Episode #15 Testosterone and Hormones Pt. 1 – The Testosterone Boosting Blueprint

Summary

Welcome to a two part series on all things testosterone and hormones. In this episode, Coach Kyle and Dr. K discuss the importance of testosterone, its effects on drive and libido, and the factors that can decrease testosterone levels. They also explore natural ways to increase testosterone and the different forms of testosterone replacement therapy. The episode covers topics such as the optimal range of testosterone, the effects of toxins on testosterone levels, and the various options for testosterone replacement. The episode concludes with a discussion on dosage and cost, as well as a preview of the topics to be covered in Part 2.

Takeaways

  • Testosterone is important for both men and women and plays a role in drive, libido, muscle gain, and mental health.
  • The normal range of testosterone may not be optimal, and individualized treatment is necessary.
  • Toxins in the environment, such as chemicals and growth hormones in dairy, can contribute to decreasing testosterone levels.
  • Natural ways to increase testosterone include improving diet and lifestyle, strength training, and optimizing sleep.
  • Testosterone replacement therapy options include injections, creams, gels, pellets, and pills, with injections being the most common and cost-effective.
  • Dosage and treatment should be personalized and monitored regularly to achieve optimal testosterone levels.

Chapters

00:00 Introduction and Overview

01:31 The Role and Optimal Levels of T in Men and Women 

07:05 Why are Testosterone Levels Decreasing

11:37 Lifestyle Changes for Optimal T

13:37 Supplementing for Testosterone

15:19 Injections

19:44 Pellets

21:38 Gel or Cream Based Options

23:09 Pills

24:34 Dosage Breakdowns

27:40 What is the Cost of These Options?

28:55 Part 2 Teaser + Conclusion 

Sponsors

This episode is sponsored by Toxic Roots.  The optimal resource for online health coaching for optimizing performance and removing toxins. Click on the link below to get started on finding your toxic roots. 

Website: https://www.toxicrootswellness.com/

Instagram: @toxicrootswellness

X @toxicroots

Sources

https://site-akiajqrf22xmaqzsiz6q.s3.amazonaws.com/DDI+Website/News/html/New+Testosterone+Trial+in+Men+(TRAVERSE)+Promising+for+Cardiovascular+Health.html

People

Peak Performance 

Dr. K 

Coach Kyle 

Transcript

​​Kyle Hulbert (00:01)

Ladies and gentlemen, welcome to the Peak Performance Podcast. I’m Coach Kyle.

Ben Kosubevsky (00:05)

And I’m Dr. K. Thank you everybody for joining us. As today we discuss hormones or more specifically testosterone. And we’re going to talk about who should be on it, why you need it, how it works, how to dose it. And just as a pre -clude, we will be splitting this into two parts where we have testosterone and then everything else. Let’s get into it.

Kyle Hulbert (00:26)

sound. Let’s go.

Kyle Hulbert (00:29)

Ladies and gentlemen, welcome to the Peak Performance Podcast. I’m Coach Kyle and I’m here with Dr. K. Dr. K, how are you doing today?

Ben Kosubevsky (00:35)

I’m doing great, Kyle, thank you for

Kyle Hulbert (00:37)

There we go. So this is a good point to say I’m not a doctor and Dr. K is a doctor, but we are not giving medical advice in any way, shape or form. So please consult your medical practitioner or actually go see Dr. K in his office so he can give you real medical advice.

Ben Kosubevsky (00:52)

That’s a good idea. And we do hormone consults by phone. You do not have to be in Jupiter in Florida. You have to be in a state I’m licensed in, but try calling us, see if I can help you.

Kyle Hulbert (01:03)

Yeah, that would be great. Um, so, I mean, I think that first point is really good is, um, you know, testosterone is, is individual. It’s an individual thing. Most hormones are. So having a team of people overseeing your hormone care is very important. So having a doctor who knows what he’s doing along with a health coach that can help advise you and how to talk to your doctor and what to ask for is also very beneficial.

So before we dive in, I just want to say, you know, having a care team and working with different people with different perspectives usually can lend the best outcome to your health.

