilliant way graficate.

Speaker 3 (52:52):
No, it really is.

Speaker 5 (52:54):
Because my kids look at us when they see pictures
like you know, in the packages, and we explained like
the whole process, and I used to say, I can college.

Speaker 3 (53:02):
It was great because that the end of the year have
all these films and I had no clue was on them.
And then you get some back you'd be like, oh,
they saw those pictures right because you was on them.
Or you get a whole pack that I had nothing.
It was all blurry or whatever.

Speaker 5 (53:15):
It's amazing because it's hard for you know, the youth
to even actually wrap their head around that.

Speaker 3 (53:22):
Like as a thing.

Speaker 1 (53:23):
My kids think I'm nuts.

Speaker 6 (53:24):
Yeah, I love it all right, Well, listen, we could
have went on for two hours there at least, and
I know might have felt a little.

Speaker 2 (53:32):
I mean, there's just so.

Speaker 6 (53:33):
Many areas that you can go to here, and I
appreciate you simplifying it for us and hopefully giving some
people some nuggets to take away. In closing, there's a
cost of doing business. There's a cost of doing business.
Please understand that the decision you make can heavily affect
you in the future.

Speaker 2 (53:55):
Get a second opinion if you have to speak to it.

Speaker 6 (53:58):
Very credible medical practitioner like doctor Jackson. If you do
have questions, his social handle is at d R d
N Jackson right dm him. If you have any questions,
ask doctor Jackson, not me. I am not the medical
professional here. Derek is not the medical professional here. Doctor

(54:18):
Jackson has an extensive background and has spent his lifetime
learning about this category before most people were even talking
about her. And that's why I felt like he's the
right person to bring on it. Plus he's a good friend.
So guys, check out doctor Jay. Thank you, Thank you, Derek.
I love you the best.

Speaker 3 (54:37):
Thanks Derek.

Speaker 1 (54:38):
Good a good weekend your Diggs. You guys, yeah yeah,
we'll get together when you're in Vancouver. I got to
come busy you Hey, that seems better. And check out
some Scandinavian hikers.

Speaker 3 (54:55):
We're some dark sunglasses and walk.

Speaker 1 (55:00):
Great.

Speaker 4 (55:00):
Guys.

Speaker 1 (55:01):
Take care and that is a good one.

Speaker 2 (55:03):
Thank you, Jerry.

Speaker 4 (55:03):
Take yeah.

Speaker 2 (55:09):
M

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Episode 170 - Dr. Dwayne Jackson: Do We Truly Need to Replace Testosterone?

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Episode 170 - Dr. Dwayne Jackson: Do We Truly Need to Replace Testosterone?