Why You May Need Supraphysiological Testosterone Levels

Dr Keith Nichols explains Why You May Need Supraphysiological Testosterone Levels.
✅ ➜Watch This Next: "EVERYTHING You Need to Know about Testosterone Cream" • EVERYTHING You Need to...
0:00 intro
0:21 What if you can not get compounded TRT cream / Atrevis base
1:51 High hematocrit and prostate cancer: cream vs injections
4:22 Supraphysiologic range
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*Disclaimer: This video and comments are meant purely informational! This is not medical advice! If you are looking for medical advice always contact your own doctor.
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[@TRTandHormoneOptimization]

✅ *➜Watch This Next: "EVERYTHING You Need to Know about Testosterone Cream"* kzbin.info/www/bejne/n52QpGNnrLlqeZY 📘 *➜e-book: "The Ultimate Guide to TRT Cream" Why Compounded Testosterone Cream is the BEST option for TRT, by Dr. Steven Devos MD PhD:* www.trtandhormoneoptimization.store/listing/e-book-the-ultimate-guide-to 📘 *➜e-book: "Acne on TRT", by Dermatologist Dr. Steven Devos MD PhD:* trtandhormoneoptimization.store/listing/acne-on-trt 🔶 *➜JOIN this channel to get access to perks:* kzbin.info/door/oLNk-4LAYsbfsQwjFWG2gQjoin 🏋🏼 *➜Best workout split on TRT:* trtandhormoneoptimization.store/listing/workout-program-for-men-on-trt

[@Senick]

"Do not use any alcohol based products on your scrotum", sounds like solid advice

[@TRTandHormoneOptimization]

100%

[@SicilianAmericanDreams]

Lol 😅

[@silverranger7142]

I've listened to lots of talk on trt....this is absolute gold!

[@TRTandHormoneOptimization]

@silverranger7142 Thank you *so much* !

[@marshallsaltzman9924]

Damn good content. Nichols knows what he’s taking about. As does Steven.

[@liftingdermatologist]

Thanks!

[@TRTandHormoneOptimization]

I appreciate that, @marshallsaltzman9924

[@gamechanger8494]

One of your most informative videos.

[@TRTandHormoneOptimization]

Glad you think so!

[@daviddavid1057]

Two great Doctors from whom you can learn a lot! We look forward to seeing other video from you! Thank you so much!🙏🏻

[@TRTandHormoneOptimization]

Glad you like them!

[@larryhobbs8769]

Love Dr Keith. Could listen to him for hours on TRT. Thanks Steven

[@giovannigiorgio8664]

Excellent show, great info.

[@liftingdermatologist]

Thanks!

[@TRTandHormoneOptimization]

@giovannigiorgio8664 Thank you *so much* !

[@barrie888]

i am a Dr , also on HRT, totally agree that undertreatment is a sig issue, my own free t is 44 ng/dl and feel great

[@duitsland2756]

Best TRT Video ❤. Looking forward to the hematocrit video.

[@TRTandHormoneOptimization]

Awesome! Thank you!

[@rikt350]

Great video Thank you

[@TRTandHormoneOptimization]

Glad you enjoyed it

[@rikt350]

That’s all I needed to hear Dose is staying up 👍

[@TRTandHormoneOptimization]

Alright!

[@adamcatchesfish6148]

This guy is spot on

[@TRTandHormoneOptimization]

Thanks!!

[@brandonmills6330]

Great Dr.

[@TRTandHormoneOptimization]

@brandonmills6330 Thank you for sharing!

[@narmypara100]

Excellent content 💪

[@TRTandHormoneOptimization]

Glad you enjoyed it

[@Mark-ks9jj]

Always a pleasure to listen to you speak Keith. The frustration many men feel around this topic is huge. If you are above the range that's been arbitrarily set by some committee is stupidity raised to some ridiculous power. Optimised treatment to achieve the best symptomatic response is nuanced, something that doesn't fit cookie cutter medicine. Thank you for speaking about the science & pharmacological reality.

[@keithnicholsmd6896]

Thank you for taking the time to comment and it's a pleasure to hear that others are listening and it's making a difference.

[@TRTandHormoneOptimization]

I appreciate that, @Mark-ks9jj

[@bintherdundat]

Amazing video! There are so many pearls of wisdom in this video that I have been searching for, it kind of blows my mind! Thank you, thank you, thank you!

[@keithnicholsmd6896]

Glad I could help. I have found that too many people ignore the actual physiology of how testosterone works. So much miss information out there and so much bro science it can be very confusing. Thanks for listening and commenting

[@liftingdermatologist]

Thank you!!!

[@TRTandHormoneOptimization]

I appreciate that, @bintherdundat

[@flow2tech]

​@@keithnicholsmd6896 wow! Amazing info and new take on all of this Dr.. I feel I'm fear mongered with many of the videos guys like Thomas O'Connor releases. ..It's almost as if starting TRT has a cascade of dangerous effects that have to be constantly monitored once u embark on that path.

[@FadetoBlack1463]

Please do that video on Hematocrit and Prostate!

[@keithnicholsmd6896]

We will!

[@sk8orhate55]

@@keithnicholsmd6896i second that please do a video on that. Also, I’m on 20mg xarelto for life. Ever since i came off of trt I’ve felt like hell. Is there a way to keep hematocrit in an optimal / healthy range . I feel like such shit I’m willing to take the risk with trt/ dvts. It’s literally unbearable. I’ve had a doctor tell me if i don’t stop taking HRT I’ll die. Fun fact that was in 2017 and I’m still here. The medical world is so fucked up in the USA it’s disgusting

[@erik1974Fortal]

That's perfect. I felt nothing with a small TRT dosage. I only got better when going supra physiological.

[@TRTandHormoneOptimization]

@erik1974Fortal Thank you for sharing!

[@pecospelagodroma]

Fantastic information! I wish my doctor knew some of this :(

[@TRTandHormoneOptimization]

@pecospelagodroma , Thank *you* for watching and *commenting* !!👍

[@quantumfx2677]

I wish there was a well put together manual on these truths & sent directly to every doctor across the globe! Some of these doctors have Egos so big they would simply throw it in the trash. But hopefully enough would not and hormone replacement would start down a true path really helping people!

[@SicilianAmericanDreams]

I will be bringing this video to my next doctor appointment to educate my doctor! 😅

[@riggs9688]

The total range used to be 500-1500ng/dL. I personally like being optimized around 1200-1500…

[@keithnicholsmd6896]

We all do! And that's the message in this video.

[@riggs9688]

@@keithnicholsmd6896 Great info! Thank you, it’s great to see doctor go for symptom resolution and not chase a number.

[@liftingdermatologist]

Me too!

[@TheRabbit91476]

I hove about 1000. Went up to 15. Could not sleep past 230 am. Always tired estrogen was 90

[@ethancowart6765]

Wow when did this use to be the normal range ??

[@caseycrossman4824]

Great information I am also very interested in the hematocrit video as I have been thinking maybe I need to go off of TRT after eight years because obviously the goal is optimal held. Then I worry about the thick blood. I also worry about the fact that my own production is probably Toast, so I am reliant on testosterone for the rest of my life to feel good. I have no problem taking testosterone, but what if for some reason I couldn’t get my hands on it.

[@lapatria100]

Quality!!!

[@TRTandHormoneOptimization]

Thanks!

[@jsyazbeck]

Fantastic summary, could relate to a lot of what he said. Took almost a year to dial in. And your t levels aren’t going to fix everything in your life.

