February 6, 2020

Podcast from: https://bengreenfieldfitness.com/podcast/hormones-podcasts/testosterone-replacement-therapy/

[00:00:00] Introduction

[00:00:47] Podcast Sponsors

[00:04:31] Guest Introduction

[00:07:04] The Effects of a Night of Poor Sleep or More Alcohol Consumption Than Normal

[00:10:34] How to gain a birds-eye view of a person's overall hormone quality

[00:34:10] Using Only Blood Tests for Quantification

[00:35:14] Podcast Sponsors

[00:38:44] cont. Using Only Blood Tests for Quantification

[00:41:20] Men versus Women Variable Tests

[00:45:55] Preferred Form of Delivery for Testosterone Replacement

[00:51:23] The Best Place to Apply the Cream

[00:54:07] Increased Testosterone Levels Can Deleteriously Affect One's Overall Health

[01:00:19] The Peptide Stacks Recommended by Renew Life Rx

[01:09:14] Why Write the Book

[01:18:42] Closing the Podcast

[01:20:48] End of Podcast

Ben:  On this episode of the Ben Greenfield Fitness Podcast.

Adam:  Our ideal person is the guy that's like, “Hey, man. You're exercising regularly. For the most part, you've taken of yourself most of your life, things you're paying attention like you know who Ben Greenfield is.” They're paying attention, but they're still not getting the results. Those are the guys we hit home runs with. They know their body that's just not adding up from a results standpoint. If you're eating pizza every day and drinking like two two liters of Mountain Dew and sitting on the couch, you don't exercise, you're 50 pounds overweight, high blood pressure, you need Tony Robbins, not hormone therapy.

Ben:  Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

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Hey, folks. It's Ben Greenfield and I am actually interviewing today's guest in a hotel room in Las Vegas. He's not in the hotel room, I am. He's on Skype, but I am here in Vegas because I was at the UFC Fight 246 last night and got to bed I think about 3:30, 4:00 a.m. or so. And so, I would imagine that my testosterone levels right now, due to lack of sleep and having for me three cocktails, which is a lot for me because I'm like a one drink a night kind of guy, I probably have the testosterone levels of a nine-year-old girl at the time that Adam and I are actually chatting about of all things, hormone optimization.

So, before I let Adam pipe in, just real quick. I'll fill you in on who he is. So, Adam is a guy who I ran into last year. I believe Carl Lanore from Super Human Radio introduced us because he specializes in all things hormone optimization, particularly for males, but I believe that his company works a little bit with females as well. And he's just spent the last 10 years exploring the whole process of hormone optimization through things like stem cells, peptides, hormone replacement therapy, a whole lot more, and kind of systematized all of this hormone optimization clinic that works with people virtually called Renew Life Rx. He also has a book that we may get into today called “Better Than the Binge,” all about the social obligation of alcohol and how to get past that.

And perhaps most importantly, he's a devoted husband of over 12 years. He has an 11-year-old son, man after my heart because I have a couple of those myself, and a 7-year-old daughter. And so, he's an entrepreneur. He's a family man. He keeps himself in peak physical condition and he's a real wealth of knowledge on hormone optimization. His name is Adam Lamb. And everything we talk about today, if you go to BenGreenfieldFitness.com/adamlamb, you'll be able to access the shownotes, learn more about his company Renew Life Rx, check out his book, et cetera. So, Adam, welcome to the show, man.

Adam:  Hey, Ben. Thanks for having me. Glad you had an exciting night there watching a fight.

Ben:  It was a good fight. But actually, tell me something like that, like one night of sleep deprivation or one night of more alcohol than one's used to consuming. Have you ever had a chance to do like pre and post-tests or look at what actually happens to hormones after just a single incident like that?

Adam:  Yeah. You know that our hormones could go up and down. There's like the system, right, throughout the day with sleep and things like that, activity. You've covered it in a lot of your show. Actually, I think even at your most recent podcast, you talked about natural testosterone where it would–folks approach us and they ask about the natural things that they can do. Number one is being active, good activity, especially using legs. Number two is healthy nutrition, which alcohol can lower testosterone and things like that. On the other side, good hydration and proper nutrients, and sleep, and also sexual activity, like regular sexual activity is good.

The one thing I'd be curious about in your situation is part of me love fighting and I used to be in the fighting space. Actually, I work with a ton of retired UFC guys. I also like the violence and stuff like that. But when you're watching that stuff, there's this primal male part of you, like instinct that's just fired up. You know what I mean? I would be curious if testosterone levels would increase in those moments like you're getting ready to get a fight or you're just being in that environment, whether it's adrenaline only or adrenaline testosterone. I'd be curious how that part go.

Ben:  Yeah. Well, aren't there some studies that show an increase in–I don't know if it's a salivary testosterone or what when guys are viewing pornography?

Adam:  Oh, yeah, for sure. It's actually blood pressure or heart rate increase and all that kind of stuff as well. Yeah, absolutely. That's why sexual activity is good for–because you're getting your body to practice the process of arousal, erection, and orgasm basically, which also helps stimulate natural testosterone. So, it's healthy.

Ben:  Yeah, yeah, except the whole neurotransmitter, not to mention the social implications of a regular pornography habit. That's probably not the best way to get your testosterone levels up. And maybe responsible viewing of UFC fights could bump it up a little bit, but you're right, a lot of these things like lifting with your legs, high-intensity interval training, proper sleep, proper nutrient management, et cetera, a lot of the stuff I've covered on previous shows are of course the foundational principles. I just recently did a podcast that was 32 different ways to naturally increase testosterone. Folks can go listen to that. I'll put that in the shownotes because I've addressed that side of things. But what I want to get into with you is more of the science of hormone optimization from a laboratory standpoint, from a testosterone utilization standpoint, et cetera. And by the way, before we jump into that, do you work with women as well as men with Renew Life?

Adam:  Oh, yeah. We have hundreds of women that we work with.

Ben:  Okay. I've got some questions for you about that, too.

Adam:  Yeah. No. I'm excited to answer.

Ben:  Okay, cool. So, first of all, in terms of quantifying, obviously, I would imagine step one is to actually figure out what's going on with your hormones if you were going to test. And some of these questions I realize we'll rabbit hole a little bit, but we have time. So, what exactly, besides just looking at testosterone, are you testing and tracking when someone comes in and they just want to know how their endocrine system is functioning their concern about libido, energy levels, et cetera?

Adam:  Yeah. It's a great question and I'll dive into specifically kind of our phase one test really is like–we do almost with everybody, we have a different one for male and female, obviously. And then if there's red flags or concern on something, then we have this phase two where we dive deeper, right? It's like you don't have to go to the nth degree with every single person if they don't even have symptoms that potentially are in that space. So, the part of the process before I go into the blood work part of it is really having a story about what's going on in your life, what are your symptoms and things like that because then that goes into those notes for the physicians to review when the results come back as well.

But over the course of time, we've replaced them. We've kicked certain panels out and added new things and we don't have like a 17-page every–just some of that stuff the reason being is it's costly, number one. We take care of some of these crazy unique folks that people just haven't been able to help that were like their fourth place. And sometimes it's just because we have the experience. We've worked with thousands and thousands of people over the course of a decade that we have the data, so it worked. On one side too, I should say that we're kind of a technology company as well. So, a lot of the reasons why we do stuff is because we could look at the data and see how it comes out.

So, going into men, we check the CBC with differential platelet, metabolic panel, lipid panel with cholesterol, and obviously HDL, DHEA, total testosterone, TSH, IGF-1, FSH, LH, PSA, estradiol, and SHBG. So, it's the phase one check-in–unless through conversation we notice that there might be a couple of things we want to add, then we're diving into the thyroid a bit more, we're diving into–

Ben:  Okay. Give me a 30-second overview for each of those parameters and why you chose those specifically for a hormone panel. And also, not to complexify this question too much, there are a couple things I didn't hear that would have expected to, like free testosterone, and I don't think you said estrogens, did you?

Adam:  Yeah. When I said total testosterone, I thought, “He's going to ask, ‘What? Free testosterone? What do I get?'”

