E245: What It’s Really Like to Start TRT: Xander’s Testosterone Journey

Like energy-wise, I feel like better than I felt throughout like my entire 30s and probably through most of my 20s if I'm being really honest. And it's like, yeah, why wouldn't you want to feel your best when you feel really good, when you feel capable of a lot? I think you're able to show up as a better man. Hello and welcome to the PillowTalks podcast. We're your hosts Vanessa and Xander Marin. I'm a sex therapist with over 20 years of experience and I'm just a regular dude. We share the ups and downs in our relationship while giving you step-by-step techniques for improving yours. Make sure you subscribe for your weekly double date full of totally doable sex tips, practical relationship advice, hilarious and honest stories of what really goes on behind closed bedroom doors, and so much more. It's the sex education you wish you'd had. Today we have a very personal episode that was hotly requested. Yeah. We're talking about Xander's testosterone journey. A sensitive topic for a lot of people. Yeah. Doesn't feel sensitive to me. Yeah. I think a lot of people, we actually had a lot of requests on Instagram for us to share about this and I think a lot of people were surprised that you wanted to share about it. Like it was supposed to be some dirty little secret that you were supposed to take to your grave. So we're doing a deep dive into this today. We're talking about what made Xander start asking some questions in the first place, the symptoms that he was struggling with, what the process of getting on testosterone looked like, and answering a lot of your questions about side effects. People were curious about all sorts of stuff from mood to the size of your balls, to your libido, to the impacts that it's had on our relationship. So yeah, let's get personal. So we're going to really dive into it. Of course, we always have to preface this by saying, we are not doctors. Absolutely not. I'm not a doctor. She's not a doctor. This is not medical advice from either of us. This is purely Xander's experience. It actually reminds me a lot of the episodes that we did about your vasectomy. Yeah. Another topic where people were like, I can't believe you want to talk about that. Yeah. It was like this. Who the fuck cares, man? I'm shooting blanks and loving it. Shooting blanks and shooting up Xander's life now. Not quite, but... So yeah, it's not medical advice. Just meant to be sharing one person's experience. But we do, like I do hope that this episode empowers people to have some information, to understand one person's experience, maybe to start asking some questions. Maybe just to see that this doesn't have, that this isn't a shameful topic. It doesn't need to be a shameful topic. It doesn't say anything about your masculinity, at least in my opinion. I'm sure there are plenty of other people out there that would disagree. But... Oh, that's silly though. Well, yeah, but I mean, I'm saying, I understand that people have feelings about that. And I'm not going to say, you're dumb for having those feelings. Like, people have those feelings. I don't understand it. I don't believe it myself, but... I hope that this episode will help to spell that. Yeah, absolutely. I don't think there's anything... If anything, I think seeking tools, seeking help, looking for resources, like... To live your best life, to be a better person. If anything, that's more masculine than less masculine. Yeah, I totally agree. I mean, that's why I have no problem talking about my vasectomy. I don't have any problem talking about this. I don't have a problem talking about the fact that I'm sober and I needed to seek help to make that happen. I think like, that makes, me a stronger person. I mean, I think a lot of it comes from that originally of like, hey, you know, I had to be very vulnerable and ask for some very vulnerable help. And compared to that, like, talking about my testosterone journey, talking about my vasectomy, like, it feels like pretty small and inconsequential, honestly. Okay, so let's start at the beginning. And we pulled all of these questions from Instagram. These were the things that people were curious to know about. So what were your initial symptoms that made you even start this path to begin with? So really just like a single one, I think, and it was lack of energy or maybe a bit of lethargy. And if I'm being really, really honest, obviously, I have the benefit of hindsight now, having gone through the experience that I've gone through. I do think that in hindsight, this may have been something that I struggled with since probably like, since I got out of college. You know, I remember kind of always just being tired a lot and taking a lot of extra motivation to like, get myself to want to, you know, go out or be up late. And of course, as we get older, you know, I have zero desire to be up late now. So, you know, my perception of the energy that I want is totally different now than it was back then. But, you know, I do think that, you know, I'm able to now be like, yeah, maybe I kind of was struggling with that for a while. But, you know, my reality now is, you know, ever since I got sober a long time ago, I realized I don't have any excuses anymore for not operating at my best, for not feeling the best. Like, I don't have any, you know, in the past, it's so easy to be like, oh, well, you know, oh, I've been working really hard, and I went out party, now I'm hungover. And, you know, now that I don't have any of that, and, you know, I'm like, I want to, I want to surf, I want to have an active life, I want to go to the gym, I want to feel my best. Then you kind of start to notice, oh, like, I feel like I'm like, you know, struggling to recover after a long surf session or going a couple days in a row or like going really hard at the gym. And yeah, and so like, I started kind of realizing, yeah, I feel like I'm not at my best. And that actually got me started going down the path of seeking out like help from a functional medicine doctor. Yeah, so I think that's important to know, like, you didn't have any really pressing symptoms. No. And it wasn't about libido for you either, which is a big misconception that a lot of people have about it. So let's let's back up though and share a little bit like what is functional medicine for somebody who hasn't heard of that? Yeah, so functional medicine is I mean, it's definitely having a moment like you hear more people talking about it on social media. Basically, functional medicine is a it's a more personalized like people call it like a root cause approach to health that is kind of looking at the whole person like your genetics, your environment, your lifestyle in in using all that to try to address the underlying drivers of disease or the underlying drivers of, you know, in my case, like maybe why I'm feeling a lack of energy, rather than just trying to treat symptoms, like that's kind