TRT Risks & Rewards: Your Testosterone Replacement Therapy Questions Answered

**Dr. Gabrielle Lyon** (0:00)
If you have low testosterone, it makes you at a greater risk for cardiovascular disease.

**Nick Barringer** (0:04)
Wait, wait, wait, wait, stop there.

**Dr. Gabrielle Lyon** (0:05)
I would be concerned if you were walking around with low testosterone. I would be concerned that you were going to have a bone fracture. I would be concerned that you're going to have heart disease. I would be concerned that you are at a greater risk for obesity and diabetes.

**Nick Barringer** (0:17)
Wow.

**Dr. Gabrielle Lyon** (0:19)
Forty percent of men in their forties have erectile dysfunction. If you have erectile dysfunction, you are at a greater risk for heart attack or stroke. Erectile dysfunction can predict a heart attack within three to five years.

**Nick Barringer** (0:31)
That's scary.

**Dr. Gabrielle Lyon** (0:32)
Obesity will lower testosterone levels and lower sperm health. If you have poor sperm health, you have a 2.6 time greater likelihood of having cancer.
Ninety-two percent of men that were depressed also had low T. When individuals age, men think that their testosterone has to go down. It's actually not true. Testosterone in, say, a 75-year-old could be potentially just as good as your testosterone in your 20s, which is shocking.

**Nick Barringer** (1:03)
That's very exciting.

**Dr. Gabrielle Lyon** (1:12)
After the statement came out from Tobias Kohler about your penis can shrink up to one centimeter if you don't use it. Had you ever heard that before?

**Nick Barringer** (1:22)
That was scary. I can tell you, that struck fear into my heart.

**Dr. Gabrielle Lyon** (1:26)
Everybody's heart, and immediately it just went viral. Because part of the problem is there's always this echo chamber of testosterone, steroids. But when you tell a guy his penis is going to shrink one centimeter, if he doesn't have sex, the world is listening.

**Nick Barringer** (1:44)
You're going to take action.

**Dr. Gabrielle Lyon** (1:45)
Immediately.

**Nick Barringer** (1:46)
Immediately.

**Dr. Gabrielle Lyon** (1:47)
And those actions can include penis pumps, lots of sex, and therefore that leads us to the conversation around testosterone and erectile dysfunction. Use it or lose it.

**Nick Barringer** (2:01)
Yes. Yes. And as a soon-to-be 46-year-old male, I'm coming to you as the expert, as the doctor that you are. Because I'm looking at my testosterone and I'm wondering, is someone that suspects that maybe my testosterone isn't what it used to be? What's the first steps I take when I go to my physician?

**Dr. Gabrielle Lyon** (2:20)
First of all, you're looking great for 46

**Nick Barringer** (2:22)
Thank you.

**Dr. Gabrielle Lyon** (2:22)
Well done. Almost 46 Testosterone is interesting. Testosterone is the primary androgen for men and also women. When individuals age, men think that their testosterone has to go down. It's actually not true. It's totally unfair and not true. Testosterone in, say, a 75-year-old could be potentially just as good as your testosterone in your 20s, which is shocking.

**Nick Barringer** (2:46)
That is shocking.

**Dr. Gabrielle Lyon** (2:47)
It is shocking. There is hope for all men. Something called SHBG goes up, which may make free testosterone a little less available. But the reality is, how do you know if your testosterone is low? There are a handful of signs and symptoms. Number one, the thing that would get a man to the doctor almost immediately is if his penis doesn't work, erectile dysfunction. 40 percent of men in their 40s have erectile dysfunction.

**Nick Barringer** (3:15)
That's scary.

**Dr. Gabrielle Lyon** (3:16)
That is scary. In addition, obesity, diabetes, all of which contribute to low testosterone, which means you have to get your left cell right. But also, everybody should have their testosterone checked. By the time they're 40, a man should know, and I would argue even earlier, if someone is under 40 listening to this, the sooner you get your testosterone checked for a baseline, the better.

**Nick Barringer** (3:41)
No, we're not going to get it checked. Like, what do I ask for? Because there's, as you alluded to, there's different forms. So is there a particular form I'm looking at?

**Dr. Gabrielle Lyon** (3:49)
And we should review your blood work. But if you are going to the doctor, what you want to look for is total testosterone, free testosterone, FSH, LH, unusual for a guy to have his estrogen checked, but we always check an estradiol. And believe it or not, everything is not testosterone related. You have to check your thyroid and even a prolactin level. Sometimes there are things in the brain, say an adenoma or some kind of benign tumor that would affect testosterone production.

**Nick Barringer** (4:21)
Wow. Estradiol.

**Dr. Gabrielle Lyon** (4:24)
Estradiol, yes.

**Nick Barringer** (4:24)