Exploring Andropause and Men’s Health

Dr. Edison de Mello and Dr. Sahar Lashin, experts in men’s health and hormone therapy, lead this engaging session on andropause—often referred to as male menopause. They discuss the physical, mental, and emotional effects of declining testosterone levels, offering insights into effective treatments and lifestyle strategies.

What Is Andropause?

Dr. de Mello introduces andropause as the gradual decline of testosterone levels in men, starting as early as age 30 and accelerating after 40. Unlike menopause in women, the changes in men are subtler but can significantly impact energy, motivation, libido, muscle mass, and mental clarity.

Symptoms and Diagnosis of Low Testosterone

The speakers outline common symptoms, including fatigue, weight gain, reduced mental sharpness, and emotional changes. They emphasize the importance of comprehensive diagnostic testing, such as blood and urine analyses, to determine hormone levels and guide treatment.

Benefits of Hormone Replacement Therapy (HRT)

Dr. Lashin explains how HRT can restore vitality, improve cognitive function, and rebuild muscle mass. She highlights various treatment options, including injections, gels, patches, and testosterone pellets, and stresses the importance of personalized dosing for optimal results.

The Role of Bioidentical Hormones

Bioidentical hormones, designed to mimic the body’s natural hormones, are discussed as a safer and more effective alternative to synthetic options. Dr. de Mello shares success stories of patients who experienced improved energy, mood, and physical health after beginning bioidentical HRT.

Psychological and Emotional Effects of Andropause

The speakers address the psychological toll of andropause, including feelings of disconnection, low self-esteem, and strained relationships. They advocate for an integrative approach that combines HRT with lifestyle changes to support mental and emotional well-being.

Innovative Therapies for Men’s Health

Dr. Lashin introduces cutting-edge therapies, including advanced diagnostic techniques and biological medicine, to optimize hormone balance and address aging-related health concerns.

Key Takeaways and Call to Action

The session emphasizes that andropause is a natural part of aging, but its effects can be managed with the right interventions. Dr. de Mello and Dr. Lashin encourage men to seek professional guidance, explore hormone replacement options, and adopt healthy lifestyle habits to reclaim their vitality and well-being.

For more information, visit akashacenter.com, email info@akashacenter.com, or call (310) 451-8880. Stay connected through their blogs and social media for updates, health tips, and supplement recommendations.

Video Transcript

00:00:00 hello everyone I’m so happy to be sharing this time with you and my brilliant colleague Dr Sahar lashin I’d like to say a few words about Dr lashin before we start Dr Sahar lashin who is trained as a board certified integrative uh gastroenterologist in Egypt made her transition to the us um about three decades ago where she was a professor at UCLA and uh as if that was not enough for her getting a second residency in functional medicine she decided to become also a board certified anti-aging medicine which has a lot to do with

00:00:47 hormone metabolism and for that she went all the way to Switzerland she did her training there not only in what we refer to as aging medicine but also biological medicine so Dr Lashin is extremely trained in helping all of us move ahead in these times of um stress when we feel like our lives need to have a little juice to move on she’s the right person to talk to my joke with Dr Lashin is that there are not enough walls in my office or her office for us for us to hang all her degrees she seems to collect them and so

00:01:26 you are going to be in very good hands tonight as we talk about about testosterone metabolism in man and also known as Mayo menopause or andropause uh for those of you who have not met me my name is Dr Edison de Mello I’m a board certified functional doctor integrative doctor and also a trained psychologist um so I integrate both eastern and western medicines and my idea of medicine is to meet my patients before I meet their diseases I want to know who they are and I want to be able to understand the function that disease

00:02:06 plays in their lives if any in other words collecting connecting the dots I’m the founder of the Akasha Center which is now going into its 25th year and I am supported by an immense talented group of professionals Dr Maggie Ney who is a naturopathic doctor Dr Kudzay who is a gynecologist Dr Dao who is an osteopathic doctor and Dr Bren Boston who started as a physiatrist and moved on to also become an integrative and functional doctor we are also assisted by Incredible Gina Galvez being an expert in regenerative medicine and

00:02:56 Susan Powell also an expert in alterative medicine uh ultrasound wave machines and um in addition to that we have other great professions at Akasha uh including our acupuncturist Dr Qiao and our incredible front office without whom we wouldn’t be able to be here discussing this meeting with you so without further Ado I want to start um by defining what uh andropause is Right In literature it’s called andropause or male menopause meaning our gonads start reduce or start producing less hormones they goes the part of our body in male

00:03:44 bodies they can produce hormones specific testosterone so that declines with age just like menopause in women men go through it’s called andropause and it’s not as accentuated as in women where there is a roller coaster that you women know what I’m talking about when you hit that age where things start to really go down your hormones start to become less and less optimal in man it’s actually gradual it’s low it starts very gradual and hormone metabolism in men and also in women but we’re talking about Men

00:04:21 start going down at the age of 30 so when you hit 40 then the hormones start going down even faster at the rate of 1 to 2% per year and so you can imagine what that does to a man who is 50 who’s 40 years old right we start complaining about not having enough stamina and I can tell you that for myself I’m 66 now and when I turned 50 I could see that my hormones needed to be replaced it took me a little while to get there personally because I were still learning a lot about hormonal metabolism in man

