Dr. Kyle Gillett

And that's more of like paracrine or autocrine, and they have more local action.

So that IGF-1, it's pretty well studied that if you just give people IGF-1, it's not going to, at physiologic levels, it's not gonna improve their body composition.

However, that IGF-1 that's autocrine and paracrine just working in those local tissues and muscles is likely part of the reason why you get a improved body composition response after exercise.

There's three big ones.

The first one is not super common, but it's a very direct correlation.

If you have a growth hormone deficiency, a true deficiency, whether you're an adult or a child, then your sleep is likely going to be affected.

And let's say you're a child with growth hormone deficiency.

Once that is replaced with therapy, your sleep is going to get significantly better.

The second one that's a very common scenario is if you're having what's called vasomotor symptoms of menopause or vasomotor symptoms of andropause, which are also applicable.

That's why a lot of women in menopause feel like their sleep is much worse, is because they have lower activity of those progestogens.

Low testosterone can lead to poor sleep, but my third scenario is actually if a man begins TRT.

then they develop a poor sleep because of sleep apnea.

It drastically raises the risk that somebody is going to have sleep apnea.

And then a lot of people, especially when they first started in the first month or two, it puts them into this hypersympathetic state because they have overactive androgen receptors, especially after a long time of being hypogonadal.

then they have a physiologic dose of TRT, and that causes the sleep issue itself.

If you're eugonatal before you start testosterone.

Meaning?

Meaning you have normal testosterone and then you start TRT or self-administered TRT, steroids, however you want to look at it.

then your risk of sleep apnea still goes up in a dose dependent fashion.

So the higher the dose, the more risky.