“you could take Minoxidil all day you could take all the pumpkin seed oil saw palmetto”
“mildly very lightly prone that's where you need to like layer up with the 5-alpha reductase inhibition pharmaceutically and then minoxidil is the growth stimulant that is fda approved and works reliably it's just hit or miss if it works based on your own enzymatic conversion”
“now obviously no one's gonna light their head on fire hopefully but that's a thing um so with respect to the the topical you know strategies like the minoxidil i mean”
“enzyme activity that leads to the minoxidil sulfate conversion that you get systemically it leads to some people like pericardial effusion like what's the best way to get that”
“Is the tretinoin oral or? Topical, you would get like a compounding pharmacy to formulate it with a minoxidil because you buy that over the counter that would be like you would now have gone to the pharmaceutical route at that point”
“i would escalate to like the pharmaceutical compounded route at that point if you needed to with like the tretinoin compounded minoxidil um it's funny the microneedling like i'm interested in for skin effects and so yeah people use on their face too like oh yeah so i you know it is”
“ensuring adequate absorption of the drug because when you do microneedling on its own like versus minoxidil on its own versus microneedling plus minoxidil like it's not a good idea to do it on a comparable outcome in terms of like you would expect the microneedling alone group to be very”
“is the same and again there's snips that like some people that have those snips are more susceptible to to believing that something is harming them um if they're like aware of those things and so yeah well that's interesting to to know but clarifying quick on the minoxidil though it's a growth stimulant it does absolutely nothing that we know of to attenuate the”
“pretty benign helpful good shampoo regardless that's why I use it but Finasteride or Dutasteride or topical antiandrogen probably going to be necessary for most people minoxidil is the thing you use to regrow hair it's not the thing that prevents loss you can cosmetically offset the”
“You know, like, even when we talk about vitamin D, it's like, you know, you should probably be at, like, 60, even though the low end is, like, 30. Typically, if you were at 40, people would be like, you know, try and bump that up to 50 or 60. With testosterone, people think similarly.”
“dramatic impact on your test levels, but things like zinc, magnesium, vitamin D, like these all have a marked impact on your testosterone, either response to it or capacity to produce it. Or even like, like you mentioned, in our podcast, a conversion of vitamin D into active vitamin D.”
“which just nobody does. And then the vitamin D it's fat soluble. Typically, you're going to have anything like a soft gel or something. And it's not always going to be at the dose you need in the multivitamins. It's just worth noting.”
“vitamin d supporting it and it's not necessarily measurable as much like directly but all you can really do is like backfill accordingly to hit your needs and then assess your kind of like proxies”
“and your blood work and your symptoms and kind of go from there in your opinion like let's say someone is on the deficient range of vitamin d their inadequate magnesium perhaps their zinc is you know maybe okay or in the in the inadequate range would getting to that sufficient status”
“additive effect most of them are i mean at least vitamin vitamin d magnesium pretty common yeah yeah i would say like you're looking at probably a potential incremental difference of 100 to 150”
“something that apps and some of it can't be directly measured either like we're talking about the total t number but it's like how do you know how much your deficient vitamin d is impacting your ability to like use it correctly and then even if you had the sufficient vitamin d the magnesium impact on all that and the dna interactions and whatnot it's like”
“something like a vitamin D that you can just sequester into sub Q fat and just like get rid of at some point. It's like it could impact your mood regulation quite significantly for a bit, depending on like what your neurotransmitter balance is at baseline.”
“Zinc, magnesium, vitamin D, not in order, just the top three, I would say. And then I guess for impact, I would probably say like Tongkat Ali, but probably boron would be my safer next choice just for like safety profile.”
“responding. Like at that point, it's kind of like, okay, you're, we could try hammering you with some HCG and see if we can stimulate a satisfactory response with like a manual, like extra push at the lighting cell. Um, or use some, you know, some of these other like augmenting, you know, steroidogenic supporting things like Tongkat or whatever.”
“Um, and those individuals like it's app, it's kind of like if you've exhausted all resources, you've tried the whole manual stimulation directly cuz HCG is the way you would actually test that out is you would actually look at, okay, if we actually hit your lighting cells directly with a signal and we escalate that to like the maximum degree and we use FSH two exogenous.”
“Like the guy, like what else could you do when you're him? Right. He's I think 50 years old. So what he did was he used HCG, which was assessing, okay, like are the testes responding to like a manual signal and they were, and he's like replaced his hormones entirely by using a manual LH mimic, essentially why his pituitary wasn't shooting out enough LH to hit.”