[@quantumfx2677]

I wish there was a well put together manual on these truths & sent directly to every doctor across the globe! Some of these doctors have Egos so big they would simply throw it in the trash. But hopefully enough would not and hormone replacement would start down a true path really helping people!

[@krane15]

Its not just the doctors, but the propaganda out in society that feeds them.

[@whpg]

Please please please record another show on 2nd erythrocytosis. I’m tired of explaining it to clinicians that continue to propagate discontinuing T based on mild expected elevations of Hbg and RBC’s. Drives me crazy!!!!!

[@TRTandHormoneOptimization]

We will

[@erick6102]

You guys continue to put out great content. Thanks so much for this information. Testosterone cream has made such an improvement on my life. I have no idea why someone wouldn’t want to try the cream over needles. Applying the cream is easier than brushing my teeth. I can bring my bottle anyway and apply it twice a day no matter what I’m doing. My sex life is as good as it’s been since my 20s and 30s (I’m 50 now) and I’m running and lifting like I was in my 30s. I’m lucky enough to have a Dr that supports my TRT as well. Thanks guys!

[@SicilianAmericanDreams]

Cream is more expensive is why people don't use it. I wasn't even offered the opportunity for it my insurance wouldn't cover it, insurance only cover IM version

[@erick6102]

@@SicilianAmericanDreams my insurance doesn’t cover any of it cause my total t was just above the low threshold. Which sucks cause I felt like mud and my libido was barely there. It costs me 60 bucks a month for cream. Small price to pay for the benefits of TRT and ease of application for the cream.

[@SicilianAmericanDreams]

@erick6102 that's great! 60$ for cream?!? I pay 40$ for IM and I was told cream is like 200$ interesting 🤔 maybe I'll look into switching at some point. Thank you for your comment!

[@erick6102]

@@SicilianAmericanDreams no problem, the pharmacy is in San Diego. Not sure if our area / state is just cheaper.

[@Xotty]

That is what I am dealing with. My level was 1200, out of the range but felt awesome. My doctor decreased my does and now I am suffering from low T symptoms around 600.

[@keithnicholsmd6896]

We see it all the time and I'm so sorry it happened to you, but it happens to so many man every day. Just find a new doctor that understands testosterone.

[@user-oh5ic4fy2h]

Doctors need to stop treating numbers only

[@greybuckleton]

Quite interesting what he said about early 30s. Sure was my life experience.

[@MontezumasViper]

What about the effect of TRT on ferritin and iron blood markers? TRT does some wild and scary stuff to RBC production. Cells that are too small and varying sizes... Part of the thinking behind not bumping numbers high is avoiding this. It also screws up pregnenolone and progesterone. This video is another win in the corner for Enclomiphene.

[@keithnicholsmd6896]

85 years of use do not support what you're stating here and unfortunately you've just been exposed to the misinformation that is rampant in the space. It doesn't screw up pregnenolone or progesterone. We doing a video very shortly on the secondary erythrocytosis from testosterone. Please stay tuned and listen to some of the Contant and hopefully I can help you unlearn and dispel some of the fears that you have. These fears are not based on 85 years of medical data.

[@LTx_z71]

I've been taking test prop keeping it at 250 to 300 mg per week going on 8 weeks into a 10 week cycle. 34 years old my blood test came back 3290 ng/dl total test. Free test is 146 ng/dl estradiol 80 pg/ml have not used an AI at all feel fine for being that high slight headaches or oily face maybe a lil irritated but nothing I can't control. This is my first ever cycle. I was going to stretch it to 12 weeks but I think that's pushing it too much being my free test is that high I didn't think I would of been a hyper responder

[@HeritageCast]

Like to see Dr Nichols and Dr Tom Travision debate... Someone needs to take Harvard and the FDA to task...

[@KingDeron]

How can I get this guy as my doctor!

[@michaelphasey-sharp9457]

I am self medicated as clinics in uk are to expensive that i had to leave, still doing same dose of 200mg of cypionate split EOD and my total test is 65.2nmol which puts my free test way over 1000 i can attest i dont feel like a super human but symptoms have kind of subsided other than slight headache here and there. Liver is fine, cholesterol all good etc only issue is slightly elevated H & H

[@MrGreeny1911]

It’s much more than testosterone rewarding the effort. Testosterone gives you the motivation confidence, grit and determination to do something about the physical and mental gutter you’ve been living in due to low T.

[@keithnicholsmd6896]

I understand your comment but from a clinical perspective every doctor will tell you that we have plenty of men that have excellent testosterone levels that don't have a lot of motivation or determination. As I tell people testosterone is not motivation in a syringe or in a cream. Motivation comes from within. The truth of the matter is some people can be lazy with good testosterone levels. I am careful of what I will say it will do. It Will improve symptoms of a deficiency. Now whether or not somebody is willing to put in a sweat equity is a different story.

[@arthurfonzarelli9828]

​@@keithnicholsmd6896interesting. Would you agree with this statement, I've been on TRT for a decade and a handful of times I've had to stop for a week or so because my order was late for various reasons and every time the first thing I notice is I feel different, non-motivated. Maybe that's just because my body isn't making any on its own I guess. So I guess I would say I agree That testosterone doesn't make me motivated but when I'm on TRT and I stop it I lose all my motivation and it's the first thing I notice

[@jacquesfourie867]

Can you discuss the breakthrough oral trt just released

[@keithnicholsmd6896]

There's nothing breakthrough about it.. Just like many other pharmaceutical versions of testosterone it will raise your testosterone levels a little bit at a great expense if it's not covered by your insurance and in order to be covered by your insurance, you have to have a diagnosis of hypogonadism meaning that you've tested twice fasted in the morning and had low testosterone levels. It is dosed to maintain testosterone levels between 450 and 970. In a four month trial they used in men they had an average testosterone level of. It is dosed to maintain testosterone levels between 450 and 970. In a four month trial they used in men they had an average testosterone level of 489+/_ 155 ng/dL.

[@bn12595]

Dr Nichols is great. My doctor also studied under Dr Neil Rozier. 2 years I've been on hormone optimization and I'm 62. Healthier now than I was at 40. Remember, hormone optimization is only 20% of the cure for metabolic syndrome. 20% is exercise. 60% is what you eat and when you eat it. Sugar is poison. High protein, low carb. You must intermittent fast 16+ hours a day to overcome insulin resistance. No snacks. My fasting insulin was 11.8. Now 4.2. My total T was 240, now 1137. Very little body fat. I have BPH and high Cholesterol. My LDL has always been above 220 and 40 HDL. I don't think my body is aromatizing Estrogen. Starting Estradiol. Hoping for great results.

[@coryholmgreen1947]

Exploring this as an option for my insulin resistance as well. Great to see that it's working well for you. Gives me hope!

[@brandonyoung4910]

Have you never checked estradiol?

[@roguejimo736]

It's irrelevant.@@brandonyoung4910

[@harryjohnson370]

I promise you, estradiol is the key for guys that struggle with trt. I supplement estradiol now at 43 years old. Never had to before. I believe years of exemestane use while bodybuilding permanently destroys aromatase enzyme in some men. My body hasn't ran on endogenous test in a decade. 2 years ago I started estradiol supplementation. Best ive felt my entire life. Libido is raging. Skin issues gone. Sleep like a baby once again. It's hard to discuss this on message boards, because everybody assumes estrogen is for trans men wanting to be female. There's quite a few men that find relief with estrogen. It would be awesome if this channel would make a video on men taking estrogen in addition to their TRT

[@brandonyoung4910]

@@harryjohnson370 Some men just produce much less aromatase enzyme than others. you are in the minority by far my friend.