Ben:  Alright, so fill me in on each of those and why you test them and why you don't test those two that I mentioned.

Adam:  Yeah, for sure. And so, going through the CBC piece is just standard health, right? We want to make sure you're healthy. Going into a lot of folks we work with, 50% are new people. They're not in the fitness space. They're like, “Man, I just want to feel better, I want to feel more confident, I want to have more excitement in my life, I want to be more playful with my wife.” Those are our favorite kind of clients because they're not trying to achieve some kind of physical goal, which you and I both from the bodybuilding space is something that's somewhat obnoxious and also fleeting. You never really get happy.

We overall want to make sure they're healthy, going in the CDC, and giving baseline, like where's your hemoglobin, hematocrit, red blood cell, and those kind of things prior to treatment, and then with the metabolic panel as well, and then lipids, cholesterol. It's another thing like healthier. Rule number one in our clinic is you got to be healthy first, number two is we're going to get you feeling better because if–we'll talk about that a little bit later with testosterone and cardiac disease, those kind of things. But if you're responsible, it's not really an issue.

Going into DHEA too, it's something we've seen over time. There's a lot of our clients who were like high stress, high functioning, guys like you that are bazillion miles an hour planes every other day type thing. And we just noticed that depletion in DHEA not only restore that, it actually put it in optimal ranges. They sleep better and they feel less stressed.

Ben:  I'm going to interrupt you about DHEA real quick because I've actually–from what I understand, the DHEA is something that if you replace that alone, like in one of the podcasts that I did, the one at the A4M, I talked about missing nutrients that would be a good idea to address foundationally before you actually begin on something like testosterone replacement therapy. It's creatine, boron, vitamin D, magnesium. And DHEA was one of those as well. But do you find in some folks that something as simple as restoring DHEA like, whatever, 25, 50 milligrams DHEA a day is something that often reduces the need for actually using testosterone?

Adam:  It's a good question. I'll say yes and no. I'll say yes, I'll think of somebody who I guarantee we know, very famous, popular marketing guy, who had–he reached out and was just like, “That was awesome.” And he's like 51, 52. So, in our head, we're like, “Testosterone.” But he didn't want to go that route and we just did some–we just recommended a good quality DHEA product to take about a couple hours before bed and it helped his circadian rhythm. His biggest concern is he wasn't wanting to get out of bed. This is like a motivational guy. That's like what he lives and breathes. And he found like he kind of lost it and that helped to restore the–and it took a couple weeks, but that's all that we did and he said he felt like he was back.

Now, we know popping amounts of testosterone or something like that and going through the full blood test. It was just like a recommendation. “Hey, try DHEA before bed, see if it self-regulates,” and that helped him. But if your testosterone is low and you have all the symptoms of low testosterone, we want to treat symptoms over just blood levels, and we'll talk about that a little bit too in this, but at the end of the day, if you don't feel good, what's the whole purpose of it?

Ben:  Yeah. It makes sense. Okay. So, in addition to DHEA, what were some of the other ones that you were talking about that you're looking at from a lab test standpoint for your basic intake?

Adam:  Yeah. So, total testosterone. Total testosterone is always giving us a good vision of the state of your body, basically, where your body's at from a testosterone standpoint. Free test, it's not as important when you're looking at SHBG, and we'll talk about those. What I want to do is I'll go through these reference ranges. That's where we think the priority isn't what you should be testing. So, the TSH is another one, the thyroid-stimulating hormone, just to see if it's buried or if it's higher than normal, we know there's an issue and we need to dive deeper. If there's not, we ought to believe that thyroid medication is the number one abused/overly prescribed hormone medication in this country, like everybody's got a thyroid issue. The reality is not everybody has a thyroid issue. It fluctuates and they just have some other issues that they think have to do with their thyroid.

And so, that's something that we test, but it may look deeper into like the T3, T4 free in some of those different ranges, but it's pretty rare that we have to do that. In a lot of times, actually, I have people end up coming off–once their testosterone is optimized, they end up coming off their thyroid medication because the reason they took the thyroid is they wanted what the testosterone actually gives them.

Ben:  Okay.

Adam:  It's an interesting thing and it was–like I said, this is all morphed over time of experiencing, collecting data, and all this kind of stuff based on how we do it to get that best output, right? The next one that I think super important that a lot of people look at is IGF-1. And so, we look at that with everybody and that'll tell a lot about sleep, stress, and then for folks that are into recovery and things like that from a muscle building or strength and those kind of things, or endurance and stuff like that that help, because IGF-1 levels decrease significantly as we get older, but also a lot of lifestyle things have to do with it. The other part of checking the IGF-1 is it can throw a red flag up potentially for a pituitary issue. That could be the cause of all of this stuff, right, the whole —

Ben:  Meaning, if IGF-1 is super low, it could indicate pituitary dysfunction that would affect overall testosterone production.

Adam:  Or super high. Yeah. I mean, we've had a few folks that have come through and they're just–they're up in the 300s, 400, and they shouldn't be because they're not–if they're taking a decent amount of growth hormone, they would be, but they're not, and so that's kind of a concern. We'll advise that they go see an endocrinologist and get an MRI of the brain. We've had, I don't know, maybe half a dozen folks come through. It never thankfully ever had anyone that had like cancer, but we've had people that had tumors that were not in cancer on their [00:20:12] _____ known of, right?

Ben:  I've been doing interviews with people about testosterone for a long time and one of the first guys I interviewed, that was actually his issue is he had a pituitary tumor, it turned out, which of course is typically not the cause of low testosterone, but it certainly can be something to look at. I didn't realize that IGF-1 could be a measure for a correlator of that.

Adam:  Yeah. It's one of those things that you test something for multiple reasons, but if we see something like a 350, 400, obviously, we get people that are doing stuff on their own, that they're not telling us about. We're like, “What's up with that?” We hope they come clean because we scare them with, “Hey, there could be a pituitary issue and we want you to go see an endocrinologist locally and we'll find it.” Then they're like, “Well, I'd take the growth hormone that I get from my [00:20:59] _____.” Then it's like, “Okay, [00:21:01] ______. Right.

And so, it allows us to help just see the state of them because folks that don't sleep very well every single time, people that we can look in during the low 100s and even dipping below 100, they all have sleep issues. I mean, you take a sleep apnea person and look at their IGF-1 levels compared to someone who's like, “Oh, yeah, I sleep great, man,” Eight hours solid, never wake up. Those people are always higher. And so, we see that from a data collection standpoint that IGF-1–the IGF-1 has a lot to do with the recovery and things like that as well. So, if you're always sore, you're not recovering, you're always tired and you're not getting good sleep in IGF-1, it's just all hurting you at the same time. We get a lot of that data out of just IGF-1.

Ben:  Yeah. That's right. I know a lot of these growth hormone-releasing peptides or growth hormone precursors they can often help people with sleep as well when they use those prior to sleep. So, it kind of goes both ways.

Adam:  Absolutely. Oh, for sure they do. And then the next thing we look at, this is for men, is FSH and LH. So, follicle-stimulating hormone and luteinizing hormone. And part of the reason is is it also tells the story of the function or those functions because usually if they're functioning healthy and properly, your natural testosterone is good and that communication from the brain and testes is happening how it's supposed to. But sometimes it's way low and sometimes it's way high, and either way, it's not a good thing. It's like if I give you directions and you still show up at the wrong place or you just don't–like I asked my son do something like five times. I'm doing my job by telling him, but the message isn't working. And I'll probably use a lot of analogies, I apologize. My goal is always to dumb it down for a lot of folks to understand.

So, with the LH and FSH, it gives us a good baseline too because those levels just about always drop depending on the path of testosterone therapy you go on, but usually on there. So, we know where they're at because we also like to help people. Throughout the course of the year, we'll usually have folks come off and do kind of like a reset to show them that, “Hey, we can get you back to where you were prior to therapy,” because that's what people–they have to be on this forever. And the answer is typically no, but the guy that's 35 is going to bounce back easier than the guy that's 65.

