32: Testosterone Replacement Therapy: The One Downside Nobody Talks About.

Michael Kummer (00:02.638)
Testosterone replacement therapy is a terrible idea. Hey, welcome back to another episode of the Primer Shift Podcast. And in this episode, I'll share with you the implications of low testosterone levels in men and women, my personal experience with hormone replacement therapy, and specifically testosterone replacement therapy, the pros and cons of TRT, and why I think it's a terrible idea for most people. I'm gonna share with you better ways to increase your testosterone levels, both naturally.

as well as with medication, that's not testosterone. My recommendation is based on my experience and knowledge, and I'm gonna bust some myths and set some expectations in terms of what you can expect when you use testosterone replacement therapy and what you cannot expect. Now I'm not a medical doctor and nothing in this episode should be considered medical advice, but let's get right to it. First, let's talk about low testosterone levels or testosterone in general, because...

Testosterone, as you might already know, is a key male hormone in muscle development, bone density, libido, hair growth, and overall mood regulation. But it's also important in women. And that's not something you hear people talk about a lot. So much of what I say in this podcast or in this episode also applies to women. So stick around. Even if you're not a biological male. And

have been diagnosed maybe with low testosterone levels. Now, speaking of low testosterone levels, symptoms of which include, or can include fatigue, depression, decreased muscle mass, decreased bone density, increased body fat, low libido, and difficulties with concentration and memory. Now, of course, many, if not all of those symptoms can also have different causes, different metabolic issues, but low testosterone just happens to be also one of those factors that can cause

Any or all of that. Now, what's interesting is that over the past several years and decades, really, we've seen a decline in average testosterone levels, specifically in men. So it's been going down and down and down. And as a result, unfortunately, the normal ranges, like if you go to your doctor and you measure your testosterone levels have also gone down. So in other words, what would have been clinically diagnosed as low testosterone, maybe 15 years ago.

Michael Kummer (02:27.982)
could not be considered normal. But the fact is just because everyone now or most people have low testosterone levels doesn't necessarily mean it's normal. So you definitely wanna be in the upper range of what is considered normal. And right now, depending on the lab you go or doctor you see your normal levels or normal levels are considered somewhere between maybe 250 nanograms per deciliter to maybe 1,100 nanograms per deciliter or somewhere in that bar.

And if you're on the lower end, that's definitely, I would not consider that normal, that's already low. And so much of what we talk about in this episode might apply and you should definitely stick around and listen to it. And if you have never tested your testosterone levels, maybe it's time to do so at your next lab work and see what levels you have. But let me maybe first talk about my personal experience. Around, it was summer of 2020, when I read Dr. Sinclair's book,

called lifespan and I got really excited about the prospect of tweaking things to improve my lifespan and health span really most importantly. So I started engaging on consulting with a doctor, local doctor here in Georgia who specializes in anti-aging, Dr. Randy Smith, who I still work with to this day. And he went through all the blood work and we did a bunch of tests and he said, well,

You know, everything looks fairly good. I mean, you're doing a good job with diet, exercise, sleep, and all of the things, but, you know, your testosterone levels are, you know, in the lower range. Meaning I think at the time I had, you know, around 400 nanograms per deciliter or maybe 380 or so. So it wasn't, it was definitely lower than I would have expected considering. You know, everything that I do to be healthy and to enjoy optimal health.

And so he said, well, you know, he would recommend a combination of, you know, testosterone injections and an anti estrogen, because, you know, depending on your testosterone levels, and especially if you inject testosterone, some of it can aromatize and convert into estrogen. And so to keep those levels in check, you know, he recommended an anti estrogen. And there are, you know, voices out there that say that's a terrible idea. There are some that said it's a good idea. So, you know, at the time I didn't really know any better and I just, you know, went with that recommendation.