00:05:03 but once I got more and more into the research I realized that there was no way I could be productive I could have my cognition intact my muscle mass you know going to the gym working out building some Mass which we all lose with age right our skin starts to sck our neck we all know that our memory is not the same so this is the benefit of hormonal replacement therapy in men and of course in women also um and so what it does for us is it increases once you replace these hormones are down they’re going down and you replace them

00:05:46 after extensive but extensive Labs including sometimes blood and urine urine together so that we can see can have a whole spectrum of what’s happening with your hormones we can see see that once we find the uh Magic dose that you need uh to be replaced with the men come back and they say that a light bulb went on they feel more vital they feel more connected to their Partners they feel better about themselves they feel better when they look at themselves in the mirror and they say that they have you know that

00:06:25 their skin is not sagging as much uh it can even improve hair growth believe it or not you have a lot of sites out there talking about um how to um prevent buness and one of the things to do is actually make sure that your hormones uh May hormones and female hormones are balanced so testosterone is not only for to help you feel good to help you have you know better body mass to help you feel better cognitively speaking it also fights chronic disease so those of us who are at high risk for cardiovascular disease for example

00:07:05 hormonal replacement therapy we do really well for those people who have a history or concerned about cardiovascular disease right so if you look at your levels and they’re low you know let’s talk to a Cardiologist about what’s going on with your heart but let’s also talk about hormonal replacement therapy it also improves um things chronic uh immune compromising conditions diabetes being one of them thyroid disease also improves with testosterone all of that which Dr Lashin will share with you her experience in

00:07:42 years of doing anti-aging medicine so I want to give the Baton here pass baton to Dr Lashin and here her um explain to us give her tips on this incredible benefits of replacing testosterone in man whose numbers Dr Lashin hello everybody thank you so much Dr De Mello so the humbleness is one of your features which I am learning from you every day so having a psychologist and an integrative doctor and a primary care and a family doctor and a lot of things together would just uh get you in place in all of that it’s all in one which is

00:08:25 I think me including all the patients were happy and lucky to have somebody who is as uh as your experience is talking about yourself and others in such a wonderful humble way uh thank you for everything um talking about the hormones which uh we enjoy always uh talking about and we love seeing the difference when we replace uh the hormones in right way because there is a lot of amateur out there uh that can miss uh our patients and we are very um uh we are very protective on our patients we want things to be done the

00:09:10 right way and we want them to feel the best forever uh the thing about male hormones and andropause is that women have always had this clear symptoms that shows itself and all women are expecting them in a certain time in a certain age and they can recognize it that quick but men I bet not a single father or a single friend told you about how they feel gradually when they start losing their hormones you will find them silently trying to manage the deficiencies they even don’t have time sometimes to concentrate that there are

00:09:56 changes happening although it’s clear for every body so for example uh the the testosterone which is the the Superman’s hormone that’s what I call it as long as you’re having testosterone even in a little bit of it you feel like a Superman and consequently you don’t have time to complain and you keep working working working for so long pushing yourself to the edge and I always say how many widows are there because there is a lot of men who just push themselves till the very end without even thinking

00:10:30 that they have a problem and then hard attack and then they are gone but since the these every single man in this world is so precious and we would like them to be taken care of the way that women take care of their health by the way if I have a a list every day of 25 patients two are men and 23 are women not because women have more problems just because men have no time to think about their health so the first thing I would like to um highlight is that please take care of your health stop for a minute and

00:11:09 think that you are approaching the 40s then it’s time to make sure that everything is good just go to the doctor check your hormones see where your levels are don’t push it to the edge till 50 when you start declining your hormones to an extent that you start feeling the difference and the first difference you’re going to recognize is not the libido is not the sexual function because if you’re a very busy guy you will think about the intellectual function so the brain functionality is directly related to

00:11:44 your hormone balance and testosterone deficiency if you feel that you are overwhelmed or you’re irritable or what we call this you’re not as happy as before or you don’t you’re not enjoying work that much because you don’t have enough time to take the decisions or to get it done or to to to have the stamina just like Dr de Mello said then think about testosterone testosterone is not a sexual hormone it works on every single cell that you have it even interact with your insulin if you have insulin resistance let’s look

00:12:26 into the testosterone if you have stubborn fat it might be because of testosterone if you’re you’re not thinking clearly or you cannot wake up in the morning refreshed and happy to do what you want to do think about testosterone if your prostate is not working that well it is also testosterone and other hormones are are there it’s it’s a symphony every every um member in this team has a a role but that is testosterone in men has a very big role that we have to respect and take care of and observe and follow

00:13:10 closely not to have this dip that happens gradually and then suddenly appears if you’re ex having a problem like a surgery done or an infection or a travel or any stress taking a decision of quitting a job or starting your own business or increasing the the the business that you have or um family member is you know having uh some troubles like elderly parents and you’re just overwhelmed and having a lot to do you will have to make sure that your testosterone is checked right because when it is you can take care of

00:13:54 everybody else not just yourself everybody will be happier so so when you think that you’re doing this for yourself and for others you will definitely have time to check your hormones and make sure that they are um in the in the right level if you don’t have the the the level the way it should be then start you will start to recognize some symptoms that it might pass by without you thinking it is of significance for example if you’re adding weight and you can whatever you do you’re going to the gym you’re taking

