Full Transcript Signs of Too Much Testosterone 0:01 Somebody's noticing these signs. You're 0:01 Somebody's noticing these signs. You're going to lose hair in your temples. You 0:03 going to lose hair in your temples. You 0:03 going to lose hair in your temples. You feel like, "I'm getting more acne on my 0:05 feel like, "I'm getting more acne on my 0:05 feel like, "I'm getting more acne on my face." But if you're noticing, "I'm 0:06 face." But if you're noticing, "I'm 0:06 face." But if you're noticing, "I'm getting black hair sprouting like on my
Podcast Introduction and Topic Setup 0:15 is my testosterone dose too high?" 0:15 is my testosterone dose too high?" Hi, I'm Dr. Valerie Davidson from the 0:17 Hi, I'm Dr. Valerie Davidson from the 0:17 Hi, I'm Dr. Valerie Davidson from the Progress Your Health podcast. 0:18 Progress Your Health podcast. 0:18 Progress Your Health podcast. >> Dr. Mackie from the Progress Your Health 0:19 >> Dr. Mackie from the Progress Your Health 0:19 >> Dr. Mackie from the Progress Your Health podcast. Uh so, the last episode we 0:22 podcast. Uh so, the last episode we 0:22 podcast. Uh so, the last episode we talked about progest- uh testosterone 0:24 talked about progest- uh testosterone 0:24 talked about progest- uh testosterone being too low. Yeah, and now remember, 0:25 being too low. Yeah, and now remember, 0:25 being too low. Yeah, and now remember, this is for women. 0:27 this is for women. 0:27 this is for women. >> So, now we're going to talk about if 0:29 >> So, now we're going to talk about if 0:29 >> So, now we're going to talk about if your testosterone dose is too high.
Symptoms of High Testosterone in Women 0:31 your testosterone dose is too high. 0:31 your testosterone dose is too high. >> Yeah, the dosing for men and women is 0:33 >> Yeah, the dosing for men and women is 0:33 >> Yeah, the dosing for men and women is completely different. You know, they're 0:35 completely different. You know, they're 0:35 completely different. You know, they're not even in the same ballpark. Women 0:37 not even in the same ballpark. Women 0:37 not even in the same ballpark. Women need to be a little careful with men's 0:39 need to be a little careful with men's 0:39 need to be a little careful with men's testosterone dosing. Um but we're 0:41 testosterone dosing. Um but we're 0:41 testosterone dosing. Um but we're talking about how to tell or determine 0:43 talking about how to tell or determine 0:44 talking about how to tell or determine if your testosterone is too high. 0:45 if your testosterone is too high. 0:45 if your testosterone is too high. >> So, let's go over the symptoms first, 0:47 >> So, let's go over the symptoms first, 0:47 >> So, let's go over the symptoms first, which of course would be more androgen 0:49 which of course would be more androgen 0:49 which of course would be more androgen symptoms. The big one is hair loss. So, 0:52 symptoms. The big one is hair loss. So, 0:52 symptoms. The big one is hair loss. So, women will notice that they're losing if 0:54 women will notice that they're losing if 0:54 women will notice that they're losing if it's about the testosterone, they're 0:56 it's about the testosterone, they're 0:56 it's about the testosterone, they're losing it more in the temples or the top
Hair Loss and Acne Patterns 0:58 losing it more in the temples or the top 0:58 losing it more in the temples or the top of the head. They'll say, "Oh, you know, 0:59 of the head. They'll say, "Oh, you know, 0:59 of the head. They'll say, "Oh, you know, the back of the hair is actually pretty 1:00 the back of the hair is actually pretty 1:00 the back of the hair is actually pretty pretty thick. You know, it's not bad. 1:02 pretty thick. You know, it's not bad. 1:02 pretty thick. You know, it's not bad. It's that top and that temple." And 1:04 It's that top and that temple." And 1:04 It's that top and that temple." And that's because that could be if your 1:05 that's because that could be if your 1:05 that's because that could be if your testosterone dose is too high. 1:07 testosterone dose is too high. 1:07 testosterone dose is too high. >> Yeah. So, if they already if a woman is 1:09 >> Yeah. So, if they already if a woman is 1:09 >> Yeah. So, if they already if a woman is already having some hair issues, 1:11 already having some hair issues, 1:11 already having some hair issues, thinning, shedding, you know, whatever, 1:13 thinning, shedding, you know, whatever, 1:13 thinning, shedding, you know, whatever, you want to be a little careful with 1:15 you want to be a little careful with 1:15 you want to be a little careful with even using testosterone if she's already 1:17 even using testosterone if she's already 1:18 even using testosterone if she's already having a problem. Now, if the dosing 1:20 having a problem. Now, if the dosing 1:20 having a problem. Now, if the dosing starts out pretty low and you're, you 1:22 starts out pretty low and you're, you 1:22 starts out pretty low and you're, you know, 1:23 know, 1:23 know, just kind of easing into it, we haven't 1:26 just kind of easing into it, we haven't 1:26 just kind of easing into it, we haven't I haven't seen too much hair loss 1:27 I haven't seen too much hair loss 1:27 I haven't seen too much hair loss directly. Have you? 1:29 directly. Have you? 1:29 directly. Have you? >> No, I mean, if they're doing too Like I 1:30 >> No, I mean, if they're doing too Like I 1:30 >> No, I mean, if they're doing too Like I said, if it's too high, then we need to 1:32 said, if it's too high, then we need to 1:32 said, if it's too high, then we need to back it down. There's other um 1:34 back it down. There's other um 1:34 back it down. There's other um concepts that go along with that. So, 1:36 concepts that go along with that. So, 1:36 concepts that go along with that. So, not just the total testosterone. If 1:38 not just the total testosterone. If 1:39 not just the total testosterone. If you're testing their sex hormone binding 1:40 you're testing their sex hormone binding 1:40 you're testing their sex hormone binding globulin might be binding up their free 1:42 globulin might be binding up their free 1:42 globulin might be binding up their free testosterone. So, if someone is showing 1:45 testosterone. So, if someone is showing 1:45 testosterone. So, if someone is showing those signs of having higher 1:46 those signs of having higher 1:46 those signs of having higher testosterone levels, then I always do
