Episode Transcript
[00:00:08] Okay, so you hit 40 and one morning you catch yourself in the mirror and think, who is that guy? Yes, we're talking about men today.
[00:00:18] So the energy that used to be automatic isn't automatic anymore. The midsection never used to be a problem and then suddenly it is.
[00:00:27] Sounds familiar to women, but yes, it happens in men too. And recovery from a workout, wow, it takes three days instead of one. Sleep is lighter, drive is lower. And every clinic in a strip mall is ready to sell you that quick fix in a vial. That is not what we're talking about today. Today we are going to talk about the longer term fixes. And I'm Dr. Lori Gerber and on this show, we don't do quick fixes. We do real medicine for real life.
[00:00:56] Lifeevity, not just longevity. And today we're talking about men's health over 40. What's actually happening in your body? The science around peptides and hormones.
[00:01:09] And it really says, how do you think about optimization? Like a grown up, like, what do we do so that this is in a grown up context instead of like a guinea pig or a texting context or a testing context.
[00:01:22] So if this is your kind of conversation, do me a favor, hit that. Subscribe the Dr. Lurie YouTube channel button, tap the bell so the next one finds you. Of course, we want to make sure that you're getting all of the similar content and that it finds you the next time. So let's get into this, guys.
[00:01:40] All right, let's start with what's real.
[00:01:43] Because the dad bod air quotes isn't a personality. It's a physiology. It's physiologically something going on. So somewhere in your late 30s and into your 40s, several systems start to shift at the same time. Testosterone production gradually declines for most men, somewhere around, I don't know, like 1% a year. After 30 through the though, the number matters far less than actually the percentage of drop. Right, so, and also the symptoms and fatigue picture. You want to get the full picture.
[00:02:17] Growth hormone pulses flatten growth hormones. That leans us out, right? It's what helps us with muscle, gets rid of fat, helps cortisol. Insulin sensitivity drops. That is crucial. Now our sugars are staying higher than they used to. So the same diet that kept you lean at 28 now parks flat around the middle. Sleep architecture changes.
[00:02:40] And since a huge share of your hormonal repair happens at night when we're sleeping, worse sleep means worse everything else. Recovery slows. Muscle protein synthesis becomes less efficient. So you lose muscle mass unless you effectively and actively Fight for it.
[00:03:00] So here's the most part most men miss.
[00:03:03] These don't happen in isolation. They feed each other. Poor sleep lowers testosterone. Low testosterone worsens body composition.
[00:03:11] Worst body composition drives insulin resistance. Insulin resistance disrupts sleep, and it's a spiral that keeps going and going. And the dad bod is just the visible symptom sitting on top of it. So this is the physiology of what's happening when our body starts to decline. This happens similarly in women. But I feel like men, we just never talk about it. And men like to kind of just sweep it under the rug. And they talk about testosterone maybe now, and maybe even working out and doing things for lean muscle. But we're not really talking about how this all interconnects. And this is exactly why my philosophy is built around a framework instead of a product.
[00:03:50] I constantly am told that we do too much in this practice and that we like to really, really treat the whole entire body. But this is what we call real3lifeevity method. And it's a backbone of how I work. And I work up every patient this way. Not just men over 40, but women over 40, young kids, adolescents, and everyone that has immune problems. Everything, we do the same style of workup. The first R is to retrieve, reconstruct, and review your data and your history, full history and timeline of how you got here, and review every input. The three reminds us that there's never one cause. And we're doing all three things. Retrieving, reconstructing, and reviewing.
[00:04:28] The E. The three doubles as an E is elimination. We get rid of anything that doesn't serve you. This is where I differ from a lot of optimization clinics. I am actually wanting to take things away before I add. We are going to talk about what we're going to pull back, what we're going to deprescribe.
[00:04:45] Any medication that might be affecting what's going on in your symptoms, we want to start pulling back. And then if we're doing a supplement stack, that stack isn't going to do anything unless I pull back the things that are already not serving you. In this elimination phase, especially with lifestyle, we're going to assess and add. So we're going to get real labs, real measurements, add things back in, add supplementation, add prescriptions and things that will serve you to get those symptoms to improve.
[00:05:13] And last but not least, that final L, which is our lifegevity, which is longevity and life lengths times six. We have six lifelinks and one longevity link, which equals our lifeevity and connecting all of it all together into a life that you wanna live for years, not months or weeks. Because we are in this for the long haul with you. So if you're finding this information useful and you wanna kind of break down every week.