00:14:31 care of your diet everything you’re doing is great but still this some fat around the waist is not going anywhere think about testosterone if if you are not remembering all the tasks all the time the way that you want think about testosterone if you have um this uh challenges with decision uh making or with interacting with others or you become nervous quicker or you started to to feel it’s there’s some hot hot flashes or sweating which is not usual testosterone can do that just like women but in a different way a little bit

00:15:09 different that you might not recognize it is related to your hormones Dr Lashin thank you thank you that was very clear and to the point let me ask you a question so what is the first step for us men to take if we want to if we’re suspicious that our testosterone is down and I like what you said in terms of you having in if you have 25 women or patients coming in 23 will be women two will be men and I can tell you that from my perspectives being a man is that there’s still this unconscious uh tape running our heads

00:15:49 that men are invincible right that we have to keep producing and this comes from cultural background generic background whatever other influences are there in the world men feel that they will only take care of things when they bro break down you see a guy taking care of the car of his car taking to be serviced on the dot every time is the light comes on that has time to be serviced those guys will take the cars to be serviced but when the light in US starts to fade we don’t think of that as a time to go see a

00:16:28 doctor to go look at what’s happened with hormone metabolism so with that in mind what would you say would be the first three steps that you would take to to ascertain that testosterone is recommended in a particular patient so if anybody is turning 40 happy birthday I would like to make sure that with the happy birthday we are happy with the hormones too so I would recommend anybody who is getting into the 40s to check the testosterone level and that can be done in blood which is the usual way that even primary care

00:17:06 doctor or any of the doctors he sees can do but for us as integrative doctors we dive a little bit deeper into how to look into testosterone and other hormones so for example we have a certain test here that we do uh that look into the details of your genetic  breakdown and synthesis of the hormones so if we have that amount of hormone is the whole amount working for you or some of it works against you which means it can take an a wrong exit of your Highway and if the hormones are taking the wrong exit they are not going

00:17:48 to be functioning the way that we want them to do so we need to know if these hormones are enough we need to know if these hormones are taking the right pathway and if they are broken they are broken in the right way and the and the uh ratios between these uh metabolites are right or not and so we order another very detailed test in urine for 24 hours to see how the levels of your hormones genetically influenced and consequently we can expect when we replace your hormones how long you going to take to

00:18:25 use these hormones and if you are expected to use them quickly then we put in consideration this aspect and we calculate the amount to be given accordingly if you are a bodybuilder I have to treat you differently than from somebody who is working by by his brains on in front of a computer every day and night if you are a person who’s getting ready for a surgery I have to calculate certain things and make sure that you are healing very well after the surgery and you are prepared for this surgery in

00:19:02 the best way and so on so the best way for uh seeing how the hormones are is to do the blood test and the urine test for the metabolites and then we can also take a look to all the other parameters which interact with your hormones for example thyroid is very crucial cholesterol as Dr Dello said because it’s the base of all the hormones to be produced used so we don’t want you to deprive yourself from cholesterol but we don’t want too much either so there is a lot of considerations that we look into

00:19:39 and according to your background and family history and your personal medical history and your brother and father and and grandfather’s history and your challenges personally in your current life and job and and and family we put all the parameters together together and then reach a conclusion to where we have to start and how frequent we have to uh look into your hormones and how we going to follow you if we are replacing them so one of the things that I I often see my patients being um or expressing

00:20:21 some confusion is that the understanding of uh the difference between bioidentical hormone versus your synthetic hormones so I’ll talk a little bit about that Dr Lashin and then please jump in and help our our participants understand the bioidentical hormones are hormone synthesized from plant-based yams being one of them right um and tofu being another one of them or soybeans so they get really harvested from that and they go through a very very tedious process process to be able to then be converted into a substance

00:21:03 that will mimic our own hormones so it’s natural based and it’s bioidentical because the structure the chemical structure of these hormones when you look under chemistry under research really mimics the chemistry or the the the format of our own particular hormones now when you compare that to a synthetic hormones you’re using hormones they’re basically coming from animals right including H’s urine that gets to be trans you know cleaned up and then transformed into hormones so can you comment on that Dr Lashin from your

00:21:47 understanding uh is that anything else that you would say to add to the fact that there is indeed quite a difference between those two levels of hormone metabolism yes so the the hormones in in the market are two parts as uh you kindly expressed the synthetic ones and the bioidentical ones bioidentical carry the the features from its name it’s biologically identical to the ones that we grew with so if you take uh a young gentleman in his 20s or 30s they will have testosterone and estrogen and progesterone and pregnanolone and

00:22:31 cortisol and thyroid all of them will be structured in a specific way and naturally produced from our internal organs and glands which are which are used to to make these hormones in a specific way and the receptors we have are used to look into this hormone and say yeah that fits me perfectly well I’m going to react and build the muscles I’m going to react and build the bones I’m going to react and protect the heart but then certain things are there out in the market and there is gray markets and then there is

00:23:12 black markets and there is a lot of colors markets that bring into uh the the the market a lot of Hazards with the with the hormones that are not uh well known how they are uh working or how they are sens I and even the synthetic hormones we know that they are synthetic and and they are synthetic because they do not look exactly like the ones that we have they are made in the lab biochemically with a special structures that might mimic or look like our hormones but it’s not the same and con and because of that when they are broken

