Jeremiah Velasquez: a fact and what we're seeing is generational decreases. What that means is that the endocrine disruptors that you're being exposed to today is getting into your genealogy and it's being passed off into your offspring. What's up guys? I'm Jeremiah, a dual board-certified NP who has been burned out on traditional insurance-based medicine. The solution? Hormones happen. This podcast is for you. If you want to learn the truth about hormone replacement therapy, peptides, and even direct primary care, join me in talking with hundreds of practitioners about what's really going on behind the scenes. To another episode of Hormones Happen. Today, I'm solo. I did something a little different. I went onto ChatGPT and I asked it, what are some of the biggest pain points or questions that people have regarding HRT, TRT, overall wellness? And what we'll do today is we're just going to go over these questions. Some may be a little wonky. I haven't looked at them ahead of time, so I don't know. But I'm going to go over these questions and I'm going to answer them just in a very candid way. Because chances are some of these questions are something that you may have a question about. And if we can answer it, well, why the hell not? So starting off, what TRT actually is versus what people think it is. Now, this is a really good question because a lot of people have a misconception regarding not just TRT, but also HRT. A lot of people think that it's some magic cure to all of their problems, that it's the panacea to every issue that you may have. And that couldn't be further from the truth. The reality is HRT or TRT, regardless of what you want to call it, is a very powerful tool, but it's a horrible crutch. If you've got specific issues with your relationships, your health, your wealth that are going on outside of testosterone or optimization, you really want to develop a strategy to work on those before starting. Because otherwise, it's not going to guide you into the right pathway. It's going to help you cope. and execute these plans more efficiently. But if you don't have a plan to begin with, then it's not going to help. For instance, you may be having a failing marriage and there could be multiple factors for it and libido possibly one of them. If you think that just taking testosterone is going to fix all those problems, you're setting yourself up for failure. You need to really inventory what other interventions can you do outside of Loving this content? Make sure to follow us on Instagram, Facebook, and TikTok for even more insights. And hey, while you're there, don't forget to like, comment, and share. It really helps us grow. Now let's get back to the podcast. Optimization, couples counseling, talking to your spouse about some specific things. And using the testosterone or the TRT to really hone in on those. That's the biggest one. That's the number one thing that I will say for most people is if you come into the clinic and we're talking about your goals for optimization, if you don't have a clear-cut idea of what optimization looks like for you, and you say, Well, I just want to try it and see what happens, I promise you, you are going to be disappointed. You are going to be disappointed because it is not going to make goals for you. That's the biggest thing. And That also kind of goes to where I think testosterone isn't for everyone. TRT, HRT isn't for everyone. I think it's for the person who has had a very detailed idea or detailed plan of what they want to execute out of life. What do you want to achieve from life? What are you wanting to experience? What are your goals? Because if you're going through life without a plan, this isn't going to give it to you. This is going to be a very powerful tool to help you get to your end point. But it's not the map. Okay, and that's important to know. How hormones decline with age? Well, this one's pretty simple. It's pretty clear cut. When we talk about hormone production, we really have two specific sites of these sex hormones. We have our gonads, we have our adrenal glands. Typically, when we talk about hormone production, we talk about our gonads. So hypothalmic, pituitary, gonadal, or ovarian axis. So what we have to realize is there are a lot of different tissues involved. We have our hypothalamus, pituitary gland. Gonads ovaries. With women, it's a little bit different. We'll talk about that in a second. But with men, these tissues age as we get older. Of course, they're organic tissue. As organic tissue ages, guess what? It becomes less efficient at signaling, at taking up r receptors. It's not going to do its job as efficiently, just first and foremost. That's a guaranteed. Now we add f feel to this fire by accelerating this process with endocrine disruptors. BPAs in the plastics, fluorides in the water. So we're doing an acceleration of degeneration of these organic tissues. Now with women, a little bit different because what'll happen for females is you're on a menstrual cycle, right? So your hormones are going up and down, up and down until you hit this period called menopause, where they just fall off a cliff. And menopause medically is defined as one year without a period. Nonsense. It's it's honestly just once you have no more eggs to ovulate. Once that last egg goes through what we call atresia, meaning just it dies, your ovaries are not going to be responsive to LH and FSH. So what's going to happen is