Ben:  So, you'll put someone on testosterone to get their levels up and then gradually take them back off the testosterone?

Adam:  Not necessarily gradually. We're just at the belief, and just with anything like this shouldn't be done always. We want to see what the body does, but I'll use me personally. October, I come off testosterone completely and do like a reset and did similar to like a post-cycle therapy type thing. We don't like to use that term, so it's usually associated with steroids abusive bodybuilding, but it's very similar structure. And then after that, doing labs about a week post-reset and showing like that's really where your natural levels are going to stay as opposed to somebody who might go on testosterone come off, whether it's financially or some other health issue happens and they have to come off and then they're in this low–the natural function is not shut down but–and it can be shut down but significantly heard based on the exogenous testosterone that you're putting into your body.

And so, we just pay attention to the LH and FSH baseline for us to see where you were because sometimes they come in and they're at 0.4 LH and at 0.8 FSH. That's low. We might be able to get your testosterone back up just by increasing LH and FSH to maybe like HCG or Clomid protocol or something like that.

Ben:  Gotcha. Or of course for LH and FSH, a big part of that from almost a–very similar like an HPA access standpoint would be things like stress, sleep, nutrient management, et cetera, because the issue there would be the actual message from the brain getting delivered to the testes to produce testosterone not happening properly, and that's usually more of like a stress issue if it actually is impacting LH and FSH that dramatically, right?

Adam:  A hundred percent. What's funny is you would think–and any client of ours you talk to would tell you that we talk and ask a lot about their life that they don't typically get when they go into their standard family practitioner. And because we understand that stress is massive, especially when it comes to like erectile dysfunction, things like that–I think the medication doesn't work, they're like, “My estrogen is too higher,” or, “My estrogen is too low,” or, “I've not enough –” they want to blame the drug, but the conversation and lifestyle like, man, they're stressed out. It's like if I put a gun to your head, I don't care how attracted you are to the opposite sex. You're not thinking about sex, right?

And certainly, we have these fight-or-flight things going on. Sometimes it's part of our life, but we don't realize it and stress is so massive to your point with a lot of the symptoms that could be related to low testosterone. That's case in point why FSH and LH is another thing to look at through these testing.

Ben:  And then what else after LH and FSH are you looking at?

Adam:  Yeah. So, PSA is one that's important. We want a good baseline. I can't recall. Obviously, I don't see everybody's stuff or hear everybody from a patient standpoint, but we try to keep everybody under one. But we also want to know–this guy came across recently. He was like a friend of a friend of mine. So, his PSA came back really high and had he not come through our process, he would have never discovered it. He had to go in and he had to get the prostate exam and get things checked out. And thank God, he didn't have cancer or anything, but it was something to look into. If there was a situation, maybe it would have been caught early instead of something later.

Anyway, it just gives us a good baseline because too much testosterone a lot of times can increase prostate to a bad spot. But also, too high LH and FSH we've seen convert over to higher–folks that just come with really higher than normal LH and FSH have higher prostate levels as well. So, again PSA for baseline, we want to make sure testosterone therapy is not causing a negative impact. In most cases, it actually lowers their PSA.

Ben:  Okay. Got it. So, anything else in addition to the PSA?

Adam:  So, next would be the estradiol. Estradiol was again a good baseline piece of where we want to be to just find out how their body may react from like an aromatization to testosterone and where they start because some guys come over. There are 20 some guys come over, there are 43 and declining out through lifestyle diet, things like that. We stopped doing total estrogens, and part of it is there's so much stuff that can affect your estrogen level that's not as important. I mean, if you eat soy regularly, if you have–there's a guy, just quick story for listeners about the guy who had almonds was like his snack on his desk every day and his estrogen was like 300, which is super high for a guy. We couldn't figure out why and we just talked. While he's talking, he's eating. I'm like, “What are you eating?” He's like, “Almonds.” And I said, “Well, that's probably converting because legumes and things like that have been shown to convert estrogen. He came off, he stopped eating almonds, and he was eating a lot of almonds for the record, and his estrogen went down under 100. That was the only thing changed.

Ben:  Interesting. Well, I know estrogen is related to inflammation as well. And if the almonds were from like a trail mix, in many cases, those things are coated with vegetable oils as well. So, sometimes there's things coming in along with the nuts that may make an impact as well.

Adam:  Yeah, for sure. And everybody's is buying. There's one thing too with this whole space that any absolute for anybody is wrong, right? Like, what works for you and works for me and works for the guy down the street can be different. So, everybody's body I think utilizes certain things differently, absorbs things differently, and it can respond to things differently. And so, we measure that throughout the process with our clients. Every two weeks, we have follow-up specific questions related on where we think they might be in the journey to get data to see if the physicians want to change dosing, increase something, take away something, add something, something like that. And most of the time, I think about 86% of time we have it dialed in initially, which is good.

And then the last thing, which is potentially the most important thing, is sex hormone-binding globulin, SHBG. That's something we've been super focused on, like hyper focused on for the last–let's say four years we started really looking into it, two years we've been hyper focused on that because we've seen that there's for the “happy” feeling of somebody on testosterone, or not on testosterone, really is this correlation of a ratio for SHBG to testosterone. And with guys that have high SHBG, low SHBG, either/or could have this low testosterone symptom and it just has to do with the ratio of the total testosterone and SHBG. We've just found that whether it's high, they may require a higher dose of testosterone to get that down as opposed to trying to cross it down. Or if it's low, trying to bring it up first before we put them on therapy. It just works.

Ben:  Well, in many cases, from what I've seen in folks that I've tested and worked with, high sex hormone-binding globulin is also something that seems to pop up over and over again on a high-fat, low-carb diet. And I've seen some evidence that it may be because sex hormone-binding globulin also somehow is involved with the transportation of fats through the bloodstream or the interaction with the fatty acid metabolism. And sometimes you might see artificially elevated values of SHBG in a state of a high-fat, low-carb diet. Have you run across anything like that?

Adam:  Not specifically. There was a lot of talk too, like obesity was tied to high SHBG. And some of the guys that we've seen with actually total contrary to–with high SHBG are like super-fit guys. And what we've seen is that a lot of the guys that we'll see, let's say they're 40 and their testosterone is 700. So, anyone else, usually on the planet, would say, “Oh, man, you're fine, 700, that's great,” but their SHBG is at 130. And what we found is that usually the conversation that those guys have always been muscular, athletic. When you think of like 18-year-old LeBron James, that didn't have 900 testosterones. There's like 1800.

And so, we've been doing a lot of testing, and this is something we could talk about too, with younger folks like athletes to show them like, “Hey, man. When you were 22, beast, your testosterone was at 1700.” You and I can look at different athletes and people talk about, “Oh, it's got good genes.” Well, yeah, it's his whole testosterone function and recovery and growth hormone, all those things. Those are what we're talking about when it comes to just absolute beast athletes. I think when I was younger, some of these guys that I knew, they were like pizza and drink beer and they look like bodybuilders like two weeks out. And they just had good genetics, but a lot of it was–we're not testing testosterone in 18, 19, 21. My son, I'll definitely do that because I understand that difference.

Actually, you mentioned Carl Lanore earlier that Carl and I talked about a lot. And so, we're working with some young athletes to do their blood work when they're healthy, no symptoms, feel amazing, right, crushing goals and things like that to see what that looked like then. So, 10 years from now, if they don't feel like that, they can compare and have an understanding of what might have happened, whether it's just natural testosterone, going lower or–with fighters, for example, like UFC fighters, these guys get so many concussions, TBIs, things like that. It's going to affect your endocrine system, which can ultimately lower your testosterone. So, you used to be a fighter at 1500 testosterone, five years later because you've been pounded in the head so many times. And so, stuff like that that we're looking into and testing because it's interesting for us and we like the data.

Ben:  Okay. Got it. Now, are you running all these with blood measurements or using anything like saliva or urine?