00:23:54 by the enzymes or used by the cells they change into a components or compounds that are not exactly friendly to the body so for example the prim marine or the certain there is long long history with Prim Marine being used in certain areas of the world and primar is is known to increase cancer breast in women on the other hand when we are giving the proper estrogen and the proper progesterone for women they are protected against cancer breast although they are on hormones simply because when our hormones are not in the right um

00:24:39 ratios we get exposure to toxicity inflammation uh infection challenges uh inability to regenerate and all this cause the elderly people men and women to develop Cancers and that’s why the fear uh that developed or cancer can develop from hormones and then the repetition of the hormones were ruined long time ago because of some studies that were not well done and consequently after that when they had addendum and they said no after studying the the population on hormones for four years and then 10 years actually we found them

00:25:24 protected against um the overall mortality decreased the the cardiac attacks decreased the cancer um exposure decreased nobody really cared from the medical societies and of course the patients or the media to rectify the wrong impression and the wrong idea that happened because of some studies that the setup of the studies were not uh that well made and uh I believe Dr D who you have uh mentioned mentioned before that uh there is no relation between testosterone and cancer prostate can you can you more about this yes yes thank

00:26:08 you and that’s uh in in my practice when I when a man comes in and we go through the steps of identifying the levels of hormones so at aasha um do lashin Dr Ney Dr Boston and Dr Kudzay and myself we are the hormonal Specialists we really look very very intensely into what your blood levels are showing and some of us also want to see where your metabolites are metabolites is when you get a hormone you your hormone is replaced what you excrete it’s not necessarily the same format of the hormone or the same chemical that you

00:26:52 ingested because the body goes through changes and it can that hormone can be metabolized into other comp components so in order for us to be very comprehensive we need to look not only at the blood level at this space and time but also the metabolite of those hormones what is it really doing in your body so once we go through that steps we take the history we will look at family history as well we look at cancer history inevitably the question that a man has is can testosterone cause prostate cancer and the answer is no

00:27:30 testosterone does not cause uh prostate cancer however if the cancer is already there testosterone will enhance it so and I can give you an example of a patient that I recently saw um and needed testosterone and so we put him on testosterone his levels were very low and within two months his PSA which is the level of it’s called prostate specific antigen it’s the levels that we look at um hormonal speaking to see how well the prostate is doing is that any inflammation is that any cancer and PSA

00:28:11 in high numbers can be a sign of Cancer this particular gentleman had very low testosterone did great on when we put him on testosterone but then two months later he Pro his levels of PSA went up so in a way testosterone helped him or helped me and his other doctors diagnosed a cancer that was there that was undetectable so in other words summarize this testosterone does not cause prostate cancer testosterone is actually protective of most male organs but if prostate cancer is hovering around there

00:28:54 somewhere testosterone will then enhance it by showing a increased PSA so that’s something that I really wanted to discuss tonight Dr lasLashinhan because it’s there and there’s a lot of misunderstanding about Pro excuse me about testosterone and prostate cancer do you have anything else to add so some of the patients are concerned about will I be forever on the testosterone replacement which is one of the things that I get asked a lot Dr de Melo and I believe we share patience and we know that that’s

00:29:34 sometimes a concern but I usually tell them that uh if you have a great uh CEO and and this person decided to retire or to quit the job what’s the only way to get the job his job done after he leaves get another one right so we’re going to hire another one which is the testosterone that we start replacing when the the testicles with the cells which start by the way to uh degrade and decrease in number at age 18 in men so at age 18 you start the slope to to decrease uh of the decrease of the testosterone but it doesn’t happen

00:30:21 clearly except in the 40s and the 50s and some people even can be lucky to be pushed a little bit more but still uh the decline will be sudden afterwards so every men will go through disintegration or decrease in the number of the liic cells which produce the testosterone and it’s not a surprise we shouldn’t wait for disasters to happen we are integrative doctors we proactively inter uh interfere to stop the problem from happening and if it happens and then we see the patients after it happened then we try to reverse

00:31:01 it or we try to control it to the best way so it doesn’t propagate more it’s totally a complementary uh strategy to the the classic medicine uh who are very well trained to take care of the disasters that happens but for us we want to prevent it or to reverse it or to make the disease less Progressive and we both complement each other right so so one of the things that I think I’ve also come across that is that men who go through testosterone replacement therapy and they come back and they’re feeling better but not as as the energy

00:31:48 is not as increased or the cognition or the libido is not as increased as in other men who are undergoing the same treatment and I want to share that that what I see as being a reason for that when I compare those two groups those who do really extremely well on testosterone replacement therapy and those men who are slow to start a lot of it has to do with lifestyle right if you take the social no matter in what format and we’re going to talk to you about the options available what whatever format of

00:32:25 delivery the S is available for you if you don’t add a lifestyle modification to that regimen you are likely not going to benefit as much from it as you could otherwise yes there’s going to be some benefits you’re going to see increased cognition you’re going to see better libido but not to the extent of other men who are exercising and I say 45 minutes to an hour minimum three times a week including uh aerobic exercise right people who are working on that diet at akasha every every patient who is