Cream Application and Local Hair Growth 1:48 testosterone levels, then I always do 1:49 testosterone levels, then I always do the free testosterone, the 1:50 the free testosterone, the 1:50 the free testosterone, the dihydrotestosterone, the DHT, and we do 1:53 dihydrotestosterone, the DHT, and we do 1:53 dihydrotestosterone, the DHT, and we do the sex hormone binding globulin. But we 1:55 the sex hormone binding globulin. But we 1:55 the sex hormone binding globulin. But we can talk about that a little bit later. 1:57 can talk about that a little bit later. 1:57 can talk about that a little bit later. But I have seen women that have uh 1:59 But I have seen women that have uh 1:59 But I have seen women that have uh have lost hair. Like, I remember I was 2:00 have lost hair. Like, I remember I was 2:00 have lost hair. Like, I remember I was at my dentist's office, this was a 2:02 at my dentist's office, this was a 2:02 at my dentist's office, this was a number of years ago, and she was and she 2:04 number of years ago, and she was and she 2:04 number of years ago, and she was and she knew that I did hormones, but she was 2:05 knew that I did hormones, but she was 2:05 knew that I did hormones, but she was getting her she was doing her HRT from a 2:08 getting her she was doing her HRT from a 2:08 getting her she was doing her HRT from a from another physician, and we're just 2:09 from another physician, and we're just 2:09 from another physician, and we're just kind of talking about it. And I she said 2:11 kind of talking about it. And I she said 2:11 kind of talking about it. And I she said something about her testosterone. I 2:12 something about her testosterone. I 2:12 something about her testosterone. I said, "Well, if it's too high, you're 2:13 said, "Well, if it's too high, you're 2:13 said, "Well, if it's too high, you're going to lose hair in your temples." And 2:14 going to lose hair in your temples." And 2:15 going to lose hair in your temples." And she lifted up her hair, and she 2:16 she lifted up her hair, and she 2:16 she lifted up her hair, and she literally had no hair on her temples. 2:18 literally had no hair on her temples. 2:18 literally had no hair on her temples. And I go, 2:19 And I go, 2:19 And I go, "You can just kind of, you know, cut 2:20 "You can just kind of, you know, cut 2:20 "You can just kind of, you know, cut some bangs, you know, it's not But it 2:22 some bangs, you know, it's not But it 2:22 some bangs, you know, it's not But it But it was, you know, it can happen." 2:24 But it was, you know, it can happen." 2:24 But it was, you know, it can happen." And then also acne. So, you can Now, 2:26 And then also acne. So, you can Now, 2:27 And then also acne. So, you can Now, granted, some women are just more prone 2:28 granted, some women are just more prone 2:28 granted, some women are just more prone to a little bit more acne or pimples, 2:30 to a little bit more acne or pimples, 2:30 to a little bit more acne or pimples, and that's totally normal. But, if you 2:32 and that's totally normal. But, if you 2:32 and that's totally normal. But, if you feel like, "I'm getting more 2:34 feel like, "I'm getting more 2:34 feel like, "I'm getting more acne on my face, especially the chin and 2:36 acne on my face, especially the chin and 2:36 acne on my face, especially the chin and the jawline," that can be that the 2:38 the jawline," that can be that the 2:38 the jawline," that can be that the testosterone level is too high. Or and 2:41 testosterone level is too high. Or and 2:41 testosterone level is too high. Or and we're humans, we all have hair all over 2:43 we're humans, we all have hair all over 2:43 we're humans, we all have hair all over our body, but if you're noticing, "I'm 2:45 our body, but if you're noticing, "I'm 2:45 our body, but if you're noticing, "I'm getting black hair sprouting like on my 2:48 getting black hair sprouting like on my 2:48 getting black hair sprouting like on my face and 2:50 face and 2:50 face and then that could be a sign that your 2:51 then that could be a sign that your 2:51 then that could be a sign that your testosterone is too high. 2:52 testosterone is too high. 2:52 testosterone is too high. >> Yeah, so if you're just starting 2:54 >> Yeah, so if you're just starting 2:54 >> Yeah, so if you're just starting testosterone, it's always going to go 2:55 testosterone, it's always going to go 2:55 testosterone, it's always going to go from the breakouts to the hair growth to 2:58 from the breakouts to the hair growth to 2:58 from the breakouts to the hair growth to the hair loss in sort of a kind of a 3:01 the hair loss in sort of a kind of a 3:01 the hair loss in sort of a kind of a chronological order almost. 3:02 chronological order almost. 3:02 chronological order almost. >> But, that's if your dose is too high. 3:04 >> But, that's if your dose is too high. 3:04 >> But, that's if your dose is too high. Right? It's not going to happen if your 3:05 Right? It's not going to happen if your 3:05 Right? It's not going to happen if your dose isn't too high. I will say, when 3:08 dose isn't too high. I will say, when 3:08 dose isn't too high. I will say, when you do testosterone, you always want to 3:10 you do testosterone, you always want to 3:10 you do testosterone, you always want to do it transdermally. You never want to 3:12 do it transdermally. You never want to 3:12 do it transdermally. You never want to take oral 3:13 take oral 3:13 take oral testosterone. It's just not good for 3:14 testosterone. It's just not good for 3:14 testosterone. It's just not good for you, and you don't absorb it anyway. 3:16 you, and you don't absorb it anyway. 3:16 you, and you don't absorb it anyway. But, if you're going to do it, you want 3:18 But, if you're going to do it, you want 3:18 But, if you're going to do it, you want to do it as a cream. 3:20 to do it as a cream. 3:20 to do it as a cream. If you put it on your arms, you could 3:22 If you put it on your arms, you could 3:22 If you put it on your arms, you could wherever there's a hair follicle, it can 3:23 wherever there's a hair follicle, it can 3:23 wherever there's a hair follicle, it can cause hair growth. 3:24 cause hair growth. 3:24 cause hair growth. >> Mhm.