Ben Kosubevsky (01:34)

Well, I mean, I think that’s true for most things. You know, I tell people all the time, I’m just a piece of your puzzle. All the things we’re doing in my office, it may help you 100%, good chance it won’t, and you’ll probably have to go do some other things on your own with some other people. That’s just how it goes.

Kyle Hulbert (01:49)

Yeah. And that’s actually a very good sign of how good a practitioner is. If a practitioner is telling you that they can solve everything for you, they’re probably not a great practitioner because they need to know their limits, they need to know their scope, and they need to have a network of other practitioners and people in the health realm that can help you in different ways that they can’t.

So let’s go ahead and dive on into testosterone. So, I mean, I wanna start with women because it’s so often overlooked that women need testosterone too. And I believe that testosterone by volume is the actual highest level of a hormone that women have in their bodies. They actually have more testosterone than estrogen.

Ben Kosubevsky (02:42)

Really.

Kyle Hulbert (02:43)

Yep, so it is so necessary for both males and females to have testosterone. And overall, whether you’re male or female, what this molecule really does is a lot of things, but kind of the main thing is drive. Your will to do things, your will to wake up and go to your job, get things done, your will to advance in your career, take really good care of your family, go work out, whatever it might be, it’s…

that it’s the molecule of drive or will or wanting to do things. Kind of associated with dopamine, it’s the hormone. I would say it’s kind of the hormone version of that drive neurochemical of dopamine. Is that a good read on that, Dr. K?

Ben Kosubevsky (03:25)

I mean, yeah, pretty much hormones when the key regulatory hormones in the body. So if you’re low in it, a lot of things stop working. But to touch on your point, so you say it’s really high in women’s, does that mean the ranges for women should be higher than that for men? Women’s testosterone would be like 2000.

Kyle Hulbert (03:42)

No, no, no. So even though it’s one of the most abundant hormones in a woman’s body, the ranges are still much lower than what men need to be optimal. So in terms of optimal ranges, you know, you’re looking at total testosterone, men, probably optimal. Your lab work will tell you that the range is somewhere around 250 to seven, eight, or 900 is probably, depending on your lab, is where the range is. Optimal is a different range.

So once you get out of traditional lab work and traditional medicine, and move to optimization, you kind of want to be for men, you want to be around north of 500 or 600 for sure. And then usually I’ve seen people need to cap out around 12 or 13 hundred at the very max, but it’s very individual. So most people feel optimal at 700 or 800, and that’s myself.

800, 900 is kind of where I like to cap out or else I get too much aromatization. So it changes to estrogen. Uh, and then some people just feel optimal, a higher 12, 1300, um, depending on, depending on who they are and their needs.

Ben Kosubevsky (04:53)

So I wanna pause right there and bring up a point. And I think we mentioned this in previous episodes, but I think it’s worth noting again. So you said optimal versus normal range. And so that 275, if it’s not optimal, where is it coming from? So what people have to realize is normal is not necessarily what’s good, it’s just what is average for, in America, for Americans.

Kyle Hulbert (04:53)

Go ahead.

Ben Kosubevsky (05:18)

And so this is a well-known fact in most people that deal with hormones. The average testosterone levels have been significantly decreasing over the last hundred years in America. And so what Quest and LabCorp do, and that’s why the ranges slightly differ, they’re pretty much the same, but what they do is every 10 or so years, they take an average pool, and this doesn’t just apply to testosterone, it applies to all hormones or all blood work, but they take an average of what they see.

And so if everyone is sitting between three and 500, that’s just what they’re gonna consider normal. Regardless of the fact that you wanna be over 500, as long as that’s what everyone is, that’s okay.

Kyle Hulbert (06:01)

Yeah. So the scary part of this is someone can come on in at like a 290, um, and be considered not deficient in testosterone, even if they have all of the symptoms of hyper gonad, hypo gonadism.

Ben Kosubevsky (06:16)

Yeah, and also the second part is they don’t take age into account for testosterone. An 18 year old and an 80 year old should not have the same testosterone counts. But when you go to the Quest, they don’t they don’t take that into consideration. Everyone is two seventy five to eight hundred.