[@SicilianAmericanDreams]

They need to go on JRE Podcast!

[@clintcarter]

Where the video on prostate cancer!! Thank you in advance!

[@TRTandHormoneOptimization]

Here: kzbin.info/www/bejne/hZDdqICAaZqUf7ssi=xHAKZ8hqeeZHHwiD

[@clintcarter]

@@TRTandHormoneOptimization 🙏🙏💪🙏🙏

[@chriscollins8327]

hello DR.Nichols i recently started trt and i switched to cream 25% over the cypionate and im feeling really goodI want to thank for information especially about shaving scrotum before application of cream with a regular razor not an electric razor"GOOD STUFF" but it does seem that people always end up going back to cypionate my Dr. said same thing to me but what are your thoughts on that.Thanks

[@keithnicholsmd6896]

That has not been my experience at all. Stephen and I haven't gone back to injections. Why would we go back to injections? When the cream works as good if not better for us than the injections did there's no need to go back to injections. But here is your answer in a nutshell because I see it all the time. People that make comments like that such as your doctor have no real experience with the cream and a long-term experience with the cream. They haven't treated literally thousands of patients with the cream as well as injections. So in a doctor makes a statement like that that doesn't have any real experience just let it go in one ear and out the other. If you're feeling good there's absolutely no need to change. I will tell you though that a 25% solution is a little more than should be compounded. The reason we use a 20% solution is because anything more than that has a high likelihood of precipitating out and not working. In other words you can only put so much solid and a liquid and 20 mg/ gram is what a reputable compounding pharmacy will tell you is the maximum amount once again to prevent the testosterone from precipitating out

[@manmedicine]

Outstanding. Common sense is not common.

[@keithnicholsmd6896]

Thanks and just to let you know you do excellent work.

[@WJHandyDad]

the lab my doc uses says T should be between 200-700. I was at 700 and my doc said "that's too high, we need to lower your dose" even though I feel like crap with a lower level and feel pretty good at ~700

[@arthurfonzarelli9828]

I can help you with your problem, get a new doctor. Seriously 90% of the doctors who take insurance probably even higher have no clue on how to deal with testosterone. You're fighting losing battle it's better just to pay out of pocket and get good quality service

[@DB961]

You need to change doctors, they have no idea what they are talking about

[@DB961]

@@arthurfonzarelli9828 I could not agree more. Pay out of your pocket and get the best care.

[@jksjksjks3339]

Women must take progesterone if taking excess testosterone, also daily dose of Iodine/Iodide. T will aromatase in women and cause 5 different types of cancers when T/estradiol are not balanced with progesterone. Women (and men) also need to supplement iodine/iodide (lugol’s or equivalent) for optimum gland function.

[@keithnicholsmd6896]

Testosterone does not aromatize in women and cause cancer. It is used to treat women with cancer and in high doses. Your information is completely false. Testosterone is apoptotic to breast cancer cells. You need to look at the work by Dr. Rebecca Glasser in women with breast cancer, utilizing testosterone.

[@TheArcoffire]

Please do the video on the correlation with prostate cancer I really want to hear that I recently had a scare of prostate cancer It turned out to just be prostatitis but I would really love to hear this guy from this videos opinion on that and so please do that video soon

[@v2mp1re]

correlation can appear because of too much DHT conversion, just use 5mg tadalafil eod to control PSA lvls and that's it (that's what we do in europe).

[@keithnicholsmd6896]

@@v2mp1re not true!

[@keithnicholsmd6896]

Testosterone and Prostate Cancer: THE HISTORY OF DR. HUGGINS, DR. MORGENTALER, AND THE SATURATION MODEL The belief for over seven decades has been that high testosterone causes prostate cancer or increases a man's risk of developing prostate cancer, that low testosterone is protective against prostate cancer, and that if you raised testosterone you would cause an existing prostate cancer to grow rapidly…The “equivalent of pouring gasoline on a fire”. Now where did this androgen hypothesis originate? It came from a paper written in 1941 by two urologists Drs Huggins and Hodges. Dr. Huggins was a very well-known urologist who in fact went on to win the Nobel Peace Prize in 1966 for his work with hormones and cancer. In this paper they looked at men with metastatic prostate cancer. Back then there was not a PSA test so they looked at something called prostate acid phosphatase as a serum marker for metastatic prostate cancer. In this study Dr. Huggins reported that when men were castrated either surgically or chemically the acid phosphatase levels went down. He also gave testosterone injections to men and he reported that in every man that got testosterone injections the acid phosphatase levels went up. Now this was an important paper at the time because it was the first paper that identified a cancer to be hormonally sensitive. This paper established three things: 1. That prostate acid phosphatase could be used as a serum marker for metastatic prostate cancer. 2. Castration was effective for metastatic prostate cancer. 3. Testosterone injections given to men with metastatic prostate cancer was dangerous. Now when you take a closer look at the paper you see that testosterone injections were only given to three men. Results were given for only two of those men and one of those men had been surgically castrated so he was no longer hormonally intact and what we would call "androgen deprived “. So the general conclusion that "cancer of the prostate is activated by testosterone injections” was based on one hormonally intact patient who received testosterone injections for only 18 days who's acid phosphatase levels went up and down and were essentially uninterpretable. So decades of depriving men of testosterone was based on the over interpretation of the results of one single man in one study Now you may wonder how that can happen but the problem was that in the 1940s and 50s there weren't many physicians with experience using testosterone so no one had an adequate knowledge to question the results so it became dogma… that testosterone was dangerous for prostate cancer It wasn’t until the 1990s that a Harvard urologist by the name of Abraham Morgentaler began to question the validity of the Androgen hypothesis. In 1988 he began treating men with sexual dysfunction and low testosterone levels with testosterone . At that time there wasn't any Cialis or Viagra so treatment options were limited. What he noticed was that not only did they improve sexually but they also improved both physically and mentally. Now at this time his treatment defied standard medical practice because in the 1980s testosterone therapy was limited to three groups of men 1. Men who had congenital or genetic disorders like Klinefelter's 2. Pituitary disorders 3. Those with absent testes from injury or illness etc… He became concerned because some of his colleagues warned him that he could potentially be causing harm based on the work of Dr. Huggins. So in 1992 he began performing biopsies prior to initiating testosterone therapy in symptomatic testosterone deficient men who had normal PSA's and digital rectal exams in an effort to rule out an existing prostate cancer. What he found was 11 out of the first 77 men that he biopsied had prostate cancer. Now remember low testosterone was supposed to be protective against prostate cancer and what he found was that approximately 14% of men with low testosterone levels had prostate cancer. Now this percentage was almost the same as the percentage of men that have prostate cancer with increased risk factors such as an elevated PSA or a positive digital rectal exam. So low testosterone was found not to be protective and these findings were published in the Journal of the American medical Association in 1996. So now that he knew that low testosterone was not protective , what about high testosterone being harmful? In 2004 Dr. Morgentaler published the paper “risks of testosterone replacement therapy and recommendations for monitoring” in the New England Journal of medicine. For that paper he performed a review of the World literature between 1985 to 2004 looking for any worrisome relationship between testosterone and prostate cancer or testosterone therapy and prostate cancer. He was unable to find a single article that testosterone increased a man's risk of getting prostate cancer or that testosterone therapy caused prostate cancer progression. He also made the observation that with a 10 fold increase in testosterone prescriptions after the release of Androgel in 2001 there was not an epidemic of prostate cancer. We know that 50% of men more than 50 years old have micro foci of prostate cancer in their prostates. If Increasing levels of androgens cause cancer to grow more rapidly then we should see more cancer growth in these men but we don't. The observation has also been right in front of us for decades that younger men with high testosterone levels don't get prostate cancer but instead it is a disease of aging when testosterone levels decline. So in 2007 Dr. Morgentaler developed the saturation model to make sense of two opposite observations that the data reported. Castration decreases testosterone and the PSA goes down. If you increase testosterone levels out of the castrate range the PSA also increases. But the data also shows that for most of the range of testosterone levels including supraphysiologic levels there's no change in PSA level or prostate size. This is because androgens have a limited ability to stimulate prostate tissue. In order for androgens to exert an effect on prostate tissue they must first bind to the androgen receptor. Once the androgen receptors are fully saturated with androgen any increase in androgen will simply be excess. This saturation of the androgen receptors occurs at a very low level which is around 250 ng/dL. Above this level androgens have no further effect on benign or cancerous prostate tissue growth. Think of the prostate like a house plant. If you deprive the plant of water it will shrink. If you give it water at this point it will grow. Giving it any additional water past this point will have no effect on growth. You could give it a constant water supply and it will never grow into a tree. Once it's thirst has been quenched giving it any additional water will have no effect on growth and the same goes for testosterone and the prostate. So what does the modern data show us? 1. In hypogonadal men testosterone therapy does not increase the risk of developing prostate cancer even in high-risk individuals. It may in fact have a protective role against high-grade cancer and Studies have shown that higher levels of testosterone can suppress prostate cancer growth. There is an inverted U with regard to prostate cancer cell proliferation and testosterone levels. At low Testosterone levels there is suppression of prostate cancer cell proliferation, between castrate levels and the saturation level (hypogonadal) there is growth, and with high levels of testosterone there is once again suppression of prostate cancer cell proliferation. The unfortunate reality is that about 1 in 6 men have prostate cancer and if you are in a clinic and you're seeing at least 60 patients then you are most likely treating at least 10 men with active prostate cancer. So all of these clinics are in effect treating men on active surveillance with prostate cancer without any detrimental effects. 2. Testosterone therapy does not increase the risk of progression in men on active surveillance. In fact, Low testosterone is a predictor of who will progress on active surveillance 3. Testosterone therapy does not increase the risk of biochemical recurrence after treatment of prostate cancer by radiation therapy or radical prostatectomy. Studies have shown decreased recurrence rates in men on testosterone therapy. Multiple studies have revealed that low testosterone is associated with 1. An increased risk of developing prostate cancer and higher grades of cancer 2. A more advanced stage of cancer at surgery 3. A increased rate of recurrence after surgery 4. Decreased survival The current landscape of TTh in the setting of PCa has gone through several paradigm shifts from viewing testosterone as potentially dangerous (the proverbial ‘‘fuel to the fire’’) to generally safe, and now to a protective measure and potential therapy. J Keith Nichols MD .

