Founder's Story
The Testosterone Myth That’s Costing Men Years of Their Lives | Ep 299 with Shalin Shah CEO of Marius Pharmaceuticals
15 Jan 2026
Chapter 1: What is the main topic discussed in this episode?
So Shaulin, it's really great to have you today and talking around this topic that we're gonna dive into because it's something that I've been asking doctors about, my doctor, I've been asking friends about. It seems like every friend once a week tells me that they are doing something with testosterone therapy and I can't even figure out where or how to get tested.
And I'm about to be 42 in like a couple of weeks. And this is something that's been on my mind But I also can't really get necessarily a straight answer from anyone. I hear so many, there's negatives, there's positives. I don't even know. But why is there such a conversation nowadays? Like right now in 2026, why are so many people talking about testosterone?
So it comes down to this overall concept of health and wellness, right?
Chapter 2: Why is testosterone therapy becoming a popular topic in 2026?
How prevalent this is in 2026 now, right? And the fact that also patients or effectively consumers have reclaimed their healthcare to a certain degree, right? I think a lot of people are fed up with the system, mainly centered around sick care. You spend seven minutes with the doctor on average. It's hard to get an appointment. That can take months in itself.
you're really not fixing any problems, right? You're just throwing on some band-aids at best. So people, plus the information out there, right? Like think about how much more information is at their fingertips. So people have taken their health back into their own hands. And I think that's an incredibly powerful and important step at fixing healthcare. Again, we certainly need professionals.
We need our doctors. We need our nurse practitioners and so forth.
Chapter 3: What are the biggest myths surrounding testosterone?
But people need to care about their health care. So them spending this time and starting this process journey, incredibly valuable. So again, testosterone sits at the foundation level of our general health, right? I mean, there are a couple of things that you got to be doing for your health that are non-negotiable. That's diet, sleep, stress, exercise.
But the next layer on top of that is your hormonal health. And testosterone is a key hormone. there's actually an androgen receptor on nearly every organ in the body, right? So whether that's your brain, your heart, bone, muscle, all of these processes involve testosterone.
So now that this is becoming better known, people are talking about it, people are asking their doctors about it, or they're also going their own route to get testing because historically it has been challenging. The molecule... Testosterone has really been stigmatized. If you go back, you know, you mentioned about to turn 42, right? You remember the days of baseball and steroids, right?
Testosterone got really mixed up in all that and also in the Olympics in 88, right?
Chapter 4: How does testosterone influence overall health?
Ben Johnson, Canadian sprinter, was found positive with testosterone, among other things, and they threw the baby out with the bathwater and banned it from a controlled substance perspective back in 1990. So again, a lot of stigma around this topic for many, many years, a lot of myths and misconceptions. that are being corrected, which is a good thing.
I think we're moving in the right direction. But medical sort of science takes a long time to correct. But nonetheless, people are interested in their health, and they're figuring out how important this is, not just about sexual health, not just about muscle building, but their overall metabolic health. And that's why this is front and center today.
What would you say are the two to three biggest myths right now around testosterone that if you could just eliminate those myths?
So two are around its safety. So people think testosterone causes heart attacks. That's not true. The largest randomized trial in history around testosterone was done specifically to look at testosterone and heart attack risk, and it found there was no correlation. So that has been done and put to bed. That study actually came out, it was the Traverse study, came out in 2023.
So it's already two and a half years old there, but it's still making its way into general general public, but frankly, patients and providers are still just finding out about this, right? That's one. Second is that testosterone causes prostate cancer.
Also, a myth that's been put to bed, not just by the study that I just mentioned, but numerous other studies that have been done historically, and all the way back to the original paper that proposed this, basically.
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Chapter 5: What are the safety concerns related to testosterone therapy?
It was a study in the 1940s with three patients. One was female, so you had two guys, and one guy got prostate cancer, right? He was an older gentleman, which they all have that chance anyway. So that's another big one. But I think the third... General misconception is, and I call it a misunderstanding, is just how important this is.
Again, I mentioned there's an androgen receptor on every organ in your body. So it plays a role in your cognitive health, in your cardiovascular health, your bone health, your muscle health, your fat metabolism, even all the way down to your mitochondrial, right, which is your cellular level. There's a role for testosterone in those processes.