“But I also would like do some due diligence to just like assess like what's happening. And I think HCG for people who are like secondary hypogonadal is sometimes a good middle ground of assessing. Like, is this a testicle functionality problem?”
“so you have to account for that differential too some people get highly estrogenic from hcg in particular which is like a female like literally in pregnant women's urine to stimulate lytic cells that's what it's like purified from um and you know there's some speculation as to if”
“notable effects on like i don't know epigenetic modifications from hcg plus fsh mediated babies like not that i'm aware of not that i've seen any literature point to but it's worth noting”
“recombinant fsh is insane and hcg in itself is expensive and then you're stacking that on top of your testosterone that you're using it's not necessarily an affordable thing for everyone so a lot of guys just let their testes atrophy because that's what they can afford to do and they want to still get”
“now you just have like these shriveled you know like raisins that you have to like re-stimulate the baseline through like insane aggressive dosages of hcg and fsh like not cool at what point does that atrophy start to recur i mean like how long do you have to be on you know trt before that really starts to happen um it's pretty”
“Tongkat Ali another very notable one this is one that um works for a different mechanism. It seems to be a bit more speculative how it works but it seems to do a few things potentially”
“extract you get you want to look for one that is HPLC tested for Eurycomanone that's the active ingredient in Tongkat Ali that actually has the bioactive effect that you're looking for There are a lot of Tongkat Ali supplements that just say Tongkat Ali or”
“Eurycomanone. Got it. and e-u-r-y-a-c-o-m-a-n-o-n-e i think. Now how does Tongkat Ali compared to like boron is it i mean it sounds like for men it might be like you're getting a bigger bang”
“affect the SHBG binding complex like i would be trying to i might misremember and i don't want to misspeak so okay well yeah it's just kind of interesting but would would the Tongkat Ali work in women as well just through the SHBG or maybe the boron like i don't know which if just for off like off the you know topic here boron”
“And then the Tongkat is like more of a speculative one that you don't want to just like take until you've exhausted some of the other options, but is like the more exotic kind of like hammer that you might want to take to the situation if it's like your last resort before, you know, I've tried everything, my lifestyle is perfect, my diet's dialed, my”
“I guess for impact, I would probably say like Tongkat Ali, but probably boron would be my safer next choice just for like safety profile. Okay. Great. Unless, and then if you're like the anxious person adding ashwagandha and just be like cognizant of what it's, how it works.”
“some, you know, some of these other like augmenting, you know, steroidogenic supporting things like Tongkat or whatever. But if that's not working either, like your testes are cooked and you got to be on test at that point because you're just not responding to any natural stimulation whatsoever.”
“Okay. So. No, I certainly don't want to leave a podcast saying, get on Finasteride or Dutasteride, or else you're screwed. Like, there's an ROI calculation to be made similar to any sort of hormonal therapy that is not to be minimized. There are side effect profiles with these drugs, just as there is with any drugs.”
“is very significant and uh shockingly Dutasteride is a similar side effect profile to Finasteride even in studies comparing them where you have near full inhibition of systemic DHT versus only 60 to 70 percent via Finasteride which only inhibits two of the three isoenzymes in the scalp so it's like it's not there's a side effect profile it's just overblown by media but it's not zero”
“That seems like a legit pathway for some men that are like a little bit skittish about potential side effects with the oral um drugs as well, because like the Finasteride and do what is the other one Dutasteride um you know you mentioned the the erection but like is there are there any other serious side effects with those”
“like post Dutasteride or post Finasteride syndrome. Interesting you'll never have you you'll never hear about post Dutasteride syndrome though yeah even though it's a way more potent drug because it's largely a media driven construction it's not to say it's not real there's definitely side effects from”
“like the mild Ketoconazole which probably is not going to be sufficient but like over the counter pretty benign helpful good shampoo regardless that's why I use it but Finasteride or Dutasteride or topical antiandrogen probably going to be necessary for most people.”
“I take enough to put me at like 800 and like my free T is like the high normal. I think that the Dutasteride like probably whatever like excitotoxic toxicity or cardiotoxicity that I might otherwise be like net netting over into like an area I wouldn't want I would anticipate and speculate that the DHT reduction is probably inhibiting that whatever detriment might be there”
“you know, game changing, dramatic impact on your test levels, but things like zinc, magnesium, vitamin D, like these all have a marked impact on your testosterone, either response to it or capacity to produce it. Or even like, like you mentioned, in our podcast, a conversion of vitamin D into active vitamin D.”
“to get an adequate doses. All but zinc is typically adequately in adequate doses multivitamins, but the magnesium in particular almost never is because of the weight of it. You would be having to take a multivitamin that's like eight to 10 capsules otherwise, which just nobody does. And then the vitamin D it's fat soluble.”
