The Science Behind Testosterone Health

In this episode of TRT Talks, Dr. Nayan Patel and Dr. Ryan Jones from Thrivelab chat about the benefits of testosterone replacement therapy (TRT), including more energy, better mental clarity, improved libido, and increased muscle mass. They explain how testosterone naturally declines with age and how factors like chemicals in food and plastics can make it worse. The doctors stress the importance of regular check-ups when using TRT to stay safe and get the best results. They also talk about how nutrition, exercise, and sleep play a big role in getting the most out of your TRT journey.

Transcript

Nayan Patel (00:00)

Welcome back to TRT Talks Podcast brought to you by Thrive;ab. Today, we are covering the basics and discussing the benefits of testosterone replacement therapy. I'm Dr. Nayan Patel, Chief Scientific Officer at Thrivelab. And today, I'm joined by Dr. Ryan Jones, Chief Medical Officer at Thrivelab. Hello, Dr. Jones.

Ryan Jones, MD (00:21)

Hey, Dr. Patel, how are you doing? I'm excited to chat with you today, help men understand some of the benefits of testosterone replacement therapy and what they can expect on our journey and clear up some of the biggest myths and misconceptions about testosterone. Testosterone is the male hormone and its effects began as early as six to eight weeks on a developing fetus. The Y chromosome, which we all know is the one that distinguishes between male and female stimulates latex cells to produce testosterone and that relationship from there  never ends. Testosterone pushes a fetus towards male development, peaking around the second trimester, leading to sex differentiation, determining which sets of genitals you'll have. It sets early tone on growth velocity, bone density, muscle mass, and as the testosterone is flowing through your body, it also creates a little bit of a feedback loop to where you become more sensitized to it.

Testosterone itself tends to upregulate testosterone receptors for a developing fetus. And that kicks in again, not until about the adolescent years, which we're all familiar with the big effects that testosterone has at that time. You get your voice deepening, your skin may kind of flourish a little bit with acne to your chagrin possibly. Your height and growth velocity continue to go. Your muscle mass develops and differentiates into two different pathways. And one thing that is a little bit under reported about that is there's also a little bit of masculinization of the brain. So some of the different abilities and skills that we tend to notice between males and females start as early as in utero and are stimulated and or regulated by testosterone development. So things like spatial reasoning, some of your visual acuity along those lines.

As you get a little bit older in age, it impacts things like mood, libido, muscle mass, and your cognitive function. Of course, it has a big impact in fertility, sexual function. And that's typically where we start to notice a bit of a problem. So as men age, the levels tend to decline somewhat steadily over time. And this can be insidious. It can be a little bit difficult to notice. For some of our patients.

Testosterone levels these days compared to generations before are as much as 50 % lower in some studies than their counterparts who grew up in the 40s, 20s, 1800s, 1600s. And in addition to that, the decline appears to be a bit more rapid for many of our patients and for the population at large. And so this has become a huge problem. There's many factors that contribute to it. I'm happy to delve into some of it myself.

But some of the lifestyle factors, Dr. Patel, are you aware of any of the lifestyle factors that impact testosterone as people go through their days and their lives?

Nayan Patel (02:54)

Absolutely, but let me before I say that part. I just want to make sure people understand that testosterone is not just a male hormone. Females, the number one hormones in females is also testosterone. So it's not just a male thing I just want make sure people understand that it's both male and female things and so we all need testosterone replacement. The levels are different for both male and females. But regardless we want to make sure that both are taking care of people with testosterone needs.

Now going back to the environmental factors, it's huge right now because we are exposed to so much chemicals through our food supply. It's been ever tainted. I'm blessed to be living in California where 80% of the land is organic and we have access to some organic foods and vegetables over here, which kind of, it's a nice thing, but overall, the food supply is tainted and

some of those chemicals that have been used in farming are actually estrogen mimicking compounds. And those compounds are actually depleting hormones, it reduces testosterone in men. And so the food supply is actually the biggest culprit why we are seeing, like you said, that now we are seeing ever before 50% reduction in testosterone levels at any age for anybody and we are seeing that it's just solely from food supply. If you compound that with environmental sources, it's a whole different game.

