 Our next caller is Alisa from Ohio. Hi Alisa, how can we help you? Hey guys, I'm really excited to be here and Sal, congratulations on your book. Thank you. Yeah, so I'm kind of a recent listener. I started about six months ago, but I've been all of your past episodes. And most recently, I've been following Adam's HRT journey. So for me personally, my question is around testosterone supplementation for women. I listened to the, was it John Romano podcast recently? And I don't think he covered this or if he did, he was negative on supplementation of testosterone for women. So I'm just a little bit of my backstory. I've been into fitness since I was 15 and I am in my late 40s now in about a year or two ago. I was having a lot of trouble sleeping. I had insomnia, very low energy. I was also having trouble concentrating kind of fuzzy brain. So I went to my regular GP and she offered to prescribe sleeping pills to me. And I just said, no, thank you. A friend of mine was seeing an MD that specialized in HRT. And he ran my labs, saw that I was low in progesterone, testosterone and also high, super high estrogen. So he recommended supplementation with progesterone and also a little bit of testosterone. So what I mean by a little bit is I can barely fit it into the syringe. It's like on the one line, it's one, I think it's 1.5 milliliters or 0.15 milliliters is what it is per week. And now my levels are somewhere around 100, like the fifth day after I supplement and I'm sleeping much better. I have more energy, I'm concentrating much better at work. And then just recently about a month ago, I went to see my GP and she saw that I was supplementing with testosterone and she asked me if I was transitioning. And I was really confused. I said transitioning to what and she said, well, that would be the only reason a woman would supplement with testosterone. And I guess I just want to know from your eyes opinion, is that true? Is she crazy? Which of my doctors is nuts? Yeah, no, that's a good question. So first off, this is a problem with GPs. Yeah. So first off, we're not doctors. So this is going to be our advice is based off of our experience and experience working with clients. Number one, I'm going to refer you to somebody on social media that I think is excellent with balancing out with helping women balance out their hormones. Dr. Jolene Brighton. So if you don't know who that is, find her. She's got great information on balancing out progesterone estrogen and testosterone. Testosterone is present in women and it does have a role in a woman's health, just like it does in a man's. Now in a man, it's the dominant hormone. It is the male hormone. But in women, low testosterone can cause things like low libido, low confidence, low drive can contribute to osteoporosis or osteopenia, muscle loss. I'm not sure what the amount of testosterone you're being prescribed right now. It definitely isn't one milliliter because that's 200 milligrams. That would be more than what a man would take every week. But that one little line, it sounds like you're on something like 10 milligrams. I'm not sure what the dose is, but it sounds like you're working with a specialist in the field. Now a general practitioner is not a hormone specialist, just like they're not a nutritional specialist. I've had clients go to a general practitioner and the general practitioner give them dietary advice that makes me shake my head. So I would definitely refer to the hormone specialist because that is exactly what they're specialized in. You did mention you feel a lot better too, and I feel like that's the best evidence of all. If you feel good, then you're probably on the right track, at least in comparison to how you were doing before. 10 milligrams of testosterone is not going to transition you into a man. I'll tell you that right now. I don't know what the dose is, but that sounds like a feeling. We don't know exactly what it is, but by what you're describing, I think it's very, very low, and that amount is not going to transition you into a man. This has been a constant battle in my entire career with general practitioners, as they go through their schooling many times, three decades before. A lot of them stop learning or going beyond that, and they give advice in areas that they're just not a specialist. If you're seeing a hormone therapist, trust me, he or she knows their shit probably a lot more than the GP does in this area. Like Sal said, I think if you're feeling good and you like the way you feel, you're probably doing really, really good. And to Jolene Brighton, we did two episodes with her, so if you haven't listened to those episodes, you can search on Mind Pub. That was mainly what we talked about, was woman's hormones. Here's the one thing I will say about hormone imbalances. Oftentimes, there is a root cause to why hormones are off. And what you can do, there's two routes you can go with fixing this. You can either solve the root issue, which sometimes is very difficult. It can be challenging. It can be very mysterious. The other option is to just supplement with the hormones and balance them out exogenously. The problem with that is you may be masking the symptoms of whatever the root cause was in the first place. So those are the two options. Now here's the deal. Sometimes you can't figure out the root cause, or sometimes your hormones are so out of balance that that becomes a more pressing issue. For example, if you're a man and something in your life is causing your testosterone to crash, and you can't figure out what it is and you're trying to raise it, but it's so low that it's like, we need to get this up because it's causing health problems. That can also be the case with women as well. So those are the two kind of the two directions. But yeah, you're working with a specialist in hormones. I would listen to them over the general