So I think we've discounted how important this thing is and how helpful it can be for our general health. Helpful and safe, right? I think, again, when you get rid of those misconceptions, you realize that this is safe at physiologic dosing. You know, you don't question when your doctor tells you to take vitamin D because you're low. Vitamin D is a hormone. What are we doing over here?
Chapter 6: How can individuals get tested for testosterone levels?
And I think that general third misconception is sort of the, you know, let's call it the trump card, the speed, right, that needs to be fixed.
But hey, I want to feel like I'm 24 again. You know, I always joke with my wife. She's like, oh, are you 24? Like if I do something that that seems like I'm younger, she's like, oh, are you 24? So what somebody like myself? So I'm turning 42. I definitely don't feel like the same as I did at 24 years. Just, you know, all the things that you mentioned don't feel like my cognitive.
I don't know if that feels the same. I'm not sure. Energy probably doesn't feel the same. Definitely really hard to lose weight, hard to pretty much gain muscle, even if I work out. So these are things I'm like, you know, I think there's something off possibly. But how do I even get started?
Chapter 7: What innovative solutions are being proposed for testosterone therapy?
Right. So and all these signs and symptoms are consistent with testosterone deficiency. Right. But what's important is that, like you're saying, how do you start? It is a lab value, right? So there is a number. Not to say the number drives everything, but that will give you a good indication of where you are. And if you're in that lower normal range, it very well could be a testosterone issue.
So for you to start really, again, medical sort of traditional system is just catching up to this. But I would go to my doctor and advocate for a testosterone test. At 42, it is warranted. You have some signs and symptoms. It's a cheap test. It would be with your standard blood panel. And I would just make sure that that happens.
If you don't have a good primary care that you can go to, there is, you can either do some of this testing through online vendors, right? You can set up an appointment at LabCorp Request and do this, or there are even at-home tests available today. So you can do an at-home test and get an indication of what direction, you know, where you are on this scale.
And again, it doesn't warrant further investigations.
Chapter 8: How can listeners advocate for better healthcare regarding testosterone?
I love how people are so health conscious nowadays. Longevity is like the thing biohacking, you know, it's great to know that we don't necessarily need to wait for the doctor to get a test. For example, that there's so many in-home tests, like the simple thing of a test. I understand like a doctor might need to prescribe something.
But the fact that you can't even get a test to figure out if they need to do something always boggles my mind. I know you just sat down with the FDA. What happened with that?
So that was a landmark panel, an FDA expert panel on testosterone replacement therapy. I believe there were 13 experts on the panel, all with extremely decorated CVs, decades of research in this space. But the message was very clear. Again, this is a vital metabolic hormone. that we should be paying attention to. It plays a crucial role in overall men's health and female health.
I will say that too. I don't want to discount that side. It's an important female hormone too. But we have a men's health crisis in this country. Men on average live seven years shorter Their lifespan is seven years shorter than a female. So, you know, there's multiple reasons for that.
But testosterone is the single best biomarker of your overall health because, again, like I mentioned, it influences all these parts of the body. So that single test can give you an insight into your cardiovascular health, your inflammation in your body, your glucose or your, you know, metabolism there. So again, a single test that's most important.
But to your question on the panel, there were three main takeaways. One was screening. So we should be screening every man for their testosterone levels for this, again, this biomarker insight that I'm mentioning. Could it be for everyone over 40? That's an easy number to pick, but it could be even earlier. So you have a baseline. Say you're 30 years old and everything's feeling great.
But at least you know, when I was 30, my testosterone level was maybe 750 nanovariants per deciliter. So when I'm later in life too, not that you're treating to that number, but you understand your progression, right? Because we're all on slightly different paths there. And what might have been good for me might not have been your exact number. There's a wide range there. so testing is one.
The second is broader labels because the label right now, as you look at the, the, that's called the package insert on a product, like a product like our, say Kaiser tracks, um, you know, it's indicated for a very narrow patient population. And in fact, most of the men that are testosterone deficient fit a broader definition. And it really doesn't matter.
Like most diseases, actually I talked about this, like most diseases, You don't think about why I necessarily have this. You treat the disease, right? If you have high blood pressure, sure, you should make lifestyle adjustments, but you take blood pressure medication. You have high cholesterol, again, lifestyle is important, but you take cholesterol medication.
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