Ryan Jones, MD (04:19)

Right, and to let people know what some of those environmental factors are, there's kind of a list. This class in general are known as endocrine disruptors. There's as many as 100,000 man-made chemicals out there that interact with our biology on some level. And as many of 1,000 of them is believed to be an endocrine disruptor. And they are everywhere, right? Pesticides, as you mentioned. Atrazine, I believe it's one that's a key component in this is estrogen mimicking, like you said. And it comes with the two biggest components of the American diet. It is used to treat corn crops and sugar crops. And if anyone knows anything about the American diet, those are two of the biggest staples, two of our biggest products in the agricultural industry. So very difficult to avoid because even in products that are not specifically corn or sugar related, that high fructose corn syrup is everywhere. So that becomes a very difficult pesticide to avoid. BPAs are common. They have been decreasing in recent years as public awareness about that potential endocrine disruption has grown. Many plastic bottles you'll see, particularly the reusable kinds, will mention that they're BPA free, which I'm glad about as our cultural kind of awareness of the potential effects here has grown, that different aspects and corners of our society are taking initiative to reduce those. They're also though those BPAs, they're in flooring, they're in toys, they're in food packaging, they're often in canned goods. Many of the drinks, even if they're not finally produced in a product containing BPA, are made with plastics or processed with plastics during the production and assembly lines that contaminates them with BPAs. So very difficult on its own to avoid. Now know you mentioned that you live out in California and a lot of the crops are organic there, but unfortunately there's one class out there, one that's not spoken about so much called dioxins, which is particularly potent for people who live near factories and industrial complexes. This one tends to invade the soil quite a bit and get into groundwater. And aside from that, trash burning and wildfires tends to release this one into the atmosphere. So people who live anywhere in proximity may be affected by those.

There's perchlorates, which are used to make fireworks and mild explosives. Those also tend to seep into ground and river water. PFAs are a huge glass compound regarding this, used in many industrial applications. Non-stick pan, paper manufacturing, textile coatings, again, more food packaging. Phalates is the big one, and I think that's probably the one that people get kind of the most incidental exposure to get in food packaging, cosmetics, and I know many of our guys may not be using them, but certainly our ladies are nail polish, hairspray, aftershave, skin cleansers, shampoos, toys, perfumes, colognes, medical device tubing. So even if you go to the hospital, the place where you're supposed to get help when you need it, you're still potentially being contaminated by some of these products.

And phytoestrogens. Now I know we're speaking about crops. That one particularly pops up in our conscious because some of our patients are concerned about whether or not our products contain any of these phytoestrogens, AKA compounds found in soy. Do you have any thoughts on that?

Nayan Patel (07:27)

I will scare them one more thing because the only thing we left out is the meat source. All the hormones in the meats to make them bulkier is not helping. That's the biggest endocrine disruptor we have. DES is a banned substance in the United States, but guess what? It's still available to be used on livestock.

Ryan Jones, MD (07:45)

Right, right. And then we ingest it directly, taking it into our bodies almost helplessly. So even our bros out there, our gentlemen, our older patients trying to eat this high protein and healthier diet are still sometimes being incidentally affected by that. So I completely agree. One more regarding particularly the recent pandemic that we had, triclosan. It's another product that's marketed as antibacterial. It was included in a lot of hand sanitizers. It was used before in a lot of soaps and shampoos. We were literally bathing in it, right? Just to further highlight the ubiquitousness of this. And so this is only to point out that men who feel like they may not have been exposed or been affected, these compounds are everywhere. So it's worth getting a check, particularly if you experience any of the symptoms that we'll talk about here in a little bit, to know that you're not alone. This is a problem that we're facing as a society as a whole. Your neighbors are going through it. Your friends, your families may be affected as well. So this isn't something to shy away from. But luckily some of us are, some corners of our society again are paying a little bit more attention. There's one great story about that. PCVs, polychlorinated biphenyls, were used in a lot of hydraulic fluids, electrical components, things like that. But they were actually banned in 1979, which is a tremendous win. However, for our older gentlemen, our patients in their 60s, 70s, 80s, some of the damage may have already been done. That exposure has already happened. And of course, those products, once manufactured, are still out in the environment doing the jobs and tasks that they were assigned to do. So again, a widespread problem in many ways.