practitioner when it comes to hormones. Things to look out for with testosterone with women? Are you getting any masculinizing effects? Are you growing hair where you normally didn't? Are you noticing a deepening of your voice? Is your libido like way out of control where you become impulsive? Those are mood swings. But it sounds like you feel way better than you did before. Am I correct? Yeah, I feel better. I mean, my husband hadn't said anything about me being super hairy or anything. He hasn't noticed anything, so... I agree though with Sal. I do think, and if you've listened to my story back when I was on hormones, then I came off and I spent a good three years and during this podcast sharing that kind of journey of trying to troubleshoot it and figure it out myself. And I had some success. Like I was down in the low 200s and I worked myself up to about 400 naturally. But I'm recently back on hormone replacement therapy now and feel a lot better. I just wasn't where I never could get it back to where I think I was before. So I've also known that I'm kind of signing up for that for the rest of my life. So to Sal's point, if you never kind of get to the root cause of what's causing all those issues, then you might be signing up for taking those hormones forever. But hey, if you can't figure it out naturally and figure out what the root cause is and it's improving your life that much right now by doing that, that's something that I'm doing. So I totally agree and understand. Right. So root cause, couldn't age just be one of the root causes? No. You will notice a change in hormones as you age, but there's a natural change and then there's the unnatural types of changes. So for example, a man's testosterone will lower as he gets older, but it shouldn't crash, right? So you shouldn't be a man in your 40s and have testosterone that's 250 or something like that. Now, it'll be lower than it was when you were 18, but not that low. And the same is true for women. You'll notice changes in progesterone and estrogen and even a woman's testosterone, but if they're lower than what would be considered a healthy range. But even those situations though, Sal, a lot of times the factors that cause that of aging is actually less of them aging and more of the lifestyle change over those years. That's what I'm saying. Yeah. And also, the ranges that you'll get from the labs can be so wide. And healthy is usually not at the extremes. The range for a man's testosterone is 300 to 1,100. What the hell? That's a huge difference. So does that mean if I'm 305, I'm good? Not necessarily. And they do that with women's tests as well. So, and again, your quality of life is very important. How do you feel? How is your energy? How is your skin, your recovery? Like those things are also very important. Quality of life, I think, is something that sometimes we ignore and we just look at the numbers. Well, your numbers are okay. I know you feel like shit, but your numbers are okay. So therefore you're okay. I disagree with that. Right. Okay. All right. Well, thanks. That helps. Thank you. Thank you. Thanks for calling in. Yeah, it's funny, especially when it comes to hormones or, I mean, gastro issues. Look, I dealt with gut issues, going to the GP, and was getting zero, zero answers. Oh, just wait it out. Oh, you'll be fine. Oh, take some Pepto-Bismol or whatever. I'm like, okay. This is not helping me. They have specialists for a reason. You'll get conflicting diagnosis as well. Courtney has gone through this with her thyroid as well, just the range of where they'd like her to be and what she actually was feeling through that. So there's a lot of trial and error that is going to go with it as well. Yeah, I want to reiterate that what Sal said about us not being doctors. This is always a tough area for us to skate when you get clients that come to you that have questions above your pay grade. This is not what I went to school with. But in our defense, I've dealt with this a ton. And a lot of this is communication between me as a personal trainer with the specialist and asking them questions about what's going on and then doing my best to help implement the lifestyle changes. For example, like with myself, the things that I was trying to do is more sunlight, focusing better, not over-training, making sure that I have a balanced diet. There are a lot of natural things that you can do to try and potentially address what the root causes. But at the end of the day, like you said, Sal, I mean, if she's tried all these things and it's not working, it's not helping still, and then taking this low of a dose of testosterone is helping her, then yeah, I mean, that's improving quality of life for her and I'm all for it. And this is what I can't stand about GPs is an area where they speak at a turn. And yet, because they're a doctor for so many people, they carry so much weight still. My doctor said I should eat this way or my doctor says I'm going to turn into a man if I do that. This just voices that there's more options out there too to get a second opinion to really like, you know, take this upon yourself to do more investigating and educate yourself more in the top. Yeah, I've had some GPs tell clients, they'll come to me and say, well, my doctor says I shouldn't do lower body exercises because my knee hurt so I shouldn't do any more at all. There's a huge range of exercises we can do that will actually make your knees feel better. I've had doctors GPs tell my clients to take shakes throughout the day and not eat to lose weight. Oh, we just got to drop your calories. Here's a thousand calories with the shakes. Just do this. And I'm like, okay, this is not. Now, of course, GPs have tremendous value in many, many cases. But yeah, if you have a specialist, the specialist in hormones is the person that I would defer to, not the person that's not the specialist.