your brain's still going to send these signals down, specifically your anterior pituitary gland, to the ovaries, but the ovaries are done. They have nothing to give. They're not going to be able to make these hormones because they're not going to be going through that normal menstrual phase. So as we get older, hormones are going to decline regardless. You can live the most active. Healthy lifestyle of anyone in the world, hormones are still going to decline. The variable is just the generational and I guess the luxuries that we have in a developed country that expose us to these endocrine disruptors. Symptoms that people dismiss but are actually hormone driven. So symptomology for people who have hormone deficiency, low hormones, whatever you want to call it, it varies. It varies so much. I mean, I've done a whole podcast on some of the most unusual symptoms of. Menopause. They have ranged from frozen shoulder to just a weird itching of an earlobe to just a tingle of your upper lip. The options are limitless. Same thing goes for guys. The reality is it's not every guy comes in and says, Hey, my libido's gone. I can't get erections anymore. That's not the case. Guys don't come in and say, hey, I haven't slept for a week. I have horrible anxiety and depression. It's such a wide spectrum of symptoms. It happens very slowly in most cases. And we don't really know what's actually a symptom because we can all justify, well, of course I'm stressed out. Life is stressful. Of course I'm not sleeping good. I hate my job. I like to stay up late and party. I don't know. But the reality is is a lot of these symptoms, it's really hard to even categorize them as symptoms until you actually look back and say, Well, you know what? When I actually look at how I felt, when I felt my best, when I was a twenty year old something. Yeah, you're right. That's a huge difference. And I think this is just a theory, that maybe midlife crisis is that period of time where you actually look in the mirror and you say, I don't recognize that guy anymore. Who is that? And I think that's your first kind of sense of clarity of like, wow, this is what I've changed to, possibly. Granted, no literature on that, guys. That's just my own two cents for whatever it's worth. Why middle age isn't the problem. Hormone disruption is. So once again, this goes into the endocrine disruptors, right? We are accelerating the rate at which our hormones are decreasing. That's just a fact. And what we're seeing is generational decreases. What that means is that the endocrine disruptors that you're being exposed to today is getting into your genealogy and it's being passed off into your offspring. And I see d I see it directly. I have a lot of father-son patients. They'll come to me, get their labs checked at the same time. The fathers is always higher. It's just it's amazing. And I have young nineteen, twenty year old men with testosterones on the ground floor. So we are seeing a generational decrease in testosterone and there's plenty of data to back that claim up. This isn't just something that we're making up. Middle age is really kind of an outdated term at this point because what do you call someone that never experiences a peak? That's the world that we're living in currently. And going back to middle age, right? It shouldn't just be like, hey, you're getting older. You should feel like shit. That should never be the case. The reality is you choose what you want out of life. Would I ever tell someone, and I hear this all the time, do you need hormone replacement therapy? No, absolutely not. You don't need a drop of testosterone in your body to survive. You will function. You will not die. Do you want it? That's the question. And I want everyone to view it in that way. That this is not medically necessary for survival, but it is something that you want and something you have access to. The real story behind low libido in men and women. Wow. So what I will say is I have been trying, guys, to get a certified sexologist on the podcast because there is so much that is behind the act of intimacy between couples. There is so much emotional, spiritual, physical connection. And there's so much that involves our hormones with intimacy. Now, when we talk about low libido, I mean that's a wide range of of things. It could range anywhere from erectile dysfunction to just the lack of desire. There there's a whole spectrum. But what I can say about men specifically is men will come in and one of their chief complaints will be, I can't get erections. There's a multitude of factors for this. First and foremost, we always have to think what's the cause. Is it low hormones? Possibly. Is it another like bigger issue like an arterial occlusion, that's always a concern we have to worry about too. It's been called the canary in the cave for a reason, because if you have plaque buildup in the arteries leading to the penis, chances are you have plaque buildup in arteries leading to the heart too, right? Concerning. But as far as the effects of hormones on libido, very powerful for a couple different mechanisms of different reasons. Testosterone is a huge driver of libido in both men and women. In fact, in women, during your ovulatory phase when This is the chance where the egg is going to either get fertilized and implant on the uterine wall and you're pregnant, or it doesn't. Testosterone levels are naturally increasing because it wants your libido