Interpreting Labs and Free Testosterone 3:25 >> Mhm. 3:25 >> Mhm. >> I had a patient not too long ago, her 3:27 >> I had a patient not too long ago, her 3:27 >> I had a patient not too long ago, her testosterone level looks great. She says 3:28 testosterone level looks great. She says 3:28 testosterone level looks great. She says she feels great. I have her putting it 3:30 she feels great. I have her putting it 3:30 she feels great. I have her putting it on the inner thigh, and she's kind of 3:33 on the inner thigh, and she's kind of 3:33 on the inner thigh, and she's kind of dark and hairy like me. As she started 3:35 dark and hairy like me. As she started 3:35 dark and hairy like me. As she started to get a lot of hair growth on that 3:36 to get a lot of hair growth on that 3:37 to get a lot of hair growth on that thigh. 3:37 thigh. 3:37 thigh. >> Yeah. 3:38 >> Yeah. 3:38 >> Yeah. >> You can switch it to the back of the 3:39 >> You can switch it to the back of the 3:39 >> You can switch it to the back of the knee because there's no hair follicles 3:41 knee because there's no hair follicles 3:41 knee because there's no hair follicles there, but know that, you know, as with 3:43 there, but know that, you know, as with 3:43 there, but know that, you know, as with all creams, it's going to matriculate. 3:45 all creams, it's going to matriculate. 3:45 all creams, it's going to matriculate. It might go down or might go up, so it 3:47 It might go down or might go up, so it 3:47 It might go down or might go up, so it could cause a little hair growth on the 3:48 could cause a little hair growth on the 3:48 could cause a little hair growth on the back of the thigh or the or the back of 3:50 back of the thigh or the or the back of 3:50 back of the thigh or the or the back of the calf. Now, if you're getting hair 3:52 the calf. Now, if you're getting hair 3:53 the calf. Now, if you're getting hair growth from your testosterone cream, 3:55 growth from your testosterone cream, 3:55 growth from your testosterone cream, applying it where you apply it, it 3:57 applying it where you apply it, it 3:57 applying it where you apply it, it doesn't mean that your testosterone is 3:58 doesn't mean that your testosterone is 3:58 doesn't mean that your testosterone is too high. Some of us just grow hair more 4:01 too high. Some of us just grow hair more 4:01 too high. Some of us just grow hair more easily. 4:01 easily. 4:01 easily. >> Yeah, it's kind of inevitable. You can't 4:03 >> Yeah, it's kind of inevitable. You can't 4:03 >> Yeah, it's kind of inevitable. You can't There's really not not much you can 4:04 There's really not not much you can 4:04 There's really not not much you can really do about it. 4:05 really do about it. 4:05 really do about it. >> There's some women that don't. They're 4:06 >> There's some women that don't. They're 4:06 >> There's some women that don't. They're like, "Yeah, I put it on my thigh and no 4:07 like, "Yeah, I put it on my thigh and no 4:07 like, "Yeah, I put it on my thigh and no big deal. I I shave normally. There's 4:09 big deal. I I shave normally. There's 4:09 big deal. I I shave normally. There's It's not like there's more hair growth." 4:11 It's not like there's more hair growth." 4:11 It's not like there's more hair growth." I always ask, but there's some women 4:13 I always ask, but there's some women 4:13 I always ask, but there's some women that doesn't do it, too. And then 4:14 that doesn't do it, too. And then 4:14 that doesn't do it, too. And then there's some women that do. So, don't 4:15 there's some women that do. So, don't 4:15 there's some women that do. So, don't use where you apply it, the hair growth 4:18 use where you apply it, the hair growth 4:18 use where you apply it, the hair growth as an as saying my testosterone dose is 4:21 as an as saying my testosterone dose is 4:21 as an as saying my testosterone dose is too high. It really would be more with 4:23 too high. It really would be more with 4:23 too high. It really would be more with the dark hairs on the face starting to 4:25 the dark hairs on the face starting to 4:25 the dark hairs on the face starting to grow in, even though you didn't put your 4:26 grow in, even though you didn't put your 4:26 grow in, even though you didn't put your testosterone on your face. Don't put 4:27 testosterone on your face. Don't put 4:28 testosterone on your face. Don't put testosterone on your face. 4:30 testosterone on your face. 4:30 testosterone on your face. Or if you're getting breakout Yeah, 4:31 Or if you're getting breakout Yeah, 4:31 Or if you're getting breakout Yeah, breakouts or the the hair loss. Like I 4:33 breakouts or the the hair loss. Like I 4:33 breakouts or the the hair loss. Like I had a patient She told me that she did 4:36 had a patient She told me that she did 4:36 had a patient She told me that she did testosterone injections and, you know, 4:39 testosterone injections and, you know, 4:39 testosterone injections and, you know, her level went up so high She started 4:41 her level went up so high She started 4:41 her level went up so high She started with another practitioner that when she 4:42 with another practitioner that when she 4:42 with another practitioner that when she was swimming, she was noticing the hair 4:44 was swimming, she was noticing the hair 4:44 was swimming, she was noticing the hair was just falling out off into the water. 4:46 was just falling out off into the water. 4:46 was just falling out off into the water. >> Yeah, cuz a testosterone a vial, if 4:49 >> Yeah, cuz a testosterone a vial, if 4:49 >> Yeah, cuz a testosterone a vial, if you're injecting it, is either going to 4:50 you're injecting it, is either going to 4:50 you're injecting it, is either going to be a 100 mg per mil or 200 mg per mil. 4:54 be a 100 mg per mil or 200 mg per mil. 4:54 be a 100 mg per mil or 200 mg per mil. The amount that a woman would have to 4:56 The amount that a woman would have to 4:56 The amount that a woman would have to inject to not be too much is such a tiny 4:59 inject to not be too much is such a tiny 4:59 inject to not be too much is such a tiny amount um that that is, at least in my 5:01 amount um that that is, at least in my 5:01 amount um that that is, at least in my opinion, uh and I know yours, too, that 5:04 opinion, uh and I know yours, too, that 5:04 opinion, uh and I know yours, too, that it's only going to potentially cause 5:05 it's only going to potentially cause 5:05 it's only going to potentially cause some problems. Now, there might be a few