Nayan Patel (09:14)

And the problem is not going away anytime soon. It's just gonna get worse and worse. So having a regular checkup by physicians is absolutely must for all of us.

Ryan Jones, MD (09:23)

Absolutely. And so that's what we're here to do, to fill in that gap and help our patients get back kind of on the right track. So we talked about how many of our men may be affected. And some of this is just a natural decline that men experience. We all kind of decrease. I think it tends to peak in our late 30s, sometimes early 40s, for some even earlier than that. So what are some of the symptoms, some of the things that a patient may notice, a male particularly? What might they notice? What are some of the symptoms of having low testosterone?

Nayan Patel (09:48)

The most symptoms that we get, as a pharmacist I get to see the patients for the first hand because pharmacists are so much accessible to the general public. They'll come and ask me the same question, hey I have this brain fog, my energy levels are low, I don't feel like myself anymore, I'm not motivated enough, I'm getting the weight on my belly area, my muscle mass is decreasing, my fat is increasing, my libido is getting lower, I'm losing my hair.

The other thing is that they can't seem to remember a lot of things anymore. And so all these things leads to that I'd send them to go see a doctor first of all, also check out your heart. They're also seeing increasing the blood pressure issues, the sugar levels are also increasing slowly. And by itself, it's a metabolic soup, so to speak, and the underlying cause for most men is low hormones to begin with but I don't get to see their part until they go see a physician for the first time.

Ryan Jones, MD (10:40)

Right, which is why we encourage people to reach out. These things, sometimes it's kind of like bankruptcy, where it happens very slowly and then all at once. Where you suddenly look back on your life, the things you used to be able to do, the energy you used to have, the way you used to look and feel, and suddenly it hits you like a ton of bricks. Hey man, I wish I could get back to that. What happened to that young guy, you know, riding around in the Corvette, chasing ladies, working out at the gym, who was more assertive at work, who was career-oriented in ambition? I just don't feel like that guy anymore. You know, what happened to him? And because this can sometimes sneak up on people, it's just important to pay attention to the individual components of that. It may not be all of those things together. There may be one or two that start to kick in for you that you notice a little bit different. Brain fog, loss of muscle mass, more easily fatigued. Higher content of fat tissue within your body compared to previous things, even though you're kind of keeping up with the same exercise regimen you did prior. So all of these little signs can be things that can point you in the direction that, hey, I might need to get my testosterone checked.

So with that being said, we'll kind of switch a little bit to some of the benefits of TRT and how they affect those different components there. So one that you mentioned early was brain fog. This is one I like to raise a little bit of awareness about because it's one that you may not immediately notice, I like to compare it to. If yours is one version of you and then the twin sitting right next to you and you have to take the most important exam of your life, yet you have the flu in one version and you don't in the other. That kind of lack of energy, that difficulty focusing, that kind of mental haziness will impair your functioning on that test and that is something that you can go through day to day throughout life. And that is one thing that testosterone has been shown to improve on. Have you had any personal experience with that or clients or patients that you've seen benefit?

Nayan Patel (12:23)

So personally, I mean, when I take testosterone, it's like, it's the biggest boost I get in my memory function. Having the mental sharpness really, really helps. And it just doesn't take a lot of testosterone to get there. Just enough so that you have the middle sharpness. I think it's the conversion of testosterone to DHT that actually gives you the memory boost.

