The Dr. Gabrielle Lyon Show

Your testosterone number matters at every age, but most men never learn what theirs should be. Mayo Clinic urologist Dr. Tobias Kohler explains why ~500 is the target, why 1,000 is already running hot, what 2,000+ does to the heart, and why a randomized trial found lifting without steroids beat steroids without lifting. Plus: the blood test that catches heart risk your cholesterol panel misses.Dr. Kohler returns for his second appearance (his first, on erections, testosterone and muscle mass, is one of the most-watched episodes in the show's history). This time: why men's longevity is roughly 50 years behind women's; the Princeton IV consensus he co-chaired, which treats ED as one of the strongest predictors of a future heart attack and points young men toward a coronary calcium scan; the 0–12 ceramide blood test that changes with your behavior; how to get a testosterone baseline that actually means something; what redlining to 2,000–3,000 does to the heart, the set point and the skin; Peyronie's disease, Viagra vs. Cialis, the pills-to-implant ladder, sexual rehab after prostate surgery, and a patient who got stronger with zero testosterone.About Dr. Tobias KohlerTobias S. Kohler, MD, MPH, is Professor of Urology at Mayo Clinic, a fellowship-trained andrologist with 25+ years of clinical and surgical experience and 250+ peer-reviewed publications. He co-chaired the Princeton IV Consensus Guidelines on ED and cardiovascular disease, co-founded the EROS penile implant registry, and co-edited Contemporary Treatment of Erectile Dysfunction (2nd ed.).Dr. Kohler's first episode → https://youtu.be/__xtrUa3Dck🙌 Thank you to our sponsors:Cozy Earth - Egg Life - Ladder - 📺 Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:YouTube: https://bit.ly/4boCFC3 Spotify: https://bit.ly/4cWTbLG 📱 Connect with Dr. Gabrielle Lyon:Instagram: https://bit.ly/4uk9adc TikTok: https://bit.ly/3OFK3kJ X.com: https://bit.ly/4l3YlaX Facebook: https://bit.ly/3MBrJso LinkedIn: https://bit.ly/3N1nrdL Website: https://bit.ly/3NdV2kT Books: https://bit.ly/4r6ugZK Newsletter: https://bit.ly/402QCAj ⏰Chapters00:00 Men are dying earlier than women the penis is the check-engine light03:26 Boys stop seeing doctors for 20 years the case for an Office of Men's Health10:57 Princeton IV: ED predicts heart attacks, calcium scans, and Cialis12:44 The ceramide blood test your cholesterol panel can't replace20:37 Cardiac risk calculators, statins, and what your LDL should be25:38 GLP-1s, fertility, and "what's the risk of doing nothing?"29:05 Testosterone: the ~500 target, why 1,000 runs hot, what 2,000+ does to the heart31:44 Check your testosterone at 25 and why steroids won't make you a pro36:57 Tolerance and the new set point redlined men can't escape38:13 The 1980s trial: lifting without steroids beat steroids without lifting42:06 Steroid cocktails, arrhythmias, irreversible side effects, and the sarcopenia trade-off53:04 Peyronie's disease and Viagra vs. Cialis57:32 Penile implants: the knee-replacement analogy and the pills-to-surgery ladder1:02:27 Sexual rehab after prostatectomy and the questions to ask before cancer treatment1:07:55 Closing: be proactive and the patient who got stronger with zero testosteroneDisclaimer: This podcast is for general informational purposes only and does not constitute medical advice or create a doctor–patient relationship. It is not a substitute for professional medical advice, diagnosis, or treatment. Do not disregard or delay seeking medical advice because of something you heard here.