[@TheArcoffire]

@@v2mp1re I have no idea the Cialis had any effect on PSA levels That's very interesting

[@keithnicholsmd6896]

We are going to do a video on it. I tried to send you an attachment, but I guess it was too much in one message.video on it. I tried to send you an attachment, but I guess it was too much in one message. Send your email and I'll send you an attachment, explaining testosterone and prostate cancer in detail

[@jeffmorabito10]

It depends on individual. Theres a study out there where they had patients on 600mg a week of Test and no issues.

[@keithnicholsmd6896]

Those are the Bhasin dose response studies are they were given 25, 50, 125, 300, and 600 mg for 20 weeks

[@andre.shaw91]

@@keithnicholsmd6896 what about impact on heart health? Don’t levels above the range cause ventricular hypertrophy? Have you seen this in any of your patients and if so at what levels? Also, cream causes DHT to rise 3-4x the reference range and DHT has been shown to have an effect on cardiac remodelling. Have you see any evidence of this actually occur in practice? Just trying to determine at what levels there is cardiac risk on trt. I am going to see a cardiologist soon to see if any hypertrophy from trt usage.

[@keithnicholsmd6896]

@@andre.shaw91 it's been studied for 85 years or more and it's never caused those issues. You need to understand the normal range and then you understand the optimal levels that we are talking about we're actually normal previously. We're not talking about bodybuilding abusive numbers. But numbers between one and 2000 were completely normal in the past. The normal range presently is based on a group poisoned men (EDCs) that do not produce much testosterone anymore. As I have stated in previous videos every parameter of health that we can measure improves with optimal levels but it does not when we maintain sub optimal levels (mid normal range). Please watch the video on DHT. It will explain your concerns. The answer to your question is that testosterone does not cause any of the issues you're concerned about but that does occur with anabolic steroid abuse

[@Frank-gd5zk]

there has got to be more to it than just a super physiological level of testosterone. I mean you’ve got to look at lifestyle, factor such as diet, blood sugars, sleep, emotional stress. There are so many factors that I think it would be almost possible to get to that one proper number for most men.

[@keithnicholsmd6896]

Unfortunately, that will never be the case with regard to one proper number for most men. That is because due to genetic variations with regard to androgen receptor sensitivity every man will have his own number. In addition, varying levels of SHBG will have a role on available free testosterone. And now, in this day and age, we also have to factor in exposure to environmental toxins that interfere with testosterone, actions and compete for the antigen receptor as well. All of these factors lead to one path, and that is to treat based on symptoms, and not a number.

[@betterplacetobe7896]

I take 400mg Test E per week for 3 years now. Bloodwork is optimal, blood pressure healthy range. Calcium score 0, echocardiogram normal. My lifestyle is on point and diet is really clean.

[@Capt_Curious]

Lucky dog. I can’t take more than 200mg of cyp or my face feels like it’s going to explode when I lean over

[@zmb5501]

They are scared to power up man.

[@krane15]

If anything, the legislature and the medical community would favor just the opposite. If the male population are all passive, they're a whole lot easier to deal with.

[@BigNord]

@@krane15 United Sheep of America

[@plankroad8062]

At 1100 to 1500 test are you recommending low dose arimidex. There seems to be a conversion about not using an ai . I personally feel better using 1/2 mg split twice a week , my test is 1200 and i get anxious as hell and emotional when i dont use any ai

[@boxerboss5284]

That anti aromatose inhibitor guy, Bossa?, would tell you to up your dose to 200+ and micro dose the TRT everyday lol😂

[@BigDees19]

Do a how to control hematocrit and how to self check at home with cheap at home realiable machine you could save lives

[@keithnicholsmd6896]

We will be discussing this in another video, but the increase in hematocrit from testosterone has never been shown to cause harm in any study today. It has been used and abused for 85 years and the increase in hematocrit has never caused harm just like it doesn't cause harm when we live at high altitude. But an upcoming video will discuss this in the miss information about it. Thanks for commenting.

[@lectrix8]

Seems like a good approach is to go up to a slightly supra-physiologic range, and titrate down to where undesired sides go away. If the sides are purely estrogenic, then leverage an ai before needing to lower the test.