of the hallmark, I think of typical Western medicine. It's like you go to the doctor if you're like, Oh, I can barely get out of bed, like what's wrong with me? Help me out. And so then they're like, Oh, you're having this really extreme symptom. How can we treat that? Rather than, you know, functional medicine is like through a lot of blood work and testing and whatnot. It's like, Okay, how can we look at the data that is available to us about you to figure out how we can like minimize your risk for disease or how we can maximize how you feel rather than waiting around for you to start complaining about like a real serious significant problem on. So when it comes to testosterone, this is really interesting. I didn't really know anything about testosterone or, or, you know, testosterone replacement therapy or much about hormones at all before I got started with this, because like the very first time I went to go see a functional doctor, you know, they order you a big panel of labs. So if anyone's interested in doing this, no, you're going to get a lot of blood work done. There's no way to do functional medicine without that. And you know, one of the tests they do is for, you know, a hormone panel. So you get your testosterone levels. And so I didn't really realize that for most people that that's abnormal to have your testosterone levels checked, because the interesting thing is in the US at least, I don't know about other countries, but most primary care physicians will never test men for their testosterone levels, unless that guy is complaining about pretty significant or serious symptoms around low libido or erectile dysfunction. And often I've heard from a lot of people who even just like kind of ask like, Oh, should we check my testosterone? A lot of time I've heard a lot of people say that our doctor was just like, no, no, you don't you don't need to worry about that. So it's almost like doctors, typical primary care doctors are a little bit dismissive of the need to do that, which is interesting. Obviously, I'm not a doctor. I'm not saying that that's I'm sure there's reasons for that. But, you know, when you go in the functional medicine route, like that is one of the first things that they are testing on you. After my very first appointment, my doctor kind of tagged the fact that my testosterone level, it was not as low as it would eventually become. But it wasn't high. And she kind of called out, Hey, like, given my, given my health, my age, and the my activity level or my desired activity level, because, you know, also part of functional medicine is they're like, Hey, what do you like to do? Like, what does your day look like? What do you aspire to do in terms of like, hobbies, activities, sports? Like, so she knew that I surf, she knew that I wanted to surf a lot. And she was like, I just want to call out like your testosterone isn't super low, but it's definitely not ideal for the level of activity that you want to have. So yeah, I actually looked up my old blood tests before you recorded this episode that I could see what those levels because everyone said, Okay, well, what, what were the actual levels? So, yeah, so like, I'm looking at it here, that very initial test, my levels were actually 425 for total testosterone, which, which is not super duper low, but it's definitely not, it's not close to high, and it's not close to ideal, either. So yeah, like between, so then, you know, like I was saying, there's a lot of blood tests and functional medicine. So, you know, in 20, you know, I think I started doing that in like 2021 or so, in like 2022 to 23, my total T fluctuated between that like 425 to 275 range. But yeah, my doctor kept referencing that, you know, ideally, ideally for your desired activity level and your age and your health, like, you want to be in the 800 plus range. So I saw that I was like, Oh my God, that seems like way higher. Like, you know, that like, it almost seemed kind of impossible. So yeah, like at that point, we weren't really talking about TRT, testosterone replacement therapy. And we were just starting to talk about lifestyle changes. So like, you know, she was like, you know, what are some things maybe that we could do on that, you know, that could move this in the right direction. Before we talk about that, I want to get into what you've learned about normal levels. And again, not medical advice. But this is something in my own journey. I've really had to learn that what most Western doctors consider normal with blood work isn't necessarily the guidelines that we actually should abide by. Or at the very least, it's a really wide range that, you know, where like, within that, there's probably a more ideal range on. So yeah, like, yeah, the what we consider the normal range in the US, personally, I think is kind of bullshit. Again, not a medical doctor, I'm sure. I'm curious if there are some medical doctors listening that want to, you know, to disagree with me, definitely write in like, I'd love to learn more about your perspective on this. So my understanding of all this from doing lots of blood tests, because when you do a blood test, it will typically show you what is the and I don't know if it's like FDA approved or what the if there's like a governing body that approves what these ranges are. But what it shows as the typical range for testosterone in the US is between 250 on the low end and 1100 on the high end. So they show that as green and then it's red below that and it's red above that. Now, the like the medical term for low testosterone is a hypogonadism. That's a good word. Hypogonad is I don't even know if I'm pronouncing that correctly. But my understanding for that is that typically it's if your total T levels are below 300, and you have some other or other symptoms of low testosterone present. So like low energy, low libido erectile dysfunction. And so if you have like a level below 300 and you're complaining about any of those issues, that basically, you know, that is considered hypogonadism, like low testosterone, which would in theory, the you know, the treatment for that would be testosterone replacement therapy. But the interesting thing is that most primary care physicians in the US, they will say that anything above the minimum of 250 or sometimes I'll say like 300, like, oh, if you're above 300, yeah, you're fine, you're totally fine. Despite the fact that the optimal ranges are really way above that. And even like to be to be fair, talking to like, I actually I see a different functional doctor now that we've moved to Santa Barbara. But you know, talking to her, you know, what she has said about libido, because typically libido is like the first thing that men are worried about when it comes to testosterone, what she said is like, yeah, the range is, you know, you know, 300 or whatever, like down to 300, it's not like your libido is totally gone. She's like, your libido is going to be one of think about it like from