00:33:08 undergoing hormonal replacement therapy is given a chance to speak with our nutritionist and we have an incredible team of functional nutritionist that’s that includes Allison and Kyo who are there whenever we need them to be able to come in and tell us what what is it that or what kind of foods the patient can e can eat that will enrich the optimization so exercise diet stress what’s your cortisol level what are you doing to distress in addition to exercise right are you a person who sweat the small things are you learning

00:33:51 of how to look at the bigger picture and if not do you have a circle of friends of family of or your partner what you can be able to talk to uh or to talk about what’s what’s bothering you because when your cortisol is high it rains on your parade of hormones so no matter how much of an improvement Dr laLashinshin and I want our patients to have if your cortisol is high we also need to work on that cortisol to bring it down and at akasha we do have an adrenal component to every Testo to every hormone metabolism that we do including

00:34:33 adrenal support adrenal complete to be able to decrease the levels of cortisol in in people’s uh blood and to also be able to tell them that cortisol is anti- everything it’s anti-insulin it’s anti testosterone in a way because it increases its optimization and the other thing that I think is important for people to really understand is that it takes time it’s not a quick fix you’re going to you’re going to see a difference but you’re going to see more of a different as a difference as time goes by as and

00:35:09 as you stay compliant to the to the various formats of delivery of those hormone replacement therapies that we’re doing so lifestyle diet mental health um emotional health spiritual health exercise all play a big part in how successful your hormone replacement can be uh and Dr Lashin do you have anything to add about that uh just that we have a lot of tools to uh recognize the deficiencies early on we just need uh the gentlemen to be more aware about their health and to uh keep some time for evaluations so they

00:35:54 can continue doing a great job the way they do in their life and uh I was always wondering that being having Dr de Mello representing can you please tell me what’s the the first terrifying sign that would bring a man to your clinic Okay we men are some of us are really connected to our our well-being to how we perform in between the sheets and that’s that’s how men most of us are designed is that whenever things are in the way of our sexual performance or enjoyment that’s that’s when men come in um and and when they come in Dr

00:36:48 Lashin the first thing that I do is take an inventory of where they are because if are they not having a good experience in between sheets in the bedroom because the relationship is not doing well so if they’re not if the relationship is not satisfying them emotionally and otherwise no matter how much testosterone you’re going to be able to increase in that man it’s not going to be optimized to the level of um highest performance because emotional connection is not there whereas women can make that

00:37:23 connection so much more quicker than man they can connect their bodies to something that’s going on other than sexual pleasure or or or performance a man for the most part comes in when their libido is low or when they don’t have productivity to the the way they used to have remember man whether we are modern men or oldtime man man of the old country man of the new country what binds together the common denominator is that we think ourselves as having to be productive that’s that’s the common denominator we have to we are we think

00:38:08 ourselves as a providers even though women are providing much more than men these days for the simple fact that there’s 52% of women out there and 40% of men but still a woman will be able to come in when she feels I there something slightly off a man will wait until the next shoe drops before he will come in and so I tell you my fellow men out there listening to this we can do we can do this differently we can be connected to our bodies in a way that it’s not only about sexual function it’s about overall

00:38:50 well-being it’s about thinking ourselves in a more positive light it’s about looking at our own mortality we know we all have an expiration date it’s only a matter of time right but we can look at our mortality as something that’s going to inspire us to live more fully in the present and so that we don’t have to wait until we get sick to then go fix the what needs to be fixed that we can fixing now so when is the better time to come to a doctor well certainly everybody who is sick need to go see a

00:39:29 doctor but if there was a time for you to come to look at overall health and well-being you would be when you’re not feeling sick it would be when you can sit down and say Here’s how I’m doing and then together with Dr lashin myself or our other colleagues can then do an inventory of your health and saying okay you’re doing well here how about in this aspect of your life are you happy with it so taking an inventory and being curious about your overall performance your overall well-being I think is the

00:40:03 name of the game um Dr Lin can you tell us a little bit about your approach to the treatment component of hormone replacement therapy yeah let me just add a little thing that libido is one of the latest things that uh is lost so there is so many other things and functionalities in men that precedes libido uh and and uh that’s why if it is reaching the libido level there is already a lot of things that has been compromised on the way so the the testosterone has been suffering for long enough till people can get to the level

00:40:42 of loss of libido although that yes Dr de that’s the driving force for men to come to the clinic but sometimes it’s important for men to come when they have lack of focus or memory troubles or some uh brain fogginess or lack of energy or this stubborn fat around the around the waist there is a lot of things before reaching the libido that happens which might be uh important for you to recognize to go to the doctor not to to reach the level of loss of libido so the different ways uh back to the question uh that we can replace the

00:41:22 testosterone uh with as we said it’s a testosterone is not a solo player it is a a very important player uh in the team so we have to replace testosterone but we have to pay attention to pregnanolone and estrogen and progesterone and um the P3 health and the adrenal gland with the cortisol and the thyroid gland with its production of T3 and T4 um lots and DHEA and DHT all the hormones that we take care of either by U making sure it is enough or making sure it’s not too much uh is important for the testosterone to

00:42:09 be adjusted specifically that some people think that taking testosterone on its own is sufficient sometimes testosterone take the wrong exit go to estrogen in in instead of having your testosterone working for you it’s now working against you it’s adding your weight it’s causing your emotional ability to be higher you you’re going to have uh troubles concentrating it’s going to be very uh challenging to take care of your health so uh when you have troubles uh seek attention and evaluation of all aspects of hormones