[00:05:41] So subscribe. Subscribe to us. Leave a comment telling me your age, your number one frustration over your body. And I read them all. I will reply and I will help you with some answers. And. And they also help me to shape future episodes. So please leave your comments for me.
[00:05:57] All right, let's start with the foundation.
[00:06:00] Not a vial, not a quick fix, not a med. I have to say this clearly because the Internet won't. No peptide, no hormone will outwork a broken foundation.
[00:06:11] If you're sleeping five hours, drinking four nights a week, not training and eating.
[00:06:17] Eating in a way that is driving insulin resistance. Injecting something that is like putting premium fuel into a car, in a car with flat tires, four flat tires. This doesn't work. I've watched women and men, but men specifically spend thousands of dollars at clinics chasing the molecule when the molecule was never a problem. So foundation first, every time.
[00:06:41] Sleep first.
[00:06:43] Seven to nine hours, protected, uninterrupted sleep. This is where the majority of natural growth hormone and testosterone are produced. This is when that work happens. Fix this. And some men feel halfway better before we do anything else.
[00:06:57] Resistance training. This goes without saying. After 40, lifting is not optional.
[00:07:03] Same thing with women. It's medicine. It's the single most powerful lever for body composition, insulin sensitivity, bone density, hormone health. Right. Three or four sessions a week of progressive, focused big movements.
[00:07:19] And of course, we need to fuel that muscle development. And that comes with protein and real food.
[00:07:26] Men under 40 are under eating protein, overeating, processed carbs. Women are too. Men are not different than us. We anchor the diet around protein and whole food. And a lot of the air quote dad bod starts to resolve on its own. Why? Because we can't put on that belly fat if we're not eating carbs and processed sugar. It just doesn't happen. When you're eating lean proteins and vegetables, you don't have that extra surplus of sugar to deposit around the body, especially in the midsection.
[00:07:56] Stress and alcohol. No one wants to talk about stress and alcohol. We're going to talk about it for a second. Chronic stress keeps cortisol elevated.
[00:08:06] Cortisol is catabolic. It breaks things down, including muscle that you're trying to build.
[00:08:12] And it parks fat where you don't want it in the belly.
[00:08:16] So alcohol suppresses testosterone and Wrecks sleep. So now you have this cortisol cycle that is not functioning and not working for you. You don't have to be perfect, but you do have to be honest. So, so eliminating that or decreasing your alcohol and trying to mitigate stress is really, really important.
[00:08:36] This is part of that elimination step in action. And it's free. It doesn't cost you anything. Right? And I'm a physician who would rather be take things away and do things that are free than add in 10 things because I really want to see real improvement. Right? That's not meant to be me conservative. It's just everything's more effective if you do it in this order.
[00:08:59] And now's what everyone wants to talk about, right? The hormones, the testosterone. How do we do this? Right? How do we put this back in a way that makes sense? And every man over 40 eventually has this talk because testosterone does decline.
[00:09:13] And here is my position.
[00:09:15] Testosterone replacement is a legitimate FDA approved treatment for men with diagnosed hypogonadism or low test, meaning genuinely low levels puts plus symptoms confirm with proper morning labs, ideally not just one more than one when indicated and supervised. It can be genuinely life changing for men.
[00:09:38] And obviously we wouldn't be doing it if it wasn't working. And that is why so many men are coming to me for help with this. At this stage in life.
[00:09:47] TRT is not a lifestyle accessory. It's not something you start because you saw an ad and you want to feel 25 again. Starting testosterone affects your own natural production.
[00:09:59] It does suppress it to some degree, even if you do it cautiously. And it can affect fertility and it requires ongoing monitoring. So we want to make sure that we're looking at your red blood cells, prostate markers, and it's a decision that you make with a physician that's looking at the whole picture like we do, not a checkbox on a website.
[00:10:17] Okay. This is why I have the assess step and I work that so hard in our real 3.
[00:10:24] Before anyone talks treatment, we're talking about everything and looking at all these numbers and doing a full assessment. I want a morning total or morning total and free testosterone. But I also want the full picture. Thyroid, metabolic markers, sleep, other medications that you're already on. Sometimes low T symptoms can actually be a thyroid problem or a sleep apnea problem or a side effect of something else in their cabinet or that they're taking. So I want to treat that first. And the testosterone story can completely change. That's the difference between optimization and a vending machine or just someone that's doling out testosterone.