Adam:  That's a great question. I hate saying this, but we've always done it with the blood work and it's like a trust thing. We trust that data. I think that we would be open to doing some different urine stuff or different saliva stuff, but we would probably contract that to somebody who's really experienced in there. We stay in our lane. If there's something that we're not real good at, we're not going to try to be good at it with Dr. Google or something like that. And so, everybody has the confidence. I have no problem saying I don't know. Our history and past, what we've done with folks has always been through blood work and we trust that outcome because it's been very successful. There's some great stuff I think with saliva and urine and doing different kind of testing to dive deeper especially in certain things.

Ben:  Hey, I want to interrupt today's show to tell you a little secret. Did you know that if you have canola oil, vegetable oil, anything, any oxidized rancid oil, one of the best ways to protect your cell membranes against the potentially deleterious effects of that, say, Whole Foods hot salad bar is spirulina? Spirulina is amazing for this. It's almost like having activated charcoal in your back pocket, but far more nutrient-dense and is going to bind up all the vitamins and minerals.

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Yeah. I'm certainly a fan of the DUTCH complete panel just because it can give you a patterning throughout the entire day of how the endocrine system is fluctuating between cortisol, testosterone, et cetera, versus that single snapshot from blood, which is–I think one of the issues with blood testing is you're only seeing one measurement during the day versus the natural variations that should be occurring during the day. So, is that something that you ever consider, like if you test someone and let's say their, whatever, their morning blood levels of cortisol are elevated, which is the case naturally in many people, but perhaps cortisol is extremely low the rest of the day after that morning rise? I mean, how is it that you wouldn't want to look at some of those variations throughout the day?

Adam:  Yeah. And I think you're totally right. We work with a lot of trainers that refer clients over. One in particular has everybody do the DUTCH test first, and then ultimately, they come over to us because it's likely a testosterone deficiency. Like I said, these are our surface kind of tests. And then if we have to go deeper, we refer out. Like I said, we're not experts in certain areas, or not experts I should say in everything, but we think we're really good at some of this stuff that we do. But the biggest concern with that is we have these baselines. We have everybody do fasted testing. They do it the morning. And that's the items that we look at. And then if we need to, throughout treatment, to test other things, we definitely send them out. There's folks we get blood work on every 30 days, every 90 days, and just about everybody goes every six months.

Ben:  Every six months would be like gold standard for the minimum amount of time between tests, or the maximum out of time between tests?

Adam:  Yeah. There's folks that worked with us for five, six, seven years and they're self-experts. We've empowered them to really understand their health, what works. We still have them go every six months to make sure because something else can occur in your life. I think of it like if I can get folks to check their blood work regularly, think of how much disease or other issues that we could potentially identify early for them that may have nothing to do with hormone therapy. But for me, it's like doing the right thing and doing a good thing by making them get their blood work done regularly.

Ben:  Yeah. And are you testing anything different in women versus men? Like, everything you just described, is that typical male panel and would that look different if you were testing a female?

Adam:  Yeah. So, women will look at things like pregnalone, progesterone. We do look at total estrogens with women, not estradiol as much. But other than those that I just listed, it's pretty similar as far as that. What our experience is, and I know a lot of people don't like the statement, is we've seen that women are typically taking everything under the sun except for testosterone. We've just seen testosterone be the–I couldn't tell you, Ben, how many times we have women that are taking 2, 9, 12 things and they still feel like crap, they still have all the symptoms. We take them off it, usually have them do like a 30-day just like clean the body out, detox, and just do like a low-dose testosterone cream and they're like, “Oh, this is what I've wanted for nine years.”

Ben:  Really? So, you have women do a low-dose testosterone cream?

Adam:  That's usually the first place we go.

Ben:  Even more than a progesterone, huh?

Adam:  Oh, yeah, without a doubt.

Ben:  Interesting.

Adam:  Yeah. And one of the things we've actually seen too, it's very unique with women because here's a deal. Guys, we don't work with guys under 30. Maybe some unique rare cases we've had guys that had certain issues that testosterone is just going to–it's going to help them. Most of the guys under 30 usually wanted to be bodybuilders and their goals don't line up with our ideal client goals. People just want to feel great, be healthier, feel inspired. But with women, women after having a baby can have just a total wreck of their hormones, right? And so, we've seen where we've had younger women come aboard, testosterone's in the tank, estrogen's in the tank, progesterone's in the tank, all these things, and their body is still in like baby-making years, maybe not baby-making mode, but baby-making years.

And so, we found that instead of giving them different patches and creams, and pills, and all this other stuff, just doing testosterone, it's kind of like this authoritative hormone that once it's elevated to optimal levels, the estrogen falls back into place, the progesterone falls back into place, their cycle is now normal again. And then if they're younger, the great thing is we can bring them off testosterone and their body just that–it's like the clock, the timepiece keeps ticking. Obviously, if we had them at a 50 testosterone, now they're down at a 40, but before they're at a four, but they're doing it naturally. We've seen that happen with women like “come back”. With guys, it's tough unless it's an LH, FSH situation.

But a lot of times, women too, one of the biggest things with menopause is just optimizing their testosterone eliminates the symptoms of the hot flashes, the night sweats, the irritability, the vaginal dryness, all that kind of stuff, just testosterone cream. And if you put someone on five things, especially women–men, there's certain things that we know what needs to be there. You can't just have a one-legged stool. But with women, we always just start with one thing, usually testosterone, or maybe it's thyroids, but typically it's testosterone.

And then depending on the feedback, sometimes they're great and it's problem solved. Why put them on more drugs? But other times, we may add some things as we go so that we have those reference points of like, “Oh, hey, I'm having trouble sleeping now,” or, “Hey, these hot flashes came back.” Alright. Well, let's pull out whether it's DHEA or whatever it might be and just really measure that stuff as we go. But yeah, testosterone is like the main, number one thing that we do with women, low dose.

Ben:  And when you say low dose, how much is that?

Adam:  So, when you think of an average male testosterone, there's like a 200 milligram. A female is maybe 2.5 to–it would be 4 milligrams. But I think of, off the top of my head, a client who is like retired bodybuilder. She's abused her body with tons of drugs, but she's like in her 50s now. And so, she needs a little bit of a higher dose. She might be on like a five milligram, or maybe even as high as like a 7.5 or something like that. So, it varies, but like Suzy down the road, 125 pounds, just kind of go with the menopause, like maybe even a 2.5-milligram cream will do it.

Ben:  Okay. Now, that leads me to a question I wanted to ask you about, and that would be, let's say you ultimately determine that testosterone does need to be replaced in a man or woman who you test, and you mentioned the cream, and I'm curious because there are a lot of different methods out there from injections to pellets, to gels, to creams. What are your guys' go-tos as far as the actual method of delivery if you find that testosterone is low, you've already addressed foundational principles like nutrition, sleep, stress, the type of exercise someone is doing, et cetera, is still low? So, at that point, what would be the form of delivery that you would use?

Adam:  Yeah. So, I would say 80%, and I'll just say men. Women, there might be two women that do very small dose injection. It has to do with some–they're having transdermal absorption issues like two of hundreds of [00:46:55] _____ that we work with. We like the cream, but let's say 80% of our male patients, for example, do cream, testosterone cream. Two reasons. A, we believe it's the healthiest, safest, most effective way. B, a lot of our guys are just–they're like, “I'm not putting a needle in.” They're not comfortable.

Guys like you and I who were experimental and we've been in this space a long time, it's not scary to have a needle. But most people, they shake. You know what I mean? So, the thought of that. And that's a lot of the reason why they don't pursue testosterone because they think they have to go to the doctor and get injections every week, or they have to take like AndroGel. A lot of the gels just aren't very great. And so, we use compounded testosterone cream. And the cool part too is you can adjust the dosing. We have guys that are doing 3:00 in the morning, 3:00 at night, or 2:00 in the morning, 3:00 at night. Two and two is probably the average. Maybe it's one and one.