A Patient Case With Unexpectedly High Levels 5:08 some problems. Now, there might be a few 5:08 some problems. Now, there might be a few women that could tolerate that. 5:09 women that could tolerate that. 5:09 women that could tolerate that. >> And if you can, please write us a 5:10 >> And if you can, please write us a 5:10 >> And if you can, please write us a message. 5:11 message. 5:11 message. >> Absolutely. Yeah, there's Yeah, there's 5:13 >> Absolutely. Yeah, there's Yeah, there's 5:13 >> Absolutely. Yeah, there's Yeah, there's a few women that can totally tolerate, 5:14 a few women that can totally tolerate, 5:15 a few women that can totally tolerate, um but when it comes to testosterone, 5:16 um but when it comes to testosterone, 5:16 um but when it comes to testosterone, especially if you're starting it for the 5:18 especially if you're starting it for the 5:18 especially if you're starting it for the first time, and I learned this from you, 5:19 first time, and I learned this from you, 5:19 first time, and I learned this from you, too, is that you always want to start a 5:21 too, is that you always want to start a 5:21 too, is that you always want to start a little low to see what your tolerance 5:23 little low to see what your tolerance 5:23 little low to see what your tolerance actually is. And then that dose can 5:25 actually is. And then that dose can 5:25 actually is. And then that dose can actually start to work up over time 5:27 actually start to work up over time 5:27 actually start to work up over time later. Uh 5:28 later. Uh 5:28 later. Uh on the last episode, you were talking 5:29 on the last episode, you were talking 5:29 on the last episode, you were talking about sometimes you'll use it either 5:31 about sometimes you'll use it either 5:31 about sometimes you'll use it either daily 5:33 daily 5:33 daily or you might use it a few times a week. 5:35 or you might use it a few times a week. 5:35 or you might use it a few times a week. Um when that dose starts to rise is when 5:37 Um when that dose starts to rise is when 5:37 Um when that dose starts to rise is when you potentially want to think about 5:39 you potentially want to think about 5:39 you potentially want to think about taking a couple of days off. Uh because 5:42 taking a couple of days off. Uh because 5:42 taking a couple of days off. Uh because that's going to minimize some of those 5:43 that's going to minimize some of those 5:43 that's going to minimize some of those cosmetic side effects. 5:44 cosmetic side effects. 5:44 cosmetic side effects. >> Yeah, if they're having the cosmetic 5:46 >> Yeah, if they're having the cosmetic 5:46 >> Yeah, if they're having the cosmetic side effects or um some women that like 5:48 side effects or um some women that like 5:48 side effects or um some women that like to work out, maybe I'll have them do it 5:50 to work out, maybe I'll have them do it 5:50 to work out, maybe I'll have them do it on their workout days to help with 5:51 on their workout days to help with 5:51 on their workout days to help with recovery. But, if the dose if somebody's 5:54 recovery. But, if the dose if somebody's 5:54 recovery. But, if the dose if somebody's noticing these signs 5:56 noticing these signs 5:56 noticing these signs that oh, you know, I feel like, you 5:57 that oh, you know, I feel like, you 5:57 that oh, you know, I feel like, you know, I'm breaking out, or I'm getting, 5:59 know, I'm breaking out, or I'm getting, 5:59 know, I'm breaking out, or I'm getting, you know, sometimes people can get a 6:01 you know, sometimes people can get a 6:01 you know, sometimes people can get a little puffy. I wouldn't say it's as 6:03 little puffy. I wouldn't say it's as 6:03 little puffy. I wouldn't say it's as much um from the testosterone, but 6:05 much um from the testosterone, but 6:05 much um from the testosterone, but sometimes women will notice that. Some 6:07 sometimes women will notice that. Some 6:07 sometimes women will notice that. Some Like I said, the hair loss 6:09 Like I said, the hair loss 6:09 Like I said, the hair loss is their dose might actually be pretty 6:10 is their dose might actually be pretty 6:10 is their dose might actually be pretty low. So, some women can tolerate it, and 6:13 low. So, some women can tolerate it, and 6:13 low. So, some women can tolerate it, and some women can't. That's where you would 6:14 some women can't. That's where you would 6:14 some women can't. That's where you would do like a, you know, check their sex 6:17 do like a, you know, check their sex 6:17 do like a, you know, check their sex hormone binding globulin, check their 6:19 hormone binding globulin, check their 6:19 hormone binding globulin, check their DHT, cuz some women will take their 6:21 DHT, cuz some women will take their 6:21 DHT, cuz some women will take their testosterone, and it converts right into 6:23 testosterone, and it converts right into 6:23 testosterone, and it converts right into DHT, and they're going to have hair 6:24 DHT, and they're going to have hair 6:24 DHT, and they're going to have hair loss. And then some women don't have 6:26 loss. And then some women don't have 6:26 loss. And then some women don't have that pathway. You know, everybody's 6:27 that pathway. You know, everybody's 6:27 that pathway. You know, everybody's different genetically. We're all 6:28 different genetically. We're all 6:28 different genetically. We're all different with our lifestyles, with what 6:30 different with our lifestyles, with what 6:30 different with our lifestyles, with what we're doing. And then there's some women 6:32 we're doing. And then there's some women 6:32 we're doing. And then there's some women that might have um, you know, that that 