You say "steroids" and picture a baseball scandal, a jacked guy, a bad spray tan. But cortisol is a steroid. Estrogen is a steroid. The cream you put on poison ivy is a steroid. The word covering all of them is also covering testosterone therapy for women, and that collision is quietly costing women muscle and bone they don't have to lose.In this solo episode, prompted by a magazine interview on steroid use in women, Dr. Gabrielle Lyon breaks down what these molecules actually are, what they do inside a cell, and why the line between medicine and misuse has nothing to do with the word "steroid."Study and References:The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men (Bhasin et al., NEJM 1996) - https://pubmed.ncbi.nlm.nih.gov/8637535/Testosterone Enhances Estradiol's Effects on Postmenopausal Bone Density and Sexuality (Davis et al., 1995) - https://pubmed.ncbi.nlm.nih.gov/7616872/Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019) - https://pubmed.ncbi.nlm.nih.gov/31498...ISSWSH Clinical Practice Guideline for the Use of Systemic Testosterone for HSDD in Women (2021) - https://pubmed.ncbi.nlm.nih.gov/33814...The Global Epidemiology of Anabolic-Androgenic Steroid Use: A Meta-Analysis (Sagoe et al., 2014) - https://pubmed.ncbi.nlm.nih.gov/24582...What Is the Prevalence of Anabolic-Androgenic Steroid Use Among Women? A Systematic Review (Piatkowski et al., Addiction, 2024) - https://onlinelibrary.wiley.com/doi/1... "The Compounds for Females Are Really Commonly Faked!": Women's Challenges in Anabolic Steroid Acquisition (Piatkowski et al., Drug and Alcohol Review, 2024) - https://onlinelibrary.wiley.com/doi/1...Explore More from Dr. Gabrielle Lyon:Premium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.comWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon's clinical team https://drgabriellelyon.com/new-patie...📱 Connect with Dr. Gabrielle Lyon:Instagram: https://bit.ly/4uk9adcTikTok: https://bit.ly/3OFK3kJX.com: https://bit.ly/4l3YlaXFacebook: https://bit.ly/3MBrJsoLinkedIn: https://bit.ly/3N1nrdLWebsite: https://bit.ly/3NdV2kTBooks: https://bit.ly/4r6ugZKNewsletter: https://bit.ly/402QCAj📺 Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:YouTube: https://bit.ly/4boCFC3Spotify: https://bit.ly/4cWTbLG⏰ Chapters:00:00 - Beginning01:25 - Introduction: The Sister Who Says "Oh My Gosh, You're Taking Steroids" Why Medicine Needs a Shared Vocabulary03:43 - What a Steroid Actually Is: Four Rings of Carbon04:49 - Anabolic vs. Androgenic: Same Receptor, Different Effects06:16 - A Brief History: From Wasting Disease to the Weight Room08:59 - Restoring vs. Exceeding: Why the Range Is the Whole Game11:38 - The Davis Trial: Testosterone, Bone Density, and Lean Mass13:38 - Oral Compounds, the Liver, and Why Conversion Matters14:20 - What Gets Sold Isn't What's Labeled: The Australian Drug-Checking Data15:31 - The 1.6% vs. 4% Myth: Reading the Prevalence Data Correctly18:33 - Why GLP-1s Are Pushing Women Toward Androgens20:26 - Permanent Effects: Voice Changes and What the Literature Shows21:33 - The Four Questions to Ask Before Any Androgen Conversation24:25 - Closing: Entering the Sarcopenia Era‼️ Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Most people assume becoming a parent is an emotional change, but a measurable part of it is hormonal, and it happens in fathers too. I sat down with Aldrich Chan, Psy.D., to talk about what changes in the brain, why the split we draw between mind and body does not hold up, and what decides whether stress reads as manageable or overwhelming when the hormones are identical either way.Want ad-free episodes? Subscribe to Forever Strong Insider: https://bit.ly/4u5VSReGet Aldrich Chan’s books here: https://www.drchancnc.com/books 📱Connect with Aldrich Chan, Psy.DWebsite: https://www.drchancnc.com/ YouTube: www.youtube.com/@draldrichan Instagram: https://www.instagram.com/draldrichanFacebook: https://www.facebook.com/draldrichan LinkedIn: https://www.linkedin.com/in/draldrichan/ 🙌Thank you to our sponsors:One Skin - Get 15% off at https://bit.ly/4hlfso9 Timeline - up to 20% off when you subscribe and save at https://bit.ly/4xkRIFw David Bars - Subscribe and save 10% on every order’ at https://bit.ly/3SGC7Cd 📺Watch the “Dr. Gabrielle Lyon Show” every Tuesday at 9AM EST:YouTube: https://bit.ly/4boCFC3 Spotify: https://bit.ly/4cWTbLG 📱Connect with Dr. Gabrielle Lyon:Instagram: https://bit.ly/4uk9adc TikTok: https://bit.ly/3OFK3kJ X.com: https://bit.ly/4l3YlaX Facebook: https://bit.ly/3MBrJso LinkedIn: https://bit.ly/3N1nrdL Website: https://bit.ly/3NdV2kT Books: https://bit.ly/4r6ugZK Newsletter: https://bit.ly/402QCAj ⏰Timestamps:00:00 - Introduction: what a neuropsychologist measures03:25 - Mild cognitive impairment and proactive interference04:52 - The SAD theory: separation, alienation, discord06:30 - The default mode network and 46.9% mind wandering08:56 - Reframing ADHD as an evolutionary advantage18:21 - Evolutionary mismatch and hunter-gatherer comparisons21:03 - Neuroplasticity, epigenetics, and the 24-hour timeline24:29 - Mind-body dualism and the gut-brain connection31:31 - What fatherhood does to the brain and testosterone36:47 - Choice overload and the four-bit working memory limit39:54 - Temporal discounting and building immediate feedback43:23 - Vital signals and how to identify a core value49:49 - Intuition, somatic markers, and the vmPFC55:00 - The 20-watt brain versus a 10-gigawatt supercomputer01:02:58 - Only 35% of the brain is built at birth01:06:13 - Creativity, nothingness, and the fear of uncertainty01:16:31 - Process, flow states, and the jazz pianist studies01:22:53 - Mirror neurons, group selection, and the rat experiments01:34:20 - Eustress and the line between moderate and major stress01:44:39 - Alloparenting and what the Hadza numbers show‼️Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.This episode includes paid sponsorships.