And a lot of it has to do with like where do they feel the best because for me, I feel like 800 is probably my number, like 850 if I were to just pick one, where I feel the best. Higher than that, I'm a little libido distracted, I'm probably a little bit more intense. And under that, I'm a little more ugh, right? But some guys, they need to be at a 1000 or 1100 or 1200. And some guys, if they get up to 800, they feel anxious and they're finding themselves distracted or something like that. So, finding that the cream allows us to help adjust dosing just based on that feedback loop that we get from them. And then injections, we'll usually do like a split dose during the week of injections. The once a week is not ideal.

Ben:  And you're not combining injections with a cream, you're doing one or the other?

Adam:  Yeah. We've done a couple hybrid where you'll do like, let's say half CC of testosterone, for example, and do like a one pump at night type thing. We've had some folks do that. We had a lot of folks who travel and they're not comfortable taking–they're going overseas regularly or they didn't want to travel with the injection. So, we'll have “travel cream” type thing that we'll have them do that helps keep those levels optimized. The cream really gets that natural testosterone pulse, and that's where we see that being most effective.

Ben:  You mean the natural testosterone pulse and that testosterone is pulsing a couple of times a day, for example, in the morning and in the evening, so when someone's using a cream, they're using a cream applied to the, I would imagine the testicles or an area of high blood flow in the morning and then also in the evening?

Adam:  Yeah. And so, we'll talk about the scrotal application in a second, but you're exactly right, that night and morning mimicking to the point where if you do it–and when you think about when you're breaking down this dose as opposed to like 100 milligram injection twice a week and you're breaking down this dose to like a 14 milligram injection, do twice a week or twice a day or whatever. You're almost sneaking it into the body, and it's a bioidentical cream so the body–there's just less disruption, less change as opposed to–you take a guy that's doing a 1 CC injection every two weeks, the side effects are not even worth being on testosterone.

Ben:  And in no way matches the natural fluctuations of testosterone like doing a huge bolus at one point versus doing smaller doses morning and evening on a more frequent basis?

Adam:  So, bad. And what we'll see too is that guy might feel like Superman for five days and then a little bit normal, and then feels like crap again, but his hemoglobin, hematocrit, they're all shooting up, red blood cell count, LH and FSH shutting down because there's so much testosterone coming at one time. So, they're getting all the negative piece and some of the positive, but we have guys that do testosterone cream that their LH and FSH don't even go down, they stay there because it's the proper dose with that natural testosterone pulse. And so, they don't need more drugs, they need less drug.

Ben:  And so, that would also be a situation which you would be less likely to blunt the body's natural production of testosterone when you're using testosterone therapy if you're using something like a cream. Okay. And you said that the best place to apply the cream would be scrotally?

Adam:  No. I know that that's been super popular. We actually have folks do the back of the knee or forearm, or I personally do shoulders, the absorption–but everybody's skin's different, bodyweight. Like if you have a higher fat content, the absorption can be a little bit different. I know there's guys that do it. That's not our path because I know that it works well putting it on the back of my knee, or on my forearm, or on my shoulder, or something like that. So, I just think of it like the last place in my body I want there to be a problem is down there because everything works really great, and I know that putting the cream on my shoulders, for example, works really great too.

And so, we don't necessarily advise that, but I know that we have guys that do it. But I'll tell you, recently I had a guy who's been a client for a couple of years. He's always been a forearm guy and he started doing it scrotally, and then his estradiol went up strangely after he'd been doing that for about 90 days-ish. I remember it's time for his refill and he mentioned that. And the dude's trying to figure out like, “What's going on? Why this sudden change?” Like we talked about earlier, we're going through diet, sleep pattern, nutrition, like are you eating something different? And then I don't know why it took to the end of the conversation, but he's like, “Oh, I switched to scrotal.”

And so, we switched them back and the symptoms went way, not that that's going to happen to everybody, but we just mentioned that, whether it's an absorption, it's absorbing more and it's peaking higher, those kind of things. We wouldn't know without doing significant testing into it. We just know from our patients we've been working with for so many years, doing it this way, it's worked well. So, we usually just say forearm, shoulder, back of the knee, but it's to each their own. I personally, like guy to guy, I've never done it and I don't know that I would, like I said, try it.

Ben:  And for women, is it still vaginally?

Adam:  No, same thing, back of knee, forearm. Yeah. And with women, our biggest challenge sometimes is that just making sure that their bodies–that they don't use lotion and things like that. You want to make sure absorption is good or the area is clean and dry for doing it. But yeah, never ever has any of our physicians ever had them put it on vaginally. I'm not saying it's bad, I'm just saying we've never done it because we've never really had to. We get the results without getting there.

Ben:  One concern that people might have, because this recently, two different research articles recently came out. One in the Journal of the American Medical Association and I think the other one was the Annals of Internal Medicine where they were addressing testosterone replacement therapy and talking about an increase in cardiovascular events or an increase in inflammation, or some other concern from a medical standpoint. Did you see either of those papers?

Adam:  No, but I heard about them, actually, some from mutual friends of you and I, but there's–with some of those studies we look into, I think there's got to be a lot of responsibility in testosterone therapy. It's like handling a gun, right? Guns are bad, but you have to understand the gun before you hand it. It's like driving. You can't just get behind a car because you like cars, you need to understand how the car works. And the same thing with testosterone therapy. You can drown in water, but you also need water to survive.

And so, we really do a good job, in my opinion, of making sure, like I said earlier when we first got in this that you have to be healthy first before testosterone therapy because if you're eating pizza every day and drinking like two two liters of Mountain Dew and sitting in the couch, you don't exercise, you're 50 pounds overweight, high blood pressure, cholesterol is through the roof, you need Tony Robbins, not hormone therapy. You got to get some things together first to your point like the natural health aspects of getting active, getting the right nutrients in your body and doing that first. And I think what the problem is is there's a lot of times in–like the situation of those studies that they're not those folks that are getting testosterone, they're folks that don't have the best health situation or regular healthy lifestyle.

Ben:  Right. These are people that maybe have not adjusted their lifestyle, but that are using testosterone replacement therapy as a Band-Aid. And what we'd have to see actually is a comparison between people who use testosterone replacement therapy, and also have set up all those foundational principles from nutrition, low stress, sleep, et cetera. And those who simply are slapping it on and continue to sleep five hours a night and fly all over the world and eat a crappy diet and they're just basically using testosterone to cover up some of those issues that it's probably going to be a different impact on heart health and PSA and all the other things like inflammation that some folks will say testosterone replacement therapy will cause. It would be interesting to actually see what happens with healthy people who use something like this.

Adam:  Yeah. And that's the first part. The second part, and like our panel of docs is of an agreement that like 90% of testosterone therapy is not done properly. And we see it because we have these guys that are on therapy and they find our clinic through one of our clients or something like that. We've seen a guy recently; he's getting 300 milligrams of testosterone every three weeks. If you do that, you're going to end up with some cardiovascular issues. His blood work was a mess and that guy's like 36 years old. It shouldn't be because he's athletic, he's pretty health-conscious.

Our ideal person is the guy that's like, “Hey, man. You're exercising regularly. For the most part, you've taken care of yourself most of your life and athletic. You're eating the right things, you're paying attention. You know who Ben Greenfield is, you know what a keto diet is, you know what intermittent fast –” like they're paying attention, but they're still not getting the results. Those are the guys we hit home runs with because they know their body, they know their health, they know the things that they're doing and it's just not adding up from a result standpoint. Almost every time, that case is–it's a hormone issue. But sometimes, these cardiovascular studies, it could be somebody who's just not healthy and then adding testosterone to it. It isn't going to make you healthier, right? It's like buying books and not reading them. It's not going to really do anything good for you except to take up space.

Ben:  Now, could any of this have something to do with the actual form in which the testosterone is delivered or what's co-administered with it? Because I know a lot of doctors are administering everything from like HCG to DHEA to other compounds that are delivered along with the testosterone. Do you think that's part of this at all as well, like administering testosterone by itself versus things that you would normally have a company with the testosterone?