6:35 that might have um, you know, that that 6:35 that might have um, you know, that that free their total doesn't convert into 6:37 free their total doesn't convert into 6:37 free their total doesn't convert into their free. Like, for example, I said on 6:39 their free. Like, for example, I said on 6:39 their free. Like, for example, I said on the last podcast that I typically have 6:41 the last podcast that I typically have 6:41 the last podcast that I typically have high testosterone levels. I always have. 6:43 high testosterone levels. I always have. 6:43 high testosterone levels. I always have. That's just it kind of runs in my 6:44 That's just it kind of runs in my 6:44 That's just it kind of runs in my family. And I don't have PMOS, but uh 6:48 family. And I don't have PMOS, but uh 6:48 family. And I don't have PMOS, but uh I just recently did my uh testosterone, 6:51 I just recently did my uh testosterone, 6:51 I just recently did my uh testosterone, and I'm not taking any, and my total was 6:54 and I'm not taking any, and my total was 6:54 and I'm not taking any, and my total was 40, and then my free was 3.9. Which 6:57 40, and then my free was 3.9. Which 6:57 40, and then my free was 3.9. Which that's a pretty good conversion. But, 6:58 that's a pretty good conversion. But, 6:58 that's a pretty good conversion. But, let's say a woman's taking testosterone, 7:00 let's say a woman's taking testosterone, 7:00 let's say a woman's taking testosterone, you have them on the HRT cream, their 7:03 you have them on the HRT cream, their 7:03 you have them on the HRT cream, their testosterone level in their blood total 7:05 testosterone level in their blood total 7:05 testosterone level in their blood total is 40, but their free is like one. You 7:08 is 40, but their free is like one. You 7:08 is 40, but their free is like one. You know, then you'd know it's being they're
Why Numbers Don't Tell the Whole Story 7:11 know, then you'd know it's being they're 7:11 know, then you'd know it's being they're not getting the benefit of the free 7:12 not getting the benefit of the free 7:12 not getting the benefit of the free testosterone. It might actually be 7:14 testosterone. It might actually be 7:14 testosterone. It might actually be diverting to um dihydrotest DHT, the 7:18 diverting to um dihydrotest DHT, the 7:18 diverting to um dihydrotest DHT, the dihydrotestosterone, or the sex um 7:21 dihydrotestosterone, or the sex um 7:21 dihydrotestosterone, or the sex um hormone binding globulin might be 7:22 hormone binding globulin might be 7:22 hormone binding globulin might be elevated, which is blocking the total 7:25 elevated, which is blocking the total 7:25 elevated, which is blocking the total from turning into the free T. 7:26 from turning into the free T. 7:26 from turning into the free T. >> Yeah, so that the total testosterone is 7:28 >> Yeah, so that the total testosterone is 7:28 >> Yeah, so that the total testosterone is bound to the sex SHBG. 7:31 bound to the sex SHBG. 7:31 bound to the sex SHBG. >> Or it encompasses all of it, the free 7:33 >> Or it encompasses all of it, the free 7:33 >> Or it encompasses all of it, the free and the and what's bound. 7:36 and the and what's bound. 7:36 and the and what's bound. >> Right. Okay. Well, I'll I'll explain 7:37 >> Right. Okay. Well, I'll I'll explain 7:38 >> Right. Okay. Well, I'll I'll explain that. What do you mean by 7:38 that. What do you mean by 7:38 that. What do you mean by >> So, when you do a total testosterone on 7:40 >> So, when you do a total testosterone on 7:40 >> So, when you do a total testosterone on a blood draw, you'll you'll get the 7:42 a blood draw, you'll you'll get the 7:42 a blood draw, you'll you'll get the results back. That total is all the 7:44 results back. That total is all the 7:44 results back. That total is all the bound testosterone and all the free 7:46 bound testosterone and all the free 7:46 bound testosterone and all the free testosterone all in one pool. Where you 7:48 testosterone all in one pool. Where you 7:48 testosterone all in one pool. Where you can do a separate test, a little more 7:50 can do a separate test, a little more 7:50 can do a separate test, a little more pricier, it really it really is, but if 7:52 pricier, it really it really is, but if 7:52 pricier, it really it really is, but if you're trying to determine why are their 7:54 you're trying to determine why are their 7:54 you're trying to determine why are their levels at 40 but they're having symptoms 7:56 levels at 40 but they're having symptoms 7:56 levels at 40 but they're having symptoms of it being too high. Or even at 20, 7:59 of it being too high. Or even at 20, 7:59 of it being too high. Or even at 20, let's say their testosterone total was 8:01 let's say their testosterone total was 8:01 let's say their testosterone total was at 20 but they're still breaking out or 8:03 at 20 but they're still breaking out or 8:03 at 20 but they're still breaking out or having, you know, back acne or 8:05 having, you know, back acne or 8:05 having, you know, back acne or something, we want to find out why, then 8:07 something, we want to find out why, then 8:07 something, we want to find out why, then you would do the free testosterone to 8:08 you would do the free testosterone to 8:08 you would do the free testosterone to see how much of the total is converting 8:10 see how much of the total is converting 8:10 see how much of the total is converting to the free and then you could do the 8:12 to the free and then you could do the 8:12 to the free and then you could do the sex hormone binding globulin because 8:14 sex hormone binding globulin because 8:14 sex hormone binding globulin because that binds the testosterone. If you have 8:16 that binds the testosterone. If you have 8:16 that binds the testosterone. If you have a lot of sex hormone binding globulin, 8:17 a lot of sex hormone binding globulin, 8:17 a lot of sex hormone binding globulin, that's going to bind your testosterone 8:19 that's going to bind your testosterone 8:19 that's going to bind your testosterone so it can't convert to free or like I 8:21 so