Kyle Hulbert (06:33)

Yeah, that’s a big point. Although, you know, the biohackers might disagree with you there because I know plenty of old people that want the testosterone level of an 18 year old.

Ben Kosubevsky (06:42)

I mean sure, that’d be nice, but it’s not expected.

Kyle Hulbert (06:46)

No, it’s not expected. Yeah. So the range basically, the normal lab range is around 250 to 800-ish. It changes a little bit based on the lab, but optimal is north of 500. Probably I would say optimal 6 to 1200 is where I would put the optimal range for men. And then for women, the lab work, I forget where the top of the lab work is, but I think it stops around 50, and the bottom is around 8.

So eight to 50 on total testosterone. And then optimal is actually between 60 and 100. So the optimal range is completely outside of the normal range of testosterone for women. So, I mean, again, it’s just like you said, it’s the average. So testosterone has been dropping not only for men, but for women, it’s for everybody across the board has been dropping. And the average for women has actually dropped significantly. So,

Ben Kosubevsky (07:30)

Why is-

Kyle Hulbert (07:44)

What we’re seeing is women can come in with a free testosterone of nine, eight, still be in range, the bottom of the range, but still be there. And they’re not considered deficient. When really this is crushingly low. And along with this comes all kinds of other random health things that pop up. Like I’ve seen people who, when they supplement with testosterone, their lipids fix themselves.

and so does their glucose control. Just like that. Only lifestyle change.

Ben Kosubevsky (08:20)

So, let’s bring up a point is, do we know why testosterone has been dropping in America?

Kyle Hulbert (08:27)

Well, I don’t want to get canceled in this podcast, but talking about this is a sketchy topic, but I mean, it really comes down to toxins. It’s all the toxins are environment and you’re looking at everything from self-care products, Xenoestrogens, plant toxins. You’re looking at chemicals. A lot of the chemicals that we use in our everyday life and farming and pesticides and all that stuff operate as.

estrogen in the body except a thousand times up to a thousand times more powerful than estrogen. And then you’ve got things like mold. There’s a mold that’s, I’m gonna have to remember the name. I’m not remembering the name, but anyway they put it in the ear of cows and they get fat on 30% less calories. And that one is basically how it works is it’s a super potent estrogen mimicker.

And so it is everywhere, personal care products, pesticides, our food, our clothes, even in our water, there’s estrogen in our water. There’s been all kinds of studies showing estrogen in our water. Some of it’s due to a small amount, it’s due to like birth control not being effectively filtered out of our water system in our water treatment plants. And then all kinds of downstream, the biggest one is the downstream effects from industrial processing or farming from all these pesticides that are just making it into our water.

and our water filtration systems and our city water treatment plants are not set up to filter pharmaceutical waste. So it just gets right through.

Ben Kosubevsky (10:03)

So I think that’s part of it. The other part of it is dairy. The amount of growth hormones in the dairy industry is ridiculous and a lot of those growth hormones promote estrogen production. And if you look, there’s dairy in literally everything now. Things that have no business having dairy have dairy. And I think that’s the second aspect to it is we’re all getting flooded with growth hormones.

Kyle Hulbert (10:19)

Mm-hmm.

Yeah, and that’s very important. And this is why, you know, making sure that you live a clean lifestyle and slowing your flow of toxins is very important. So, I mean, something like dairy, I mean, this can be avoided by using local organic, raw milk, that type of stuff. And you can avoid all those hormones. This is a shameless plug from my coaching company, Toxic Roots. If you think you might have toxins that are affecting your hormones, call us up and we can go through an initial consultation and we can talk and…

If you need some hormones and stuff like that, we can talk to Dr. K and we’ll help you out there. So I mentioned what it does and I mostly said drive, but there it does a lot of other things. You know the main one people think of sex drive, which I categorize under drive. So your libido, it controls your libido. It’s a thermostat on it. So if it’s low, you’re gonna have a very low libido and if it’s high you’re gonna be more like a youthful kid in terms of

libido, think of someone in their teens or how you felt when you were going through puberty. So that’s another thing. And then it actually is also has a massive effect on your muscle creation, gain, retention, and your fat levels also as a downstream effect. So those are the main effects of testosterone. Anything I’m missing, Dr. K?