Michael Kummer (04:48.846)
And the also recommended chorionic human chorionic gonadotropin or HCG, which is a compound that encourages your testes to keep producing testosterone because most hormones are regulated by a feedback loop in your body. Meaning that if you inject testosterone,

then your body stops producing testosterone because it's there, it's not needed. There is no need to produce more, right? It's not that whatever you inject, you get on top of your normal levels. No, your body shuts down testosterone production and you just use what you injected. And the problem with that is if you don't counter that effect with HCG, for example, then your testes are gonna shrink. You probably have heard this from bodybuilders and stuff. It's not the penis that shrinks, it's the testes that shrink.

because of the lack of testosterone production. And the other, besides the cosmetic issue of that, the other consideration obviously is that if your body is not producing testosterone for extended periods, there might be a risk that it's never going to start back up once you stop taking testosterone, maybe then you have lower levels than what you started. And so that was really one of the main concerns for me. And that's why it was a no brainer to also include HCG. And I did this.

for one and a half years. And at the same time, I also discovered senoestrogens. I talked about this in a separate episode, those environmental toxins or sometimes plant-based toxins that mimic estrogen in the body that can also lead to lower testosterone levels. So for me, it was like, well, I'm doing everything right, except I'm exposed to a lot of senoestrogens from plastic food storage containers, from personal care products.

from maybe the tap water I'm drinking, et cetera, et cetera. So I'm like, okay, here is what I'm gonna do. I'm gonna try to cut out as many senoestrogens as I can. And I've talked about my journey in a separate blog post as well as on a separate podcast episode. So check this out if senoestrogens doesn't ring a bell, if you don't know what it is, super important. But I figured, well, in the meantime, I'm just gonna go on a hormone replacement therapy to increase my levels because high testosterone can also then counter and mitigate some of those

Michael Kummer (07:09.454)
issues of senoestrogens that might be stuck in your body for several months. You know, if they are stored in fat tissue, you know, you might have those toxins in your body for extended periods and it can take a while for them to flush out. So I'm like, good idea. I'm going to do this in combination with, you know, making that lifestyle choice or lifestyle change of removing as many senoestrogens as I possibly can. And so I did this for one and a half years. And then I'm like, well, it's been one and a half years. I want to find out now, you know, what

how my levels are if I stop hormone replacement therapy. So I stopped it completely. And I think a month later, I got my blood drawn and my testosterone levels were like 179 nanograms per deciliter. So clinically, low testosterone. I'm like, what on earth? I thought by taking HCG, my body would bounce back within a few weeks. But then,

My doctor told me, no, that can actually take, since you have been taking testosterone for so long, like one and a half years, you know, it can take a while for you to bounce back. And I'm like, well, if it takes, if after only one and a half years, it takes, it can take months for me to bounce back. I can't imagine if I do this for a decade, you know, how, and I don't wanna be stuck taking testosterone for the rest of my life. So I'm like, no, you know, I don't wanna do this anymore. And as a side note,

During that time, I took relatively small levels. I've documented all of that in my blog post about anti-aging, so you can look up the exact numbers and my trend. But the bottom line is I took relatively small amounts of testosterone and my levels were through the roof. I think my highest levels were at 1,800 nanograms per deciliter. That's way above what I would consider a normal range, or even an optimal range. I don't need high levels like that. So I started decreasing my dosage.

couple of months, I decreased the dosage. And even with the lowest levels that I took, I was still at 15, 1600. I'm like, okay, I don't wanna do this anymore. There was a second reason why I decided to just stop doing it. So I stopped doing it. I stopped everything in terms of hormone replacement therapy. But then when I saw my low levels and that realized that it might take a while to bounce back, my doctor recommended, well, just keep using the HCG and nothing else.

Michael Kummer (09:31.278)
to encourage your testes to make more testosterone. I'm like, well, you know, that sounds reasonable. So I started taking only HCG and I bounced back really quick and I ended up with like 950 to 1050 nanograms per deciliter. And my doctor said, well, you must be a hyper responder because normally with only HCG and knowing what your baseline was, around 400.