to be up, right? It wants you to try to fertilize that egg. For for guys, absolutely testosterone is very, very powerful for libido. Also, estradiol. We can't sleep on estradiol. Estradiol is very powerful for libido. And believe it or not, we have estradiol receptors as men. On the penis, very important for helping to get healthy, full erections. So libido is a very broad topic. And a lot of us just say, well, you know, it's a nice to have. But at the end of the day, when you're in a serious relationship, libido and intimacy is so incredibly important. Fatigue isn't normal. The hormone physiology behind it. That's a tricky one. Hormones, you know, fatigue is such a broad symptom. And it can mean so many different things. What I can tell you regarding the interplay between hormone replacement therapy or optimization and fatigue is that the whole point is to decrease your daytime fatigue, help you sleep better at night. You know, testosterone actually adjusts your sleep, your sleep architecture, as it's called, and it allows you to be in phase three of sleep, which is the most restorative type. This is the phase of sleep where your body, your mind are healing. It's right before REM sleep where you actually have your rapid eye movement and your dreams. Phase three is where we want to be. And this is really powerful for helping us wake up feeling restored. One caveat to that, I guess, or dark side, whatever you want to call it, is that it can exacerbate sleep apneas. So it is very possible you can cross over from a obstructive sleep apnea to more of a central sleep apnea just because you are in such a deep sleep state. That it can actually affect the way that you sleep. You're sleeping super deep. And if you've never had a sleep study before, I always recommend that if you snore, might not be a bad idea to get a sleep study. Is it necessary? Well, no. But you know, would you want to be not breathing when you're sleeping? Kind of sucks, huh? So fatigue's a broad, broad topic. I don't know. Maybe this question's kind of leading more towards like cortisol, because cortisol can I did a TikTok on this recently. It's called pregnantolone still. So when you have your hormones, you have kind And this is specifically adrenal glands, okay? Because cortisol is made specifically in the adrenal glands. So not the HPG axis. But you have cholesterol, which then gets converted into pregnant alone, which we call the mother hormone. And from this mother hormone, you have three downstream pathways. You have aldosterone, cortisol, and all of your sex hormones. Okay. That's your testosterone, your DHT, your estradiol. The theory of pregnantolone still is that cortisol. is increased because of stress, not just emotional like, ⁓ my God, I hate my job. Let's get real for a second. Yeah, aging happens, but feeling exhausted, struggling with sleep, losing your edge in the bedroom, and watching your confidence tank, that's not just getting older. That's a hormonal imbalance, and you don't have to live with it. They'll tell you hormones are dangerous, but hand you a prescription with a mile-long list of effects. Enough is enough, guys. At StillCity HRT in Weight Loss, we cut through the noise. We offer safe, bioidentical hormone therapy customized to you and backed by real lab monitoring and personalized care because your health isn't one size fits all. If you're done with the BS and ready to feel like yourself again, strong, focused, and confident, call or text us at 719-669-4223. Let's build a plan that actually works for you. Still city HRT and weight loss. Be the hero of your own story. But just the stress that we're placed under with all the endocrine disruptors and high inflammatory environment, cortisol's demands increase. So it's going to be using up more of that pregninolone. And I don't want you to think of pregninolone as like a giant reservoir that you just have all this pregnantolone that's draining down the cortisol pathway. It's a little more complex than that. Basically, it metabolizes the pregnantolone down the cortisol pathway with all these different enzymes. So it's not draining your cortisol. reservoir of pregnolone, it's just promoting it to go down the pathway of cortisol production more so. And what does that lead to? You got less pregnantolone for your sex hormones. So we are not getting as many sex hormones. There's quite a few we're missing, right? DHEA, adrosteedone, we have testosterone, DHT, estradiol, everything downstream is going to be affected. When upstream, we're not getting the same level of conversion. So that can be a huge driver. And once again, Just assume everyone's cortisol is high. We're all stressed out. Mm ⁓ let's see, menopause and andropause. What no one explained at the doctor's office. Andropause, that's an interesting term. Kind of a term used kind of like colloquially for low testosterone in men. Like women go through menopause, men go through andropause. I don't think it's the same. I think it's kind of funny. And the reason is because with us guys, we don't have a period of time where all of a sudden our testes stop making testosterone. It just doesn't happen. It can happen. ⁓ that's definitely a pathological condition. I mean, you know, you get you get kicked in the gonads hard enough and you can definitely cause a primary hypogonadism, potentially a tumor, you know, chronic infections. There are things that can cause it, don't get me wrong, castration. But