“Which is not that complicated. I don't want to make it sound super complicated. Like, a lot of them are fine. Miranda has great articles on magnesium. There's a lot of studies on magnesium formats that are bioavailable and yield more than enough magnesium. And, yeah, the vitamin D. Having an adequate amount and making sure you're converting it and actually getting the activity from it.”
“and your blood work and your symptoms and kind of go from there in your opinion like let's say someone is on the deficient range of vitamin d their inadequate magnesium perhaps their zinc is you know maybe okay or in the in the inadequate range would getting to that sufficient status”
“additive effect most of them are i mean at least vitamin vitamin d magnesium pretty common yeah yeah i would say like you're looking at probably a potential incremental difference of 100 to 150”
“Zinc, magnesium, vitamin D, not in order, just the top three, I would say. And then I guess for impact, I would probably say like Tongkat Ali, but probably boron would be my safer next choice just for like safety profile.”
“in finasteride users and dutasteride. And it is not much different than placebo in very, very rigorous and significant high number of subject studies that were well, well constructed studies.”
“That seems like a legit pathway for for like a little bit skittish about potential side effects with the oral um drugs as well, because like the Finasteride and do what is the other one? Dutasteride. Dutasteride um you know you mentioned the the erection but like is there are there any other serious side effects with those?”
“depending on if you've seen the podcast where people talk about it or not. I've heard of this like post Dutasteride or post Finasteride syndrome. Interesting you'll never have you you'll never hear about post Dutasteride syndrome though yeah even though it's a way more potent drug because it's largely a media driven construction.”
“like the mild Ketoconazole which probably is not going to be sufficient but like over the counter pretty benign helpful good shampoo regardless that's why I use it but Finasteride or Dutasteride or topical antiandrogen probably going to be necessary for most people.”
“I do think if there's some sort of direct study, though, that would be interesting. I was just going to say the same thing. I'm pretty sure there is some anti-aging studies on Finasteride and Dutasteride, though, that might, I wish we could pull up, but we don't have the. Yeah. Well, it's something to dive into later for sure.”
“very very promising the only problem is like how many guys are actually using that medium of therapy like i don't know none like i don't know a single guy using androgel and that's fine like it's still data and it's still worthwhile and it's still good it's just like not don't take that as”
“side of the coin on that androgel you know like it's not necessarily physiological replacement the thing to note is it it should be expected that if you use more testosterone you're going”
“how the different administration methods and frequency will impact things because like you're probably not going to be on androgel using a little dose that gets you to 420 nanograms per deciliter you're probably not on that protocol and if you are like yeah okay look at the traverse trial like maybe you can get like a bit more reassurance but like you're probably not that”
“right yeah okay so then circling back to administration like the ideal way to go about it um i can say off the rip i would not do pellets i would probably not do androgel if you're a male if you're a female it's a bit different which we can get into”
“regardless of what your test levels were kind of thing Yeah I'd love to talk about those I mean you hear some of these herbal supplements and like some of the ashwagandha, fenugreek, with Tongkat Ali I mean yeah let's dive into that like are they effective which ones are effective which ones are hype yeah um i think one that i would would be worth mentioning all but the literature”
“those who can benefit from it and for some people it's like a game changer supplement that really improves their quality of life outside of just the testosterone enhancing capacity of it because some people deal with a lot of stress in their life and need that extra resilience suppression of how much it's affecting their mental state like some people they can't even get to”
“who thought this was the way to do it. And like for you and your individual biochemistry, it may not be the ideal way. Right. I mean, I've been interested in ashwagandha. I kind of experimented with it like half-heartedly like years ago. And I think I'm going to now bring it back into circulation.”
“Because once you get that blood test, you're going to be like, fuck, I shouldn't have taken ashwagandha because now I have no idea what this means.”