00:42:46 and when you replace you have to replace the testosterone among other hormones and we have also to manage your hormones subsequently afterwards so the ways that you can choose to to replace your hormones and your testosterone depends on so many things it’s very personalized approach it’s very tailored approach to you and your lifestyle and your priorities but in general we have headlines of testosterone uh that we follow so there is injections which has been there forever uh there is gel or cream that

00:43:27 can be used and there are the pallets which I am very fond of for several reasons I’m going to talk about the pallets leave the other part which Dr de is extremely expert in uh the pellets I got invested in when I tried personally and I didn’t know that it can change my life that much it was a game changer by all means and uh the same day I got my first uh pellet inserted uh I slept extremely well so deep that day so the relation between testosterone and sleep is very strong that’s one thing second thing in two weeks the

00:44:10 pellet start to reach its top level and building up in the body we need few sessions of testosterone pellets because I cannot chock the body which has been deprived for a long time from testosterone specifically if there is other uh medical aspects that I’m taking care of like obstructive sleep apnea or anemia or diabetes or uh overweight there is a lot of things that I have to consider in my calculations for the amount of pellets and amount of testosterone replacement that I’m going to start with once we insert the first uh pellet

00:44:50 uh the expectation is it’s going to work for some people it will work for two months three months some people it to work for four five months it uh it is influenced by many things your activity are you in the gym every day building muscles and uh preparing for your marathons or you are working on a desk uh if you are consuming a lot of testosterone then it will finish quicker uh if your thyroid is in a good shape or if it’s winter or if it’s summer or you are traveling across the continents there or you are stressed because of a

00:45:28 lot of uh other um changes in life all this have to be considered and by the way adjustments of the amount of testosterone uh follows all of the above so if your thyroid is lazy I have to increase your testosterone a little bit if your thyroid is adjusted or on the higher level I have to decrease your testosterone uh a little bit and so on so calculations that we do at the end we have number of pellets that we insert and then according to how long uh it’s going to work we have to tweak and adjust a few months every time first

00:46:08 year I always say give your bud one year of adjustments so you can be on the cruise afterwards right so you try few times and we try to adjust according to how you feel clinically and how we find in the labs and then uh we put all together and we uh refine the doses further it’s all bioidentical and some people are afraid that oh my God I’m going to insert something in my body well what you’re inserting in your body will last for three or four months it’s nothing that you should be afraid of because it melts away after few months

00:46:46 that’s why we need to reput it again uh every few months so rest assured if you don’t like it wait for a couple of months going to go away thank Dr Lashin those are great information we have a question uh on our chat is testosterone um something that a man could start at an older age say 70s this is yeah that’s a question from our dear patient um Stacy hi Stacy hi David yes indeed testosterone can be started at any age there’s no age where there’s a limit uh or uh where you know it’s not recommended we start uh if a man feels

00:47:40 that there his energy his cognition his metabolism is slowing down if he’s active and he wants to use testosterone um I highly recommend that he considers it and that Akasha will do a very comprehensive um um dive into their patients history we can also people who are in other states and even other country even though we certainly were not going to be able to prescribe we can give them an educational um uh educational tips on how to address this with their own doctors and what to look for so Akasha

00:48:23 does both inhouse assessment and also um tell Health assessment and can I add that the oldest patient I had on testosterone pellets was 93 years old yes and he used to fly all the way from the Middle East to to see me in the US every few months and he was running five companies of his own extremely sharp extremely functional and it was for him it’s a lifestyle it’s it’s a quality of life when you have your hormones in the right levels your quality of life and your functionality is UN unlimited it it’s

00:49:06 endless I agree I I agree and I’m not quite 70 yet but I’m getting there and I’m a perfect example I haven’t felt you know I don’t feel my energy it’s a day past 40 I I cut it the right time and I keep using it and here’s the result so yeah yes don’t let age stop you from doing anything that you want to uh you still want to to come talk to us any other questions out there I would like to open it up to anybody who would like to first ask questions on our Forum here you could put it in chat um or we could just go ahead and

00:49:50 get started we have a lot of questions from info okay okay I could get started me go here thank you both of you for this lovely presentation can hormone replacement help with mental Clarity and mood yes yes yes and a big big yes again okay thank yeah so your our brains are very very Dynamic and it needs a lot of what we call refer to as phospholipids around our brains our all the cells around it they have a membrane that protects those cells the organs and those are called phospholipids well guess what cholesterol is a

00:50:41 lipid right and so when you have when you have a brain that have enough testosterone you are enhancing main brain activity you’re enhancing what we refer to as synaptic resp responses your synapses are firing better so the answer is yes in fact it’s one of the the main reasons why women come in it’s not only because they’re feeling the change is really getting to them but also they feel brain fog and and that’s because of decreased estrogen as well which we men also have so when we talk about theotestosterone

00:51:23 replacement Dr Lashin, Dr Dombo, Dr Boston and I we all look at your overall hormone metabolism not only the saone but what is the men’s level we also have progesterone we have estadio we have prolactin so we look at everything to to balance it out so that our adrenals are its best and most enhanced capacity thank you also it also helps in decision making can you imagine if your Pros procrastinating about uh buying this car or selling your home or changing your jobs or or kitting or starting something