an evolutionary perspective, your libido is going to be one of the very last things to go, like to go completely when you have low hormone levels, like we have evolved to basically maintain some amount of libido to try to, you know, keep expanding the species, so to speak, right. But that doesn't mean that like, you're going to like have a high libido at 300 necessarily. But I think the important thing is that she was like, yeah, libido is going to be one of the last things to go. But there's going to be a lot of other things that start to deteriorate first, like your energy levels, your ability to build muscle quickly on, you know, how much brain fog or how much focus you're able to have. And so, yeah, I think it's like so many people are so focused or so many primary care doctors are focused on, oh, don't worry, your libido is fine. Without looking at, oh, well, if your levels are in that lower range, you're probably struggling with some of these other things that are really going to improve your lifestyle, like, oh, you can have more energy, you could have less brain fog, you could maybe be getting better sleep, like all this stuff that is actually super important. Yeah, I think this is about having a conversation with your doctor about what's normal versus what's optimal, you know, if that's something that you're interested in, sometimes we're just like, I just want to be a normal, that's fine. But there is a really big difference between normal and what's optimal. Okay, so you said before you started Testosterone, you tried lifestyle changes, which I do think is really important for people to recognize as well, that, you know, medications aren't a magic bullet. So much stuff that's related to health, and especially a lot of stuff related to libido is really about us needing to take a look at lifestyle and asking ourselves some tough questions and, you know, trying those types of things versus looking for that magic bullet, you know, magic pill solution. So what lifestyle changes did you try? Well, I mean, before I even talk about what I tried, what I will tell you is if you go in the functional medicine route, one of the very first questions that they are going to be asking you is, okay, like, get really, really honest. How are your stress levels? What does your diet look like? Like, those are two of the major things that they're going to ask you about, because those two things play a huge, huge, huge role on, like, yeah, on your libido, on your energy, on your overall well being. So for me, at the point that we were doing this, I had really dialed that part in, like, I was like, yeah, I have lived a pretty low stress life, I go, yeah, and sleep stress and sleep kind of go hand in hand. It's like, are you getting consistent amounts of sleep? Are you getting enough sleep? Like, do you have good sleep hygiene? Do you have low stress so that when you sleep, you actually can get rest? Or you can actually fall asleep? That's going to be probably one of the first things they ask, because it's like, yeah, if you are burning the candle at both ends, it doesn't make sense for you to be having super high testosterone levels, or it doesn't make sense for you to, even if you do have high levels of testosterone, it doesn't make sense for you to feel awesome. Like stress really, really kills you. So that's one thing. You know, I was talking about wanting to feel more, you know, to just be more energetic, and especially like to not feel so wiped out after I surfed, because that was a thing I've like kind of forgotten about that because this has changed so much. But yeah, I mean, like, I used to, I would get pretty wrecked. Like if I surfed for two hours, or I was like, in the ways were good, I was surfing a lot still, like, like multiple days a week. And at the time, I thought I was in pretty good shape. Looking back, there were some things blocking me from being as good of shape as I could have been. But on, and like, I would be wrecked, I would feel as soon as I got out of the water, I would feel like there was not enough water in the world for me to drink. Like I felt like super dehydrated, I'd feel kind of headachey, and like I would bring obscene amounts of water with me to drink afterwards, because it would just like, I would think that that was what I needed to feel better, but it wouldn't really help. And so we tried a lot of stuff. There were a lot of like other things that we worked on, which I'm not going to get into all of that. But like, you know, there were some other genetic things that I needed to do in terms of supplementation that made small differences, but ultimately weren't really moving the needle. So one thing that is suggested for raising testosterone naturally is more consistent weight training with heavy weights, not like functional training, like heavy weightlifting, you know, like have like low rep, high weight with, you know, like two minute breaks in between sets. Because yeah, that is that type of exercise is most likely to raise your testosterone. I tried that didn't really make an impact. I tried DHEA supplements. That can definitely help some people. For me, that made me feel more tired and probably felt like I lowered my libido a little bit, which is possible as well. So I stopped that. I did try this other supplement that the doctor recommended called Tong Cat Ali. I didn't really have any negative side effects from that, but it was also kind of hard to tell if it did anything. I didn't see my T levels go up a lot. So, you know, that wasn't really worth it. So each time I would try one of these things, you know, it'd be like after we'd have an appointment, we'd talk about options, blah, blah, blah. And so as I'm having more and more appointments in the, you know, years are going by, you know, she kept kind of reinforcing the idea that, okay, like there may be some more direct options here because the testosterone levels aren't moving. You were making a lot of progress in other areas. You're feeling better in other areas, but we're not really seeing any movement here. So she kept kind of tagging like, hey, at some point, if and when you want to, this could be a good option for you. Okay. So let's go to when you finally started taking testosterone. Tell us what form are you taking and tell people what are the options. Oh, and also before you answer that, I do, I want to be really careful to make sure we're saying like you were listing specific supplements that you tried. Do not take anything unless you talk to your doctor. Yes. Please. Absolutely. Okay. So now tell us about the testosterone. Well, I mean, at least also the things I suggested didn't actually work for me. So it's not really a ringing endorsement at all. All right. So my doctor actually recommended a pretty conservative approach to TRT when I initially said that I was ready to do it. And she kind of walked me through what the various options were. And she only talked about injections, almost