You know, you shouldn't be seeing those high levels, but apparently it works really well for you and, you know, being at around 900 to a thousand, that's still like, you know, considered a normal range that would be, I guess, what a healthy 20 year old would have. So nothing out of the ordinary. There is, you know, he doesn't, didn't see any, any health concerns by, you know, doing that, by keeping doing that. And so I'm like, okay, I'm going to keep doing this. And, um,

And I've been doing this ever since. And so, you know, I'm not sure if I mentioned it before, but when I stopped completely, that was in December of 2022, where I stopped taking testosterone. So it's been now, you know, well over a year where I've only been on HCG to get my levels up to the upper range of normal, without, you know, anything more. And so I feel really good with that.

And in case you're wondering, you're watching, it's only like, oh, okay, that's why Kummer looks like this because he is on HCG. I'm going to share with you, at least if you're watching the episode, a picture of me in 2018, way before I even thought about hormone replacement therapy. And if you see how I look then and how I look now, I kind of look the same. You know, it doesn't. And we're going to talk about, you know, myths and expectations a little bit, but no, just want to point it out. My physique right now has got nothing to do with HCG.

I've looked like this even way before that. But one thing that I've noticed, you know, with HCG in the equation, I've in the last few months specifically have dramatically increased my protein intake, my caloric intake, and I've added creatine, which creatine, you know, pulls water into muscle tissue and it has a lot of benefits, you know, increased energy production, you know, from a mitochondrial perspective, et cetera, et cetera.

Michael Kummer (11:42.542)
but it also pulls in water a little bit. So it makes you a little bit bigger and stronger at the end of the day, but the protein intake and increased caloric intake has made a huge difference. So now I'm eating, I don't know, maybe 4,000 calories a day, even though I'm only burning, and I've talked about how that works and why that works, why I'm not getting fat despite eating significantly more calories than what I burn in a real, so you can check that out as well. But by doing that, I've really increased my lean muscle mass.

And you can do this, you know, regardless of the testosterone levels, you know, that's just, but if you have optimal testosterone levels, you can definitely feel an increased benefit of just eating more protein. If you also work out, of course, if you just sit on the couch, it's not going to make any difference. The other, you know, funny nuance that I want to mention before we move on to the pros and cons of hormone replacement therapy and why I think it might not be a good idea, at least the testosterone part, is that I did some of my heaviest lifts.

in the gym, like a 400 pound front squat with the lowest testosterone level. So a couple of weeks after I stopped completely and I had like 180 or whatever nanograms per deciliter testosterone, I front squatted 400 pounds. And so, even strength, I would argue, is not always just a matter of how much testosterone you have. There is a lot of other factors that go into the equation.

But with that out of the way, with my personal experience out of the way, let's talk about the pros and cons of hormone replacement therapy. And, you know, first of all, the idea of hormone replacement therapy really is that if you have lower levels or, you know, lower than what you want or lower than what's optimal, you add some in and you get those levels up a little bit. I mean, it's a great idea on paper. As I said, there is a feedback loop in the body. So injecting something means...

especially hormones, most hormones that is, your body stops making its own. So there is no more endogenous testosterone if you inject exogenous testosterone. And so that's something that I would really encourage you to think about. And one of the main downsides of dealing with testosterone, even with HCG and whatever you can do to continue or to encourage your body to continue producing it, it's gonna be so little.

Michael Kummer (14:07.438)
You know, some of your hormones like LH are going to be impacted or disabled. So your body really won't make a whole lot of that testosterone. If you do that over a long time, your production might shut down indefinitely, or at least remain at lower levels than what you had before you started. And that's really one of the main reasons why I highly discourage you from going with testosterone. There are many things you can do, which we're going to talk about in a bit.

to increase your levels naturally. But if nothing else, consider trying out HCG first, encourage your body to make more without giving it the end result. Of course, if you really have low testosterone levels and you increase them by whatever means, there are certain benefits to that. You might have more energy, your mood might improve, your libido might improve, you're gonna have, if you work out and eat right,

improved muscle mass or increased muscle mass, increased bone density, also very important. Again, of course, bone density also depends on your micronutrient intake. You need a lot enough vitamin K2 and calcium, et cetera. But you also might have potentially improved mental clarity and cardiovascular health, because all of those have been associated with higher testosterone levels. And so that's definitely a good thing. There are...