Ryan Jones, MD (12:42)

There's an association there that some people think that testosterone is associated with a kind of more aggression. But I like to kind of change that and funnel that a little bit more because it's not necessarily aggression that comes out. But certainly men may become more assertive. And they become assertive, and I think in different aspects of their life, which I think is beneficial. There's a loneliness crisis out there. Many men are unengaged from social circles. And it's been shown that men on testosterone are more likely to engage in those activities that bring them closer back to their family, their friends, and activities that they used to do. With women, particularly, it tends to make you more assertive. And one hidden fact, women, particularly during their peak fertility, have been shown to prefer the smell of men with higher testosterone. So it really kind of gets you back engaged in the game of that pursuit. Libido is a kind of direct effect, a positive that it gets, which is literally your desire to chase. But also your appeal for many people tends to improve whether it be consciously or subconsciously. And then one more domain I see testosterone helping is with assertiveness at work. So I believe there was a study done, it might be close to 10 years ago or so, that correlated testosterone levels with higher levels of achievement at work and in your career. You typically have a higher salary and more subordinates at work and in more positions that delegate authority to other individuals. So that is a, kind of a social benefit, a career benefit, a romantic benefit that you may experience with testosterone, should we be able to get your levels in an ideal range. There's also the literal fix of physical benefits. I think this part is culturally the most known, right? Guys who are particularly looking to get back in shape or have noticed a decline in their exercise capacity or their muscle mass or, you know, the performance in some activity they enjoy declines over time. And so they've heard either on the street or from appropriate media. There are physicians, actors that they may admire that going on testosterone may improve those things. I've personally seen that myself and in many of my social circles that with an appropriate exercise regimen, the benefits are tremendous. But I do want to caution those who take it and we'll talk about ways to maximize it a little bit later. It does still come with a little bit of effort, right? Testosterone is not a magic muscle building compound. You don't just take your dose go to sleep and then wake up the next day or Superman or the Incredible Hulk. There's still some effort to go, but luckily motivation is one of the effects that it produces as well. So it shouldn't be too difficult to merge those two things together. And then one more is tissue oxygenation tends to go up. It can increase kind of your blood's oxygen carrying capacity. And of course oxygen is the immediate reagent your body needs to utilize fuel. It's essentially a small fire that's constantly burning in your body and oxygen is the thing that produces the free electrons to get that process going. So it improves your oxygen carrying capacity and delivery to tissues, making them more robust and typically higher performing.

Nayan Patel (15:35)

You just mentioned right now, just because you take testosterone and you go to sleep, you don't wake up the next day with the body of an Incredible Hulk, right? And so there's some work to do. And the strength comes in from making sure that your diet is good, with testosterone. Testosterone by itself is not gonna be the ultimate thing, so please make sure you understand that part. And again, people do testosterone replacement therapy to look good, which is okay, it's great to see that part. You see a physical changes in your body, but that's not the ultimate goal. The ultimate goal is to get stronger, it's to get a healthier metabolic outcomes for your body, have a sharper brain, be able to do everything that you want to do without having to worry about it. Having a good physique is a byproduct of testosterone and that's not the only part. But if you just go for the byproduct but not for the whole cake itself, then people are missing the boat all the time. I just want make sure people understand that.

Ryan Jones, MD (16:32)

And just to piggyback on that strength thing, this is particularly important for our older patients. Kind of loss of independence as people age is one of the most common noted fears among patients is that as I get older, I don't want to have to depend on anybody. I don't want to be severely ill. I still want to enjoy my life. And the importance of building muscle mass, like you say, just aside from the physique part is the actual strength part. Grip strength and core strength are two of the most highly associated factors with longevity and functional longevity as a person goes through life. If you still want to drive as you get a little bit older, play golf as you get a bit older. Pickleball, of course, is taking over the world if you still want to engage with that level of activity. Those two things are almost irreplaceable. And as muscle mass declines typically with age, you typically want to start with a little bit of a higher amount to lose from, right? If you go from a healthy, robust body as you age gracefully and nicely, keeping testosterone involved, that decrease or that decline in muscle mass will be much, much less in your core strength, your grip strength, your functionality in the world in general be much improved and that's associated with all cause mortality reduction and quality of life going up, is that higher grip strength and core strength and testosterone can can can greatly kind of push you on that way. Bone density is another one in that patients as they get a little bit older or an increase of falls for different reasons you typically when lose about 10  roughly of your bone mass for men kicks in a little bit later for men bone strength after about age 50 per decade, and that increases your risk of falls and fractures. Hip fractures are known to have a high mortality rate among our elderly patients. So literally, you become a more capable human being as you go through life, typically a happier human being and a more capable and independent human being as you go through life. If you're able to maintain that strength and testosterone is one of the key interventions to take in achieving that goal.