kind of like a worst case scenario, if nothing else works. And I don't think she really meant it like as a worst case scenario. I think that, you know, at least she saw it as like, you know, people, many people are not super stoked about the idea of sticking a needle in themselves on a regular basis to inject themselves with something. And so, you know, let's try other approaches first to see if any of that's going to be effective. So initially, for me, it was testosterone cream. So it was basically just like, it almost looked like a little weird kind of deodorant type thing, where you it has cream in it and you turn this thing on the bottom and it measures out a specific and consistent dose each time. So it bumps out like a little tiny bit of cream and you rub it on the inside of your thighs. And I was on that for maybe like two to three months on it was at first, it definitely started, I started noticing an impact like, you know, after probably a week or two, sort of like more of an impact in like three to four weeks on where I initially for a couple of weeks started feeling pretty good and feeling like, oh yeah, I've like more energy, a little more sex drive on and then it kind of tailed off. And ultimately, what happened so I got blood work as it felt like things were kind of tailing off. And yeah, my testosterone levels actually went down. And so that was interesting because what happens with the cream is it's like, it's supposed to supplement your natural testosterone production. So like, you know, your body produces some amount of testosterone, the cream, you're it's supposed to not shut down your body's testosterone production. But I guess for me, it did start to shut my own testosterone production down quicker than expected. And so as a result, like I was supplementing testosterone, but not enough to make up for what my body stopped producing. On top of that, the cream was kind of annoying because, because like you have to you have to worry about transferring it to somebody else, you have to be very cognizant of when you're putting it on each day, because it needs to be on you for a couple of hours to absorb on. And you know, so it's like, you have to think, okay, well, like, when am I going to take a shower? Like, am I going to the gym? Am I going surfing? When am I going to take a shower? And when can I do this so that I'm not, you know, disrupting what I'm going to do during the day. But also, like, it's ideal, I think to put it on around the same time every day, it's probably more ideal to put it on in the first thing in the morning. And so that can get kind of tricky, especially with surfing, because, you know, you're going in the water, it's going to wash it off. It's, it's probably would be less of an impact for someone that doesn't surf. But yeah, so that was annoying for me. I do think that maybe I try to be very careful, like, you're not supposed to let anybody touch your inner thigh area for like three to four hours after you do it. And we try to be really, really careful of that. But sometimes you forget or, you know, I think that there was, you know, probably one or two times that we had sex. And it was like, you know, right around three to four hours afterwards. And I think I may have accidentally transferred some. Yeah, my my testosterone levels got really high. You would want blood work where you kind of have a spike on. And yeah, that's not good because like women's testosterone levels are supposed to be way, way lower than men. So like for me, you know, this cream is like raising my levels a little bit. But for a woman, if she gets a tiny bit of that, like it's a disproportionate amount on like a woman would never test supplement testosterone in that way, or with that amount. So yeah, like that's something to watch out for. So anyway, that didn't work so well. And then it was like, okay, well, your natural production is declining. So this isn't really the right delivery method. Storytime. Last year for Christmas, I bought Xander this sex pillow. Best Christmas present ever. We ended up becoming absolutely obsessed with it. And through a series of really funny little coincidences, we actually ended up becoming friends with the couple who owns this company. And we became so obsessed with this pillow that we actually joined as advisors to the company. And we are sharing it on our Instagram. It is literally the first time we have ever promoted a product that's not ours on Instagram. We are that obsessed with this pillow. 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The way that Clomid is supposed to work is I believe it stimulates the pituitary gland. It basically tricks your body into thinking that it is low in testosterone so that it will produce more, which is kind of interesting. Oh, the other benefit to Clomid is that it supposedly does not decrease your fertility levels. That's a huge consideration with testosterone. I know there's some questions about that later. But yeah, like cream and especially injections, that really will impact your fertility levels as a man. Whereas Clomid does not. So Clomid can be used for men who are still trying to conceive or still want to have kids and also need testosterone replacement. But that also didn't work out so well. One, it was really actually, it was really hard to get it. Like the pharmacy didn't always have it in stock. It was, that was not covered by my insurance. It was quite expensive. Like I think it was like over $100 for like a month's supply or something like that. Sometimes I would be able to find like a good Rx coupon and it was way less. But it was like, we would be like one day there was a great coupon for it and another day there were no coupons for it. And so it just felt like a constant battle of like, okay, which pharmacy can I get this from and keeping having to like transfer my prescription, which was really annoying. But and it also like that took a while to impact me because I was coming off the cream where it kind of like slowed my natural production. And so then there was this waiting period for the Clomid to like fire up my natural production. And so there was like a month where I was like, I was really low energy. And that was tough. And I just had to kind of trust, hey, it's going to get better. The problem with this though is it did get better. But when we tested my estrogen levels also went way up as well. And so you can improve your testosterone. Like my testosterone went up to like 850 or something like that. But my estrogen went way up as well. And when your estrogen goes up in concert with your testosterone, it kind of cancels out the benefit that you get from the higher testosterone, because ultimately how you feel it's all about T to E ratio testosterone to estrogen. And so you want that ratio to be not like unlimited high, but you want it to be relatively high. And so yeah, once we got this test back showing that my estrogen had gone like way into the red, like too high