Adam:  Yeah, for sure. There's so many variables in those studies and that's why we don't–there's a big thing recently, or probably than last year about anti-estrogen and things like that being the worst thing for you and stuff like that. We're not of that belief. We also don't believe everybody should be on something. It's just a matter of what does your blood work tell us, what's your past health history tell us, what's your follow-up lab work tell us, where do we need to adjust, where do we need to add, is there something we need to do, was it HCG for six weeks every six months, or maybe you need one [00:59:09] _____ every 10 days, maybe you need two weeks. I personally take a half milligram twice a week. When I did my blood work —

Ben:  You mean as an aromatase inhibitor to keep from excess estrogen?

Adam:  Correct, yeah, taking it–yup. And so, if I went two weeks without it, I'm moodier, I don't feel as good overall just my body, and that's some people, some people don't. Then people will bring up studies where it showed bone density went down. Actually, a scientist friend of mine, we're talking about that and he actually did the DEXA scan and his bone density didn't. But also in that study, were those people all on testosterone? No. Which we know can help with bone density. And so, some of the studies, you know what I mean, like, they're good I think for referencing and paying attention to and sparking that research, rabbit trail for yourself, but I think that just going into hormone therapy not aggressively, but monitored healthy people that know what they're doing, I think that's the best way to do it to avoid being one of those potential statistics.

Ben:  Got it. Now, Renew Life Rx, are you guys using things other than hormone replacement? Like, have you delved into peptides or stem cells or any of these other things that often are used in that same type of anti-aging cocktail?

Adam:  Yeah. So, we do a lot with different–like growth hormone releasing peptides, BPC-157, things like that for healing. We have a sister company here where I live in a Houston area called Regenerative Revival. We do regenerative medicine, so we do tissue-derived allograft, stem cell treatment, amniotic fluid, PRP, those kinds of things. They're separate entities, but all under the same philosophy of care type thing. But as far as in the Renew Life Rx, the hormone optimization, absolutely [01:01:09] _____ peptides are just game-changer amazing that can help folks, but also making sure there's the right resource, the right supervision with them to get the best out of them and stay healthy too but —

Ben:  So, give an example of that. I would love for you to delve into because I know you guys have these different stacks, like peptide stacks. There was one I saw on your website like a fat loss peptide stack. What would be in something like that?

Adam:  So, I think, and I'll have to go by memory, but something like tesamorelin with a–there's the fat loss cream. That cream really helps with localized fat and cellulite loss.

Ben:  Okay.

Adam:  So, there's different stuff based on different goals. The usual focus for us is like fat loss, lean muscle, gain, recovery, work with guys that train like animals like you that their body is just not keeping up with it, maybe there's IGF-1 deficiencies, things of that nature. And so, those are all things that we look at when it comes into the peptide realm and recovery.

Ben:  Okay. And I just pulled up this fat loss peptide stack on the Renew Life Rx website and it says that that's three things, an anti-obesity drug injection that says it helps to immobilize fat cells, a CJC Ipamorelin injection to stimulate growth hormone secretion to cause fat loss, and then this transdermal fat loss cream. It says it's glycyrrhetinic acid and aminophylline transdermal fat loss cream. What's an anti-obesity drug? Because there is a peptide called AOD that I've heard of before. Is it like an anti-obesity peptide? But I've never really delved into it or asked anybody about it on a podcast.

Adam:  Yeah. And so, no, that is actually what it is. That's right. I apologize for–I'm more of the business structure guide. I let the smart science guys do theirs as well. But yeah, no, it is, it's the AOD injections. We're doing the AOD injections with the CJC 1295 Ipamorelin and the fat cream with a lot of really good results.

Ben:  Yeah. I'd be curious to see if someone could lose weight on that, like waking up in the morning, doing something like a fasted morning workout so you're mobilizing fatty acids, using something like this transdermal fat loss cream that apparently can almost spot reduce fat in target areas and then doing like the growth hormone secretors at night like CJC Ipamorelin. Have you noted that with something like that, people actually can accelerate fat loss significantly, or are you guys still experimenting with it right now?

Adam:  Yes. So, for me personally, I haven't done the AOD. We've had everybody that's used that to my knowledge and I'll have to pull up the data to look into that, I apologize I didn't have it prepared, to give you that specific feedback. But for me, for example, I'll use the fat cream in the morning, I get up, I put it on, I go grab the coffee, I turn on my infrared sauna, and then I go sit in the sauna. It's about 15 minutes or so after I've put the cream on and I noticed for sure in my midsection personally. And then usually at night before bed, I do–I rotate between the CJC Ipamorelin before I go to bed and tesamorelin first thing in the morning. And I'll do faceted workouts, I do intermittent fasting, so I don't eat 'til noon. So, me personally, I know that journey as far as the results, and then the blood work and the lifestyle story that we get from the clients. But I know that it became, like you said, it's on our website, it became something that we talked about because we had a lot of results, good results with folks doing it.

Ben:  Yeah. The tesamorelin is interesting because that's a pretty potent fat loss, muscle gain type of peptide. And from what I understand, and I've never done something like this myself, so I'd be curious to ask you, if you were going to do something like that, could you use tesamorelin as a peptide in the morning for like a morning workout for muscle gain and fat loss, and then for the growth hormone secretion during bed and the better sleep then use CJC Ipamorelin in the evening and stack those three together?

Adam:  Yeah. And we've had folks who–actually, I think one of our physicians did that and the IGF levels, IGF-1 levels get higher than necessary.

Ben:  So, you may be in two anabolic estate or have risk for too much mTOR activation?

Adam:  Yeah, for our goals, like for the goals of what we wanted function as a clinic, that can happen, yeah. And so, I always take everything back to me personally, like I wouldn't do that. I could, but I don't. I just think a little bit. Less is more. We want to get the best results with the least amount of drugs possible.

Ben:  Okay. Got it. Another one I saw on your website was the Benjamin Button longevity cocktail. What is that one?

Adam:  Yeah. So, we hopped on it. That was more of like an attention catcher because I think you probably–it was like mainstream news and that's why we hopped in on that. There was the conversation about growth hormone, metformin, and DHEA being that's showing signs of reversing aging. But the study was only done in like nine people, but we had that as a–we want to have that conversation. It's like as a parent, you want to be the dad that has a conversation about sex with your kid, not the neighbor kid having the conversation like what he learned from his older brother. And it's the same thing, like we kind of did that internally, and then obviously, we put that article off externally because we want to have that conversation so people aren't going and making assumptions or poor health decisions or going down the wrong track of something that maybe wasn't studied as well as it could be.

Ben:  And what was in that cocktail, the Benjamin Button cocktail?

Adam:  Yeah. It was growth hormone, DHEA, and metformin.

Ben:  Oh, okay, yeah. I know the study that you're talking about right now. I talked about that one on a podcast and mentioned that what I would like to see is perhaps using some more natural substances like, for example, colostrum instead of growth hormone and maybe see something like, some bitters or herbs or spices like berberine or vinegar or cinnamon. And then the third component was DHEA. Maybe leave that in there, but replace a couple of the more hefty pharmaceuticals or growth hormone with something a little more natural and see if you get similar results. Yeah, it is interesting that they pretty significantly reversed the epigenetic clock in that study by something like two and a half or three years.

Adam:  Right. Yeah. It's interesting and we'd like to see where that goes. We're always looking into that and I think actually how you and I first met was through Hector Lopez, who's a guy we work closely. We're constantly looking in. That's the backside conversations that I've had with our team and looking at like, is this real? There wasn't a big enough study. How can we look into it? How can we quantify it? How could we figure out a safe, better way to look at that? We always look at those things, but nonetheless, it's a conversation that makes ABC and Fox News, or whatever. So, we have to be prepared to have that conversation so people aren't out there trying to misinterpret information that they saw on the news, right?

Ben:  Yeah, yeah. Hector's an interesting guy. I actually had him on the podcast. We did a show about the dirty backend of nutrition supplement companies and how the supplements are manufactured and the difference between CGMP and non-CGMP and crazy ingredients you can find in supplements that aren't supposed to be in there. We actually had a pretty interesting podcast a couple years ago. So, I'll remember to put that one in the shownotes for this episode again, which are at BenGreenfieldFitness.com/adamlamb.