typically our hormones and natural progression of aging just slowly decline over time. It's a very insidious process. And oftentimes it's one of those things that we aren't usually in in tune with. Now, with women on the other hand, with menopause, as we talked about earlier, there is a sudden decrease in those hormones that, you know, is pretty difficult to ignore. Some women have more symptoms than others. And you've probably heard of the typical symptoms of night sweats, hot flashes, typically states that are correlating to low levels of estradiol. TRT for the high performer, why it's not for everyone. So we kind of talked about this earlier, you know, TRT, HRT, it's not for everyone. I don't think that everyone's gonna get the same benefit from it. And I hear all the time, people will say, How do I know if this is gonna work well for me? Well, what are your goals? What do you plan to do with this? If you have the answers to these questions, or you've at least entertained the idea, chances are you are setting yourself up for success because you have a plan. And failure to plan is planning to fail. So if you're just gonna take these hormones, without any idea of what you're wanting to achieve, y you're you're going nowhere. You know, you're just driving off into the distance. You don't have a destination. So typically I I don't know what it means by the high performer, but I'm assuming it means someone that has a plan, someone that already thinks that, hey, this is what I want to do with this. This is my goal, whether it be in the gym, in the boardroom, in my marriage, whatever it may be, ultimately if you have a plan, you're going to do much better with a tool. How optimized hormones influence decision making, drive, and confidence. So we talk a lot and we think a lot about the physical benefits of hormone replacement therapy or optimization therapy. But the thing is, these hormones do an amazing amount of things for us mentally, right? Testosterone and the way that it influences serotonin reuptate transporters to help with depression, anxiety, progesterone, the way that it works to upregulate GABA A receptors in the brain. Estradiol and its interplay with serotonin and dopamine. These are all very, very important characteristics that we have. And in fact, I did a TikTok not too long ago about a specific subset of guys who have this gene abnormality called the warrior gene, where they'll actually take testosterone and they will get anxious. maybe depressed to the point of maybe even developing palpitations, right? These are the guys that don't respond well to high doses. These are typically the guys that do well on low doses. And actually from a lot of the studies and literature that I looked at, benefit quite a bit from magnesium supplementation. And so everyone's different. But what I can tell you is that hormone replacement therapy, and I'm just speaking from a personal perspective here, has improved my ability to make decisions, has increased my I guess reasonable risk tolerance as a business owner, clinic owner, and practitioner, and has improved my confidence dramatically. And that is a recurring thing I hear time and time again from men and women. I typically hear this from someone who's got a big decision coming up, whether, hey, I want to go back to school for this. Hey, I want to leave a dysfunctional relationship. Hey, I'm a business owner and I'm trying to make some some changes in the business. Typically, not always, but typically These will be the people that will have the best response because you just need that little bit of an edge, a little bit of a push. And I see it time and time again where we get favorable outcomes with optimization, hormones, and body composition. So it goes without saying, of course, testosterone is going to alter your body composition in what I would consider to be a favorable way. It's going to improve your muscle protein synthesis, which is going to help retain nitrogen and allow your muscles to become better. More full, it's gonna help them build up, it's gonna increase nitric oxide levels. Estradiol is fantastic at helping with feminizing features, redistributing fats called the hormone of youth for a reason. It helps to give you your feminine curves, rest, hips, and these hormones all work synergistically together to achieve these. Now, is it going to be like a full body makeover? Absolutely not. This also goes back to what are you willing to put in to the gym, right? I tell everyone. Man or woman on or off hormones, you need to take advantage of your ability to build muscle right now. We need to build as much high quality muscle as possible now to carry us into the future. As we get older, does it get more difficult? Well, sure. Absolutely. Little nagging injuries start to build up. Of course, without optimization, hormone efficiency goes down. It goes down even while on optimization, but it's more difficult. And so now is the time. And you may be 70 years old listening to this. It's not too late for you. You look back when you're 80, you're gonna say, man, when I was 70, I really should have been hitting the gym. It's never too late to make a drastic transformation, but now is the time to cultivate as much muscle as possible, guys. And I specifically say muscle because it is such a metabolically active tissue. It's it is the s fountain of youth. Muscle is the fountain of youth. And you need to build as much of it as