Ben Kosubevsky (11:48)

that pretty much sums up. There’s a bunch of like secondary effects that’s testosterone but we don’t want to just over complicate this topic.

Kyle Hulbert (11:55)

Yeah. The last thing I will say on this is it’s very potent for mental health. Um, if you are low in testosterone, like I was, I was, uh, remember the optimal range is about 600 to 1200. I was one 59 when I got my first testosterone test. Uh, so extremely low, clinically low on all lab work. Anyway, it was just low. Um, and I had all kinds of like depression, anxiety and things like that. And when I started supplementing, uh, and fixing it, um, supporting my testosterone, uh, that went away.

just like in a couple days. So mental health issues gone. So.

Ben Kosubevsky (12:30)

And to give you guys an idea, so Kyle in college was an elite level rower. And so he was performing at that level even with low testosterone, most likely. So just because you can perform at an elite level doesn’t mean your testosterone isn’t low. It’s probably still worth getting checked out because…

Kyle Hulbert (12:37)

Mm-hmm.

Yeah, yes, yeah.

Ben Kosubevsky (12:55)

there’s a chance that if you need it elevated and you get it elevated, you could perform so much better than you already are.

Kyle Hulbert (13:02)

Yeah. And thanks for saying I was performing at elite level. I appreciate that. That might be a bit of a stretch, but hey, I’ll take it. Yeah. So no, but that’s, that’s huge. Actually, what a lot of people don’t realize is all the training that goes into collegiate sports and, and high intensity sports like that often actually lowers your testosterone even further. So you could still be performing well or decently, but maybe have some mental health issues or have just low energy in the afternoons and that kind of stuff, and it could be your testosterone.

Ben Kosubevsky (13:08)

what

Kyle Hulbert (13:32)

So we kind of talked about what it does, why we need it, males and females. We talked about ranges. You want to move into how to increase it or is there anything else with your tip?

Ben Kosubevsky (13:43)

Yep. Now let’s talk about how to treat it.

Kyle Hulbert (13:48)

How to treat it. Okay. Well, number one out the gate diet and lifestyle. This is huge. And I know everybody says this and most people don’t want to hear it. And most people want the quick easy fix, but, um, the, the thing is testosterone is extremely respond, respond extremely well to diet and lifestyle. So if you clean up your diet, you eat whole natural foods, increase your protein to a gram per pound of body weight.

and get, start strength training in an appropriate manner, most likely your testosterone will increase. I’ve worked with people and I’ve seen, it’s not uncommon for people to double their testosterone from two or 300 to 600, just with diet and lifestyle alone. A lot of times what we’re eating and how we’re living is just not conducive to healthy hormones. And if we change those things, we can radically improve our testosterone.

Any points there for me, Dr. K?

Ben Kosubevsky (14:48)

Um, I mean, no, that’s, that’s a really big aspect is even before you get into supplementation and, you know, getting on testosterone injections, try and fix it yourself naturally as much as you can, because I mean, eventually most people that aren’t testosterone end up hating the injections after a while. Cause it kind of sucks to have to focus off twice a week with two different things.

Kyle Hulbert (15:09)

Yeah. So actually that’s a, that’s a good point. It reminds me the other third pillar of a good lifestyle, increase your testosterone sleep. Most of your testosterone production is regulated during your sleep. So if you’re not getting that deep sleep, um, in the first half of the night, your testosterone levels will be lower. So if you fix your eating whole natural foods, strength train two to three times a week, uh, appropriate for your situation.

and maximize your sleep and we’ll probably have an episode on sleep and how to maximize it later. That will dramatically increase your testosterone. Like Dr. K said, well before you get into supplements or actual testosterone replacement itself. That’s where to start.

Ben Kosubevsky (15:53)

Yeah. Um, okay. Let’s yeah. Sorry. I was going to say, let’s say, you know, you’ve tried all that stuff and you’re testosterone still like two 50. What do you do?