in the positive direction, we stop I stopped taking the pills because I was like, okay, this is this is clearly not working. And the crazy thing with that was we stopped I stopped taking the pills and like 48 hours later, I started feeling incredible because what happened was my estrogen level started dropping my testosterone took a lot longer to to go down. And so that gave me I had like two weeks where I felt like better than I had ever felt in my life up to that point. We were in we were in Chile. Remember that? And I was like, I was like, Oh, my God, this is I feel like I could like hike all day long. And then I want to have sex with you all the time. And we had a good time on that trip. Sure did. And on so that was kind of like my window into Oh, this is what it's supposed to be like when your t to e ratio is when your t is a bit higher and the ratio is in a better place. And so that gave me the confidence to be like, All right, I want to do the injections because now I know what this is supposed to be like. It's it was it was kind of like a light switch had been flipped. And all of a sudden, like, I was like, Oh, this is how I'm supposed to feel. I want to do I want to do whatever approach is going to allow me to get to a consistent level of testosterone, stay there. And then also be able to find the right level of estrogen and stay there as well. So at that point, I talked to my doctor and we got she got me on injections. Okay, so talk about injecting yourself because I think this is something a lot of people are really scared of. I mean, I was I was nervous of this. The funny thing I was actually not very nervous about it. And then the first couple of times I needed to inject myself all of a sudden, I was like, Oh, my God, this is really real and kind of scary. It's a trip, man, like it is a real trip doing it because on. So yeah, what they say is the best place to inject yourself is like your butt, like or kind of like the side area, like above your glute on the problem is, if you are injecting yourself like good luck trying to reach around there on with more than one hand, like sure, maybe you can do that with one hand, but like, you don't have you can't really see where you're going. And I was like, okay, if I'm doing this myself, I don't want to I don't want to be completely dependent on like Vanessa to inject me. And my doctor also was like, Oh, you could come into the office and get injected by us. But I was supposed to be injecting like every three or four days. I'm like, I'm that that's like absurd to be trying to do your injections around going into someone's office, right? It's like, I need to be able to do this myself. So the second best place to do it is in your thigh. And when your thigh, it's right in front of you. So that's that's where I have been doing it on. But it is, yeah, it's scary, like, when you're doing in your thigh, this is called intramuscular injection. It's a long it's like a one inch needle. And it's a fairly thick gauge needle, because the testosterone itself, I take testosterone,cipionate. It is a pretty viscous fluid thick, thick. Yeah. And so you need a wider needle in order to actually like, to be able to draw it up and and push it through the needle. It was a bit scary. And I definitely, for the first like two months, I kind of I got to a point where I was like really getting in my head about it. I'd be like standing there with the needle like I hear you in the bathroom. And it would be like, I'd look down at my leg, I'd see the needle, I'd see my leg, and I'd be like, I can't pull the trigger. And it kind of got to a point where I was like, So yeah, that was tripping me out. On the other hand, I'm starting to feel really good. And I'm like, so I'm feeling good enough or I'm not like, it's not like scaring me away from doing it. It's just tripping me out in the moment. And so I kind of had to, I kind of had to figure out how to reframe my perspective on doing it and be like, All right, I got to figure out how to just push through the standing there, like going back and forth with my hand. This is not helping. Like, it's got to just be like, boom, just you got to just get it in. And I also did some research and found some different techniques in terms of like kind of how you hold your your skin, kind of like pulling on the skin on your leg a bit. And that really helped. I think it was called like Z-track or something like that as a way of like, you pull it up, you inject yourself, then as you pull the needle out, then you let go of the skin. And so yeah, at this point, I'm pretty proficient at injecting myself. But you just had a change. Like, oh, yeah, I'm about to yesterday. Yeah, well, we will see. I am going to very likely be switching to daily subcutaneous injections rather than every three day intramuscular. So intramuscular is a longer needle, like a one inch needle, because you got to get into your muscle through the skin and into the muscle. I'm actually going to be trying out a switch to daily, much smaller daily dosages of subcutaneous, which is in the in the skin or kind of like in the fat, just below the skin. Yeah, actually, sorry, it's a Q. It's just below the skin, like into the kind of fat. So like that would be like in kind of like my love handles or like in my belly. So that is a, I think assuming I'm literally I going back and forth, or the I got to find the right, the right knee syringes to be able to do that because it's tricky because it's like I said, viscous substance, like a small insulin needle is probably too fine of a gauge to to be able to inject that. So it's like, I need to I need to I'm talking to my doctor and calling some pharmacies to figure out where I can get the exact right syringe for this. But yeah, the plan is to do that. And because yeah, for me personally, I don't mind doing giving myself a subcutaneous injection. That's different. It's like you get to pinch your skin. It's like you don't feel it nearly as much. And you're injecting a much smaller amount. So it should be easier. It should also supposedly result in more stable levels of testosterone, because you're getting the same amount every day, rather than like, I give myself a larger dose every three days. And it should have some other kind of positive health impacts in terms of like my blood viscosity and stuff like that. Okay, can you talk quickly about estrogen blockers? Yeah, so this is another thing to know if you go the TRT route is you can add testosterone, but you very likely may also need to take something to inhibit what is called aromatization, which will raise your estrogen level. So like the way that testosterone breaks down in your body, there's a couple of different pathways that it takes when it breaks down. One of those pathways ends up converting, or I think what they call it aromatizing into estrogen. So if you add a bunch of testosterone with nothing else, you will almost certainly also raise your estrogen levels. Now how