“like there are natural things that you could do on the women's side like dhea i'm sure at some point we would have ended up talking about not meaningfully impactful for men's testosterone levels because the majority is driven through intratesticular testosterone”
“a significant chunk of that could be driven through dhea mediated conversion and if that is the case in your low dhea via an assessment of the biomarker dheas typically as a proxy”
“sulfated dhea you may highly benefit from like a basic dhea oral supplement that's like you know uh easier to predict what's going to happen it's like an actual marker you can point to as deficient based on like”
“favorably to an adequate dhea dose when warranted for testosterone conversion like i've seen pretty dramatic changes to the degree of women on combined oral contraceptives attenuating entirely the loss in testosterone production via”
“benefit from some suppression it kind of depends like some women need to use like anti-androgen to maintain like a more neutral profile to not get like hirsutism and whatnot which is like like hair growth that would be reflective of like masculine characteristics um so yeah like in”
“androgen related activity in the scalp that's where you can then look to you can have a bit of a top-up like ketoconazole shampoo for example is like a mild anti-androgen too that could add some additive protection on top of let's just say you're on finasteride instead of the more”
“some extent depending on i don't know if you're prone to like i don't know fungal overgrowth for example but in general it's like a mild 5-alpha reductase inhibitor and topical anti-androgen that's just like a good shampoo that doesn't require like the risk profile of a finasteride dutasteride but it's like”
“Avoid your multivitamin, probably, if it has biotin in it or biotin-containing supplements., and be hydrated to reflect your actual haematology profile correctly”
“from a mineral side, you know, you have, you know, magnesium, zinc, and the vitamin D3 are going to be three things that specifically on top of the minerals and vitamins that everyone's familiar with from multivitamins and what not are more difficult to get in adequate doses”
“And then the vitamin D it's fat soluble. Typically, you're going to have anything like a soft gel or something. And it's not always going to be at the dose you need in the multivitamins. It's just worth noting. So those are just some low hanging fruits that are, if you don't look to those as part of your micronutrient optimization strategy, like you could be overlooking low hanging fruit.”
“interaction with the oral combined oral contraceptive pills, depending on which drug they're using. In general, ethanol estradiol plus some progestin, depending on how androgenic the progestin is, it'll depend on how much the SHBG goes up. But you'll see in adolescent women or women who are in full adulthood that are taking combined oral contraceptives, their total”
“And that's only with oral. That's with oral, but like any sort of progestin that is synthetic will have negative feedback to some degree, all but much lesser so via a localized IUD releasing a levonodogestrel or something.”
“via the progestin and estrogen induced suppression through the DHEA. So like by that, I mean starting off with like a 70 total T, getting suppressed down to like, you know, 30 or something on your combined oral contraceptive, taking DHEA and getting back up to 70 while you're still on the combined oral contraceptive.”
“You know, otherwise. Otherwise, it would get through your diet, but likely not sufficiently. Maybe zinc you might, but, like, magnesium. Pretty difficult, I would say, for a lot of people. They don't realize how deficient they are. And then even, like, supplementing accordingly. It's, like, you know, getting one that you respond, that you tolerate well with your digestive system.”
“and your blood work and your symptoms and kind of go from there in your opinion like let's say someone is on the deficient range of vitamin d their inadequate magnesium perhaps their zinc is you know maybe okay or in the in the inadequate range would getting to that sufficient status”
“Zinc, magnesium, vitamin D, not in order, just the top three, I would say. And then I guess for impact, I would probably say like Tongkat Ali, but probably boron would be my safer next choice just for like safety profile.”
“And, ideally, you would have not taken certain confounding variable supplements like biotin that can cross-detect as, you know, estrogens and whatnot.”
“Avoid your multivitamin, probably, if it has biotin in it or biotin-containing supplements.”
“isn't super robust it is uh boron so that potentially has a suppressive effect on shbg levels there's some literature that looks promising all but i wouldn't hang my hat on and say it's”
“a bigger bang because it's doing it's working in two different ways it's a good question boron is a mineral that is um seems to be something that is”
“Withanolides not just your standard run-of-the-mill generic ashwagandha you want to look for Ideally a patented you know uh Sensoril or a KSM-66 these are patented formats of ashwagandha that are standardized to a um target yield so you know that what you're getting is what you're supposed to be getting”
“ksm 66 that's five percent sensoril is ten percent the difference between why you would pick one or the other is the actual total dose you could get away with using less milligrams of”
“the less that hcg is not like a bioidentical gonadotropin for men that you would otherwise be using to shoot to your testes it's like a replacement for it and recombinant fsh is like it's fsh but it's still like grown in a lab it's not from your pituitary does that matter i don't”
“recombinant fsh is insane and hcg in itself is expensive and then you're stacking that on top of your testosterone that you're using it's not necessarily an affordable thing for everyone so a lot of guys just let their testes atrophy because that's what they can afford to do and they want to still get”
“one that is notable that might do something is shilajit. If you get a high quality shilajit, it may provide enough, like the actual capacity of your organ to respond to hormones is partly conditional on its ability to tolerate stress and reactive oxygen species locally too”
“kind of like net out more local hormone yield. So shilajit seems to be impactful on intratesticular antioxidant activity, but I wouldn't, uh, it's another one that requires like careful sourcing.”
