Paul Turek
speaker
358 appearances
1 recordings
1 series
first heard Jun 2025
last heard Jun 2025
Paul Turek’s voice in public audio — every appearance, attributed to the second.
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Well, have a flu and try to get your testosterone level up. You can't do it. You have to spray it in your nostril, each nostril three times a day. And it's gooey and it's gel-like and men within a week will call and say, can't do this. Yeah. We've had more luck getting women to use this. So the other big difference is between the two types of testosterone replacement or supplements.
one is, we'll call it the natural ones versus the exogenous ones, is side effect profiles differ widely. It's very difficult to get polycythemic or thickening in your blood with the physiologic levels. It just doesn't happen very often. I've seen it once or twice, but if you take testosterone exogenously, you're at risk for polycythemia or blood thickening.
So testosterone stimulates epipotent in the kidney, you make more blood. Athletes love it, but if you went on a long flight and you're dehydrated, you're going to throw a clot. And people look at it for longevity, and it's like, be careful. Because I've seen 70-year-old men want longevity in taking this stuff, and then they have a clot, and they have a stroke, and now they're 71.
So, I mean, the studies aren't broad, but Ramasamy just did another paper on it. The most significant event occurring with testosterone replacement or supplementation is polycythemia and events. The high level for hemoglobin 17, Maticrit 50, you start seeing events happen about 18, definitely 19.
So once a week, and I think twice a week, you can have the dose, right? So that is a little safer, but then it becomes the intensity and just, I can't do it like that or whatever. I want a pellet instead. Do you put pellets in?
You know, in the arm, they put it in subcutaneously. We put it in the butt, and it's a couple-minute procedure in the office. You don't have to worry about anything. There's no compliance issues. We don't have a lot of side effects or consequences from it. It's done with a trocar and a thick needle.
And pretty quickly, within a couple days, you'll get a level, and then it'll slowly decay, pretty much half of it by three months or so, and then the rest by four to six. It's supposed to be a six-month physiologic level. But normally it's four, four or five. And men feel great for a while and they can feel it because it's slow, but it is even.
And you do have this risk of polycythemia and things like that. But there's a three-month perivariate risk. And then usually when you're in the normal range, it kind of goes away. So I don't see a lot of consequences with that if it's six months.
Might even improve it. HCG depends on the dose. So like you said, high doses suppresses. Normally, for all you want LH and FSH going to the testicle, you want the water and the sunlight. You want the testosterone. If you've got the testosterone, but your FSH is, if you don't have any sunlight, you're not going to bloom.
So I usually add Clomid to HCG if the dose is above 1500 units three times a week, because that's going to start suppressing the FSH and Clomid will keep it going.
I shoot for the normal range of 500 to 1,000. I'm not an anabolic guy. I'll melt it today.
Well, it's HCGs that's driving the T. We're just trying to protect it. If you said, what do you give on isolation as monotherapy? Yeah, what would you give for a Clomid monotherapy? 12.5 to 25, typically, depending on how sensitive the system is. And do you prefer Clomid and Clomiphene? So it's very interesting. Clomiphene's really good. It's an interesting FDA story.
So Clomid is not approved for men. And clomiphene isn't either. Clomid's approved for women and clomiphene's not approved for either. Clomiphene's compounded. Clomid is available for 50 years. So a lot more data. And once a cis isomer was a trans isomer. So they're different. And the estrogenic effects are slightly different. So I have enormous experience.
I have 560 men on clomid and I have fewer in clomiphene. But it was developed for older men to preserve their testosterone levels as they age because the signaling tends to get weaker. The pituitary tends to get lazier. And this is to keep your testosterone levels up more physiologically than taking testosterone. So it went through some very good randomized trials that were published.
This was clomiphene? And clomiphene citrate. And they were done by reputable people in the field. and published, and then it went to the FDA for approval for secondary hypogonadism, sort of age-related changes, not primary testicular failure, in age-related androgen deficiency of the aging male or Adam. FDA sat on it for a couple of years and said, nope. What? Good question.
So it's published, they're good trials, it's safe, it's as good as Clomid, and they didn't approve it. And I think it's hard to know, but I think the reason was that there's such an uproar about testosterone in America right now, and the FDA doesn't like what's happening. What happened is you can advertise your drug to the consumer now,
So you know all the biological response modifiers for psoriasis, all those drugs go on and they give you five seconds on the benefits and the lesions go away and then 25 seconds on side effects, right? So you can do that. If you do that with testosterone, what you hear is, do you fall asleep after dinner? Are you not as athletic as you used to be? Are your erections not as good as they used to be?
There's 10 questions in the Adam questionnaire and everyone who ages- Every guy's going to be like, yeah. Everyone who ages has those issues, right? So it's a no-brainer if they go on TV, they're going to want this stuff. So the cat's out of the bag. They're stuck.
And so now when any testosterone trial comes back, they're going to point out, the FDA makes sure that we point out the dangers of testosterone replacement. So this is part of that energy, which is, you know, we don't want another testosterone.
They're really safe drugs. My effect is someone comes in who's young, who maybe wants kids, hasn't had them, And they have a low testosterone of 220. You measure their LH, which no one does. It's low. Secondary hypogonism. So it's not a testicle failing. It's a signaling issue. And that's probably stress. So I said, get rid of your stress. And they say, how do I do that?
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