some downsides as well to injecting testosterone, besides the fact that your body might stop producing its own. And that is, it increases the risk, potentially increases the risk of certain cancers. You might get acne, and that's very often related to testosterone aromatizing to estrogen. You might see skin issues like acne, sleep apnea, blood clots, and potential mood swings. So I think, and also based on my experience, you're gonna see those...

specifically if you have higher than normal levels, right? So if you inject so much that you are at, you know, 2000 nanogram per deciliter or more like, you know, bodybuilder type of levels or liver King type of levels, you know, You would very likely see some of that now you can take medication to counter some of that But at this point, I would say you're not doing this to improve your health You're just a drug addict, you know at the end of the day who wants to look big So, you know, there are there are certain risks with overdoing it

Michael Kummer (16:32.43)
and specifically with testosterone. So I highly encourage you to not go the easy route and then check testosterone right away. Try some of the things that I'm gonna discuss here next first. And if those fail, or if you're not gonna see the improvements you want, maybe there is a genetic issue after all, or a genetic component that prevents you from getting to optimal levels for your age.

then you couldn't consider HCG. And that's the reason why, you know, I've done that and why I'm on HCG still. But the first thing that you want to consider is your diet, you know. Diet rich in protein, especially animal-based protein, healthy fats and certain minerals like zinc, magnesium, selenium and boron, ideally again from animal-based sources are incredibly important for maintaining optimal testosterone levels. If you are short on any of those,

You could see lower than normal levels and the easy fix is just to increase your intake. You know, from a protein perspective, you know, eat more meat, you know, healthy fats, butter, tallow, ghee, what have you. And micronutrients. I mean, you can find many of those in the meat, in regular meat, in eggs, in egg yolk in particular, but also organs, of course, you know, and that's one of the reasons why I decided to, with my wife together, to start selling.

freeze-dried beef organ supplements. So you can get all of the micronutrients without having to worry about sourcing and preparing and organ meat and the taste and texture that some people, many people unfortunately don't like. So diet should be fairly easy to figure out. And on the flip side, there are some foods you definitely wanna avoid, like the ones that are either high in phytoestrogens, those are plant-based estrogens, and synthetic.

Xenoestrogens and soy obviously is a rich source of phytoestrogens that you want to avoid, but also processed foods like Kale cornflakes. I mean, Kellogg's or Kellogg developed or invented cornflakes to do exactly to lower the testosterone levels and to lower male libido. So stay away from processed crab food from many plant-based foods that have high levels of phytoestrogens and xenoestrogens.

Michael Kummer (18:51.278)
You have taken care of the diet aspect. Exercise is not an important factor and I specifically resistance training. So weightlifting, you know, lifting heavy weight and doing high intensity inner wall training or HIIT workouts can naturally boost testosterone levels. And so if you do that in combination with diet, you're already on a very good track to achieving better testosterone levels. Sleep is another important factor that many, you know, completely misunderstand or at least are not aware of.

If you don't spend enough time in the restorative phases of sleep, that is deep and REM sleep, then your testosterone production is very likely negatively impacted. So really make sure you're getting enough sleep, you're getting enough quality sleep, you spend enough time, about 40% on average, in the restorative phases of sleep, so that you allow your body to not only recover, but to produce hormones at night when you sleep and to get your testosterone levels up.

most people probably don't correlate or associate with testosterone. But the thing is that vitamin D that's synthesized from sunlight plays a crucial role in maintaining proper testosterone levels. So if you're never in the sun, if you wear sunscreen all the time, you know, and never get those UV rays directly onto your skin to allow for proper vitamin D production, then you likely also inhibit your testosterone production. So if on the flip side, what that means is if you have low testosterone,

low vitamin D levels, chances are you might also have low testosterone levels and vice versa. So get enough sunlight, obviously don't get sunburned, but get enough sun exposure without sunscreen, without wearing clothing. Do it safely and responsibly obviously, but make that a regular part of your routine. Every day ideally already during winter when the sun is not that strong, you can build up your sun callus and feel much better than in summer when the UV index is higher.