“but in general if you're using it properly and at a high enough dose you will be limited by this enzymatic pathway and there are ways to upregulate it one is compounding the minoxidil with tretinoin which can upregulate the sulfo transferase enzyme and allow more of that conversion to take place”
“i would escalate to like the pharmaceutical compounded route at that point if you needed to with like the tretinoin compounded minoxidil um it's funny the microneedling like i'm interested in for skin effects and so yeah people use on their face too like oh yeah so i you know it is”
“itself as well. So I think from a minerals and vitamins standpoint, the low hanging fruits are typically going to be like B vitamins, but in particular, like from a mineral side, you know, you have, you know, magnesium, zinc, and the vitamin D3 are going to be three things that specifically on top of the minerals”
“Let's just say you get a blood test and you see where you're at. From there, you can start doing some of the minute changes, like putting, you know, a chlorine filter on your shower head, do this, change your water source, whatever. Do you notice an incremental uptick in your gonadotropin output or your response to it at that point?”
“people are more like susceptible to a placebo effect where they like believe in something and it's gonna happen and i'm like like i'm taking all my creatine i'm like yes i'm like i'm not getting sleepy in the afternoon and it could be placebo but i don't care because it's a real effect right”
“I think a lot of those have been disproven like tribulus, D-aspartic acid, fenugreek.”
“So primary hypogonadal, like you're gonna probably be on exogenous testosterone and it's literally like testosterone. You can't fix it with enclomiphene. You can't fix it with HCG. You can't fix it with HMG. There's no other way around it.”
“You can't fix it with HCG. You can't fix it with HMG. There's no other way around it.”
“or the cream and the other method is intranasal which i'm sure you've probably heard of for like you know hypoactive sexual disorder for women has a potential for that um as well as uh for men as”
“ketoconazole shampoo for example is like a mild anti-androgen too that could add some additive protection”
“much lesser so via a localized IUD releasing a levonorgestrel or something.”
“that? Is that so? It's like a very terrible blood pressure drug. So, it was originally prescribed for uh high blood pressure as a Loniten, oral, yeah. Oh, I thought it was topical, yeah. So, what they found when they prescribed it for blood pressure decades ago was that one of the side effects, besides like”
“You should see the nutty shit that people on like Reddit and whatnot dump on their heads. Melatonin right yeah. I think sulforaphane was one too at one point broccoli sprouts on the head didn't end up working though um i'm sure it has like some like indirect benefit for like systemic health but like at the end of the day the unfortunate reality”
“don't use you know plastic tupperware and like heat it up and stuff like that”
“Ideally a patented you know uh Sensoril or a KSM-66 these are patented formats of ashwagandha”
“Or, sure, get a shower filter. But, like, it's not going to be the game changer.”
“That's the reality for a lot of guys. I think in Europe, they do testosterone undecannoate maybe, or it's either a Sustanon formulation, maybe it's undecanoate and they'll do like one shot every like few weeks. It's crazy. So they'll like shoot their test into the stratosphere and it'll like crash into hypogonadal territory and then they pin again or shoot, inject.”
“i would not do pellets i would probably not do androgel if you're a male”
“Tlando um Jatenzo and Kyzatrex, and they've basically managed to make a lymphatically absorbed testosterone undecanoate you can actually swallow orally whereas back in the day they would have had to make it hepatotoxic to actually make it through the liver”
“undecanoate lymphatic absorption patented format so there is three i believe t Tlando um Jatenzo and Kyzatrex and they've basically managed to make a lymphatically absorbed testosterone undecanoate”
Also filed under Testosterone Undecanoate
“but in particular, like from a mineral side, you know, you have, you know, magnesium, zinc, and the vitamin D3 are going to be three things that specifically on top of the minerals and vitamins that everyone's familiar with from multivitamins and whatnot are more difficult to get an adequate doses.”
Also filed under Vitamin D
“because they have these auto injector pens that are pre-loaded so you like have to shoot it in one shot or you don't take it yeah so like Xyosted is like the pre-loaded testosterone and anthate pharma grade that is often prescribed and it's like well you gotta you either do the one shot one kill and take the whole dose or you like don't take it”
“Yeah. Like, in general, I think the most reliable things that move. The needle, if you were deficient, what is, I don't know, people are familiar with the ZMA. It was, like, the first, like, combo supplement that was sort of seen as, like, a testosterone booster that was available on the market.”
As referenced on air, with the quote and the moment. Reported, not evaluated.
“there's the, the Traverse trial that came, that's kind of, we got some pre, pre-publicate, like pre, pre-data here where it seems as though, um, this is a very large trial placebo controlled where it seems as though men, these are older men that were, at least it seems to be hypogonadal, like they were low testosterone.”