you can right now. Hormones and sleep, the most underweight performance tool. We already kind of covered that. We talked about how the hormones affect your sleep architecture, keeps you in phase three sleep. Phase one sleep is kind of that shitty sleep where you're kind of going in and out of sleep and consciousness. That's typically where you end up when your hormones are drastically affected. Not a good place to be. You're just not getting recovery. It's not getting rest. And we want to be in phase three. Phase three is The most beneficial form of sleep that we have. My doctor says my testosterone is normal. Okay. This is something that we hear all the time, right? You get your lab work, your testosterone is within that normal range, just meaning that it's not highlighted with a red H or L, whatever, saying it's high or low. And so we just say it's normal. But the question is, do you feel normal? That's what matters. The labs aren't going to tell us everything. That's just a small piece of the puzzle. Now, I'm not saying we disregard them completely. But I'm saying that it's only a small piece of the puzzle. And you really have to think, am I treating labs or am I treating a person? And sometimes we get really caught up in medicine saying we treat with this number or we don't treat with this number. And it's just it's inappropriate in all ways, shapes, and forms. It's not individualized care at all. Is TRT dangerous? What the science actually shows. So, you know, we've talked about this ad nauseum as well, the risks of Testosterone and hormones, does it cause prostate cancer? Does it cause breast cancer? Does it cause blood clots? Right? We've heard all these things before. And what's really important to know about estrogen and testosterone is if you have a testosterone or estrogen-dependent cancer, estrogen or testosterone are going to cause those cancers to grow. Now, whether you're making that naturally or you're being optimized with it, doesn't matter. The next question is at what point do we say you're already at your maximum risk? Of a hormone related cancer? Is that a total testosterone of 250? Is it a total testosterone of 500? Is there a difference between the two? These are all factors we have to consider. As long as you've got a drop of estrogen or a drop of testosterone, you run the risk of a hormone dependent cancer. That's just the way it is. But what we have to really realize is does the risk increase with optimization? And if so, to what degree? Now, I'm not going to get too far into it, but a lot of the literature actually shows that it does not. And unless you have no estrogen or no testosterone, you're never fully safe from breast cancer or prostate cancer, any kind of testosterone-related cancer. So the reality is no, I think a lot of these risks are overblown. Are there risks? Sure. There's risks to everything. There are risks to getting into your car, to drive to work. These all have to be calculated risks. And we just have to assume, based off of our informed decision making, that the benefits outweigh them. The women's health initiative fallout, how one study hurt an entire generation and why the narrative is changing. All right, I like the way that it worded that. So we've talked about the women's health initiative before. It was a study done in the early two thousands, and originally, I believe it was done to show the cardiac safety of hormone that replacement therapy for women. However, the study design was pretty poor. With the average age of the participants being in their sixties, having some degree of cardiac disease, and well past menopause. So they weren't able to evaluate symptom alleviation. Not only that, this is the big one, they used two synthetic hormones. They used a conjugated equine estrogen, which was a combination of different estrogens derived from horses, pregnant horses, and they used midroxy progesterone acetate, which is a basically a chemically altered version of progesterone that'll be called a progestin. And they saw that when used together, there was a very slight, very slight increased risk of breast cancer. Now what happened? The study was stopped prematurely, and the headlines all said hormones cause breast cancer. Now, if I'm if I'm a provider and I see that something that I'm doing is causing significant harm, you better believe I'm gonna stop. I'm not faulting anyone for what happened after that. The whole Issue is the way that the study was done and portrayed. But prudent providers were stopping therapy. Patients were scared out of their mind, rightly so. And we're still suffering from that today. Now, granted, there's a lot of changes. A lot of things have been redacted and they've re-evaluated the findings of the study. And unfortunately, because of that study, though, there's always just going to be some kind of tarnish on hormone replacement therapy for women. And I see it to this day. Women are still suffering because of that. Do natural test boosters work? Well, it depends. Now, what are the most powerful natural test boosters in the world? Sleep, protein, weight training. That's it, guys. If you want some natural test boosters, those are what you want to invest your money in. Because, you know, Asha Gwanda, Fenangreek, Tribulus, sure, the studies have shown maybe very, very slight increases in total testosterone, but we have to realize these levels are gonna change anyway. And chances are if someone's taking