Last Friday I sat down with Dr. Ben Evans of Men’s Vitality Center, a board certified internal medicine doctor, to discuss low hormones and Testosterone Replacement Therapy (TRT). He is a health nut, lifter and former athlete who has been specializing in TRT for almost 20 years and so he really knows his shit. Otherwise, I wouldn’t have had him on the show.
You can listen to the full episode by Clicking HERE
Dr. Evans discusses how your testosterone levels can affect you no matter your age or where you are on your fitness journey. It was a pretty interesting discussion as we dove into the Bro Science of testosterone and TRT.
Listen to the entire 47 min podcast HERE.
Here are a couple of the topics we talked about in the podcast, but you want to listen to the entire thing to catch all of Dr. Evans’ insights and knowledge on the topic. We probably covered all your questions on hormones and fitness. But if we missed anything, leave your question in the comments and we will get you an answer.
What is testosterone? (4:52)
Testosterone is the essential male sexual hormone that gives men their physical and mental characteristics. Testosterone is directly related to muscle mass and aggressiveness (in a good or a bad way). The normal range of testosterone in a male can range from 300-950 ng/dL, where in females levels are around 15 to 70 ng/dL.
Why would someone need Testosterone Replacement Therapy? (5:45)
As you age, hormones naturally drop resulting in the decrease in muscle mass, strength, and speed. All of this is directly related to the drop in testosterone levels. TRT is needed when symptoms start to interfere with daily life.Symptoms of low testosterone include fatigue, inability to maintain muscle mass, or increase in abdominal fat. If you were experiencing low T, you may notice your sexual performance and libido may have tanked. Your blood pressure or blood sugar may be higher than normal or you may lack motivation or may even be depressed.
Fitness-wise, you could be doing all of the right things, like eating well and exercising, but still not see results. Your strength gains may start to diminish, you could have a decrease in muscle mass even though you are lifting. You could feel depressed; have poor recovery, increased abdominal fat, and lack of energy. You would feel like you were ice-skating uphill. All of this could be due to a hormone imbalance or low testosterone.
What may cause low T? (12:30)
Besides normal aging, low T can be caused by a head injury, testicular injury, taking certain opiates/pain pills or illicit drugs, thyroid issues, or diabetes. Stress, sleep deprivation and obesity are also known to decrease testosterone levels. Because of these issues, younger men can experience symptoms of low T that can really impact their life and physique. Stress and lack of sleep is a big culprit and is why Dr. Evans says some first responders (such as firefighters and police) experience low testosterone.
How to get treated for low testosterone? (15:08)
If you are experiencing any symptoms of low testosterone mentioned above, Dr. Evans recommends visiting the doctor to have your lab work done. They will use it to check your hormone levels and determine if your testosterone levels are low.
Once the doctor has determined that testosterone replacement therapy is right for you, they will put you on a hormone treatment regimen. Dr. Evans prefers testosterone injections to creams or pellets. With injections you can control the dosage to make sure you are getting the right amount.
Too much and you can experience some side effects. For instance, if you are getting too much testosterone, what is not being used in the body gets converted into estrogen and that can result in gynecomastia (aka gyno, man boobs)
Dr. Evans isn’t a fan of testosterone cream because it is hard to control the dose and can rub off on other people, such as your kids or wife when you hug them (yikes!). Testosterone pellets also have their issues with controlling dosage and can lead to infections at the implantation site.
How much does testosterone replacement therapy cost? (23:02)
Insurance can cover testosterone replacement therapy if lab tests show you are hypogonadal (testosterone levels below the normal range for men). Dr. Evans said that some of his patients who don’t qualify for insurance coverage pay out of pocket, which is just around $200 per month.
Are there side effects of testosterone replacement therapy? (20:00)
Side effects can happen when the dose of testosterone is too high. That is why Dr. Evans strongly urges anyone taking testosterone, whether through a doctor or recreationally, to have their blood levels checked frequently to avoid unwanted or dangerous side effects.
Besides gyno mentioned above, other side effects can include increasing red blood cell production, enlarged prostate, or it can exacerbate other pre-existing conditions.
One example Dr. Evans mentions is that many bodybuilders experience sleep apnea, which also increases red blood cell mass. Combining sleep apnea with too high of a testosterone dose can result in thickening of the blood. This makes the heart have to work harder to pump that thickened blood through the body and can cause heart failure, clots or stroke. In the world of fitness, which is a world of excess as Dr. Evans puts it, it is important to make sure you are being monitored when taking testosterone.
Can you boost Testosterone naturally? (28:39)
Dr. Evans says the best way to naturally increase testosterone levels is to use the most basic advice. It goes back to diet, exercise and sleep. Eating real, healthy foods along with healthy fats, like fish oil. Get rid of the simple sugars (no more Frappuccino’s and orange soda), because the more obese you are the less natural testosterone you are producing. You are actually making more estrogen since it is fat that converts to estrogen. That is a bad ratio in men.
Dr. Evans also recommends heavy lifting exercises or big compound movements, such as squats, deadlifts, and Farmer’s Walks. These types of movements boost testosterone production.
Most importantly, Dr. Evans recommends getting good sleep, which helps to maintain hormone levels. He recommends 6-8 hours per night, which confirms the saying “sleep for gains”.
What are the biggest benefits of Testosterone Replacement Therapy? (39:56)
Dr. Evans says that for his patients TRT is life changing. His patients say that TRT saved their life, saved their marriage, saved their job, gave them their life back, helped them feel like a man again, helped them lose 100 lbs, or helped them get into the best shape of their life. Most of all, his patients report that their confidence is back, which helps them get back in the gym or back to kicking ass at work and at life.
Give the episode of full listen HERE and please share with any friends, family, or co-workers on a fitness journey who you think this might help. If you have any questions regarding hormone replacement or TRT, feel free to leave your question in the comment section.
If you have any concerns about your testosterone levels, you can visit a Men’s Vitality Center to get your labs done to check your levels and then go from there. There are 6 locations throughout the valley in Scottsdale, Mesa, Glendale, Avondale, Phoenix, Tempe, and Tucson. You can call or visit their website to schedule an appointment.
Until next time eat well, train hard & be nice to people.
Jeremy Scott Fitness Podcast
Scottsdale Personal Trainer ~ Make Success Mandatory Author