[00:11:02] So if you're sitting here and you're going, okay, but is this actually me?
[00:11:09] That's the exact question that my intake is built to answer. So head over to mydrlori.com and that's spec spelled out M-Y--O C T-O R-I or gosh, T R T-O-R L-O-R-I.com. that's my doctorlori.com and fill out the intake form. It's how we start every real conversation and it's how you get questions like this answered for your situation instead of the Internet situation.
[00:11:38] So let's bring in the peptide landscape, guys. So what you're actually hearing about all these peptides on the market, the word is the buzzword of all buzzwords right now. And it's where I want you to slow down and think clearly, because what is a peptide? A peptide is just a short chain of amino acids that are signaling molecules. Your body makes them constantly. The majority of them are actually naturally made in the body. And it's the category is real, it's science. It's genuinely interesting, right? We're all fascinated by these peptides. But interesting is not the same as proven or proven and approved. Right? For you.
[00:12:18] And that distinction is where a lot of men get hurt or waste a lot of money and just get separated from money. Because honestly, if it's not, if you don't fix that foundation, they're not going to work. And if you're not dosing them appropriately and looking at everything else, it's not going to work. So let me walk you through the names that you've been hearing consistently, and I'm going to tell you what each one is and what the actual status is. Not the hype, not that, not whatever one's like, you know, not the rumors, if you will.
[00:12:48] So let's talk about growth hormone secretagogues, long word for stimulating growth hormone.
[00:12:54] It's a family of compounds that includes CJC, 1295, epamorelin.
[00:13:01] And the idea is that instead of giving HGH or growth hormone directly, you nudge your own body to release more of its own. These are all light switches. They turn on and turn off different parts of the body.
[00:13:13] It's conceptually elegant. The reality is that these are not FDA approved, as are most peptides. Not FDA approved. And the human evidence for body composition anti aging claims people make is limited, however, and it's in this regulatory gray zone. Right? We know that all these peptides are in a Regulatory gray zone. But I will tell you under close medical supervision, this can definitely have positive effects.
[00:13:43] It can help to lean out body fat. It can help to put on muscle mass.
[00:13:48] It can also help with cortisol regulation.
[00:13:51] I will never say this is a sure thing or a sure bet, but the clinical evidence suggests that it can definitely assist in these areas. Okay, so when we talk about body composition, these growth hormone secretagogues have been a very large topic of conversation.
[00:14:10] Another one, AOD 9604. It's a small fragment of growth hormone originally investigated for fat loss.
[00:14:18] So it's great for belly fat, and it has a lot of. It has shown a lot of promise to breaking down belly fat. The human trials that tested for it for obesity did not deliver the results that people hoped for. This is not for obesity. This is for that little kind of belly fat that people can't get rid of, that last little bit around the abdomen or so that you look a little bit more ripped or lean. Okay. It's not a weight loss drug, and that's not what this AOD 9604 is about.
[00:14:51] So when you hear it sold as a fat burning protocol, I do think that's getting ahead of the evidence. But it was tested as a fragment of growth hormone for weight loss. But I will tell you clinically, what we're seeing is it helps to lean out the belly area specifically. Okay.
[00:15:10] All right. So again, that's step two in kind of reformulating a plan for. For peptides in the body composition area.
[00:15:20] Let's talk about mgf. Mgf? Actually, I don't think it's talked about enough. It's mechano growth factor. It's a variant of IGF1, which is a growth hormone stim.
[00:15:32] And we talk about IGF1 a lot with muscle repair. But I will tell you again, the evidence is thin on this particular on mgf.
[00:15:43] But what I do see MGF helping for, especially when used with a good workout regimen and a good lifting regimen, is that it does help to enable growth of muscle and development.
[00:15:57] So while I can't say that it has an established place in clinical care, I use it for helping with growth of muscle groups.
[00:16:10] All right, so let's talk about inflammation, BPC157 and TB500. These come up as a pair or partner in conversations all the time. And we talk about recovery of tendons, we talk about gut health. And anecdotally, there's a lot of buzz on this. And actually it is in IRB reviews, right now studies for efficacy in the decrease of inflammation for various disease processes. So I will tell you that the data is emerging and it has been around for quite some time. It is produced in the gut. All right, so we know that it does have a significant effect on inflammatory conditions of the bowel and the gut.