much your estrogen goes up is kind of depends on you and your body and like how how much goes to which pathway, it's not like a simple equation, or they can be like, Oh, if you add 100 milligrams of testosterone, you're going to increase your estrogen by Y amount. That's why you have to be doing constant blood testing, not constant, but like every couple of months testing to make sure your levels are right. And so for me, you know, kind of probably for the first three months doing injections, I was like starting to feel really good. And then it kind of reached a point where it felt like things kind of plateaued or maybe started to go backwards. And that was aligned with when I got some tests back that my estrogen levels had gone way up kind of into the red again. And so at that point, I'd talk to my doctor about what we could do. And basically the best option is you get on what's called an aromatase inhibitor. So I take, I take a pill called anastrasol, which basically it inhibits some of that conversion of the testosterone into estrogen. It's a little bit tricky to take because it's, it is a you're taking it like basically from it's a it's a pill that's meant for women. And so as a man, you're taking it off label. So it's like, it's a one milligram pill and the dose for most guys who are using it for testosterone is you need to be taking a quarter of a milligram. So like, I have to cut this pill into quarters, which is a pain in the ass. And not super consistent. But that's what I do. And it works. And that worked really well. So that, I feel like that has gotten me to a super duper stable level where I feel good about like, you know, I don't I'm not worried like, Oh, God, next month, am I going to be feeling good? Or am I going to be feeling lethargic? I think that this also just speaks to the importance of finding a doctor who's thorough and that you enjoy working with because you've had you've made so many changes, so many little adjustments. It's not like this straight A to B path. Yes, it's really important. So what have you discovered about for your unique body, the testosterone levels that feel best for you? Yeah, so that's a that's a good question. Because yeah, I've, I've definitely I've experienced like the whole gamut now I've actually experienced being what's called super physiologic like above the range, because we kind of accidentally overshot initially with the dosage that I was on, and then reduced it what seemed like should have been enough to get down back into the range, but then it didn't quite. And so yeah, now I kind of know, okay, this specific amount keeps me probably gets me to around like somewhere between like 900 and 1000. And I think that that is really for me the right level. Because even though like you could, you know, shoot for like I want to be right at 1100 at the top of the range. The more tests the higher my testosterone is, the more disproportionately my estrogen levels rise. And so that completely just cancels out the positive benefits of the testosterone. So it's like it's really not worth it. So for I've come to realize for me, in order to have like the best balance of both testosterone level, and that ratio of testosterone to estrogen, that I think for me it's being around like 900, 950, something like that. So that's kind of where I am I'm aiming to be. Okay, how much does it cost and does insurance cover it? So yeah, my my insurance does cover injections because I was diagnosed with low testosterone. Because like as I was saying, you know, I had some results that were below 300. So my doctor was able to, you know, get my insurance to accept a diagnosis of that. So yeah, my testosterone, I get a vial every month, it costs $15 with the insurance. I think it's said the last time I picked it up, it said like, you saved like $67 with insurance or something. So presumably it would be like 67 plus 15 or something without insurance, maybe. I'm sure it varies wildly. Yeah, it probably varies wildly. And then I pay like $5 every couple months for syringes. Okay, now let's do some rapid fires about side effects. I know you've kind of talked about some of these as we've gone through, but by far and away, the thing that people were most curious about were the side effects. So has it impacted your libido? And again, like that wasn't the original reason that you started it, but have you noticed changes to your libido? Oh, in every way, both positive and negative, which is interesting. So yes, it has when my levels are right and my ratio is right, it definitely, it definitely impacts my libido in a positive way to an extent. Like my, I feel like in the last many years, like I've had a really great relationship with sex and my desire and like, you know, kind of it not, you know, not always being like, Oh, I'm like incredibly horny, but like I want, I want the closeness that sex brings us. And that's something I want to seek out with on TRT. I've noticed as well, that I experience more like a lot more spontaneous desire and like, Oh yeah, like really feeling like, Oh, I really want that or I really need that. That being said, there have been some times when we're still dialing in the levels where, where in the doctor, your doctor will tell you this, if you are not, if your libido is feeling out of control high, we need to talk about that because that's, it's not beneficial for you. And I've, there's been some brief moments as things were, you know, accidentally a little too high or whatever, where I was like, Ooh, I can start to understand why people are like, Oh, this is, this is not, this is not manageable. It's like, you just find yourself randomly thinking about sex, like in, in opportune moments. And I, I could not keep up that I was like, Oh boy, like it was fun at first. And then it was like, Oh my God, I can't even look at him. And he's just gonna want to have sex again. So yeah, important to get your, get it dialed in, but it has been, I think you've enjoyed the impacts that you've noticed. Yeah, it's definitely, it's definitely been enjoyable on. Yeah, I think it's in a good place right now. But I was also going to say, I've also noticed the impact it can have on tamping down your libido because it can also create too much estrogen. Like in times where, you know, my, I raised my estrogen levels too much. I've also experienced how it can actually shut down your libido or kind of mask it with too much estrogen. So that, that has been interesting as well. I definitely have a better respect for the role that hormones play in, in the, I want to be careful with libido because I think people think of libido as just a physical thing. Just a physical thing. But it's not like it's how much you want, it could be like how much you spontaneously want sex, but you can also want sex because of the way sex makes you feel, the type of connection you feel, the pleasure that you know that you will feel, you know, once you get started. And so yeah, I definitely have