it can't convert to free or like I 8:21 so it can't convert to free or like I said some women that that their 8:23 said some women that that their 8:23 said some women that that their testosterone turns into 8:24 testosterone turns into 8:24 testosterone turns into dihydrotestosterone. That happens in men 8:26 dihydrotestosterone. That happens in men 8:26 dihydrotestosterone. That happens in men too. 8:27 too. 8:27 too. You know, all the all those same factors 8:28 You know, all the all those same factors 8:28 You know, all the all those same factors happen in men and women but it's some 8:30 happen in men and women but it's some 8:30 happen in men and women but it's some way to give us a little bit more insight 8:32 way to give us a little bit more insight 8:32 way to give us a little bit more insight or clues on how we can properly treat 8:35 or clues on how we can properly treat 8:35 or clues on how we can properly treat this person. 8:36 this person. 8:36 this person. >> Right. Right. Right. All right, now I we 8:38 >> Right. Right. Right. All right, now I we 8:38 >> Right. Right. Right. All right, now I we mentioned this on the last one so I have 8:40 mentioned this on the last one so I have 8:40 mentioned this on the last one so I have a patient that I saw maybe, you know, 8:42 a patient that I saw maybe, you know, 8:42 a patient that I saw maybe, you know, couple weeks ago and her she's only on 1 8:45 couple weeks ago and her she's only on 1 8:45 couple weeks ago and her she's only on 1 mg of testosterone. She's on some biased
Exercise, DHEA, and Hormone Conversion 8:49 mg of testosterone. She's on some biased 8:49 mg of testosterone. She's on some biased as well. She's only taking it once a day 8:51 as well. She's only taking it once a day 8:51 as well. She's only taking it once a day and her testosterone is like 180 189 or 8:54 and her testosterone is like 180 189 or 8:54 and her testosterone is like 180 189 or something like that. 8:55 something like that. 8:55 something like that. >> Well, that's um 8:57 >> Well, that's um 8:57 >> Well, that's um That That I would say is probably more 8:58 That That I would say is probably more 8:59 That That I would say is probably more of a zebra. Um it might, you know, it's 9:01 of a zebra. Um it might, you know, it's 9:01 of a zebra. Um it might, you know, it's probably not the You don't see that 9:03 probably not the You don't see that 9:03 probably not the You don't see that commonly. Like this is more of like, oh, 9:05 commonly. Like this is more of like, oh, 9:05 commonly. Like this is more of like, oh, this is interesting to see that. 9:07 this is interesting to see that. 9:07 this is interesting to see that. >> Sure. Sure. 9:07 >> Sure. Sure. 9:07 >> Sure. Sure. >> Does she have any signs or symptoms of 9:10 >> Does she have any signs or symptoms of 9:10 >> Does she have any signs or symptoms of her testosterone being too high? 9:11 her testosterone being too high? 9:11 her testosterone being too high? >> I know I we kind of went through the 9:13 >> I know I we kind of went through the 9:13 >> I know I we kind of went through the gamut all that and she, you know, she 9:15 gamut all that and she, you know, she 9:15 gamut all that and she, you know, she feels relatively pretty good. She's 9:16 feels relatively pretty good. She's 9:16 feels relatively pretty good. She's working out on a regular basis. 9:19 working out on a regular basis. 9:19 working out on a regular basis. Uh you know, I asked her, you know, kind 9:21 Uh you know, I asked her, you know, kind 9:21 Uh you know, I asked her, you know, kind of clarifying over and over and uh it's 9:23 of clarifying over and over and uh it's 9:23 of clarifying over and over and uh it's like that a little bit of a head 9:24 like that a little bit of a head 9:24 like that a little bit of a head scratcher, why? And not only now this is 9:27 scratcher, why? And not only now this is 9:27 scratcher, why? And not only now this is where I I, you know, it's a little fishy 9:29 where I I, you know, it's a little fishy 9:29 where I I, you know, it's a little fishy that both her testosterone and her 9:32 that both her testosterone and her 9:32 that both her testosterone and her estradiol levels were both high. 9:34 estradiol levels were both high. 9:34 estradiol levels were both high. And she's on such a small uh on such a 9:36 And she's on such a small uh on such a 9:36 And she's on such a small uh on such a small amount, and she's only taking it 9:38 small amount, and she's only taking it 9:38 small amount, and she's only taking it once a day versus twice. 9:39 once a day versus twice. 9:39 once a day versus twice. >> Well, she may have put her hormone 9:41 >> Well, she may have put her hormone 9:41 >> Well, she may have put her hormone creams on right before the blood test. 9:43 creams on right before the blood test. 9:43 creams on right before the blood test. >> before? The night before? 9:44 >> before? The night before? 9:44 >> before? The night before? >> That's interesting. And then or maybe it 9:46 >> That's interesting. And then or maybe it 9:46 >> That's interesting. And then or maybe it was on her arm or it touched her arm. 9:49 was on her arm or it touched her arm. 9:49 was on her arm or it touched her arm. You know, that like I said, that's 9:50 You know, that like I said, that's 9:50 You know, that like I said, that's probably not as common for 1 mg of 9:52 probably not as common for 1 mg of 9:52 probably not as common for 1 mg of testosterone to be well, almost 200. 9:54 testosterone to be well, almost 200. 