[@keithnicholsmd6896]

In thousands of patients I've never seen estrogenic sides, nor have any of them had to use an aromatase inhibitor. When we were both in our late teens and early 20s with excellent testosterone levels, we didn't need an AI. Why would we need one now? If testosterone therapy is done correctly there's never a need for an aromatase inhibitor. Men just tend to ignore or forget, or maybe they were never taught the actual physiology of testosterone. Testosterone exerts the majority of its actions through its active metabolites at the tissue level. So in order for testosterone to provide us with the beneficial effects in our brains, bones, heart, blood vessels, sexual organs, etc. it Has to be converted into its active metabolites, and that's why they're called active metabolites. When we block those active metabolites, we block the beneficial effects of testosterone at the tissue level. Men think that testosterone does all the work as testosterone, but it does not. It works through It's active metabolites.

[@AlchemyOfEvilAndLight]

​@@keithnicholsmd6896 last test 800 total free 40 estrogen 45 still feel like trash that was 160 mgs a week 190 mgs I bloat up feel lazy, what if I go 300 mgs a week?

[@zmb5501]

New netflix documentary idea, The supraphysiological man. Morgan freeman voiced.

[@7end7fan81]

😂

[@liftingdermatologist]

LOL

[@krane15]

I wouldn't

[@narmypara100]

😂💪

[@ricardohague5491]

Pretty sure AI can recreate it lol, would be the perfect way to view this in one go!

[@markholmes5695]

I feel far better being at supraphysiological levels, no doubt, but, blood markers all better @125-150mg /week. So I may happen to add a little blast once a year, for research purposes of course.

[@TRTandHormoneOptimization]

@markholmes5695 Thank you for sharing!

[@MamboGuy914]

What about shbg dropping and changing your free testosterone level?

[@keithnicholsmd6896]

You first and foremost base adjustments on symptoms not a number on a piece of paper. If your SHBG goes down then your free testosterone is going to go up and if you're not having any symptoms, then OK that's your number. I mean, do you notice when your SHBG goes down? My guess is probably not, but that you've been taught to follow SHBG, which is completely unnecessary. If you start having any symptoms of too much, then lower your dosage to lower your free testosterone level. Just like we overcome high SHBG by increasing the dosage. We can lower the dosage if need be for Low SHBG. I don't even measure SHBG I follow free testosterone levels only and make my adjustments based on symptoms

[@user-wt9fo5sx5s]

I get extreme fatigue from the injection. Will I get the same from cream?

[@markm4380]

I think I need to go to a clinic. Does anyone know symptoms of high free T with low total T? I have 254ng/dl Total T with 52pg/ml Free T and FSH at 1.6 and LH at 1.7. I dont have my SHPG or estrogen numbers.

[@TRTandHormoneOptimization]

Thanks for your interesting question, @markm4380 Please post your question in our facebook group: facebook.com/groups/hormoneoptimization/ We will answer you there.

[@bryngu81]

Is a free test of 78 & a total test of 367 considered low?

[@narmypara100]

Im in a permenent state of super high range

[@TRTandHormoneOptimization]

What levels?

[@GJ-DT]

Testosterone makes effort feel great! 💪

[@TRTandHormoneOptimization]

Exactly!

[@arthurfonzarelli9828]

I've had to go off of TRT a couple times just for like a couple weeks waiting for my next order and I lose all my motivation It's incredible I noticed it right away when I get lower.

[@GJ-DT]

@@arthurfonzarelli9828 always have a backup vile on hand.

[@trochantermainsign8874]

I am taking 280 mg a week as an 80 mg injection every other day. My total T is 1776 ng/dL and I feel good. I didnt feel as well when my total T was at 1000 ng/ dL. That being said, I just restarted 140 mg a week of nandrolone as well. I dropped the nandrolone for a 100 days and did not feel nearly as good. So between T and N, im taking 420 mg a week of. AAS. I did that for almost 2 years and I want to stay there from now on.

[@mr.t6046]

Enclomiphine Citrate. 12.5mg eod. Game changer. Hands down. No TRT sides like balls that literally shut down and look like raisins. Enclo doesn’t mess with FSH nor LH.

[@keithnicholsmd6896]

OK for a younger man wanting to maintain fertility but it doesn't work very well for middle-age and older men with testosterone deficiency symptoms. They don't look like raisins by the way, unless you started with tiny testicles to start with.

[@mr.t6046]

Hold up! You, as a respected Dr on this subject, which I respect, know all too well that exogenous administration of T, especially at high doses, absolutely shuts down the FSH and LH! Resulting in negative feedback issues. No wonder bodybuilders take HcG off-cycle to get the “volume” back from their testicles. Why in God’s name would you recommend “Supra” doses when you will 💯 cause ITT. I’m just not following the math here in comparison to the Citrate version of Enclomiphine and the known feedback loop that it doesn’t affect? Help to educate me on this! I appreciate your work!!!

[@D_XDC]

Dropping my test below 200mg pw was the most depressing thing I've ever done

[@TRTandHormoneOptimization]

@D_XDC Thank you for sharing!

[@bryanscruggs7566]

Around 300mg a week is where I typically feel good. Sometimes I will go up to 500mg a week for weight lifting purposes. Over 700mg a week is where I notice aromatization issues and either aromasin or dht needs to be employed, of course this all individual.

[@TRTandHormoneOptimization]

@bryanscruggs7566 Thank you for sharing!

[@shekelberggoldstein1387]

Have you been doing 300 as TRT over a long period of time? I've been on TRT for about 25 years and have always stayed at 200/wk except for when I've done pellets. Obviously shoots up big time on pellets and fades but now when doing 200mg/wk it barely registers. I split it 100 twice/wk. A couple of weeks ago I did about 160 vs 100 and felt like a man in the gym again.. What do you notice at 500 or 700 over 300?

[@MakingItHappenMWC]

I just got my blood work in yesterday. Everything was good, but Test was down to 213. That's way low. Age 46. I wonder if that is causing me to be dizzy. Could be. Anyhow, gonna see my Dr soon to work on this. Blood work 2 years ago my test level was normal so. It's dropping for some reason.

[@BigNord]

You can thank Monsanto (gmo) big pharma and big plastic.

[@MakingItHappenMWC]

@@BigNord could be. Im taking a 2nd test to confirm. Dr already prescribed trt but gna have a 2nd test done just n case. Just weird that my panel wqs perfect and only test was off.

[@BigNord]

@@MakingItHappenMWC Good luck and best wishes on your health journey.

[@robertthompson5501]

What about Hematocrit and Hemaglobin? Injection or Gel? 🙏🏻👹🏊‍♀️🏋🏻

[@FreedomFox1]

200 mg of testosterone cypionate raises me well over 2,000. There’s no added “feel-good” effect, but it has improved my chronic pain. Bloodwork looks good, but seeing testosterone levels approach 3,000 does have me worried. Also at these levels I am way over what the doctor describes as the free testosterone saturation point, but I’m not getting “steroid-like gains” (really, about the same as physiological levels), so I’m not sure about that theory.

[@brentonl]

Same here. Well over 3k! Reduces inflammation and chronic pain. Period

[@keithnicholsmd6896]

What is the free testosterone? Total really doesn't matter

[@Opendjr]

Can anyone have a half educated guess on this little theory I have….not feeling optimised on trt atm. Been on a few years now. Done lots of watching reading etc. could the answer to me feeling better b progesterone. Obviously balls are shut down…most progesterone is produced there but the slack is picked up the adrenal cortex, once balls drop out however if I have chronic fatigue syndrome would that hamper progesterone production in the adrenal cortex…fatigue libido depression occasional insomnia. Just started hcg injections twice week to hopefully kickstart my nuts and a bio identical pregnanolone cream. Hopefully I’m heading in right direction. Labs all appear within normal however. Finding a Dr here in Australia that can think independently is difficult…they r all too frightened to even prescribe it at best of times in fear of getting a rap on the knuckles by ama

[@Simon.Forrester]

Where can I find a doctor in the UK that thinks like this

[@TRTandHormoneOptimization]

Thanks for your interesting question, @Simon.Forrester Please post your question in our facebook group: facebook.com/groups/hormoneoptimization/ We will answer you there.

