I love to talk a little bit about hormone replacement therapy in men . Um When one looks on social media and the internet , there seems to be a younger and younger cohort of guys and people in their teens and twenties showing up to the table thinking uh that injecting testosterone cate or taking Anno VR or whatever it is is going to be the right idea .
So I do wanna acknowledge that . But with that in mind , how do you think about and perhaps occasionally prescribe uh and direct your patients in terms of hormone replacement therapy in men person , in their thirties , person , in their forties , who's doing almost all the other things correctly . Uh What sorts of levels do you think are meaningful ?
I think that they simply don't understand and don't care because it's a , um pill mill and it's a money mill . I think that nowadays it seems almost everybody who's doing T RT is taking lower doses more frequently every other day or twice a week , dividing the dose and being very , very careful with these estrogen or aromatase blockers . Um We , we , we , most of our patients do not take aromatase inhibitors .
But then you get into a little bit of the vicious cycle of will having a normalized testosterone facilitate you doing those things better . So , uh let's just assume we come to the decision that this , this , this person is uh a good candidate for , for testosterone replacement therapy . The next question is , what's the method we're going to do it ?
But it seems to me that similar to the Aia's rule as it relates to longevity that we could come up with a broad contour rule in which if a male of any age is not trying to get decent sleep , exercise , appropriately , appropriate nutrition , minding their social connections , et cetera , et cetera . The idea of going straight to testosterone seems like a bad idea that said , just like with depression and antidepressants , there is a kind of a cliff after which uh low enough testosterone or low enough serotonin prevents people from sleeping exercise , social connection , et cetera . So I do wanna acknowledge that .