9:54 testosterone to be well, almost 200. >> Sure. 9:55 >> Sure. 9:55 >> Sure. >> It would be 9:56 >> It would be 9:56 >> It would be >> That That's the uh my point is that's 9:57 >> That That's the uh my point is that's 9:57 >> That That's the uh my point is that's one of the reason why we don't 9:58 one of the reason why we don't 9:58 one of the reason why we don't necessarily chase numbers too much. We 10:00 necessarily chase numbers too much. We 10:00 necessarily chase numbers too much. We don't chase them if they're too low. We 10:01 don't chase them if they're too low. We 10:01 don't chase them if they're too low. We don't chase them if they're too high. 10:03 don't chase them if they're too high. 10:03 don't chase them if they're too high. But, when it's too high like that, now, 10:05 But, when it's too high like that, now, 10:05 But, when it's too high like that, now, granted, as long as she's not having any 10:06 granted, as long as she's not having any 10:06 granted, as long as she's not having any of those cosmetic issues, and this is 10:08 of those cosmetic issues, and this is 10:08 of those cosmetic issues, and this is the point of, you know, is your dose 10:10 the point of, you know, is your dose 10:10 the point of, you know, is your dose high enough or, you know, too high, is 10:12 high enough or, you know, too high, is 10:12 high enough or, you know, too high, is if you're not having any of the cosmetic 10:14 if you're not having any of the cosmetic 10:14 if you're not having any of the cosmetic things, then there's really no harm or 10:16 things, then there's really no harm or 10:16 things, then there's really no harm or you know, problem with those um with 10:18 you know, problem with those um with 10:18 you know, problem with those um with that level being high as it is. 10:20 that level being high as it is. 10:20 that level being high as it is. >> Ex- Exactly. Like some women love having 10:22 >> Ex- Exactly. Like some women love having 10:22 >> Ex- Exactly. Like some women love having their testosterone up in the 80s. Like 10:24 their testosterone up in the 80s. Like 10:24 their testosterone up in the 80s. Like they're like, this feels great. And some 10:26 they're like, this feels great. And some 10:26 they're like, this feels great. And some women like it, you know, don't like 10:27 women like it, you know, don't like 10:27 women like it, you know, don't like that. Ev- you know, everybody's 10:29 that. Ev- you know, everybody's 10:29 that. Ev- you know, everybody's different. It could be cuz, you know, we 10:31 different. It could be cuz, you know, we 10:31 different. It could be cuz, you know, we make our um DHEA, which is an adrenal 10:34 make our um DHEA, which is an adrenal 10:34 make our um DHEA, which is an adrenal hormone that comes from the adrenals, as 10:35 hormone that comes from the adrenals, as 10:35 hormone that comes from the adrenals, as that's converting over to testosterone. 10:37 that's converting over to testosterone. 10:37 that's converting over to testosterone. So, that could be That's another way 10:39 So, that could be That's another way 10:39 So, that could be That's another way that somebody might have a little bit 10:41 that somebody might have a little bit 10:41 that somebody might have a little bit higher levels of testosterone if they 10:42 higher levels of testosterone if they 10:42 higher levels of testosterone if they have a good amount of DHEA that's 10:44 have a good amount of DHEA that's 10:44 have a good amount of DHEA that's converting to testosterone.
Final Takeaways on Testosterone in Women 10:46 converting to testosterone. 10:46 converting to testosterone. >> Sure. Uh for a woman, uh there's 10:48 >> Sure. Uh for a woman, uh there's 10:48 >> Sure. Uh for a woman, uh there's actually some benefit 10:50 actually some benefit 10:50 actually some benefit sort of long-term benefit um by having a 10:52 sort of long-term benefit um by having a 10:52 sort of long-term benefit um by having a little bit of a higher testosterone. 10:54 little bit of a higher testosterone. 10:54 little bit of a higher testosterone. Now, I'm certainly 189 wouldn't be my 10:56 Now, I'm certainly 189 wouldn't be my 10:56 Now, I'm certainly 189 wouldn't be my choice. I'd like to see it maybe, you 10:58 choice. I'd like to see it maybe, you 10:58 choice. I'd like to see it maybe, you know, I you know, in below 100. Um but, 11:02 know, I you know, in below 100. Um but, 11:02 know, I you know, in below 100. Um but, she's not having any of the cosmetic 11:04 she's not having any of the cosmetic 11:04 she's not having any of the cosmetic issues or really any other indications 11:07 issues or really any other indications 11:07 issues or really any other indications of having too high of a testosterone 11:09 of having too high of a testosterone 11:09 of having too high of a testosterone level. 11:09 level. 11:09 level. >> And testosterone's great for your bone 11:11 >> And testosterone's great for your bone 11:11 >> And testosterone's great for your bone density. 11:11 density. 11:11 density. >> As I'm saying, her bones, muscle. She is 11:13 >> As I'm saying, her bones, muscle. She is 11:13 >> As I'm saying, her bones, muscle. She is working out on a regular basis. So, it's 11:16 working out on a regular basis. So, it's 11:16 working out on a regular basis. So, it's one of those things that we're sort of 11:17 one of those things that we're sort of 11:17 one of those things that we're sort of monitoring. I mean, her dose is already 11:19 monitoring. I mean, her dose is already 11:19 monitoring. I mean, her dose is already We We did make a slight reduction to her 11:21 We We did make a slight reduction to her 11:21 We We did make a slight reduction to her dose. Um but, still a little a little 11:24 dose. Um but, still a little a little 11:24 dose. Um but, still a little a little bit of a head-scratcher why both of 11:26 bit of a head-scratcher why both of 11:26 bit of a head-scratcher why both of those numbers would be on the high side. 11:28 those numbers would be on the high side. 11:28 those numbers would be on the high side. >> Mhm. 11:28 >> Mhm. 11:29 >> Mhm. Yeah, maybe. And you know, honestly, 11:30 Yeah, maybe. And you know, honestly, 11:30 Yeah, maybe. And you know, honestly, exercise is another way of upregulating 11:32 exercise is another way of upregulating 11:32 exercise is another way of upregulating your own testosterone. You go and do 11:34 your own testosterone. You go and do 11:34 your own testosterone. You go and do some weightlifting or resistance 11:36 some weightlifting or resistance 11:36 some weightlifting or resistance training it can't your own body will 11:38 training it can't your