00:52:06 new your testosterone will influence your decision making you will find yourself taking decisions more courageously you will find yourself more smoothly taking the steps that you have been postponing and and taking one step forward and two steps backwards you’ll always find yourself taking steps forward after your hormones are just good thank you I have uh two more questions in chat um do men experience Cycles in their testosterone like women yes absolutely we do guys guess what we do and that’s why it’s called

00:52:46 man andropause or man manopause right it goes into cycle remember testosterone starts decreasing in age 30 very slow by the age 40 you’re now losing one to 2% a year and so a lot of us will wait um to have it replaced because some of us are exercising which can increase testosterone some of us are eating better some of us think okay my diet is what make is making me tired it’s the amount of sugar it’s all true diet the am sugar you drink the lack of exercise lack of water will all decrease your

00:53:30 mental capacity and testosterone will will will decrease it even further so if you are looking at increasing your your mental capacity you need to think about lifestyle as we have talked about and also testosterone metabolism testosterone replacement okay okay we’re running short on time so I’m gonna kind of go through the questions a little bit faster um this one questions for you Dr l what testosterone levels are considered high uh considered too low or too high well it’s totally individualized

00:54:07 and personalized so it depends on who is this person how big or small this person is and how much functionality uh are we exercising every day or we or we not uh are we uh uh dealing with other medical conditions do we have obstructive sleep apnea do we have diabetes do what’s the what’s the condition so it’s totally relevant uh to a lot of other parameters and that’s why it’s extremely individualized and personalized and I see a lot of group Chats on Facebook and social media and Instagrams asking each

00:54:48 other what’s the best level that I should be at it’s just like asking uh how much food should I eat today for lunch it’s totally different it’s very personalized yeah yeah I agree there’s another question that that somebody just texted which is a very good question which is um will hormonal replacement therapy curb your own natural production of testosterone this is from our friend Jeff um the the answer is yes or no right because bioidentical hormone is perceived as the B by the body as one of

00:55:26 its kind mind it can be seen as endogenous endogenous means everything that’s coming from within whereas synthetic hormones are exogenous they are synthetic their metabolism their receptors are not as tightly bound like this right a key and the lock is not as boundy it’s not as tightly bound as if you’re doing the uh bioidentical so in bioidentical hormone replacement we don’t see a side effect of decreased hormone metabolism if you stop taking it certainly your cognition is going to suffer a little bit but it’s going to go

00:56:10 back to the way it was it’s not because you started replacing it so whatever the reason is that brought you into the office for hormone replacement therapy if you stop it the bioidentical ones you’re going to go back to the same level before no different than if you’re taking a blood pressure medication to regulate your blood pressure if you stop taking it your blood pressure is going to go up but if you are on the synthetic hormones specifically the injectable ones then yes there’s being researched

00:56:41 there that shows that it can indeed decrease the body’s own natural production of the hormone I can add a little thing as well that uh those gentlemen who are young and still having uh to to have a family and kids uh we highly advise that uh they have to to be on uh Clomid or chomen which protects the size of the testicles from getting smaller uh with a replacement of hormones and also uh protect the fertility so those who want to keep the fertility if they are still in early age um semen uh or sperm can we have to keep

00:57:26 that in uh a bank just in case and also we protect uh the fertility by the chomin but uh we usually advise by doing both keeping uh sperm in Banks and taking clammy Fen and uh it is not common to have uh people uh in 20s or 30 early 30s with a big problem with uh testosterone except if there were certain reasons for it if they removed the testicle for a cancer or they have been exposed to chemotherapy or something like that and we definitely we everybody knows that if you are delivering food uh from outside the

00:58:07 kitchen might not be that functional either because of this you are delivering the food so if you are taking testosterone it’s because you don’t have enough anymore or anyways so that’s why you’re seeking the replacement or if you are having some but it’s not that efficient or good enough then you will need the support anyway but yes it might affect the internal uh production over the long run and might in decrease the size of the testicles if you’re not on chrony yeah and Dr Lashin there’s a very

00:58:41 good question here that I’d like for both of us to answer and it the question comes in two parts part number one does testosterone therapy affect hair growth or hair loss and I know that you have in in your other Clinic um an interest in hair replacement therapy so and the second part of that question is does it reverse fat gain in man which the answer of course you’ve already answered and there was yes but let’s answer those two question in tandem um how does it affect hair growth or hair loss so if the

00:59:20 testosterone takes the wrong exit from the highway of your uh uh of your pathways then it will go more towards the DHT DHT is dihydrotestosterone it’s a metabolite of the testosterone extremely powerful uh strong hormone uh for men to to have but it cause boldness and if you are in your 20s or 30s and started to feel uh some boldness here or mere recession in the front of the head we have to uh immediately evaluate your hormones and block this pathway there is ways to block it and clean the body from the DHT

00:59:59 and redirect the testosterone into the right pathway that’s one thing having the fat the resistant fat around the waist this means that also the testosterone is taking another wrong exit from the highway in your Highway uh internally and this means your testosterone is genetically directed to go towards estrogen more and I have seen even doctors who who didn’t know uh why they are not losing weight although they are doing everything right and when we checked their estrogen and we found it high and we were able to clean the body