something to naturally increase their testosterone. They're probably also going to the gym, weight weight training, probably trying to prioritize health, sleep, and nutrition. So what is it? Is it this adaptogen or is it their lifestyle changes? The other question is, is it going to move the needle? Is it enough to give symptom resolution and achieve those goals of optimization? If it is, hell yeah. If it's not, I mean, how long are you going to be you know, hit your head against the wall here. Receptor sensitivity and why some people respond better than others. I think receptor sensitivity is is it, you know, you could take as much testosterone as you want. If your receptors aren't sensitive to it, they're not taking it up, which there are genetic desensitization conditions for this, it doesn't matter. You're not going to get the effect. The effect is what we want. The dosage doesn't necessarily tell us the effect. Some people may disagree with that. But if your receptors are the issue, Well, I mean, you're kind of screwed in a way. One thing I can tell you is that on your antigen receptors, you have what are called CAG repeats. They're these small chains of DNA, which are essentially just like these chains of amino acids. And the length is inversely related to how sensitive you are. So when you have these really short chains of these CAG repeats, you're much more sensitive to antigen stimulation at the receptor site. Whereas if you have these long chains, you're not very sensitive at all. And so this is going to be the guy that comes into the clinic with a Normal testosterone, maybe even a pretty good free testosterone, and he still feels like shit. This is gonna be the guy that isn't going to respond well to 200 milligrams a week. They exist, guys. And unfortunately these guys kind of fall through the cracks and are just told, hey, you're just abusing this stuff. But they do exist. And granted, with all the shit going on with our hormones, I mean, is it possible that we're seeing more of these genetic anomalies? Well, sure, why wouldn't we? And those are just the ones we know about. We don't know nearly as much about the human body as we'd like to think we do. So I think that the receptor sensitivity is everything. If you're not getting stimulation, you're not getting effect. Matacrit, Stradel, SHBG explained clearly what labs actually mean, why context matters. It is all context. Do I think we always need to check everything all the time? No. What do I like to check? So I typically will check a CMP. CBC, if you're just starting with these hormones, I like to check in LH and FSH just to see is your body naturally making its own hormones? And some guys will say, Yeah, I've never touched anything. We get that their hormones, LH FSH completely gone, and they have a total testosterone undetectable. You sure about that? So LH and FSH, just because it gives us a better idea of what that connection between the brain and the testes are. And you know, we can differentiate a primary and secondary hypogonadism, granted, what utility is there other than saying, hey, you may need a brain MRI? I also like to check, of course, a total and free testosterone. Some people say I'm lazy because I don't calculate it out myself. You know, I've done some studies on that. You can calculate it with your sex hormone binding lobulin and your total testosterone and even an albumin. I don't think it's more accurate. I don't think the hand calculation is more accurate. I suck at math anyway. So, you know, from what I've looked at, a free testosterone on lab work is the most accurate. I don't know what to think about it. It's easier for me. It's easier for you. So why not? So total free testosterone, SHBG, sometimes maybe on that initial one, we'll get it, we'll get an SHBG. I think it's a good teaching point, just explaining how we differentiate total from free testosterone. I always get a PSA. It's just something I I've always done, something I've always just ⁓ felt, why not? It also helps to open up that conversation of does testosterone cause prostate cancer, right? And that's it, man. I don't think you need anything else. I don't think you need a cortisol, ferritin, DHEA, pregnant alone. Can you get Sure. You can get all kinds of vitamins too. I just don't think it's necessary. On follow up, the biggest things that I would think that would even be relevant would be a C B C. I get it, you've tried hundreds of supplements in the past with disappointing results. Forget it, it ends now. At Velasco Supplements, we don't just sell supplements, we provide solutions, having treated thousands of men and women with difficulty sleeping, low energy, and just not feeling like themselves. We've developed these specific formulations based on clinical guidelines and science. We've only included what works and nothing that doesn't. All supplements are third-party tested with clear, transparent labeling. Because while I'm proud of what's in them, I'm even more proud of what's not. It's time to get the results you've been waiting for this whole time. Check out Velascosupplements.com and see if we have a solution for you. About it, honestly. Because at that point, you know, once you're on treatment, the level of testosterone, I don't care. I don't give a shit because how your symptoms are responding is the biggest thing. I don't really care what that level is. We don't aim for a specific number. Some guys feel