The days of handing out the same testosterone dose with an estrogen blocker for everyone are over.  Today, we’re developing new multifactorial programs using nutrition and hormone replacement.  The goal is to get away from treating testosterone in isolation.  Despite the ads you’ve been undoubtedly seeing everywhere, there is more to longevity than testosterone alone.  We need to focus on organ functionality and how each organ is interconnected.  To explain this, I need to take you back almost 20 years.

It Began with a Paradigm Shift

I started thinking differently in 2005 when research showed the gut (i.e., the microbiome) was considered the “second brain.”  “WTF?!” was the response from 90% of psychiatrists.  That’s right, Doc, time to go back to school on the human metabolism! I knew then that psychiatrists needed to do more than just talk therapy. 

We had hundreds of patients calling our pharmacy who saw six or seven different psychologists, psychiatrists and social workers who pushed eight different diagnoses (i.e., bipolar, depression, schizo—you name it).  This is how out of touch the mental health system was—and is.  It hasn’t changed much.

Patients were being given scripts for five different meds including antidepressants, antipsychotics and benzos, which they were told they needed to stay on for life.  Is that any way to treat a patient?  And don’t give me “this is the standard of care” bullshit!  My response was: dig deeper—these people have nowhere else to turn.

Because of my work with the anti-aging community, I was trying to wrap my head around why physicians and therapists did not think about how deficiencies in estrogen, testosterone, progesterone, thyroid hormones and cortisol could be responsible for all the patients’ symptoms.  It’s not rocket science to test naturally occurring hormones in the human metabolism, then correct the deficiencies with low-dose bioidentical hormone replacement.

Back then, hardly anyone tested for nutritional or hormonal deficiencies.  No one tested the microbiome.  Within eight weeks we helped 80% of our clients feel better.  All the testosterone treatment centers need to follow the new research and stop treating testosterone in isolation.  Why?  Because every organ system is interconnected.  Stay with me here.

Why You Need to Know This 30-Letter Word

How many 30-letter words do you know?

Psychoneuroimmunoendocrinology.  Say that three times fast!  This 30-letter word is an example of the future of personalized medicine. It demonstrates the study of multiple metabolic systems together.  When studied separately, they are not fully understood.

How does hormone replacement improve mood, brain, nervous and immune system function?   Looking only at testosterone is myopic; we need to look through a therapeutic lens.

Let me give you one more powerful example.  You’ve heard of heart disease, diabetes, dementia and obesity, right?

Ready for this?  They are all one disease.  That’s right, all one disease.  Conventional medicine treats them separately with specialists and special medications.  You can see how people end up on five or more different pharmaceuticals.

What do heart disease, diabetes, dementia and obesity have in common?

1. Elevated blood glucose
2. Elevated Insulin
3. Inflammation
4. Nutritional / hormonal deficiencies

If you cure one, you’ll cure all four.  And I know you’re asking yourself, “Why isn’t this common knowledge?”

MONEY!

In some areas, this IS common knowledge.  The ketogenic diet movement has educated millions of people to this fact.

When I write these articles, you must understand where I’m coming from, what I’ve witnessed.  I’ve watched family members take car keys away…seeing the sadness of losing one’s independence is crushing.  Everything I’ve seen scares the hell out of me (read my article about my early experiences in nursing homes), so I get up every day and work out so I can avoid sarcopenia (muscle wasting).  All the symptoms of aging can be slowed to a stop with hormonal and nutritional replacement and 30 minutes of exercise per day (a combination of aerobic and resistance training).  Trying to find a physician to work with you is like finding a diamond.

Why Low-T Clinics are Dangerous

Four years ago, I shot a video for the Russ Scala YouTube channel titled “Are Low-T Centers Dangerous?”

I was trying to hold them accountable for their one-size-fits-all treatments of testosterone only.  Come on, it’s 2023!  We can do better.

There are thousands of metabolic pathways in the human metabolism and all you’re going to do is give testosterone as a fix-all?  Well, good luck with that.

We would get three or four clients a month from low-T centers dispensing testosterone only.   Clients were getting worse once they started testosterone treatment, which consisted of the same treatment for all men: a 100 mg shot once a week with an estrogen blocker.  This is a dangerous protocol that can damage the lining of the arteries around the heart.  The 100 mg shot causes a spike in testosterone that converts to estrogen and causes endothelial dysfunction.  In other words, damage to the delicate lining of the arteries, which when healthy release nitric oxide, keeping arteries wide open and preventing blockages.

The Low-T Clinic Scam

We still have hundreds of low-testosterone clinics around the US that think all you need is testosterone.