Kyle Hulbert (15:54)

So moving.

So here, this is where we get into the very debated topic of supplements for testosterone. Personally, I’m not a fan. There are a few supplements that have been shown to have small raises in testosterone. I’m not gonna mention them because I don’t really support them. If you clean up your diet and lifestyle and your sleep is optimal and your testosterone is still low and you still have low testosterone symptoms,

Most likely the boost you’re gonna get from using supplements is not enough to increase it to where it needs to go. I mean, you’re looking at a 10 to 20% increase if you do the right perfect stack. And usually, you know, 20%, even a 30 or 40% increase on 250 is usually not enough to get you to where you need to be. I don’t wanna go too deep into it because it’s just a, I think it’s a predatory area in supplements. You know, everybody wants testosterone. So take this Tmax 3000.

Supplement to boost your libido and testosterone and what they do is usually they fill it with things that will boost your libido Increase your sex drive which makes you think your testosterone increased, but really it’s just a it’s just a libido increasing supplement So I would stay away from those generally you can get into them if you are if you are someone who is like six seven hundred And maybe dial in your lifestyle

just a little bit more. That’s when I would consider supplementation. And if you want more information on that, just reach out to us and we can, maybe we can do a mini episode on supplementation for optimization, but I don’t really wanna dive into it here.

Ben Kosubevsky (17:46)

Okay, so then, you know, how do we actually treat it and what do we do?

Kyle Hulbert (17:52)

Yeah. So how do you treat it? Um, well, I’d like to start with the main line that everybody thinks of first, and then we’ll go through, um, all the different types of, of options, um, schedules, and then non actual testosterone replacement options. So that sounds good.

Ben Kosubevsky (18:09)

Yeah, it does. Go ahead.

Kyle Hulbert (18:09)

So, yeah, so when people think of testosterone, they think of needles, injections. And sadly, usually injections are the best way to do it. Injections to replace your testosterone, testosterone replacement therapy as it’s called, although has been renomered to testosterone optimization therapy. If you like to optimize yourself, consists of basically going to a doctor who knows what they’re doing.

They’ll test you for certain things to make sure that it’s safe for you to go on testosterone. If it makes sense and your symptoms align and your numbers are not where they need to be, the doctor will prescribe testosterone injections. And then you basically, you do these on a regular basis. And what you have to know here is most likely when you go on testosterone injections, if you do them by themselves, this is a thing you’re looking at for life.

You’re most likely going to be on this for life to maintain your testosterone levels, because if you take testosterone by itself, your natural production will drop. And it could, it could come back. It’s very possible, but I’ve seen things where it’s, it could take two to five years to come back after stopping testosterone. So it’s very important to know what you’re going into and either have a strategy to mitigate it, which we’ll talk about a little later, or know that you’re going to most likely be on this for the rest of your life.

So dosing protocols, when you go into a doctor, a lot of times what they’ll do is they’ll prescribe a testosterone injection once every two weeks. And this is, yep, that’s the standard. Look at Dr. K’s face.

Ben Kosubevsky (19:55)

That’s actually really, that’s horribly concerning because the half life testosterone injection is like two to three days. There is one super long lasting injection of it that does last a couple of weeks, but it’s not available in America. I have friends from Australia that do it.

Kyle Hulbert (20:02)

Yeah.

Yeah. So the main prescribed type of testosterone injections is testosterone cypionate. Um, that’s what we see a lot. Um, but most doctors in this, and I got actually prescribed this way is one inject, one massive injection once every two weeks. And what that does is that causes a spike of testosterone through the roof, probably north of 2000 for a few days. And then a massive crash down. And then you ride it out. The last.

ten or so days, just at a low level. And then you get another huge spike two weeks in. So the optimal protocol, well, as is, to be honest with you, I don’t really know. I would imagine it down-regulates your testosterone even more because it’s getting these massive signals. I do know that a lot of people experience terrible come-down mental health effects.

Ben Kosubevsky (20:48)

instead through your body.

