Dr. Larry Lipshultz - Urologist and Testosterone Therapy Expert in Houston

[madman]

My guest today is one of the country’s most respected medical experts on TRT, otherwise known as testosterone replacement therapy.

He’s an authority in using testosterone to help males improve muscle tone and strength, and enjoy more energy and improved health.

Dr. Larry Lipshultz is a Professor of Urology and Chief of the Scott Department of Urology at Baylor College of Medicine.

Recognized as a leading expert on men’s health, Dr. Lipshultz is a highly respected author, editor, teacher, and lecturer.

Dr. Lipshultz instituted a fellowship training program in male reproductive medicine and surgery that has trained more than 110 physicians who are now in practice.

Dr. Lipshultz, who holds the Smith Chair in Reproductive Medicine; received his medical training at the University of Pennsylvania; and received fellowship training at The University of Texas at Houston as the first American Urological Association (AUA) research scholar.

So today we hope to give you guys all the answers on TRT TTh, from one of the country’s leading experts on the subject. Dr. Larry Lipshultz, welcome to the show




14:18-16:12

testicular shrinkage

*so we give them something called hCG (human chorionic gonadotropin) they do a shot and injection subcutaneously once a week and we can prevent loss of testicular size


fertility

*We give them high doses of hCG and high doses of something called FSH and they can mix them together, give themselves injections three times a week, and we can literally get them back to where they were

*the other thing we're looking at now though is can these individuals also take low-dose testosterone at the same time so they don't suffer from having the recurrence of the symptoms that made them take testosterone to begin with and I don't know the answer to that yet, it looks very encouraging that once we get sperm production going with hCG and FSH, we can introduce testosterone to some degree, but I don't have the data yet 100%




24:28-24:59

advice for men thinking about testosterone therapy

*well again you know it's baby steps it's you know take if your going to a doctor and he's going to offer testosterone for some type of complaint and they have low testosterone don't jump in with very high levels of testosterone therapy I mean go start low because you may get a lot of benefit at a very low level


This needs to be hammered home on all those forums!

We keep it real here.

--------------------------

Introduction to Dr. Larry Lipschultz and TRT Misconceptions
Host (Lee Labrada): My guest today is one of the country's most successful experts on TRT, Dr. Larry Lipschultz. Welcome to the show. There seems to be a lot of misconceptions about TRT.
Dr. Lipschultz: I'm glad you asked that. Actually, I don’t like the name “TRT.” We’re not really replacing testosterone; we’re supplementing it.

Addressing the Stigma Around TRT
Host: For the longest time, there’s been a stigma. Some people think TRT is just for men with erectile dysfunction.
Dr. Lipschultz: That’s absolutely not the case. There are many misconceptions around testosterone therapy.

Dr. Lipschultz’s Background and Contributions
Host: Dr. Lipschultz is Professor of Urology at Baylor College of Medicine and has trained over 110 physicians. He’s recognized as a leading expert in men’s health.
Dr. Lipschultz: I was inspired to enter urology by a role model during my time at Penn. I just wanted to follow his path.

Understanding Testosterone Therapy vs. Replacement
Dr. Lipschultz: We’re not "replacing" testosterone. Unlike women with estrogen, men don’t stop producing testosterone. I prefer the term "testosterone therapy."

Clarifying Who Needs TRT
Host: So who is a candidate for testosterone therapy?
Dr. Lipschultz: FDA guidelines indicate it’s for those with low testosterone. But this definition is often too rigid, as optimal testosterone levels vary by age.

Challenges with Insurance and Low Testosterone Coverage
Dr. Lipschultz: To get insurance coverage for testosterone, patients need levels under 300 nanograms per deciliter, which isn’t always fair, especially for younger men.

The Medical Community’s Hesitance Around TRT
Host: Why has the medical community been slow to accept testosterone therapy?
Dr. Lipschultz: Misleading studies have linked testosterone to cardiovascular risks. However, upon further research, we’ve found no clear connection.

Testosterone Therapy and Heart Health
Host: Does testosterone therapy increase cardiovascular risk?
Dr. Lipschultz: No, it doesn't. We conducted a study showing that men with higher testosterone had fewer cardiovascular markers.

Addressing Cancer Concerns with Testosterone Therapy
Host: Can testosterone cause cancer?
Dr. Lipschultz: Testosterone doesn’t increase cancer risk. The prostate can only absorb so much testosterone. Beyond a certain level, there’s no growth response or cancer risk.

Testosterone and Hair Loss
Host: Does testosterone cause hair loss?
Dr. Lipschultz: It can, as testosterone converts to dihydrotestosterone (DHT), which influences hair loss. But medications like finasteride can help manage this.

Benefits of Testosterone Therapy
Host: What are the benefits of testosterone therapy?
Dr. Lipschultz: It helps with energy, muscle mass, weight management, and mood for those with low testosterone levels.

The Role of Estrogen in Obesity and Testosterone Therapy
Host: Obesity can increase estrogen levels in men, right?
Dr. Lipschultz: Yes, body fat converts testosterone to estrogen. Managing weight can help reduce estrogen levels.

Age and Testosterone Therapy Considerations
Host: Does testosterone therapy slow down aging or reduce disease risk?
Dr. Lipschultz: For men with low testosterone, it can have positive effects. But it’s controversial for those whose testosterone is not classically low.

Testicular Shrinkage and Fertility with TRT
Host: Can TRT cause testicular shrinkage?
Dr. Lipschultz: Yes, if the body stops producing testosterone naturally. HCG can help maintain testicular size and function.