an appreciation for the role it plays in that kind of like carnal desire. Yeah, but that's just one part of it. Yeah. And I have to say like libido is affected by so many things other than just our hormones. And I think we, especially with men, I think we do a disservice when we say, oh, just get on testosterone, like that'll improve it. But there are so many other things that are affecting your libido too. So yes, it can help in cases where you actually have low testosterone, but it's not a magic bullet and it's not like the one and only thing that's going to affect libido. Oh yeah. No, if I'm in the, you know, my life is really, I've taken care of a lot of stuff. I've spent a lot of time addressing a lot of the things that used to get me really stressed out and anxious or worried. And those aren't a part of my life anymore. That being said, there have been some times where I have been stressed or overloaded or anxious about something. And yeah, absolutely. My libido is not sky high, even on with higher testosterone levels in those situations. So I think I have been able to experience a lot of the real positive impacts, like unmasked of testosterone because I've taken care of all this other stuff in my life. So like Vanessa was saying, yeah, if you're working 80 hours a week and you're like, oh, I just want testosterone so that I want more sex. Like I'm sorry, it's not, it's not going to work like that. Okay. Did it shrink your balls? It has, I don't think it has. That's definitely that to be to be totally fair, that is a possible side effect. It can make your balls a little bit smaller. I think it was like 10% like you can't you wouldn't really be able to see oh yeah, it probably has, but I don't know if I can see 10% of what that is. I definitely haven't noticed that your balls seem smaller. I mean, I don't really I mean, honestly, if my balls did shrink, I wouldn't really care that much because like the positive impacts have been so great for me. I'm not like placing so much value on ball size, but I don't know. I don't think I have particularly large balls to begin with. So I don't really care, but yeah, I don't know. So it hasn't for me. That is definitely a thing that it can't I I think it's important for people to be aware that that is something that can happen. If you are really, really worried, I can't afford to lose a centimeter of ball, then yeah, maybe don't do it. Can it affect your fertility? Yeah, I already said absolutely yes. Cream and injections will 100% affect your fertility. You know, my the funny thing for me when I said that I was ready to get on it, my doctor like sat me down and had a real serious conversation. She was like, I know that you already have gotten a vasectomy, but before you do this, I want to triple confirm with you. There's not any world in which you think you might want to have kids. Let's see. She's like, heaven forbid, you and Vanessa were to break up like would you possibly change your mind if you were with somebody else? Like that was like how like how much she wanted to she's like, I cannot prescribe this for you in good faith if there's any part of you that is wanting to maintain some amount of your fertility. And I was like laughing. I was like, hey, I mean, like I already made this decision and getting a vasectomy. And she's like, yeah, you can reverse the vasectomy. Like you can't like yeah, if you got off, if I got off injections that maybe some of my fertility come back, but probably there would be some lasting damage to it. So for most men, you want to wait to do this until you're done having kids. That being said, there are some oral medications like Clomid that you can do that will preserve your fertility. Did it improve your sleep? Yeah, I think so. Honestly, I think that me doing this whole palette expansion was really the thing that improved my sleep more. But I do feel like I do feel like yeah, I mean, like I definitely have more just kind of drive and focus to get stuff done during the day. And then when it's time to shut off at night, I feel like it's really easy for me to just shut off. Okay, you've definitely answered this one already, but let's just go over it again. Did your energy improve? Yeah, so my energy, it's not like I'm not like bouncing off the walls to be really clear on it's more of I feel capable of a lot more. I don't ever have the question in my mind of like, Oh, am I going to be too tired for this? Which is definitely something that would go through my mind before like, Oh, so and so wants to go on a hike like, Oh, it's like four o'clock and like, I'm kind of tired. Now I'm like, yeah, even if I am like, relaxed or lying on the couch or something, it's like, I feel like I have, I trust that I have the energy store required to do whatever it is that I need to do. And also, you know, like I was saying when I would surf before this, like I would be, I would just be so wrecked, I would feel like super dehydrated. That has all like, completely gone away. It's probably a combination of the palette expansion and getting better oxygen, but also the testosterone and having more energy is like, yeah, I can, I can surf twice in a day. If the waves are really good. I can surf and go to the gym if I want to, I don't usually do that, but I can if I want to. You know, I go surfing, I get out, I drink a reasonable amount of water to rehydrate myself, and I feel relatively normal. I can go do a whole day's worth of work and not be like, Oh God, am I going to be like battling a headache the rest of the day? Okay, this was one that a lot of women were worried about. Did you experience anger, aggression or grumpiness? I did not. However, these are very, oh, I did. Yeah. They're just for like, there were maybe two days where you were still dialing things in that you were, and it wasn't like, like anything intense, but you were definitely a little aggro. And I was like, Oh, I think that's the testosterone. Okay. Well, maybe maybe this is a better question for you to answer. It was very, yeah, it was mild and it was literally two days, two different days that I can think of. But I did notice that and it is, you know, it is something to keep an eye out for. I think it's something that couples should talk about ahead of time. So you're a, you know, because it's kind of, it can be a little nerve wracking to bring up to somebody like, Hey, you're being a little aggro. So if you have a conversation ahead of time, like, Hey, this is something that might happen. Let's make sure we feel comfortable talking about it if and when it does. But yeah, it was, it was just because your levels hadn't reached that optimal phase yet. Now that you're like in a good place, you have an experience. Yeah. And this is very much something your doctor will talk to you about. Like if you, and this is the point of having a doctor that you trust and you are able to talk to you on an ongoing basis, the doctor is available for you because yeah, like my