Kyle Hulbert (21:05)

Like on day four and five, they’re starting to get anxiety and depression because they were just at the super high. And now all of a sudden they’re tired and depressed and anxious because of this roller coaster. So it, not an optimal protocol. So then you’ll get into the next level where some doctors will prescribe once a week. I still don’t think that’s optimal. The optimal level starts at twice a week injections. That’s where it begins. So you wanna do smaller injections.

twice a week. Now, the most optimal protocol, which most people will never do because it’s super annoying, is very small injections daily. This will keep the level basically stable as you go through the week. However, adherence to this and basically doing it, injecting yourself all the time is very annoying and it just, people don’t wanna do it. So twice a week is usually where people end up. Is that what you see Dr. K?

Ben Kosubevsky (22:02)

Yeah. Um, that, I mean, that’s where I try and start most people. And so the, the trick to doing twice a week injections is, uh, you know, I have people that they will go and inject her testosterone and immediately go get blood work. I’m like, that’s not what we told you. You have to go get your blood work at the halfway point between your injections. That way we can see your low point and you know, we know how low you’re getting. I think higher than that’s great. And so that’s how we adjust your injection doses.

Kyle Hulbert (22:32)

Yeah, that makes a lot of sense. So on the daily schedule, that’s another thing. It’s super easy to adjust dosages because everything’s streamlined. So you can get lab work whenever. But once again, very few people will do that. I myself split the difference. So I do every other day injections. And then I inject on the off days, a different prescription, which we’ll talk about in a minute.

Ben Kosubevsky (22:56)

But hold on, before, you know, we’re talking about injections, but my friend Bob, he’s on hormone cream, and my friend Tom, he’s on pills, and my other friend Jim, he’s on pellets. Why would he get to be on all that stuff and I have to inject?

Kyle Hulbert (23:11)

So there are lots of downsides to everything else, except maybe cream, which we can talk about. The pellets, let’s start with that. This is my least favorite form of testosterone supplementation because it is a little pellet you put under the skin, a testosterone, little incision, put it under there, and it’s my least favorite for a lot of reasons. One, you have to get cut. You have to have something under your skin sitting there. And then the dosage is very, very difficult to modify.

You gotta take pellets out and scoop them out from under your skin if it’s too much or you need to put more pellets in. It’s just, it’s not a good idea. There are other options that are just better.

Ben Kosubevsky (23:53)

Um, I mean, I, yes and no. Once you get your dose stabilized and just so you know, it doesn’t go in the arm. Like you just showed, it normally goes on top of your butt cheek. Um.

Kyle Hulbert (24:01)

Yeah. I’m just showing him. I can’t show my butt cheek.

Ben Kosubevsky (24:06)

You could, but then we’d get shut down. But no, so pellets, they have a positive, and the positive is once a month, you go to your doctor, they do an incision, they put the pellets in, off you go. And the one downside to them, for my opinion, is there are a slow release formulation where your dose is supposed to be steady. It is higher in the beginning and lower towards the end of the month. People definitely feel it wearing off, but it is definitely a more…

consistent dose. If you’re someone that’s like, I’m not going to do my injections twice a week, I might do them every other week if I remember the impelatory better option for you.

Kyle Hulbert (24:42)

Yeah. So, and he brings up a good point. You know, I’m talking from the perspective of a biohacker, meaning I am like rigid in all the things I do, and I am on point and I am on my schedule and I don’t miss things and I have it all figured out. You know, Dr. K is coming from a perspective where he works with most of the average humans. And so adherence is actually the number one thing when it comes to testosterone replacement therapy, actually doing it.

So that’s probably the main benefit of a pellet is the adherence is probably one of the easiest Because it’s once a month you have to do something so from the from the Pellets we have let’s do gel next They have gel based options I am NOT a fan of these for a few reasons one absorption of gel is limited as opposed to cream Number two

is it can rub off on other people or animals. So I’ve heard cases of people’s dogs being messed up because it rubbed off on their dog. Yeah, it can rub off and create all kinds of issues with other people. So if you have to go with a gel or a cream because you’re not gonna do the injections or you don’t like the pellet, I would recommend staying away from the gels and going for a cream base.