Sinoestrogens we already talked about, from plant-based sources, from food-based sources, but there are many, many other, unfortunately, areas where you can expose yourself unknowingly to those chemicals. And the problem is with Sinoestrogens, they mimic the hormone estrogen, so they bind to the estrogen receptors in your body. And unfortunately, every cell in our body has estrogen receptors, so it can impact you on a variety of levels.

Michael Kummer (21:16.494)
And those chemicals are found in plastics, especially plastic food storage containers, plastic water bottles, in pesticides, in personal care products, deodorants, creams, lotions, soaps, everything. And they disrupt your endocrine system, meaning your hormone balance. And one of the side effects of that is, or one of the results of that is potentially low testosterone levels. So by cutting out or

removing or reducing your exposure. You're not going to be able to cut everything out, unfortunately, on modern world, but by reducing your exposure to senoestrogens, you give your testosterone production and your testosterone levels a chance and likely get them up a little bit. There are also supplements, dietary supplements you can take, you know, like beef testicles, for example, have actually testosterone and other sex hormones in them. So that's one of the ways on how you can potentially improve your testosterone levels.

There is D aspartic acid, there's fenugreek and ashwagandha and some other supplements that likely won't move the needle a lot. So you're not going to double your testosterone levels, but based on information and studies I've seen, there are certain supplements that can give you a bump of maybe 100 to 200 nanograms per deciliter. And that might be enough, depending on where your levels are right now. And if everything else fails or if you've taken care of...

all of those lifestyle factors and you feel like, well, there's not really anything more that I can do better to support my testosterone levels and I'm still on the lower end, maybe because of genetic factors or whatever the case might be, then I would recommend you consider together with a doctor HCG. The downside of that HCG is it's relatively expensive. I think I pay like $250 just for the medication per month. That's a significant amount of money depending on, you know.

what your budget for lifestyle optimization is. You might also have to consider, you know, Dr. Fiat or what have you, depending on how you do it. But if you wanna do it right and using high quality sources of HCG and you work with a medical professional, it's likely gonna cost you more than just what the medication is gonna cost you. And so that's obviously a downside, but everything else considered, everything else being equal, HCG, I think, in my opinion, is the better approach to...

Michael Kummer (23:38.798)
hormone replacement therapy instead of going straight to testosterone and then disabling your own production. So my recommendation really is to exploit all of your lifestyle options first including diet, exercise, sleep, environmental toxins etc. And if that doesn't work, if that's not enough, it definitely will work but it might not get you to the levels that you want. Consider HCG.

have the information of Dr. Smith down in the show notes. So you can reach out to him or, you know, find someone in your area that you want to work with, you know, do all the lab work, do all the tests and make sure you, you, you know, you make the proper decision and don't jump to testosterone first. I've talked to a lot of people in my environment who either are doing hormone replacement therapy, who did it in the past or consider doing it. And a lot of them started with testosterone first.

because it seems like the lowest hanging fruit and the quickest win, but many of those then actually drop testosterone and are back on only HCG because of all the reasons that I have outlined in this episode. So I think do yourself a favor, start with the HCG first, see where it gets you. Again, if you have exploited all of your lifestyle options and you might be perfectly happy. You might not be a hyper responder. So you might not get to a thousand nanograms per deciliter.

But if you get to 700, 650, 700, 800, whatever it is, as a man, you know, that is, as a woman, obviously your levels would become significantly lower. That's really all you need. You don't need to have 2,000 nanograms per deciliter. I would argue, you know, that's, higher levels are not necessarily better. In fact, there are maybe downs, there are many downs of having too much of sauce drawn, like, you know, aromatizing it, you know, dealing with some of the side effects.

including a potential cancer risk, et cetera. You don't want to get there just from a wellness perspective. It's not worth it. Now, before we wrap this up, let's talk about some of the myths and expectations. You know, so you kind of figure out what can you expect from going on a hormone replacement therapy or even testosterone replacement therapy and what is it that you might have heard, but that's, I don't think I'm going to have. And the first of, first of all that I want to say is just injecting testosterone.