doctor was like, here are all the symptoms that you need to watch out for. These are things that can happen and they are all fixable, but you need to tell me if you are noticing any of these so that we can make adjustments. Because yeah, I think like what I would not want for anyone is that like some doctors like, okay, boom, here's testosterone, check back with me in six months and like you're on your own. Because yeah, like that's like, yeah, then if you're going to get like really aggro, you might not notice it, but other people might notice it and like that's not a good situation. Did you build muscle? Yes. Once I got on the injections and my levels were really much higher, it was kind of like I said, I felt like a switch had been flipped. It seemed like a switch got flipped for me in terms of my metabolism and in terms of my ability to add muscle. Like I didn't change the amount that we were going to the gym was surfing and it was like all of a sudden within a couple of months, I started building muscle in a way that I had never experienced and looking back, I think I always really struggled to add muscle and struggle to and to like lose, you know, kind of like little bits of fat. I mean, you were when we met your six feet tall when we met, you were 125 pounds, like you're a naturally very thin person. Yeah, but then I added, but then I basically went up to like 170, 175. I've kept the same weight, but I've basically just converted everything to muscle. Your body looks totally different and it's great. Did it affect your skin? Yeah, in positive and negative ways. So on the one hand, there's this thing called the TRT glow. Everybody stops them and is like, Oh, are you even on vacation? You're so tan, you're glowing. Just my face. It's like weird. I don't know what it is. It's really just like neck and face is yeah, my face, it just looks more flushed in a really healthy way. So that's been a nice thing. On the flip side, probably the biggest side effect that I've had is some acne pimples like on my face and on my face. I was getting some on my face in my beard, remember? But no, on my chest more than anything, I did finally figure out, my doctor helped me figure out a supplement. I take like DIM and Sol Palmetto. And that has completely stopped. It's basically like a whole, it's like how testosterone ends up breaking down. And this supplement or that combination of supplements kind of, I guess, helped block some kind of thing that was causing that those pimples to happen. So I'm very happy to have figured that out. Did it affect hair growth? Yeah, I've had a couple random patches of I've got like some weird, I'm not a very hairy. I have a great head of hair, but I don't have, I've never had a lot of body hair. And yes, testosterone can definitely make you grow a lot more hair. So for me, because I'm not a super hairy person, it's been funny because I have just like a couple random patches on my arm that kind of blew up. They're not big, but they stick out because I don't have any other hair around them. So yeah, that's a thing, but it's not like a problem. All right. And last question, did it affect your voice? I don't know. What do you guys think? I don't think so. I don't think it has at all. All right. Well, that is your testosterone journey. Testosterone testimony. Testosterone testimony. Yeah, I mean, it's been, it's been really interesting watching you go through it. And, you know, it's been great to see you feeling very empowered to pay more attention to your health, to really get tuned into yourself. I think like working with a functional medicine doctor, like, it's very interesting because it does force you to be more in tune with your body. You're doing blood work more frequently, you're doing check-ins more frequently. Forced you to get really honest with yourself. It's like, hey, is this, are these things that I'm eating really serving me? Am I really operating at my best or not? You got to be willing to, you got to be willing to try stuff that you might not want to if your end goal is to really feel your best. Any final words you have for maybe like a dude who's listening to this thinking like, oh, maybe is this something I should look into? Or maybe anyone were still worrying about like the masculinity aspect of it. It's so interesting because I think that people think that, oh, well, like my testosterone level or my like not paying attention to my testosterone level and therefore like how much I work out or what I look like or what I look like, that's the measure of who I am as a man. And if I were to find out I had low testosterone levels, like, oh my God, that would somehow make me less than or if I needed to be on TRT because I had low levels that I would somehow be less than, I don't know, I think that's bullshit. Because like the reality is, is like, do you want to feel your best, especially as you am, I mean, for me, it's like, I, you know, I just turned 40. And I'm like, I feel like I'm 20 again, in many ways. I, you know, unfortunately, I still I got some aches and pains that a 40 year old is starting to get from, you know, like going hard surfing or in the gym sometimes. But like energy wise, I feel like better than I felt throughout like my entire 30s and probably through most of my 20s, if I'm being really honest. And it's like, yeah, why wouldn't you want to feel your best when you feel really good, when you feel capable of a lot, I think you're able to show up as a better man when you're able to, to, yeah, to like ask questions and figure out what you need to do to be better and to feel better. I think that is, I think that's like, that's like real masculinity. It's not masculinity isn't just, oh, let me like, let me like, pretend to be something. It's like, no, it's having the confidence in who you are. And for me, this is this, I think has helped me build this confidence of, oh, yeah, I'm able to do the things I want to do. I'm able to excel in the things I want to excel in. I'm able to, to look the way that I want to look in the mirror. You know, I get the results out of the out of the work that I do on my body. And, and yeah, and then I like being able to like, in our sex life, I like being able to show up the way that I show up. Like, so for me, I feel really fucking manly. And yeah, I hope the same for you. Like, I would hope that people, I'm not saying everyone should do this, but I think that a lot of people might be bearing their heads in the sand a little bit. Or, or like, I hear so many people who are just scared to even find out what their levels are. What's it going to say about like, what, like having data on yourself, like it doesn't, it's not going to change anything. All it's going to do is give you what you need in order to decide, Oh, do I, do I want to make a change or not? All right. Well, that's all for today's episode of Pillow Talks. Thank you so much for listening. Join us again next week. We release new episodes every Thursday.