Nayan Patel (18:28)

I want to mention one more thing about the testosterone is that where people need to take the testosterone for more for strength, more for muscle mass, more for bone strength. Because the example I want to give you is about my dad. At the age of 85, 88, he had lot more muscle mass, better strength, strong bones, was walking six miles a day, even with arthritis, and having enjoying life. But if you see his testosterone levels were very high, but his body did not show up like a 20-year-old boy. He was still an 85-year-old man with the testosterone level very high. what that proved to him was he was having better muscle mass, better muscle strength, and better bone health. So I want to make sure people understand that even at the age of 80 plus, you can still use testosterone therapy to have a better grip of yourself, better muscle mass and better bone strength, because that's what's going to keep you alive more than anything else.

Ryan Jones, MD (19:23)

You know, you mentioned patients who are even 80 plus, and it kind of brings me to, I guess, my next point, because there was a recent study done, and this talks about dispelling one of the myths associated with taking testosterone. Many men are concerned they will have negative outcomes, particularly cardiac. I think maybe there's some not ideal studies done a couple of decades ago that hinted that maybe this is something to be concerned about versus maybe not.

Several studies have since come out to kind of dispel that but I want to highlight one that was recently completed I think last year maybe around the summertime it was done at Harvard published in the New England Journal of Medicine and if you know anything about Medical journals that is the one to get published in for peer-reviewed science and in that study they enrolled about 5300 men maybe slightly less Aged 45 to 80 which is a great patient population because that is typically who was on testosterone replacement therapy and the idea was let's take a group of guys in this age group, we'll leave basically half of them alone and see what their cardiac outcomes are, things like heart attack, fatal and non-fatal, needing to get a stint placed, myocardial infarctions, things like that. And then let's give the other half who are needing testosterone replacement, let's replace their levels. Typically the range was between 350 and 750 for most of the patients. So again, they were targeting an ideal range. They had a patient population that was wide with a diverse background, very mimicking of the American adult population, which is something I always like, men 45 to 80. And what they showed was in the control group, the placebo group, there was 7.3 cardiac, it was a rate, I'm sorry, 7.3% of cardiac events. And then the testosterone group, only 7%, right? Essentially equivalent, which demonstrates that the replacement therapy that those men took did not increase any risk of heart attack or stroke or death in that group in that study. A large study, well powered, well published, that I've read personally, that I think is just one more kind of notch on the belt there to indicate the safety is here so we can dispel some of the myths and rumors about people being concerned that I'm going to take this, I'm going to have a heart attack, I'm going to regret it rest of my life. The safety has been demonstrated over and over.

Nayan Patel (21:38)

But I just want to make sure people understand just because it's safe, does not negate you from seeing a doctor on regular basis because testosterone, if it's unregulated, prescribed without proper monitoring, it can put you at risk because it can increase hematocrit, hemoglobin in your blood and that can put you at risk as well. So having proper monitoring is absolutely a must.

Ryan Jones, MD (21:54)

Right, and that was one of the key components of the study is making sure that the monitored, they loved the levels, were monitored and in a safe and efficacious range. Not allowing our patients to kind of use and abuse the medication is key. It's a medication, it's a very powerful tool. Whenever we measure it, we're talking about nanograms per deciliter. You know, there's milligrams, which is already a small dosing, there's micrograms, and there's nanograms. And this is really hints to the power of this hormone interacting with our bodies. And so they had to make sure that it was in the safe range, and so do we. Right? As the old expression goes, the poison is in the dose. Right? So if you're going to be on a medication, right, you need to be properly monitored. The range needs to be set, expectations need to be set correctly. And that begins by having a qualified, skilled, and caring healthcare provider guide you along that journey. And boy, do we have those in droves.

