Episode 176

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Published on:

21st Oct 2025

TRT Risks & Rewards: Your Testosterone Replacement Therapy Questions Answered

In this highly requested AMA, Dr. Gabrielle Lyon addresses the most critical questions surrounding male hormone health. Dr. Lyon tackles the fear, stigma, and misinformation surrounding Testosterone Replacement Therapy (TRT), revealing why a low testosterone level is a major predictor of serious health issues like heart disease, bone fracture, and obesity.

She breaks down the current medical consensus on TRT, the risks of replacement, the truth about dosing, and what every man over 40 needs to know about their hormone health. This is a must-watch to separate the bodybuilding myths from the medical facts.

Chapter Markers

0:00 - Intro: Low Testosterone is a Predictor of Heart Disease

1:12 - The Penile Shrinking Myth: What Caused the Viral Frenzy

2:20 - Testosterone Levels: The Truth About Aging in Men

3:44 - The First Step: What Labs to Ask Your Doctor for

4:22 - Why Men Need to Check Their Estrogen (Estradiol)

6:13 - The Medical Cutoff for Low T and Androgen Sensitivity

7:27 - Low T is Linked to Fatigue, Depression, and Fat Deposition

9:27 - TRT and Cardiovascular Health: Is it Protective or a Risk?

10:36 - Erectile Dysfunction Predicts Heart Attack Within 3-5 Years

12:30 - The Stigma: Why Doctors Don't Check Testosterone

13:00 - TRT vs. Steroids: Defining the Line

14:21 - Infertility and TRT: What You Must Know

15:18 - Safety: What are the Risks of TRT for Men?

16:33 - The Stigma: Why Doctors Don't Treat Low T

17:15 - TRT and Obesity: Treat Concurrently or Wait?

18:10 - Menopause vs. Andropause: Why Men Don't Have to Decline

19:34 - Testosterone Boosters (Ashwagandha, Tongkat Ali)

26:11 - Different Forms of Testosterone Administration

28:09 - Intranasal Testosterone for Less Impact on Fertility

30:38 - Managing Expectations: How Long Until You Feel Better?

33:00 - TRT and Muscle Gain: The Highs and Lows of Dosing

36:47 - The Win-Win: Low Risk, High Reward

39:00 - Blood Flow & Erectile Function: Cialis and Exercise

40:17 - Semen Quality as a Marker for Overall Male Health

41:29 - Parenting and the Cost of Unhealthy Humans

41:45 - How to Raise Testosterone Naturally (The Pillars)

42:29 - Low-Dose Cialis for Cardiovascular Health (Preemptive Strategy)

43:59 - Dr. Lyon's TRT Journey and Early Concerns

46:00 - Outro

Key Takeaways:

  • Low Testosterone is a major health risk. Low T is linked to an increased risk of bone fracture, heart disease, obesity, and diabetes.
  • TRT is often protective. Contrary to the long-standing myth, replacing low testosterone to a healthy range does not increase the risk of cardiac events. It is, in fact, protective against cardiovascular disease.
  • Erectile Dysfunction (ED) is a canary in the coal mine. ED can predict a heart attack within 3 to 5 years.
  • Men can maintain high T levels. Testosterone levels in a healthy 75-year-old can be just as good as in a man in his 20s.
  • The solution is often concurrent. For an obese or overweight man with low T, concurrent treatment with TRT and a lifestyle intervention is often the most responsible approach to provide the motivation needed for weight loss.
  • Low-dose daily Cialis (2.5mg to 5mg) may be a viable preemptive strategy for cardiovascular health due to its blood flow benefits.

This episode is brought to you by:

Find Nick Barringer PhD at: 

Find Dr. Gabrielle Lyon at: 

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.

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About the Podcast

The Dr. Gabrielle Lyon Show
The Dr. Gabrielle Lyon Show promotes a healthy world, and in order to have a healthy world, we must have transparent conversations. This show is dedicated to such conversations as the listener; your education, understanding, strength, and health are the primary focus. The goal of this show is to provide you with a framework for navigating the health and wellness space and, most importantly, being the champion of your own life. Guests include highly trustworthy professionals that bring both the art and science of wellness aspects that are both physical and mental. Dr. Gabrielle Lyon is a Washington University fellowship-trained physician who serves the innovators, mavericks, and leaders in their fields, as well as working closely with the Special Operations Military. She is the founder of the Institute of Muscle-Centric Medicine® and serves patients worldwide.