Ben Kosubevsky (25:50)

Dogs, Alston, me.

Kyle Hulbert (26:07)

It’s a better absorption. It’ll go in more quickly and there’s less of a chance of it rubbing off on someone, but you still need to be very careful about it rubbing off. To that point, I think there is one optimal place to place testosterone cream based on the literature that seems most effective, and that is on a dry shaven scrotum. So place your testosterone cream on your balls, and that has the…

best absorption rating and probably least likely area to affect other people. But again, this is something you need to be careful with. Don’t put testosterone cream on your balls and then be intimate with your partner because that can cause all kinds of random effects. So that’s probably the optimal place to put it. A side note is it seems to be more androgenic, so you will get a higher increase of DHT and

free testosterone most likely from this application because of it being put on the balls, meaning it could possibly accelerate hair loss if that’s something you’re worried about.

Did I cover those pretty well?

Ben Kosubevsky (27:15)

Yeah. Um, so, okay. So I know the last thing is trunks pills. Why can’t I just take a pill? My favorite thing is just take a pill and move on with my day.

Kyle Hulbert (27:27)

So you can, if you want to. I’m not comfortable with pills yet, just because they came out recently. They’re new, they haven’t been around for years and years, and we don’t have a lot of data on how effective it is, any side effects long-term, to my knowledge. But what’s your read on it, Dr. K?

Ben Kosubevsky (27:48)

Truthfully, I don’t really ever prescribe the pills. I don’t know how to dose them. It’s just not something I ever got into. I do the cream, I do the injections, or I do alternatives, which aren’t actually testosterone. So, if your opinion on pills is as far as we can go with this episode.

Kyle Hulbert (28:06)

Yeah. So, I mean, with the pills, again, it’s, I think it comes back down to compliance. If a pill is going to be the way that you’re the most compliant, I would say that I would probably put it third in my list in terms of optimal order. I would go injections, cream on your scrotum, pills, pellets. That’s how I would put it. And if that’s the thing you need to be compliant, then go for it. I’m still not hyped about.

the lack of data because I believe these hit the market a year or two ago. Um, and so I just want to see, you know, five, seven, 10 years of these things and people being on them and the effects downstream before, before I’m really comfortable with them.

Ben Kosubevsky (28:48)

Yeah, I mean, that’s a really valid point is let’s not experiment when we already have things that we know work.

Kyle Hulbert (28:55)

Yeah. So when it comes to dosage, I mean, what, what kind of dosage of testosterone, like milligrams per week, roughly, do you, do you put people on? I know it’s probably a huge range, but

Ben Kosubevsky (29:09)

Right. So for guys, I don’t treat women’s hormones. They’re just unfortunately far more complicated than male hormones. Guys hormones are super easy. You aim for the middle. For girls hormones, it is super, it depends on the day, their cycle, a bunch of other factors, progesterone and all that stuff. So I don’t treat women. For men, let me talk this out. I start people on usually 0.2 or 20 units twice a week of 200 milligrams per milliliter.

That’s adjust a little bit depending on what your base testosterone is. So it’s that 40 twice a week.

Kyle Hulbert (29:45)

Yeah, 40 milligrams twice a week. Yeah, so testosterone and sepia comes in vials that have 200 milligrams of testosterone per milliliter. That’s the standard that testosterone and sepia injections come in. So 20 units is basically one-fifth of a milliliter. And so it would be about 40 milligrams twice a week. So at 80, 80 weekly, roughly.

Ben Kosubevsky (30:12)

Yeah, that’s about right. And then from there, so I have, the way I do it is, you know, we get base blood work, we start, we do blood work 30 days after starting testosterone. If we’re at a good range, it ends every three months for the first year and then twice a year after that. If it’s bad, you know, if we need to adjust, we do once a month adjustments until we get a good range and then every three months and every six months. Because you don’t, basically, you don’t want, if a doctor says, yeah, I’m gonna start doing testosterone, see you next year.

Don’t go back, don’t start that. Because testosterone needs to be adjusted and checked religiously in the beginning. You’re gonna run into a lot of problems. Hypogonadism is the first one.