Nayan Patel (22:31)

Yes, and I like the range that was very specific was 350 to 750 because most guys that come to us that wants to look different than what they already are, are shooting for the thousand plus ranges which is going to superphysiologic ranges of testosterone. They may get there, but there's a cost to pay at that high level sometimes.

Ryan Jones, MD (23:09)

Absolutely. I guess one of those causes sometimes that there's a concept that I sometimes talk about with my patients of taking more testosterone than you can use, right? Because then you start to get spillover effects. I basically like to compare it to if you're going on a long road trip in your new car, the first thing you do is fill up the gas tank. But once that gas tank is full, you don't put any more gas in there, right? It just basically spills on the floor. You're waiting for someone's lit cigarette to catch on fire or you're just wasting money as it evaporates from the ground. Is there any danger to taking excess testosterone? I mean, you hinted at it there, but what are some of the effects that can occur if you're taking too high of a dose?

Nayan Patel (23:45)

So for example testosterone doesn't stay by itself, in the human body testosterone will convert into estrogens. Testosterone converts to DHT. Testosterone converts into different components and the metabolites of this testosterone are also toxic. So the body has to process anything that's excess testosterone into different metabolites. Though some of the metabolites are carcinogenic. And so now we have an issue. A long-term user of overdosing on anybody with high levels of hormones is a potential of getting cancer. And you know, people always put bad names to hormone replacement therapies, causes cancer. It's not that the hormones itself cause cancer, it's the overuse of hormones that's the issue over here. And so I just want to make sure people understand that having proper monitoring is a must. You should not be going to the gym and taking some testosterone from your buddy because, you know, yes, you may save some money, but there's a bigger price to pay at the end of your life. And so we want to make sure people do the right thing. And having a sound medical journey of using sound medical advice from physician who knows what they're doing, using the research that is current, not from 35, 40 years ago, that was published just last year. And using those parameters to help our patients is probably the most important thing that you can get.

Ryan Jones, MD (25:10)

Absolutely. So speaking towards that a little bit, when you begin your journey with us, with Thrivelab, one of the first things that we ask you to do, because even though we did talk a little bit there about the numbers and effective ranges, and we'll delve, I guess, a little bit into dosing, the first thing I want to hear about is what you're feeling, right? So the first piece of information that we gather in addition to you signaling, that I would just like some help, is our self-assessments which indicates which of these symptoms are you going through and how severe do you feel these problems are for you? Because I want our providers to be armed with some of that information ahead of time so they can begin tailoring that therapy in an ideal way towards our patients. But that information by itself alone isn't quite enough for a long-term journey with our company. And part of our safety is that we also would like our patients to complete labs early in the process and then have pretty scheduled intervals depending on your dosing and what some of your symptoms were and what medications you were on. I typically like to collect a basic to somewhat extensive panel, but in our company we try to do the fewest that are necessary. One, tracking your hemoglobin over time is important to us, getting a baseline liver function and kidney function. We don't want to just throw medications out there to potential fragile eggs only to have them shatter and have negative outcomes. We want to make sure that our providers are treating our patients safely and effectively and that requires having information about their physiology which is obtained through blood work.

Nayan Patel (26:26)

And prescribing testosterone is the easy part. Maintaining them at a proper range so they have better outcomes is the harder part. As you know already, just giving them one hormone is so easy, right? The prescription and they're off, they're gone. But having outcomes is what we're here for, not just prescribing hormones.