amazing at seven hundred, some guys feel amazing at fifteen hundred. And you have to realize too, if you're dosing more than once a week, you're never really gonna get to a trough or the lowest point of your labs. It's always gonna appear elevated. And I have a lot of primaries that always freak out about that. But I have guys that are injecting every other day. We're not gonna have a low point, and when the low point's gonna be at its peak still. So, you know, I don't get too caught up in any of that. But I think that ⁓ the labs are important. I think it very much ties into the whole picture, but I take it with a grain of salt. Our conversation is much more valuable to me. The role of progesterone in men and women. Well, the role of progesterone in women, I'd say, is a lot different than men. First and foremost, progesterone in the context of hormone replacement therapy. The role of progesterone is to essentially modulate the uterine lining to prevent it from becoming excessively thick. When you're on any type of estrogen, it's going to thicken the uterine lining. This is expected. And if it's unopposed, meaning that we're not doing anything to prevent it, any growth, any unopposed growth of a tissue is going to pre expose predispose you to cancers. Specifically in this context, endometrial uterine cancers. Progesterone helps to modulate that uterine lining. Now, outside of that, progesterone is very powerful. Anxiety, insomnia, depression, because of its interplay on GABA A receptors in the brain. So, yes, I have many women who have had hysterectomies on progesterone and they love it. Now, what about guys? This is a little more nuanced. Can guys benefit from progesterone? Why the hell not? We make this stuff. We make the progesterone already. Do you think that our bodies just selectively choose to be low in testosterone? No. Progesterone is also very powerful for men. We just don't really have a lot of research. I know they've done some studies. I think one study actually showed that it caused worsening of anxiety. One study showed it improved your survivability from COVID-19. There there's all kinds of freaking studies out there. But what I will tell you, having taken it myself, you won't find better sleep. This stuff truly is the volume of the brain because you take it, you are knocked out. Now, once again, not having a uterine lining, I don't take it all the time. Not as important. I'm not protecting anything that I'm aware of, but I take it occasionally to help me sleep. And I love it. I wake up the next day feeling fantastic. So I think that there is a lot of benefit to it. I think there's gonna be a lot of research coming out showing that, hey, we really should be pushing this for guys the whole time. I really do think that's gonna come down the pipeline here. Let's see, practical world world guidance, super valuable for listeners wanting action steps. All right, we're gonna make that the last one here. So really the biggest thing is I want everyone listening to this to know that hormone replacement therapy is optional. Okay. What regardless of what anyone tells you, you don't need it. Don't feel strong armed into having to do this. Okay. This is something you elect to do, something you want to do, because it is going to better your life. Before you even consider it though, have a clear objective of what you want. If you've got some really debilitating symptoms, okay, that's a great goal. I want to get rid of these. Perfect. If you may not have significant symptoms and you say, hey, I want to be the top performer in my firm. I want to improve my gym performance. I want to do XYZ. Well, that's that's a goal too, right? That's a goal too. Optimization, it falls perfectly under that umbrella. But have a clear objective of what you want. Because at least with me, when we're standing across from each other and we're talking, I really want to know what those goals are because that's going to give me an idea. What kind of person are you? Are you a good candidate for this? Because once again, everyone is not a good candidate for it. Can everyone take it? Sure. Is everyone going to benefit from it? No. But have a clear goal in mind and have objectives and don't be afraid to ask questions. You have so much information at your fingertips right now as a consumer. There's no reason that you shouldn't be asking questions. Your provider doesn't know everything. I sure as hell don't know everything. I learn from my from my patients all the time new things that I never even knew about or even thought about. So we have to work together. And so yeah, find a provider that works with you. You guys have a synergistic relationship because they're gonna help you be better. You help them be better. But at the end of the day, guys, really define what optimization means for you. If you guys like this kind of just a quick little single solo podcast where I just look at s some questions, whether it's ones that you guys send in or chat GPT, whatever, let me know. I'll start incorporating these more. That's a wrap. Thanks for joining us today for another great episode. I hope you found this useful and look forward to helping you move forward in your continued pursuit of knowledge. It doesn't have to end here though. Check us out on TikTok, Facebook, and Instagram. If you want to be on an episode of Hormones Happen, shoot us a message at HormonesHappen at stillcity-trt.com. Stay hungry, stay optimized.