own body will 11:38 training it can't your own body will probably from from the conversion of 11:40 probably from from the conversion of 11:40 probably from from the conversion of making the DHEA to testosterone but it 11:42 making the DHEA to testosterone but it 11:42 making the DHEA to testosterone but it does upregulate so it's 11:44 does upregulate so it's 11:44 does upregulate so it's >> Well, that's the whole reason why we 11:45 >> Well, that's the whole reason why we 11:45 >> Well, that's the whole reason why we want you know, patients to exercise is 11:48 want you know, patients to exercise is 11:48 want you know, patients to exercise is because of the androgen impact but at 11:51 because of the androgen impact but at 11:51 because of the androgen impact but at the same time it's not a little bit of 11:53 the same time it's not a little bit of 11:53 the same time it's not a little bit of going to the gym every every you know, 11:55 going to the gym every every you know, 11:55 going to the gym every every you know, she does go to the gym like 5 days a 11:57 she does go to the gym like 5 days a 11:57 she does go to the gym like 5 days a week maybe even 6 days a week and her 11:59 week maybe even 6 days a week and her 11:59 week maybe even 6 days a week and her number um is still on the high side. 12:02 number um is still on the high side. 12:02 number um is still on the high side. >> feels good like you said it really don't 12:04 >> feels good like you said it really don't 12:04 >> feels good like you said it really don't chase the numbers see how you're feeling 12:06 chase the numbers see how you're feeling 12:06 chase the numbers see how you're feeling and what your 12:07 and what your 12:07 and what your you know, the signs and symptoms and 12:09 you know, the signs and symptoms and 12:09 you know, the signs and symptoms and then like I said there's different blood 12:10 then like I said there's different blood 12:10 then like I said there's different blood tests you can also run to kind of 12:11 tests you can also run to kind of 12:11 tests you can also run to kind of uncover the clues. 12:13 uncover the clues. 12:13 uncover the clues. >> Yeah, anything else you want to add 12:14 >> Yeah, anything else you want to add 12:14 >> Yeah, anything else you want to add about 12:15 about 12:15 about high testosterone? 12:16 high testosterone? 12:16 high testosterone? >> Yeah, so like like I said the acne the 12:18 >> Yeah, so like like I said the acne the 12:18 >> Yeah, so like like I said the acne the hair loss I've never had anybody get you 12:20 hair loss I've never had anybody get you 12:20 hair loss I've never had anybody get you know, aggressive if their testosterone's 12:22 know, aggressive if their testosterone's 12:22 know, aggressive if their testosterone's too high for a female I've never seen 12:24 too high for a female I've never seen 12:24 too high for a female I've never seen that. I have 12:26 that. I have 12:26 that. I have >> Usually there's some other factors in 12:27 >> Usually there's some other factors in 12:27 >> Usually there's some other factors in there that is making them a little bit 12:29 there that is making them a little bit 12:29 there that is making them a little bit you know, irritable or you know, just 12:31 you know, irritable or you know, just 12:31 you know, irritable or you know, just perimenopause in general they're going 12:33 perimenopause in general they're going 12:33 perimenopause in general they're going to be irritable menopause they're just 12:34 to be irritable menopause they're just 12:34 to be irritable menopause they're just going to be irritable. Usually I mean 12:36 going to be irritable. Usually I mean 12:36 going to be irritable. Usually I mean even for men testosterone usually makes 12:38 even for men testosterone usually makes 12:38 even for men testosterone usually makes them mentally feel better. 12:39 them mentally feel better. 12:39 them mentally feel better. >> Yeah, exactly. If the testosterone's if 12:42 >> Yeah, exactly. If the testosterone's if 12:42 >> Yeah, exactly. If the testosterone's if somebody's applying it vaginally cuz you 12:44 somebody's applying it vaginally cuz you 12:44 somebody's applying it vaginally cuz you can apply testosterone vaginally you can 12:46 can apply testosterone vaginally you can 12:46 can apply testosterone vaginally you can go right into the bloodstream. It can 12:48 go right into the bloodstream. It can 12:48 go right into the bloodstream. It can you know, helps a lot with libido but it 12:50 you know, helps a lot with libido but it 12:50 you know, helps a lot with libido but it can irritate the tissues depending on 12:52 can irritate the tissues depending on 12:52 can irritate the tissues depending on what um 12:54 what um 12:54 what um what base you're using but I wouldn't I 12:56 what base you're using but I wouldn't I 12:56 what base you're using but I wouldn't I wouldn't say um 12:58 wouldn't say um 12:58 wouldn't say um like I said I I I think testosterone for 13:00 like I said I I I think testosterone for 13:00 like I said I I I think testosterone for women can be a game-changer. 13:02 women can be a game-changer. 13:02 women can be a game-changer. >> Absolutely. Yeah, yeah. 13:03 >> Absolutely. Yeah, yeah. 13:03 >> Absolutely. Yeah, yeah. So 13:04 So 13:04 So any final comments or we 13:06 any final comments or we 13:06 any final comments or we >> I think this was great. 13:07 >> I think this was great. 13:07 >> I think this was great. >> Yeah, so if you have any comments to 13:09 >> Yeah, so if you have any comments to 13:09 >> Yeah, so if you have any comments to share you can write them in the comments 13:11 share you can write them in the comments 13:11 share you can write them in the comments below otherwise we'll see you on next 13:13 below otherwise we'll see you on next 13:13 below otherwise we'll see you on next episode. I'm Dr. Maki. 13:14 episode. I'm Dr. Maki. 13:14 episode. I'm Dr. Maki. >> And I'm Dr. Valerie. 13:15 >> And I'm Dr. Valerie. 13:15 >> And I'm Dr. Valerie. >> Take care. Bye-bye.
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