[00:16:57] And you know, we have a lot of animal data that is very intriguing. And like I said, it is under trials right now for human data which is seeming to be very promising, but it is not approved yet. I will tell you that this is probably one of my most used compounds and it is great for helping to decrease inflammatory conditions, joint problems, injuries, chronic gut inflammation, chronic overall body and autoimmune conditions. This is fabulous for helping to decrease those markers. I can't, again, I can't say that it's been proven, I can't say that it's data proven and I can't say that we can get complete resolution. But I can say that anecdotally these two as a compound together have been really successful. You can do it under the tongue, you can do it as an injectable, and it does come in some oral capsule roots as well.
[00:17:53] And it obviously the injectable, I would say, is a little bit easier to do around a site of injury.
[00:18:01] Okay, let's talk a little bit about libido. This is the one I get asked about the most. I would say men and women, because it's the hardest to treat.
[00:18:09] And I think that PT141 is a little bit different because it actually is FDA approved.
[00:18:16] Well, the cousin of the PT141 that we use in our peptide world. And it's approved for sexual desire in women specifically. Why? Because women all are stuck up in their heads, right? It's not like a vascular problem necessarily for females. They need the melanochordin pathway, which is the.
[00:18:36] Basically the cells or the twitchies, the signals in the brain that make you aroused. Right. Whereas for men it's usually a blood flow or a mechanism of lack of blood flow through for erectile dysfunction drugs for men, we also use this very off label, which means it's not approved. But it is a real conversation that we have. And it does actually seem to be quite effective for low libido in men that are refractory to a lot of the blood flow dilator medications such as Cialis and Viagra and those types of things, or they're on testosterone or can't go on testosterone for any reason. PT141 has been a really great adjunct therapy to assist with low libido.
[00:19:25] All right. Oxytocin.
[00:19:27] Oxytocin is the binding hormone. It's the feel good hormone. It shows up in conversations about intimacy and connection around mood. It is a real hormone with real signaling roles that are very well understood. But the compounded version that we market, that we use is again off label for the uses we use use it for. However, I will tell you that we find it clinically to be very helpful for the brain calming effect, emotional well being.
[00:19:57] We also find it as a bonding, as a bonding hormone for libido and drive, especially, especially in men and women. And it can be done as a cream, it can be done as a nasal spray. It actually has an injectable as well. And we can a lot of them combo pt141 with oxytocin as a combination.
[00:20:17] Yes.
[00:20:18] So again off label under studies right now for those uses. But I have found to be extremely successful for kind of that brain connection and mood.
[00:20:30] And then last but not least, I talk a little bit about Kisspeptin. Kiss Peptin is actually quite fascinating. It is an upstream signal. So if you think about further up. And it regulates the entire hormone and reproductive cascade.
[00:20:43] It's an area of research that is really interesting right now and guess that's the key word, right? It's in research, not proven, but it is really interesting. And I think it's a frontier that more and more of us are exploring and it is good for creating that erogenous or arousal. All right, so again, it's not proven, it's not FDA approved for that. But when we use some, when we use kisspeptin as a molecule, we're using it to try to stimulate, stimulate some libido and some arousal activity.
[00:21:17] And I will tell you, most of these, like I said, are unapproved. They sit in a regulatory category the FDA has actively flagged, which should be changing actually because they pulled a lot of that back come last, I guess two months ago and in July they should be putting out new guidelines for the pharmaceutical companies for actual production. Again, again.
[00:21:38] So I think just understand that you should talk to a provider like myself before you inject because these have very specific protocols that we've also been working on to show that they are safe.
[00:21:49] But there obviously are no guidelines put out there by the FDA at this point on them.
[00:21:54] So my job with the Real3 protocol and this Real3 framework is to stand between you and that knowledge gap. Right. To help you navigate these waters. I'd rather have one honest conversation with you about what's actually known than rather sell you a stack of vials as a fantasy, right? As something that's a pipe dream.
[00:22:14] So you know, this is the kind of straight talk you won't get from an ad or one of those quick fix programs. If you want more of it, of course, subscribe to my YouTube channel. Follow me on Instagram lorigerberdo or drlorigerber and on Facebook as well, which is just my name, Lori Gerber, or Dr. Lori Gerber actually. And share this episode with the guy in your life that you think will respond to it and is about to spend his money without even knowing what he's spending his money on at 11 o' clock at night. You might save him a lot of grief by just giving him this episode.
[00:22:49] So how to think about this realistically and logically?
[00:22:53] If you're a man over 40 listening to this and thinking, okay, what do I do here?