Kyle Hulbert (30:53)

Yeah, that’s a big deal. Like you don’t, the goal is not to turn into a bodybuilder and start juicing and going way too high. Like we don’t want to do that. It increases your risk of prostate cancer, I believe. And it’s just not a great strategy. We want to get to optimal. So there’s a sweet spot for just about everything. We want to be, depending on your lifestyle and how it feels good for you, high optimal is kind of where most people want to head. For me,

I’m not high optimal because my optimal is 800 or 900 because that’s where I feel the best not 1200 Because I tend to have a higher DHT and a higher free testosterone, which means my body can use it more readily So I needed lower total testosterone So my dosage You know you step people up over time, but you started about 80 milligrams a week my dosage currently is Right around 150 a week 150 milligrams a week

Ben Kosubevsky (31:37)

Makes sense.

Kyle Hulbert (31:51)

and that varies some weeks it’s a little higher because of my on and off day schedule. But keep in mind folks, I’m on a fairly, fairly hefty dose, but I was at 159 total testosterone at 20 years old. So I’m coming back from a deep hole. I’m not coming back from a three or 400 testosterone at 40 something. So my dose would be much higher than most people would go to.

Ben Kosubevsky (32:16)

And so the point of that is talk to your doctor about your optimal injection doses.

Kyle Hulbert (32:23)

Yep. Okay. So, I mean, that’s milligrams. Cost. Testosterone injections are not expensive. I get a 90-day supply for $36. That’s with my good RX card. That’s what it cost me. So, the testosterone injections are not expensive. Where you do have to spend a little money is finding a good practitioner. So, usually, an onboarding console will be anywhere from

$150 to $500 to see the doctor for the first time. And then their follow-ups will be anywhere from 75 to 250 bucks to just keep checking and make sure you’re in the optimal levels. And again, like Dr. K said, once you get established on where your optimal levels are, those appointments will stretch out further and further, eventually going to twice a year and maybe once a year if everything’s super stable for a long time. So testosterone, this is important to know. If you go on testosterone.

it’s going to cost you more in the first year because of working with a skilled practitioner. But by the time you get the first year done, you’re most likely gonna have your optimal levels figured out and then it’ll cost you much less. Testosterone injections themselves are very, very cheap. Cream is usually more expensive, I’ve found. Usually you have to go to a compounding pharmacy to get the right strength and that’s just a, it’s a more expensive route.

I’m gonna go to sleep.

Ben Kosubevsky (33:48)

And then I think pallets are the most expensive just because a doctor has to literally put them in you. So you have to pay for a procedure cost.

Kyle Hulbert (33:57)

Yeah, that makes sense. So we talked about cost dosage types. Uh, let’s talk about non testosterone, testosterone replacement therapy, unless we miss anything.

Ben Kosubevsky (34:11)

I’m going to stop. Yeah. I’m going to stop you right there. Um, let’s make that into a part two because this episode is ready to get long. Um, and not everyone’s going to care so much about the second part. Some people just want testosterone. So I say that we’re going to table things like DHEA, HCG and Clomaphene and all the other variants for a part two coming out very shortly after this one.

Kyle Hulbert (34:34)

Sounds good, let’s go ahead and table it. I do wanna leave you with this warning though, do not go to your doctor and ask for testosterone if you are wanting to have a child and wanting to remain fertile. Please listen to our part two to get educated on that and so you can know what to go talk to your doctor about because if you do testosterone replacement therapy, it most likely will render you less fertile than when you started.

Ben Kosubevsky (35:03)

Yeah, unless it’s properly managed and there are ways to preserve fertility even with testosterone, but that’ll be in part two. Okay.

Kyle Hulbert (35:10)

We’ll get into that. I just want to give that warning here. Well, excellent. Well, thank you, Dr. K. I’m Coach Kyle. You can find me at Toxin Free Kyle on Instagram.

Ben Kosubevsky (35:20)

And I’m Dr. K or the osteodoc on Instagram. Thank you everybody for joining us and we’ll see you next time.