I also wanted to ask you, Adam, about this idea of alcohol and why you wrote a whole book about overcoming the social obligation of alcohol, obviously also since I'm in Vegas, something that's top of mind because I think half the city is walking around with a giant cocktail cup with a curly straw sticking out of it.

Adam:  Right. And so, I think that where you and I are similar is I've been like a lifetime body hacker, biohacker, whatever you want to call it. And so, I constantly work and I'd be better. And I'll try different things and some stuff. I've tried the carnivore diet. It doesn't work for me. I've tried the keto diet. It doesn't work for me. Clean eating works for me and intermittent fasting, I don't eat 'til noon every day and I stop at 8:00. I've done it for four years now and it just works for me. And so, the alcohol thing was alcohol was always a part of my life. My younger years, I used to bartend. The negative side, I had an alcoholic father. So, it always was in the back of my mind. I saw it, dad left, dad wasn't around, dad chose alcohol over me type thing.

So, being a father myself, the most important thing in the world is my involvement in the lives of my kids. And so, it was just always there. It's like that elephant in the room. And I'm a guy who gets up early in the morning, fasted training, and I've been preaching and teaching about this stuff since I was in high school. And so, it didn't make sense that I drank regularly and I drink too much in my 20s. I was bartending in nightclubs and partying, doing that kind of stuff. I've probably been to Vegas like where you're at now and not seeing day for a couple of days, just living that lifestyle.

When I came to the time of when I quit drinking, it was coming off of a summer. We lived in Michigan, lived in the lake where we just get out in the boat and you're just drinking because that's what everybody's doing, and I was like, “Man, I'm sick. I don't remember the last day I didn't have a drink.” And so, I was like, “I'm going to go 30 days.” So, I stopped drinking for 30 days and I went to Vegas during that 30 days, actually for the Olympia and some other stuff. And I was like, “Wow, I went through that and didn't drink. Hmm, I'm going to try another 30 days.” So, I went 60, and then 90. And I got to 90 days and I was like, “Man, I'll never drink again.” And that decision like, I don't know, man. It was like weight was lifted off my back to just–like, I don't need it and it doesn't add up. And I had people told me like I looked younger and my mind was so much more clear. I was solving problems faster and I was like, “Holy cow, I might have done something.”

And then I reached out to–I don't know if you know who Tucker Max is. He has a book, “I Hope They Serve Beer in Hell.” He's a buddy of mine. I reached out and I was like, “Man, I want to write a book. Can you help me?” He's like, “Well, I have a company that does it.” At the time, it was called Book in a Box. Sorry, I don't remember what it's called. I just referred [01:12:00] _____, but if you want to write a book, it's an incredible process. And so, Tucker's team helped me write the book, “Better Than the Binge, Overcoming the Social Obligation of Alcohol” because I didn't want to be the guy that's like sitting down with my friend that wants to have a beer and discussing. I was like, “I want to just create a comfort area to have this conversation. If you think you have a bad relationship with alcohol, here's what I did to stop drinking.”

And it just walks everybody through the process of removing it to get around that social obligation because I had a lot of folks who are like, “Man, I get good.” And so, I hang out, get out with co-workers and things like that and everybody's got a drink and I feel obligated. I don't feel as good and I'm disappointed myself for drinking, whatever it might be. And so, I figure out a way and I've coached a few hundred people through quitting alcohol, which has been neat. I'm not anti-alcohol. I actually buy wine for my wife because she doesn't know —

Ben:  Yeah. I was going to say I've seen some evidence that small doses may actually–well, partially be a hormetic effect be healing for the blood-brain barrier. And of course, we see moderate or low to moderate alcohol consumption in a lot of the blue zones and protection against longevity and dementia and lymphatic drainage during sleep. There's a lot of benefits I think to low to moderate consumption of alcohol. But I do think that, yeah, if it's becoming a fallback for you to decrease stress at the end of the day, you're getting to the point where you're at two to three drinks a night, it is something that I think should be stepped back. But I personally drink just about 365 days a year one serving of alcohol and probably about once a month or so, kind of like I did last night. I'll have two or three drinks, but it's pretty few and far between.

And I think that concept of microdosing with alcohol is beneficial, not only because some of the polyphenols and anthocyanins and flavonols that you could arguably also get from berries or something like that, but also because of that mild hormetic effect, what doesn't kill you makes you stronger, just like a little bit of radiation, a little bit of UVA and UVB, a little bit of extreme cold and extreme heat.

Adam:  I was talking about that at dinner last night. I was saying that when I used to drink regularly, I never got sick. I get sick more, maybe once a year or something like that since I quit drinking, but I also moved to a different–yeah, I went from Michigan to Texas and there's just different allergies and stuff like that. What I tell folks that are curious in that, like you just mentioned, like having a drink 365 days a year? No problem. Your relationship with alcohol isn't bad, but some people, their relationship with alcohol is bad. But because socially, they have five other buddies that drink more than they do, they justify their three to five drinks because that guy is–“That guy is drunk, get [01:14:50] ______. It's not me, so I don't have a problem.” But maybe they do. The temperature gauge I always give folks is like if you drink to intoxication, often you have a drinking problem. If you drink to intoxication once in a blue moon, like you let things go, no big deal. And if you never drink to intoxication, you definitely don't have a bad relationship with alcohol.

Ben:  Yeah, yeah. I'm keeping my eyes quite a bit on some of these potential alcohol replacement cocktails, like at the “Boundless” book launch party in New York City, for example, we had 12 drinks on the cocktail menu. None had alcohol. They were all adaptogens, botanicals, nootropics, and everybody was drinking and felt absolutely amazing. You saw that feel of being at a cocktail party, but there was no alcohol in these things. And then there's companies like–I think Kin is one popular one that's out there right now that's making these products, these drinks that are meant to simulate kind of like what alcohol would do, but they've got different effects, like one for nightlife, one for sleep, one for being at cocktail party, whatever.

That one's called Kin. And then I'm right now in the midst of looking into this new molecule called D13 butanediol. It's a ketone ester that's bonded to beta-hydroxybutyrate. But apparently, and I actually have some waiting for me at home when I get home, it gives you a buzz very similar to alcohol, but it's a ketone-induced buzz that does not result in the toxin acetaldehyde formation. And so, that's one that could be very interesting as well, almost like a ketogenic, non-alcoholic drink that–I think they actually call it keto buzz. And I haven't tried it yet, but some of these alternatives to cocktails are pretty interesting too.

Adam:  Yeah. And I'm not super familiar with them. I become like a sparkling water snob. I have a fridge in my garage that people just bring over like weird different brands like a bunch of different sparkling water with caffeine and it's naturally flavored with apple, just all these wild different things. It's been like a fun thing that friends will come over, or also somebody just bring some unique thing. But I was at a dinner last night. No, I didn't really know [01:17:12] _____ one couple at the dinner. It's a friend of mine's birthday and I didn't know the rest of their friends. But they didn't know I didn't drink. We're about halfway through some conversation. He'd mentioned that I have a book and we talked about it.

But the point was they didn't realize I wasn't drinking with them, and it wasn't intentionally, but usually what I do is I have coffee, which is a little bit uplifting, especially in the evening with a meal. And I have a Perrier and the guy poured it in the wine glass. I'm not trying to fit in intentionally. I've kind of passed that, but for people that are looking into it, they're fine and I just have fun and have conversation. I'm an outgoing guy anyway, so I don't need alcohol to open me up. And so, that's what led me to remove it. And I'll write a book just to create a safe place for someone to ask questions or if it's something they're thinking about, right?

Ben:  Yeah, yeah. And I'm even careful if I'm having alcohol. Like here in Vegas last night, I was drinking mezcal with a little bit of soda water, lemon, and a splash of bitters. Mezcal is like micro-filtered, super low in sugar, and that's almost like a keto-friendly alcohol. And so, there's certain things I'll look for when it comes to what I choose when I am drinking to ensure I stay as healthy as possible, and nonetheless, still always pop the deactivated coconut charcoal once I get back to the hotel room.