01:00:37 and do the detoxification they lost the weight uh and definitely when we block the the wrong pathway of the testosterone and redirect it to the right way we can uh keep the hair and and grow the ones which are lost by the machines that we have and we can also uh keep uh getting the testosterone in its higher levels in the right pathway by monitoring the the treatment that we are giving and that’s and that’s one of the reasons why previously when we talked about how to assess for testosterone metabolism we

01:01:16 look at both blood as well as urine because the urine can tell us exactly where the testosterone is going as Dr Lashin said which exit is a testosterone taking and that can only be done when you do a comprehensive 24hour urine which we do at akasha as well for some of our patients there’s another question that I think is very important and I know we are a little out of time here but I’m going to push a little further and that question came from one of our all amazing staff who is asking will um

01:01:52 how does pallet um uh rep placement or or you know hormone used as pellets how do that affect a woman’s cycle so uh the testosterone uh pellets that we insert most of the time in uh postmenopausal uh one of the first things that quit working for the ovaries when the ovaries is about to retire is testosterone so women in their 40s late 30s can start having lot of Kido and uh vaginal dryness and difficulty dur achieving orgasm all this happens because of the little amount of testosterone that women have in their

01:02:38 bodies and when this is deficient the loss of uh sexual desire happens and it became clear I had a patient telling me I don’t really want to fix my erectile dysfunction because my wife told me forget everywhere from the downwards I’m done and that was like oh wow we need to fix you both yes testosterone uh is very crucial in the um in the intimate health and the sexual function of women and replacement of testosterone not only uh uh regain the uh the intimate life but also help in the lubrication of the vaginal walls

01:03:24 and protection against UT eyes and vaginal infections and uh even the the sense of wellbeing uh in women as well so um as we thank you Dr lashin as we wrap up um what I think that question pertain to is that yes hormonal replacement therapy works well when both genders uh including people transitioning from one gender to the other as we know and if you are in a Rel relationship it’s even better when both of you can ask yourselves do would I benefit from hormonal replacement therapy if I’m feeling so low because

01:04:09 what may happen psychologically speaking is that one partner is doing really well hormonal wise right cognition libido stamina and the other partner is not so that can cause a little friction in the marriage so a a lot of the guys who come to see us they come in because their Partners encourage them to come in or their Partners make the appointment and I want to tell you guys out there my fellow man that yes your partners can make the appointment but you too can take control of your own health you don’t have to

01:04:45 suffer quietly this is the 21st century hormonal replacement therapy is not the next Frontier is the frontier because it’s already here we talk about it in western medicine when I’m at the hospital for example oh yeah hormonal replacement therapy it’s the next step it’s not the next step it’s never been the next step hormonal replacement therapy has been in existence for a long time for decades all we’re doing now we are understanding our own bodies better and so therefore we have better products

01:05:20 they can attend in a more natural way to what the body needs so listen to your body it talks to you when you’re feeling anxious when you’re feeling tired when you don’t have enough energy ask yourself what could my body be telling me it speaks to you it tells you what it needs the question is are you here are you able to listen does testosterone therapy impact people with MTHFR issues yes so MTHFR it’s called metho hydrolate reductases it’s a big uh fancy word to means that these are people who

01:06:03 have an enzyme deficiency where they cannot break down B12 as readily as most of us they need a particular type of B2 called methylated B2 and because that methylated B2 will also enhance energy we enhance more metabolism and because this also connects with those phospholipids that we talked about remember we talk about phospholipids being part of the brain cells the membranes that protects it that that that also feeds it indirectly when you are doing when you have MTHFR if you are also optimize your

01:06:45 hormone metabolism you optimize your adrenal glands which can then benefit from both the specific kind of B and the hormone replacement that you doing if I can if I may add the cherry on top that we have this specific program for intimacy and Sexual Health in Akasha and the other um uh clinic in Orange County uh your other Branch uh we do have machines here and there that also complement the hormone replacement which is ultrasonic that I always say we have the stimuli and the hormones and we have

01:07:25 the machine that we work on it which can be the penis or the vaginal area and this area needs to be uh regenerated and renewed just like we regenerate anything in your home or or or your street so you need the pathways and the connection the blood supply the nerve endings to be sharpened developed just like Dr Deo said with the connections uh getting more uh together so the enhancement of pleasure would reach different level and this uh can happen with combining the replacement of the uh of the

01:08:02 hormones with the machines that we have in both clinics okay wonderful Dr Lashin yes and just a little a little more before we close and that uh we are like lash said we are present in two locations in Santa Monica is directed by me in Orange count is directed by Dr lashen who uh which is at Utopia Medical Clinic also a part of akasha um uh integration so and whoever you need uh at akasha you can see both of us anybody either in person or also T Health you can reach us as at info aasa center.com and Anna and her team will be

01:08:53 happy to answer whatever questions you may have in terms of Logistics of coming to see us or doing telehealth so without further Ado thank you all of you for joining us tonight for this what I hope was a very Dynamic conversation about how about the fact that there are better ways to for you to feel better that’s the bottom line what are the better ways out there for you to feel better and hormonal replacement therapy is undoubtedly one of those better ways out there so thank you all and have a

01:09:27 good evening thank you everyone drin thank you so much thank you so much bye bye everybody thank you