[00:22:59] Here's the grown up roadmap. 1. Get measured, get tested before you get treated. No exceptions. Anyone offering a hormone or peptide without a real workup is selling you, not treating you.
[00:23:11] Unless again you had labs beforehand or they know you or you're not doing something that actually requires a monitoring. Because there are a couple that don't require monitoring. 2. Clean the foundation. Foundation, foundation, sleep, train, protein, alcohol, de stress. Give it a real two to three months, not a weekend. And a huge percentage of men actually feel dramatically better right here and never need all the advanced tools. Now maybe we work on longevity, maybe we work on deprescribing and genetics and genetic history, which is our longevity protocols, right? Our mitochondrial help, our cellular detox, but that definitely does not fall into the world but of testosterone and getting muscle building and leaning out, right? So maybe work on a different avenue.
[00:23:58] 3. Just like I said, deprescribe before you add, run that elimination step. What's already in your life that's not serving you and that's working against you like we talked about.
[00:24:08] Take that away. First four.
[00:24:12] If you and a physician decide that the advanced tools are worth exploring, do it inside a real medical relationship like with Dr. Lurie or somebody else. And with monitoring honestly and thinking about what you're using, what protocol you're being given. And be clear in understanding that this is not FDA approved, but you're getting a quality peptide from a trusted source with certificates of authenticity on every product, right? And you're doing it under the care of a guided, super guided supervision of a provider. Okay? And when I say provider, a medical provider, it should be with a medical professional that can actually prescribe. This is not, you know, a for lack of better way, a multi level fix, right? Like a smaller. I'm selling this at my barber shop, right. This should be from medical provider that actually knows how to deal with adverse side effects and your medical history.
[00:25:11] And then five think about this in years, not in weeks, not in months. This is a long term commitment. We are doing this for the long haul. You can't turn on that light switch and expect it to never go off again, right? With a peptide you can't fix a foundation and then not can keep it going, right? This is the goal is to for it's not just a beach trip goal. It's not a I I want to take a vacation look good goal. And fine, if that's the short goal, that's fair. But this needs to be the long term goal. You want to be strong, sharp and driven and age the way that you want at 50, 60, 70, right? The dad bod was never the problem, remember, it's the physiology behind the dad bod. The slow slide, the physiological problem that was happening because your body wasn't metabolizing things appropriately. You weren't getting the right sleep, the cortisol was dysfunctional, your insulin was resistant.
[00:26:07] We're here to reverse that slide sustainably as your partner, helping you aid your way for the long haul. We all become friends. We are all here to become your guide and your lifestyle guide. And that's the whole philosophy in one breath. Real medicine, real life, real results.
[00:26:27] Done the right way or your way. Meaning proactive, participatory and preventative. We are here to prevent any of. We're here to prevent basically anything that you are thinking of as a genetic predisposition.
[00:26:42] We're also here to stop that slippery slope.
[00:26:46] So if you made it this far, then you're exactly the kind of man that I built my practice for. And you're someone who wants real answers. Not the easy one. So here's your next step. Don't guess, don't self prescribe on a forum.
[00:27:01] Go to mydrlori.com, fill out the intake form. It only takes a few minutes.
[00:27:07] And it's how every real conversation with me starts. Tell me where you are, what you're feeling, how you want to feel for the next 10 years, how you want to age, what longevity and lifeevity looks like for you.
[00:27:19] And we'll figure out what fits into that picture together.
[00:27:23] It might be a peptide, it might be a hormone, it might be really working on foundational.
[00:27:27] It might actually be working on your gut. Right. It might be working on a completely different lifelink, if you will, than what we're talking about.
[00:27:37] So let us help you decide where that best fits for you. And before you go, of course, subscribe to the channel, hit the bell so you never miss an episode, drop a comment with what you want me to cover next and follow along on my Instagram and Facebook. So it's Dr. Lori Gerber. Lori Gerber. Dio and Dr. Lori Gerber on Facebook for that. In between, you know, whatever you want to learn on social media from me. So if this helped you or if it rung a bell in your relationship and you're a girl that knows that their husband needs help as well, maybe I'm already treating you and you know that my man really needs to get on the same page as me. Send this one to the guy who needs it.
[00:28:21] I'm Dr. Lori Gerber, and this has been life, real medicine for real life.
[00:28:26] So goodbye to that dad bod and hello to the next better version of you. I'll see you next week.