[@BigNord]

To say testosterone can't raise hematocrit levels is possibly dangerous. I was on TRT cream some years ago and my hematorcit and hemoglobin both raised a bit higher than current so called "in range" standards. I stopped for a few years and my blood leveled back down. I went back on TRT a couple years ago (and remain on today self injecting cypionate about 60 mg twice a week) with overall good levels and numbers, but my hematocrit and hemoglobin are indeed again higher. I donate blood, do more cardio, focus more on water than beer like I once did and it all helps. But fact is, for some humans, test will raise hematocrit levels.

[@BigNord]

I want to add to my post, I am open to learning and realizing I am wrong on this. Always be open to others knowledge and experiences, but mix with your own wisdom. Could it be because I was on too low of a dose and that's why my hema and hemo raised? Possibly. Maybe I'll double my dose for 8 weeks and see how things shake out. I look forward to the future video discussing blood levels in more detail. Best wishes to all.

[@keithnicholsmd6896]

@@BigNord it's the most common side effects of testosterone and it's called a secondary erythrocytosis. It has never caused harm in 85 years of use. Tens of millions of people live altitude and also get a secondary erythrocytosis and it causes no harm. The harm comes from a primary erythrocytosis which gets extrapolated to those that have a secondary erythrocytosis. We will be doing a video on it in a week or so

[@roguejimo736]

My free-T was 62 ng/dl 6 months ago. Now, it has risen to 86ng/dl. I feel great, the same as when it was at 62ng/dl. Any potential problems down the road with a free-T of 86ng/dl? I inject twice a week. If there are potential problems, I would like to see supporting data.

[@keithnicholsmd6896]

It's just excess at that level just like we discussed in the video. Your androgen receptors are fully saturated except in muscle tissue, where the androgen receptors are up regulated with those levels therefore, it will help you increase lean muscle mass. But when you're only injecting twice a week, that free testosterone level was just a snapshot in time as it was different every other day if you would have tested it. You're going to have significant peaks and troughs with a twice weekly injection. Your free testosterone is not stable. So you feel great, and I imagine every parameter of your health, but you can measure is improving as long as you're exercising and eating correctly. What would be the long-term harm if everything is improving? You as well as I in the beginning were taught to fear that number. It's a fear that is not born out in the medical literature. But as we always say, if that number frightens you, then simply lower it, it's that simple and it should always be that simple. Find a number that resolves your symptoms and that you're happy with and not concerned about. That is your optimal number.

[@roguejimo736]

Thank you, Dr. Nichols. I resistance train 4 days a week. Is LVH a concern? @@keithnicholsmd6896

[@BigNord]

@roguejimo How much what is your dose?

[@roguejimo736]

.6ml twice weekly. I've been using red light therapy daily for a few years. My theory is that it is keeping my natural production working, at some level. @@BigNord

[@roguejimo736]

Is LVH a concern?@@keithnicholsmd6896

[@allenfinch3717]

My question is are our bodies evolving or are there environmental changes that are causing these lower levels of testosterone in men? Do we have any knowledge as to what level of testosterone our ancestors had(founding fathers era, Roman empire era, caveman era)?

[@keithnicholsmd6896]

Endocrine Disrupting Chemicals is the cause. Our polluted environment

[@JT76]

Any time I push my free T into the 20s and beyond my blood pressure and pulse rate go up and the anxiety ramps up like crazy. Is there a simple way to offset this or am I just one of those guys that's over saturated at a lower free T number?

[@keithnicholsmd6896]

There are different sensitivities with regard to the androgen receptor. Simply take what you can tolerate.

[@user-vv9np5iq7n]

I had that very same thing happen to me when I first started doing TRT. My dose was 200mgs weekly. After about two weeks those symptoms went away and have never returned, not even when I have blasted testosterone blood levels up to 2000 ng/ml by taking 300mgs weekly. Apparently my body had to acclimate to exogenous testosterone at first and then the elevated heart rate and BP subsided.

[@user-cj2re6um9e]

I have a question to someone out there, maybe you know. I started testosterone enanthate did 2 shots and I broke out in an elergic reaction with little pimples all over my body . I think I'm allergic to the oil in the testosterone? Any help would be appreciated.

[@BigNord]

@user-cj2re6um9e You are probably right bad reaction to the oil it should say on your bottle or scrip what it's suspended with (for example you may see grapeseed oil or some other oil) tell your provider you want/need to try a different mixture. It could possibly be a bad vile as well, but if it's from a legit prescribed source that is very unlikely. If it's from an underground lab chances of bad stuff are greater.

[@profound369]

I think this is my issue too I have weird little pimples, not a lot but just like 2 in between my legs, some in my hips

[@DB961]

Get on the cream, results are far superior to injections

[@anontablet6304]

My physician argues that the testosterone receptor can become desensitized through continual high exposure. Any evidence based responses I can give to respond?

[@keithnicholsmd6896]

Ask him to produce one study that supports his belief. It's been used for 85 years and it actually up regulates androgen receptors with increasing levels. There's no such thing as receptor burnout or desensitization. It's not you that needs to produce anything because we can give you long-term studies lasting well over a decade and these men don't experience any receptor desensitization. The question is what literature is he using for his opinion. He won't be able to produce anything

[@Brian_Life]

Is there a Free Testosterone target where men tend to feel best? My Test is 1,460 and Free T is 535, my SHBG is 9. Is Free T too high or is it fine if I feel good?

[@TRTandHormoneOptimization]

We talked about those levels in this video: kzbin.info/www/bejne/n52QpGNnrLlqeZYsi=Kz2nA5OvSw0sKhNw&t=1235

[@keithnicholsmd6896]

If you feel good without any side effects then those levels are absolutely perfect. Beautiful! Congratulate your doctor on doing a good job

[@prestongriffith208]

Help. How do I get control of my red blood cells without giving blood all the time. All my bloodwork is off been on testosterone for 14 years from a motorcycle wreck

[@bigallabowski8235]

Baby aspirin

[@user-wt9fo5sx5s]

Lower the dose.

[@prestongriffith208]

@@user-wt9fo5sx5s not an option I don’t make testosterone

[@ironballer1]

Wow u disagreed with the anabolic doc? Im interested in what u disagreed with him on

[@keithnicholsmd6896]

He did a recent video on thick blood while on testosterone. He has deleted every single one of my comments where I pointed out that the information he was providing was not accurate. I'll do a video on his video pointing out the problems. The literature that he tried to present we're not actual studies but instead nothing more than retrospective data mining studies that cannot be utilized to establish causation. He tried to present them as if they were randomized controlled trials and then when I pointed this out to him he started blocking every one of my comments. I will revisit his video when I do a podcast with Stephen on secondary erythrocytosis

[@mattmason4589]

Did keith say they mix vitamin D in with their test cream in a prior video? How much does does one container of cream cost?

[@keithnicholsmd6896]

We do not mix anything in the testosterone because if we did we would have to lower the concentration. The most solid you can put in a liquid and have it not precipitate out is 200 mg/ gram. Vitamin D three should be taken orally with your fattiest meal preferably

[@mattmason4589]

Maybe it's was Jim meham

[@keithnicholsmd6896]

@@mattmason4589 yes, that's most likely who it was. Just saw one of his patients this past week where he had everything mixed in the cream, including testosterone, DHEA, and pregnenolone etc...