You might think bone density is something you build slowly over a lifetime, but nearly all of your peak bone mass is set before age 18, in a four-year window most parents never see coming. In this solo episode I break down what happens to a child's skeleton during that window, what GLP-1 medications do inside a body that's still growing, and the protocol I'd want every parent to follow. Muscle and bone are not what a body has they're what a body was built to become.In this solo episode, Dr. Gabrielle Lyon breaks down the science of bone health in children, adolescent GLP-1 use, and muscle building in kids:Why the four years around age 12 in girls and 14 in boys account for close to 40% of the total bone mineral a person will carry for lifeWhy a hip fracture in a healthy 29-year-old is almost always a story about a childhood building phase that never happened, often tied to a history of restriction like anorexiaWhat semaglutide and other GLP-1 medications do inside a still growing skeleton, and why no long term bone density data exists for adolescents on these drugsWhy a JAMA Network Open trial found the group combining liraglutide with resistance training lost the most weight with bone mineral density statistically unchanged, while the drug alone caused bone lossThe complete protocol for parents: track strength and function over the scale, muscle strengthening and bone loading exercise three days a week each, protein at breakfast, and a screen time floor instead of a ceilingMuscle and bone are not what a body has; they are what a body was built to become, and childhood is the only window that bone accrual and muscle development happen. Understanding pediatric bone health, sarcopenia in children, and the real research on GLP-1s and adolescents is the difference between guessing with your child's skeleton and protecting it on purpose.Study and References: Sarcopenic Obesity in Children - https://pubmed.ncbi.nlm.nih.gov/41995008/Sedentary Behaviors in Today's Youth (AHA) - https://www.ahajournals.org/doi/10.1161/CIR.0000000000000591Semaglutide and Body Composition (STEP 1) - https://pmc.ncbi.nlm.nih.gov/articles/PMC8089287/Peak Bone Mass Position Statement (NOF) - https://pubmed.ncbi.nlm.nih.gov/26856587/Bone Health After Exercise vs GLP-1 Treatment - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820308Resistance Training in Kids: An Umbrella Review - https://pubmed.ncbi.nlm.nih.gov/32757164/Thank you to our sponsors:Timeline - up to 20% off when you subscribe and save at https://bit.ly/4x18cm5BodyHealth - Use the code LYON20 to get 20% off your first order https://bit.ly/4wZgg6NBranch Basics - Get 15% off the Premium Starter Kit at https://bit.ly/4i6iOfK with the code DRLYON.Explore More from Dr. Gabrielle LyonPremium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.comWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon’s clinical team https://drgabriellelyon.com/new-patient-inquiry/Connect with Dr. Gabrielle Lyon:Instagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyonX (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyonChapters00:00 - Introduction00:44 - The 29-Year-Old Who Fractured Her Hip01:20 - Muscle and Bone Are Childhood Assets03:01 - The Question I Keep Getting From Patients03:39 - The 30-Year Lifting Debate Is Over04:23 - Sarcopenic Obesity: More Muscle, Less Strength07:01 - What a Mouse Model Reveals About Muscle Potential08:24 - Screens: What the Data Shows10:00 - Food, Sleep, and the Screen-Weight Loop12:38 - GLP-1s in Teens: The STEP TEENS Trial13:52 - The Muscle Framing Mistake Everyone Makes16:49 - The Four-Year Window Bone Gets Built18:02 - The Trial That Proves Exercise Protects Bone20:29 - Prescribing Into an Unstudied Window20:46 - Why Lifting Doesn't Stunt Growth21:49 - Kids Get Stronger Without Building Muscle22:29 - The Protocol: What to Do Starting TodayIf you found this episode valuable, share it with someone who would benefit from it.Disclaimers: This episode includes paid sponsorships.The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