Thousands of internet advertisements tell men, “All you need to do is take testosterone and all your problems are over.  Take testosterone and you will find love and, best of all, you can stay hard for hours.”  Come on!  But people believe this.

Their marketing pitch is illustrated with an attractive, grey-haired man who’s jacked, sending the false message that having six-pack abs and bulging muscle is healthy.  In reality, having extra muscle speeds the aging process.

If you want longevity and performance, look to the hunter-gatherer tribes of the Maasai, Hadza and Inuit.  These people are fit and lean with functional muscle.  This is the example to follow for fitness.  After my interview with 6-time Mr. Olympia, Dorian Yates, who called me after he had two DVTs, our collaboration showed how the treatments at low-T centers can cause heart attacks.  Scary, I know!

As research director for a major compounding pharmacy, I trained hundreds of physicians to use testosterone safely.  Now we need to step up and stop just treating testosterone in isolation and look at multiple organ systems that interconnect.

Other Benefits of Balanced Testosterone

You might be wondering, if boosting testosterone alone doesn’t work, why do the low-T clinics keep getting clients?  Well, here’s an analogy for you.  When a person becomes vegan and quits eating junk food, they feel amazing for the first time in years.  Their body is getting nutritious food.  This may not be ideal long term, but they feel so good it’s like a dream come true.

The same happens when a man starts testosterone, which is a natural anti-depressant that raises the neurotransmitter dopamine, causing excitement, motivation and aliveness.  Therefore, thousands of men think testosterone is the holy grail when it’s just part of the solution.  But I bet you didn’t know that many men and women feel the same way after elevating T3 and T4 thyroid hormone levels.

Here’s another hardly known fact:  testosterone and the gut (i.e., microbiome) work in synergy.  Studies show that testosterone-deficient diabetic men have different gut microbiota compositions compared with other male type 2 diabetes patients.  Low serum testosterone patients also tend to harbor more opportunistic pathogens, which may be related to the development of testosterone deficiency.  Currently, there are no low-T clinics that I’m aware of that test the microbiome.

No one ever talks about the research on testosterone preventing neuronal cell death either.   After brain injury or stroke, testosterone combined with thyroid hormone can grow new brain tissue by elevating brain-derived neurotropic factor (BDNF).  See my point?  While hundreds of low-testosterone centers market bulging muscles and erections, Scala Precision Health has been using testosterone as part of its dementia program.  Vascular dementia is poor circulation to the brain.  When you increase testosterone, the walls of the arteries release nitric oxide, opening these arteries so more nutrients and lifesaving oxygen can reach the brain tissue.

Try to get a neurologist to look at the research though.  I’ve put these lifesaving studies into their hands and their response was, “Russ, this is all real and amazing and I totally agree but my practice is too conservative for this treatment.”

Really, Doc?  All we are doing is increasing hormones already present in the human body.  It’s called optimization.  I was persistent.  Fuck me, Doc!  Just run the testosterone labs, free and total, then optimize with micro dosing—very safe and effective—then watch how the patient’s symptoms slowly resolve.

This would drive me nuts.  Ninety percent of docs want to help but if they practice outside their standard of care, they’re liable and no physician wants a malpractice lawsuit.

We must get away from just thinking about libido and muscle.  We must think about whole-body functionality.

Simple Things You Can Do for Your Health

Testosterone levels dramatically decrease after consuming sugar due to the rise in insulin.  The average American eats over 100 lbs. of sugar per year.  Take a minute and wrap your head around that fact!

Hormone replacement facilities need to focus on diet and there have been many diets promoted since the early 1900s.  Which one is best?  Well, there is one sweeping generalization: keep blood glucose and insulin levels as low as possible.  I call simple carbs “poor man’s Prozac” because they relax us by elevating serotonin levels.

Simple carbs are refined sugars and can be addicting to many people.  White flours, grains and fruits cause a spike in blood glucose and stimulate insulin, which triggers the body to store fat.  Just cutting out these foods over six months is a good start.  People who do this see fat loss but not muscle wasting.  Monitor your lab work to track your progress.  If you can get one, using a continuous glucose monitor is an excellent tool for direct metabolic feedback.

Do your homework and become the CEO of your own health.  Read, read and read some more! Pick up the book by David Kessler, “The End of Overeating.”

I’ll tell you what I learned as a paramedic back in the early 80s.  There are two types of people: those who die peacefully and those who die screaming.  Trust me, make it your mission to get healthy.  Make small changes, that’s it.  Scala Precision Health has coached thousands of people over 30 years.  We know what works.

To the hundreds of low-T centers, this Bud’s for you!