Ryan Jones, MD (26:47)

Absolutely, absolutely. And so as you go through our journey, you'll have scheduled appointments with our knowledgeable, skilled, I personally think lovable providers. We've grown through this journey together. When we're recruiting and hiring, we make sure they're on board with the mission, right? Making sure that hormone health is affordable and accessible nationwide. We both spend a lot of time with our providers, kind of vetting them, making sure they understand the pitfalls, the risks, the benefits, so they can educate the patients, so the patients can make a decision for themselves. Of course, we're not wardens, we don't just give orders. Our job is to guide you along your journey to becoming your best self. And of course, like I said, that begins with the information you present with us, our safety protocols that we have to ensure that we're doing things in the most efficacious and beneficial way without risking harm to our patients and seeing them through the journey for the duration that they need it, which is sometimes many, many years.

Nayan Patel (27:34)

I want to address one more thing before we close out this podcast. I want to address one more thing about testosterone is not the only answer. If you think about it your muscle is not testosterone. Your muscle is built up of 6,100 amino acids coming together. So we got to address nutrition to the fullest extent because testosterone is just a signal. It's like your mother-in-law telling you, hey, Mr. Jones, can you please clean your house? I said, I got the message, I'll do it today, right? I'll do it today. But you need the messenger, you need the messenger, is testosterone, but the actual work is done by the amino acids. So you've got to make sure you have enough of, that your diet is so clean that you have all these building blocks so the message when it comes to the body is gonna build the muscle message you're looking for. Besides that, you're to have enough zinc in your body because that will reduce your stress down. Zinc will also reduce the reaction time of testosterone to estrogen. Magnesium, magnesium relaxes the smooth muscles so that you feel better. Having a proper nutrition, so working with Thrivelab provider, we don't just give you testosterone by itself because that's easy to do, but we want to make sure that nutritionally that you're also taking care of it because that's what's going to do the actual work. Testosterone is just a signal.

Ryan Jones, MD (28:52)

Absolutely. And that kind of segues into one of the, and maybe the final segment that we'll cover here today about ways to maximize your TRT results with lifestyle choices in addition to the medication. And thankfully we've recruited some excellent registered nutritionists who are available for customized and personalized nutrition advice for those patients who may need it. Your diet is huge, healthy fats, lean proteins, micronutrients like zinc and magnesium. They're essential for hormone health. TRT is powerful, right? But lifestyle still plays a huge role for our patients. Strength training is important. Endurance training is also fairly good in supporting natural testosterone levels at a healthy range. Getting adequate sleep is important as well. A lot of hormones are produced and distributed during sleep phases. So getting that rest is important. You can't train your body away from it. A TRT will give you the energy, but like you said, you're the one who's going to also have to perform if you want to get the absolute best results from it. And that includes an exercise program a nutrition program and we're helping to guide you on both of those things as well.

Nayan Patel (29:48)

And one other thing is that a lot of people have sleep apnea, people have reduced sleep, deep sleep time that they have. Testosterone replacement therapy has actually shown to improve your sleep pattern as well. And so if you're not having sleep, if you're not sleeping good, I think it's another way of looking at testosterone replacement therapy as one of the things that can help you with the sleep pattern.

Ryan Jones, MD (30:11)

So I'm glad you brought that up. I mean, it just further shows that at Thrivelab, we take a full body approach. We don't just prescribe testosterone. We want to help you optimize all the factors that contribute to hormone health. TRT is a tool in their toolbox for health and longevity, alright? So coaches, nutritionists, a provider, myself and you designing protocols in the background, of course, staying up to date on groundbreaking and new research for both safety and efficacy, seeing what the latest trends are that are beneficial to our patients, so that we're aware of those changes and then dispelling that information to our providers so that they can more effectively treat our patients.

Nayan Patel (30:45)

Thank you very much. If you are feeling off, low energy, brain fog, weight gain, it's worth taking a symptom assessment and speaking to one of our hormone providers.

Ryan Jones, MD (30:55)

And if testosterone replacement therapy is a right fit for you, it can be life changing. The most common thing I hear from patients after a few months of treatment is, I wish I had done this sooner.

Nayan Patel (31:07)

So if this conversation resonates with you or if you want to learn more about TRT, visit us at thrivelab.com. Thank you Dr. Jones for being here today.

Ryan Jones, MD (31:16)

Thank you Dr. Patel and thank you guys for listening. We'll see you next time.