[@mattmason4589]

​@keithnicholsmd6896 seems like way too many variables for one application 😊 if you don't know how you respond, could be wrong tho, an maybe it's brilliant

[@JoeyBeeFit]

Why don't people inject into their obliques?

[@TRTandHormoneOptimization]

Thanks for your interesting question, @JoeyBeeFit Please post your question in our facebook group: facebook.com/groups/hormoneoptimization/ We will answer you there.

[@williamtripletjr.5423]

I've been saying this for years! Do you really think our granddads had a Testosterone level of 8 or 900 when they were storming the beaches at Normandy? Or fighting in Korea? I don't think so. Doctors have become lazy with a fear of doing the right thing because it might not make them the money they need. It seems now the doctors Don't want to cure you, they just want you well enough to have to keep coming back.

[@michaelsmith473]

Injections and cream both made my H and H go up.

[@keithnicholsmd6896]

That's the most common side effect of testosterone, and there's no harm in it at all. It's never caused harm. It's a fear that is not based on the actual medical literature. Your H&H will go up if you move to a high-altitude as well, and that won't cause harm either.

[@krane15]

If any of us said this to our doctor or the medical community, there'd be a lot of doctors rending their lab coats in shock. Good luck convincing them that steroids isn't evil no matter how much you take. This is my 3rd attempt at treatment using the normal establishment.

[@amarakhter4547]

I'm not sure where he's seeing lipids improve with HRT. Infact the contrary seems to be the case.

[@keithnicholsmd6896]

Every single, lipid parameter improves, especially with the trans scrotal testosterone. Some men that are on injectables can have a decrease in their HDL cholesterol, but all other parameters improve.

[@user-vv9np5iq7n]

@@keithnicholsmd6896 I live outside of the U.S. where I can buy testosterone over the counter and I do DIY testosterone therapy and I have gone up to supraphysiological levels like 2000ng/ml and it had absolutely no negative effect on my cholesterol levels and lipids. Ironically when I ate a diet of steak and eggs for two weeks my total cholesterol levels went from 140 to 129, my LDL went from 95 to 80 and my HDL went from 38 to 50, the highest it’s ever been. My triglycerides are always low at 50, so they didn’t change. My testosterone levels were supraphysiological when I did this.

[@quantumfx2677]

TRT will soon be replaced with LH TRT replacement at 2,000 nanograms per deciliter to nmol/l incredible at these levels but without some side effects associated with using TRT! This will be a game changer and as well cheaper healthier and more convenient. As One injection is good for about 2 years. luteinizing hormone not only getting testosterone levels optimized but the findings are improved heart health as well! LH TRT replacement will be a game changer!

[@brandonyoung4910]

You forgot to mention it’s gene therapy and it will be thousands of dollars

[@Stoicsavage]

LH won't work for men that have primary hypogonadism or testicular failure

[@JoaoSilva-ex9xz]

Hope you right

[@brandonyoung4910]

Also won’t be available in the USA

[@tea4475]

What is the ratio of total to free

[@keithnicholsmd6896]

The percent free can vary among men but typically going to be 3 to 6. So if a man had a total of 1500 ng/dL and a free of 50 his percent free would be three

[@tea4475]

@keithnicholsmd6896 mine is about 2%. At 1250TT my free is 25 and my shbg is 40-45. What can I do to increase my free T. I'm 60 and pin 20gm 5 time a week

[@keithnicholsmd6896]

@@tea4475 don't worry about SHBG. The way you raise free testosterone is to simply increased the testosterone dose. If you were my patient, I would be increasing the dose until I got your free testosterone, 30 to 60 considering your continued symptoms. Not sure why you're doing it five days a week versus seven but I would recommend 30 mg daily and then measure your levels and make your adjustments based on symptoms and levels of free testosterone. Now you noticed I use the word you having symptoms. If you're not having any symptoms, there's absolutely no need to raise your dose but if you are having symptoms, then it's OK to raise the dose with the levels that you have.

[@MakingItHappenMWC]

After reading the comments i now feel like a woman. 214 and my free is 4.1

[@narmypara100]

The uk doctors prescribe 250mg every 3 weeks just because it states it in the box ..its madness

[@TRTandHormoneOptimization]

@narmypara100 Thank you for sharing!

[@mattrobins3721]

I’ve used various forms of test cyp for 15 years. For say 5 plus years I get all the negative effects - poor sleep, the need to eat more (weight gain). Any insight to help? New test pill out- thoughts?HELP!!

[@keaninishigaya6761]

Use test prop. I had the same issue that’ fixed it. 40 mgs every other day.

[@zmb5501]

You try pregnenalone and dhea. Did you try to raise or lower your dose. Is your testosterone to estrogen ratio correct?

[@Charlie-rt7sb]

Have you been checked for sleep apnea? All testosterone makes mine even worse and I feel like shit

[@marshallsaltzman9924]

No one can help you without knowing your dosage, protocol, and bloodwork

[@izthewiz-rb9np]

Split your dosage up. So if your dosage is 140mg per week split it up using 29g insulin needles at 20mg daily. Prior had bad insomnia from twice a week shots e2 spikes to fast.

[@DanielPekic]

Data? No. “Typically” the doses required for a “clinical effect” do not surpass the normal range. Sometimes they do, sometimes they don’t. When it comes to said subjective symptoms in men who are looking for some kind of panacea; that further lessens the accuracy of such statements. Likely, there is no magic number a man needs and will do fine with a variety of dosing schedules within 50 mg +/- But I guess I’d prefer this Doctor rather than a conservative one. 80-200 mg per week still seems fitting. I take 150 mg. I feel the same in 100 or 200 mg, only my face is slightly puffier on 200. Enjoy the “fine tuning” process.

[@keithnicholsmd6896]

You make this statement based on your decades of treatment, correct? I mean this is not your opinion, right? This is based on your knowledge of the medical literature, along with your vast clinical experience over decades of treating men with low testosterone correct ? So how many hundreds or thousands of men have you treated with low testosterone to base your statement on?

[@krane15]

The same in nature. Some men have higher/lower levels and process it different.

[@DanielPekic]

@@keithnicholsmd6896 Doctor, respectfully: If a clinician cannot consider both his clinical experience, the clinical experiences of others and the literature as a whole, then I think you’re going off track. Anecdotally alone, it seems that myself and many others even in this comment box do not require supra physiological levels for a “clinical effect.” Anecdote aside, your claims aren’t supported by evidence so until they do, you’d be wise to caution the wind with such absolute statements. Your ego is getting the better of you and you may fail to see that the truth probably lies somewhere in between. To anyone reading who’s confused and subjectively analyzing whether or not they need more or less testosterone-please consider that your symptoms may not even be related to your testosterone. Until then, it will remain true that some men clearly saturate at substantially lower and higher levels of total and Free T. I myself have been on testosterone for 11 years and my dose is 150 mg per week and my TT is ~ 15-20% below the high end of most companies reference ranges. I am thriving in all metrics one would consider desirable. Please don’t tell me or others that we are not. And yes, I’ve tried higher doses too. And yes, I’ve helped guide many too. It’s not that complex. Chill.