So, yeah, alcohol is going to be different for everybody, but I'm still a fan of microdosing responsibly. However, I do want to check out your book. I noticed it's–I think it's free with unlimited Kindle subscription on Amazon right now. Well, cool. We've been going for a while. There's so much more that I could delve into with you about growth hormone and peptides and some of those things that we just rabbit hole on forever, but for now, what I'm going to do is, A, I'm going to put all the shownotes over at BenGreenfieldFitness.com/adamlamb. That's BenGreenfieldFitness.com/adamlamb. And then B, I know that you're offering everybody a 50% discount off the initial labs and initial consultation with Renew Life Rx.

And if folks want to do that, I'll put a link in the shownotes, or if you wind up on the Renew Life Rx website, I'll just give you the code and it's BEN50. That gets you 50% off all the labs that Adam and I were talking about in the beginning of this podcast, and then an initial consultation with somebody from Renew Life Rx to go over to labs with you, make recommendations, et cetera. So, it's actually a pretty good deal. So, the code is BEN50 on that. And anything else you want to throw in there, Adam?

Adam:  No, that's it. I hope that if there's any one of your listeners that are just curious to pursue or have questions, or they're not thrilled with their current situation, we'd love to talk to them and just see if we can offer a better, safer treatment for them. And if they have any questions, we didn't do too much into the regenerative medicine side of stem-cell treatment and things like that. We have a lot of folks, five, two people flying tomorrow to get treated. That's why I'm here in the office today. And so, yeah, anything longevity and that kind of stuff, we'd love to have a conversation. They can reach out to me. Make sure they let us know that they heard about us on your show.

Ben:  Alright, man. Well, thanks for coming on. And again, folks, shownotes are at BenGreenfieldFitness.com/adamlamb and until next time. I'm Ben Greenfield along with Adam Lamb signing out from BenGreenfieldFitness.com. Have an amazing week.

Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned, over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also know that all the links, all the promo codes that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So, when you listen in, be sure to use the links in the shownotes, use the promo codes that they generate because that helps to float this thing and keep it coming to you each and every week.

 

 

Adam Lamb is the founder and manager of RenewLifeRX, a hormone optimization clinic. He has spent the last 10 years helping to explore and facilitate the process of hormone optimization through strategies such as stem cells, peptides, testosterone replacement therapy, and others.

He is also the author of the best selling book “Better Than the Binge, Overcoming the Social Obligation of Alcohol” where he helps ordinary people remove alcohol from their life so they can accomplish extraordinary things.

Adam is a devoted husband of over 12 years and a father to an 11-year-old son and 7-year-old daughter. He often speaks on managing the daily challenges of being an entrepreneur, family man, and keeping himself in peak physical condition. If you asked him to “sum up” his lifestyle in one word, it would be “discipline.”

During this discussion, you'll discover:

-What effects a poor night of sleep or high alcohol consumption can have on your body…7:04

• Lower testosterone as one might expect
• Other activities (watching a fight, viewing porn, etc.) will elevate testosterone levels
  • BGF podcast: 32 Natural Ways To Increase Testosterone

-How to gain a birds-eye view of your overall hormone quality…10:34

• Understand the story of your life: environment, history, genetics, etc.
• Phase 1 test: CBC, metabolic, lipid, DHEA, total testosterone, TSH, IGF-1, FSH, LH, PSA, SHBG, estradiol
  • CBC is for standard overall health
  • DHEA can be used to regulate circadian rhythm, overall health, rather than testosterone
  • Total testosterone
  • IGF-1 levels reveal sleep, stress, recovery; potential red flag for pituitary dysfunction
  • FSH, LH baseline, message from the brain to the testes
  • High PSA levels may be indicative of prostate problems
  • SHBG (sex hormone-binding globulin) levels rise on high fat, low carb diet
• Thyroid medication is one of the most overused medications
• Testosterone therapy is not intended to be a permanent solution
• Lack of sleep, stress, etc. affect the brain's communication w/ the body regarding testosterone production
• Many variables can affect estrogen levels, which makes it an unreliable indicator of hormone health
• There are no absolutes; everyone's body absorbs, responds differently

-Why Adam only uses blood tests to quantify his patients' hormone quality…34:10

• Trust factor: tried and true
• Other tests such as the DUTCH testare sourced out when necessary
• Every 6 months is the gold standard for the max time between tests
• Longtime patients are self-experts
• Potential to identify other health concerns when blood is tested regularly

-What variables are tested differently for women vs. men…41:20

• Pregnenolone, progesterone; everything else is fairly similar
• Women typically don't take enough testosterone
  • 30 day cleanse w/ low-dose testosterone creamyields favorable results
• Women have a wreck of hormones after having a baby
  • Testosterone elevated to optimal levels helps everything else fall into place
• Low dose = 2.5-4 mg

-Adam's preferred form of delivery for testosterone replacement…45:56

• For men: 80% use testosterone cream(prescription needed), healthiest and safest means, no needles or gels
• Doses can be adjusted based on where they feel the best
• Injections: split dose throughout the week
• It's one or the other (injection vs. cream) most of the time
• Consistent application of small doses is far preferable to infrequent larger doses

-Why the vagina or scrotum isn't the best place to apply the cream…51:23

• The best place to apply the cream is the back of the knee, forearms, or shoulders
• It's where the highest concentration of testosterone is already located
• Patients have reported imbalanced numbers after applying scrotally or vaginally

-Whether increased testosterone levels can deleteriously affect one's overall health…54:08

• Testosterone and the Cardiovascular System: A Comprehensive Review of the Clinical Literature
• Age-Related Low Testosterone
• Understand the tool before using it (similar to driving a car or owning a gun)
• Be healthy first before testosterone therapy
• Testosterone should not be used as a band-aid when you're not addressing foundational principles of health
• 90% of testosterone therapy is done improperly
• The ideal client is someone who's aware of their health, living a conscientious life, and just need a push in the right direction
• Hormone therapy will not compensate for an unhealthy lifestyle

-The peptide stacks recommended by RenewLifeRX…1:00:19

• Regenerative Revival
• Fat loss peptide stack
• The Benjamin Button Longevity Cocktail
• These are written by RenewLifeRX to educate their customers, both present and future
• BGF podcast w/ Hector Lopez on surprising secrets of the supplement industry

-Why Adam wrote a book on controlling alcohol consumption…1:09:17

• Adam's book: Better Than the Binge: Overcoming the Social Obligation of Alcohol
• Chronic biohacker (keto diet, intermittent fasting, etc.)
• Alcohol was always part of Adam's life; had an alcoholic father
• Went on an alcohol fast for 30 days, then 60, then 90, decided to never drink again
• There are benefits to microdosing on alcohol, provided it's not a “fall back”

-And much more…

Resources from this episode:

– BGF podcast: 32 ways to increase testosterone

– BGF podcast w/ Hector Lopez on surprising secrets of the supplement industry

– RenewLifeRx Lab Panel (use code: BEN50 to receive 50% off of your labs and initial consultation)

– Testosterone and the Cardiovascular System: A Comprehensive Review of the Clinical Literature

– Age-Related Low Testosterone

– Better Than the Binge: Overcoming the Social Obligation of Alcohol

– Surprising Supplement Secrets From An Industry Insider (& The Shocking Truth About Your Multivitamins).

– Scribe Writing (formerly known as Book In A Box)

– Ben's Microdosing With Alcohol article

– Kin Euphorics

Episode sponsors:

–Kion Flex: The ultimate recovery formula, Kion Flex is a bioavailable blend to support joint comfort, mobility and flexibility, and bone health. Ben Greenfield Fitness listeners, receive a 10% discount off your entire order at Kion when you use discount code BEN10.

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–Thrive Market: Organic brands you love, for less. Your favorite organic food and products. Fast and free shipping to your doorstep. Receive a gift card up to $20 when you begin a new membership using my link.

–Comrad Socks: Seriously comfortable compression socks designed to support your every move. Receive 20% off your Comrad purchase when you use discount code: KION