You have probably been told that testosterone is a male hormone. Women produce more of it than estrogen, and for many of us it is the first hormone to go, sometimes reading zero five years before menopause while periods are still regular. Dr. Susan Hardwick-Smith and I get into what that costs you in muscle and bone, why there are thirty-one approved testosterone products for men and none for women, and what the number on your own lab report is measuring.Want ad-free episodes? Subscribe to Forever Strong Insider: https://bit.ly/4u5VSReCreate Her: Aging into the Healthiest Version of Yourself by Susan Hardwick-Smith MD https://www.amazon.com/Create-Her-Healthiest-Version-Yourself/dp/1637636644/ref=sr_1_3?s=books&sr=1-3 Dr. Gabrielle Lyon with Amy Pearlman Podcasthttps://bit.ly/3TcVgvBConnect with Dr. Susan Hardwick-SmithWebsite: drsusan.comYouTube: https://www.youtube.com/@drsusanInstagram: https://www.instagram.com/drsusanofficialTikTok: https://www.tiktok.com/@drsusanofficialFacebook: https://www.facebook.com/drsusanofficial/LinkedIn: https://www.linkedin.com/in/drsusanhardwicksmith/Thank you to our sponsors:Timeline - up to 20% off when you subscribe and save at https://bit.ly/4x18cm5BodyHealth - Use the code LYON20 to get 20% off your first order https://bit.ly/4wZgg6NBranch Basics - Get 15% off the Premium Starter Kit at https://bit.ly/4i6iOfK with the code DRLYON.Explore More from Dr. Gabrielle LyonPremium Podcast Subscription: Ad-free episodes, key takeaway summaries, exclusive Q&A, and behind-the-scenes content https://foreverstrong.supercast.comWeekly newsletter: Recipes, podcast updates, and practical weekly insights https://drgabriellelyon.com/sign-up/Apply to become a patient: Personalized care with Dr. Lyon’s clinical team https://drgabriellelyon.com/new-patient-inquiry/Connect with Dr. Gabrielle Lyon:Instagram: https://www.instagram.com/drgabriellelyon/TikTok: https://www.tiktok.com/@drgabriellelyonX (Twitter): https://x.com/drgabriellelyonFacebook: https://www.facebook.com/doctorgabriellelyonTimestamps:00:00 - Introduction: testosterone in women03:00 - Eighteen years in OB-GYN and the practice she left04:57 - Thirty years in medicine, zero training on testosterone06:40 - 31 FDA-approved products for men, zero for women07:35 - Why women produce more testosterone than estrogen09:20 - What the ovaries stop making at menopause10:18 - Testosterone reading zero five years early11:41 - Low testosterone symptoms in women13:22 - Intrinsa, the 2004 patch the FDA turned down19:04 - Off-label prescribing and what FDA approval means21:35 - Cognition, breast cancer, muscle and bone25:33 - Osteoarthritis and the anti-inflammatory theory26:31 - Dosing fears: hair loss, acne, voice changes28:16 - Why gels are dosed ten times higher32:14 - The 2019 international consensus34:00 - Dividing a 50 mg tube by ten38:18 - The Baylor study: pellet versus gel at six weeks40:13 - Safety data from fifty years of transgender care45:03 - Eight years of high dosing and what it cost46:16 - Lab reference ranges versus optimal ranges48:28 - ELISA versus LC-MS, and what the study found51:07 - Why free testosterone is calculated, not measured57:58 - Tachyphylaxis and chasing the number1:01:39 - Pellets, BioTE and where the reputation came from1:06:33 - Delivery methods, cypionate and enanthate1:11:47 - Whether anything raises testosterone naturally1:13:03 - DHEA at 100 mg and what it moved1:17:07 - Drugs that lower testosterone in women1:20:55 - Closing thoughts on dosing and accessIf you found this episode valuable, share it with someone who would benefit from it.Disclaimers: This episode includes paid sponsorships.The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.