[@keithnicholsmd6896]

@@DanielPekic spoken like a man that didn't listen to the video. You should take the time to listen before you make a comment. In the video it is very well stated that not every man needs supraphysiological level but the video was made because many men do. Take the time to listen before you comment. Are you familiar with the work of Rebecca Glaser in females? Are you familiar with the Bhasin dose response studies? Are you familiar with the dozens of studies giving a little bit of testosterone and have a little effect on men? You're commenting without listening and you're commenting without paying attention to other videos where we discuss these very facts. In fact as discussed in a related video where I specifically say and I had specifically said on multiple occasions that testosterone will only improve symptoms related to a testosterone deficiency. It's not a panacea. So you and many others are very well addressed in this video but you didn't listen. Many men are not OK with putting their testosterone in the mid physiologic range. That's the point of the video. Listen before you speak... look at the title of the video "Why you MAY NEED...!!! Not all men but some men. Please check your ego sir and take the time to listen before you comment. Nobody said all men everybody has their own number I've said that over over and over again. There is no in between other than it's what each man needs individually. That's also due to the Androgen receptor sensitivity. But the bigger point of the whole video that you missed is that we should not restrict testosterone to those that need more than what we could normally physiologically produce. Some may need more thus the title of the video

[@DanielPekic]

@@keithnicholsmd6896 I listened to it all. I am sure many people listened to the entire clip and I am even more sure we have all read that famous Bhasin study too lol. Who hasn’t? A single study for that brief period? Come on man? Which one is it? Your decades of anecdote or the weak research paper you suggest to read as reference to prescribe? It is clear there is more emphasis on higher dosing despite the caveats in your methods. It’s pretty clear that you believe there are more people who need more, rather than less. I do not. I will continue to consider even short term fluctuations in blood pressure elevations and HCT as legitimate risk factors that can be causal by higher doses-that can be avoided. Those many men are probably fat, too. A lot of men who listen to these channels are. They’re often searching for a new dose to save their wellness when they just need to stop being fat. Your dose was probably fine the first time fatties. Get real. You are far less likely to need a supra physiological dose and you are far more likely to suffer negative side effects as a result of keeping your serum T within supra physiological ranges.

[@malekmalek9064]

👍

[@TRTandHormoneOptimization]

Dank!!

[@johnconnor3319]

Just did my labs My total test is greater than 3000. Will I be ok? 😂

[@abrahamfromtn7531]

❤

[@TRTandHormoneOptimization]

Thank you, @abrahamfromtn7531 , for helping to boost the algorithm!

[@tylerrohn6938]

I’ve never had more, or shittier ads than watching this video. KZbin really trying to get people to turn this off. I made it though though

[@TRTandHormoneOptimization]

Thanks for resisting 😀👍

[@CortexLabsChannel]

Saying: “there’s no evidence that one has to stay under the physiological range for replacement” does not = being supraphysiologic is good. You can’t escape that the higher the test, the higher the Estradiol (although I know you guys selectively ignore Estradiol, which is irresponsible). Some will do fine above range on TT. Some will not, it’ll numb their sensation and further shut down intratesticular hormone microenvironment (which I do not suggest). Doses that keep E2 in a reasonable range, with the addition of gonadotropin optimization, whether agonizing testicular receptors, or modulating hypothalamus / pituitary, is the way.

[@keithnicholsmd6896]

Let's say 85 years of utilizing testosterone in men and not one of those studies which showed benefits blocked or controlled estradiol. You must not understand how testosterone works in fact you don't understand how testosterone works. Testosterone doesn't work as testosterone at most target tissues it instead has to be converted into its active metabolites to exert its beneficial effects. When you block those active metabolites you block the beneficial effects of testosterone at the tissue levels. You can't unlearn what you learned incorrectly from the bodybuilding world because what you are saying in your comments it's not from the medical world and not what the medical literature shows. Do you even know where the normal estradiol level came from? I bet you don't. You by your comments do not understand how testosterone works from a physiology standpoint. You think that it's testosterones obviously because you're worried about estradiol not understanding that it is estradiol that is exerting those beneficial effects from testosterone. Of course when you raise testosterone levels you're going to raise levels of its active metabolite because that's how it works. I've asked you once before and I'm gonna ask you again. Produced one study just one randomized controlled trial for men were given testosterone and an aromatase inhibitor and it showed benefit. And you can't even understand your first statement. But I will tell you that supraphysiologic is not bad and yes and most enthesis is good in the parameters that I have outlined. If you listen to the video you'll understand those parameters and you will understand the plateau effect of testosterone. "the higher the test the estradiol" now that is the comment of the year. Yes sir that's exactly what happens because that's how testosterone works and how you get the beneficial effects the better the levels the better the benefits. You don't understand the importance of estradiol and I guarantee you don't know where the estradiol normal range came from and it certainly wasn't man on testosterone. Do you know what the normal estradiol range was in 1997 and some labs? I'll save it for when I hopefully get to do a video with you. It's amazing how none of the guidelines on testosterone recommend blocking or controlling estradiol. The Androgen Society which includes the researchers and urologist that are leaders in the world with regard to testosterone therapy adamantly stated in their most recent guidelines that you should not block estradiol. Physicians that understand testosterone understand how it works and it's active metabolites. You do not understand that. I would love to have a debate with you. I would also love to discuss the literature that you have supporting your statements concerning all the snake oils you sell. Let's see those studies utilizing your supplements

[@ninjaworrier7308]

I am guessing that to people who know nothing about TRT CortexLabChannel sounds like he knows a thing or two, but to people who've been reading and learning about TRT, he is just another pseudo-expert on KZbin saying dumb stuff and throwing in some buzz words.

[@keithnicholsmd6896]

@@ninjaworrier7308 you are one smart man and his is the smartest comment I've seen this week. Right he's a self-proclaimed expert that actually knows really nothing about the physiology of testosterone. He's just a salesman

[@phatpieface5731]

all of this comes under the assumption that the TGA-FDA-CDC is there to help.

[@stevenmiller6725]

450 to 600 range is only normal for modern "healthy" men. Certainly not normal in the 50's and 60's. 1500 realistically should be consider high normal physiologically.

[@krane15]

Thing is, the natural range is much wider than that. Too bad we/men don't get tested at our height of production. That way we know exactly what our body was producing at its peak.

[@stevenmiller6725]

@@krane15 When you're young probably not going to worry about it much. Certainly not common when I was young. Testing easier now. Good idea though.

[@mattmason4589]

Peter attia = quack😅 nowonder with a name like that

[@TRTandHormoneOptimization]

@mattmason4589 Thank you for sharing!

[@macezillamayfield2882]

“Derek more plates more dates enters the chat room “ Oh shit

[@7end7fan81]

He is no doctor.

[@ninjaworrier7308]

You mean KZbin-expert Derek? Yeah...I'll put my money on the actual expert and protégé of Dr. Neil Rouzier.

[@Art_is_life]

Memory foam mattresses can cause huge problems for the scrotum. !!!!!

[@7end7fan81]

😂😂

[@loum.4377]

I've been at 1400 and i've been at 700-800. 700 is best. Everything functions like a Rolex. More is NOT better. Dr. wants me on 200wk. I take 170 max. Less is more. Same with friends.

[@keithnicholsmd6896]

And that was specifically stated in the video. Yes, some men feel great at 700 and that's their number and some men need a number double that to get the same response. Hopefully this was all explained adequately in the video.

[@GG-wg1yh]

Be glad you are given more than you need. Use what you need for the maximum effect.🎉

[@michaelsmith473]

You drop 600 to 700 ng from 30 mg drop in dose. Bullshit.

[@HoltistheGOAT]

​@@michaelsmith473exactly!

[@ninjaworrier7308]

For YOU less is more. You are missing the point of this video, smartass!