Michael Kummer (25:56.206)
uh, is not gonna make you look like the liver King. I mean, I'm sorry, Brian Johnson for using your name again, but I think you kind of asked for it and you're probably gonna enjoy the exposure. So, um, but you know, taking testosterone and not doing anything in terms of working out and putting in a lot of effort into shaping your physique is not gonna move the needle. You're just gonna blow up a little bit in terms of adding, you know, having more water weight.

And that's it. You're not going to look any more ripped. You're not going to look any more muscular. You're not going to be significantly stronger. You're just going to look bloated, you know, at the end of the day. And so for anyone who sees people like the liver King is all, you know, I knew he was on, on whatever he was. I mean, he did more than testosterone, obviously, and it's significantly higher amounts than, you know, what I would consider hormone replacement therapy. Um, he put in the work. I mean, he worked out, out like crazy to leverage.

you know, those pharmaceuticals to get to that physique that he has. And so you only get there when you put in the work. If you just want to do hormone replacement therapy from a health span, you know, wellness, longevity perspective, if done correctly, nobody will notice. You know, you're not going to look any different. I do not look any different because my testosterone levels are at 950 now, uh, versus when they were 400, you know, it, it just doesn't, it just doesn't work that way, you know.

You need significantly higher levels and more workout that I'm not putting in the effort. I don't wanna look like the liberal king, but you need the combination of significantly more pharmaceuticals and significantly more input in terms of workouts to make a significant difference. Now, one thing that I have noticed, and that's really the reason why I'm doing it is because I'm feeling better. I recover quicker after a workout. I...

I just feel better overall and maybe my mental clarity is a little bit better. My libido is a little bit better. Not that it was bad, you know, to start with, but now it's even a little bit more. Maybe that's a downside. If you ask my wife, I don't know. Um, but it just, you feel a little bit better and you know, want to work out more, maybe you're, you recover quicker after a workout and that's it. You know, there is not much more to it. So injecting whatever you want to inject and sitting on the couch is not going to make your muscles grow, right? You have to put in the work.

Michael Kummer (28:19.406)
to make that happen and that applies to both, you know, hormone replacement therapy and not. And that's really, you know, ultimately, that's what you can expect. If you do hormone replacement therapy right, nobody's gonna notice that you're doing it likely. You're not gonna look significantly different unless you increase your workout volume and you do more resistance training, more weight training, then yes, you know, your muscles are gonna grow if paired with the appropriate diet, of course, with appropriate protein intake.

But beyond that, if you keep your workout regimen and your levels are just a little bit higher, you feel better, you recover quicker, but you're not gonna look any different. I don't look any different than I did 2018 when I took the picture that I share on the video episode here with you. I look pretty much the same. I just feel better. And that is it. And so I would...

encourage you definitely to not overdo whatever you do if you feel like, oh, you know, I'm feeling a little bit better. I'm recovered quicker and I want to work out more, but now, you know, I want to take more, I want to push my levels even more. At some point, once you go above normal levels, there are risks associated with it and those risks are not conducive to optimal health, longevity and your health span. So just keep that in mind, you know, looking like the liver King, apologies again for using his name, your name. He's not healthy, you know.

much like being a professional bodybuilder is not healthy. Yes, you might be very strong, very fit, what have you, but it's not healthy. So make sure you have your right goals in mind and you stick to those goals and you don't get encouraged or overly excited by the possibilities now that you can and check whatever you want. And with that, we're gonna wrap it up. Again, bottom line is hormone replacement therapy is a valid approach, I think. I would just encourage you to...

really carefully think if you want a testosterone replacement therapy, or if it might not make more sense to adjust your lifestyle a little bit and to boost your levels either naturally or with other pharmaceuticals like HCG to get to optimal levels and not more. I think that's the better approach. Listen to your body, work with a medical professional and if you have any questions, shoot me an email. I'm more than happy to.

Michael Kummer (30:31.15)
talk more or share more information about my experience and what I've done and why I do certain things and do not. And with that, we're gonna wrap it up and I hope I see and hear you in the next episode.