TRT and Fertility in Younger Men
Host: Can TRT affect fertility?
Dr. Lipschultz: With proper management, we can restore fertility. It’s beneficial to get a semen analysis as a baseline.

Anabolic Steroids vs. Testosterone Therapy
Host: Is testosterone therapy the same as anabolic steroids?
Dr. Lipschultz: Testosterone itself is anabolic. However, certain steroids are more potent and have different effects on the body.

Concerns for Athletes and High-Dose Testosterone
Host: What should athletes taking high doses of testosterone watch for?
Dr. Lipschultz: Regular monitoring is crucial, particularly of blood markers and lipid profiles, as high doses can impact health.

Testosterone Therapy and HDL Levels
Host: Does testosterone affect cholesterol?
Dr. Lipschultz: It can lower HDL (good cholesterol), but the effect is less severe with standard testosterone than with more potent anabolic steroids.

Cardiovascular Health in Athletes Using Steroids
Host: Are there cardiovascular risks for athletes on anabolic steroids?
Dr. Lipschultz: It’s hard to isolate testosterone, as many use other hormones like growth hormone, insulin, and thyroid hormones, which add complexity to cardiovascular risks.

Considerations for Men Considering Testosterone Therapy
Host: Any advice for men considering testosterone therapy?
Dr. Lipschultz: Start with a low dose and ensure you’re under a doctor’s care. Seek a doctor knowledgeable in this field.

Risks of Low-T Clinics and Non-Physician Managed Facilities
Host: What do you think of "Low T" centers?
Dr. Lipschultz: Some are well-run, but many are not managed by physicians. It’s best to see a specialist for proper management.

Psychological Benefits of Testosterone Therapy
Host: Does TRT affect mood or mental health?
Dr. Lipschultz: Many patients experience life-changing improvements in energy and mood, though the response is highly individual.

Conclusion and How to Get Started with Testosterone Therapy
Host: What’s the first step for those interested in TRT?
Dr. Lipschultz: Get tested, and if levels are low, consult with a specialist in your area. There are trained physicians in many cities across the U.S.

Parting Advice for Men Exploring TRT
Host: Thank you, Dr. Lipschultz, for an informative discussion on TRT. This has been eye-opening.
Dr. Lipschultz: Thank you, Lee. I hope this helps clear up some misconceptions about testosterone therapy.

Show Closing
Host: Thank you, everyone, for tuning into The Lee Labrada Show. Please like, share, and subscribe. God bless, and we’ll see you next time!

 

[madman]

Continuous Testosterone Therapy with Recombinant FSH & HCG Improves Semen Parameters

Continuous Testosterone Therapy with Recombinant FSH & HCG Improves Semen Parameters: A Pilot Study (2022) THakky, HShirazi, MChristensen, APastuszak Introduction Male hypogonadism is characterized by inadequate production of Testosterone (T) and a deficiency in spermatogenesis. The main...

www.excelmale.com

Fertility maintenance or restoration in men before, during, and after TRT or AAS

Fertility Preservation in Hypogonadal Men (2018) Robert J. Carrasquillo and Ranjith Ramasamy Introduction Testicular failure is defined as the impairment or loss of both the endocrine functions of the testis (production of testosterone, or T) and exocrine function (production of...

www.excelmale.com

 

[Deleted member 43589]

Glad to see Lee Labrada doing this interview with Dr. Lipshultz.

 

[DS3]

View attachment 29889

My guest today is one of the country’s most respected medical experts on TRT, otherwise known as testosterone replacement therapy.

He’s an authority in using testosterone to help males improve muscle tone and strength, and enjoy more energy and improved health.

Dr. Larry Lipshultz is a Professor of Urology and Chief of the Scott Department of Urology at Baylor College of Medicine.

Recognized as a leading expert on men’s health, Dr. Lipshultz is a highly respected author, editor, teacher, and lecturer.

Dr. Lipshultz instituted a fellowship training program in male reproductive medicine and surgery that has trained more than 110 physicians who are now in practice.

Dr. Lipshultz, who holds the Smith Chair in Reproductive Medicine; received his medical training at the University of Pennsylvania; and received fellowship training at The University of Texas at Houston as the first American Urological Association (AUA) research scholar.

So today we hope to give you guys all the answers on TRT TTh, from one of the country’s leading experts on the subject. Dr. Larry Lipshultz, welcome to the show




14:18-16:12

testicular shrinkage

*so we give them something called hCG (human chorionic gonadotropin) they do a shot and injection subcutaneously once a week and we can prevent loss of testicular size


fertility

*We give them high doses of hCG and high doses of something called FSH and they can mix them together, give themselves injections three times a week, and we can literally get them back to where they were

*the other thing we're looking at now though is can these individuals also take low-dose testosterone at the same time so they don't suffer from having the recurrence of the symptoms that made them take testosterone to begin with and I don't know the answer to that yet, it looks very encouraging that once we get sperm production going with hCG and FSH, we can introduce testosterone to some degree, but I don't have the data yet 100%




24:28-24:59

advice for men thinking about testosterone therapy

*well again you know it's baby steps it's you know take if your going to a doctor and he's going to offer testosterone for some type of complaint and they have low testosterone don't jump in with very high levels of testosterone therapy I mean go start low because you may get a lot of benefit at a very low level


This needs to be hammered home on all those forums!

We keep it real here.

No disrespect to Dr. Lipshultz, but he is widely known as catering to high dose anabolic/androgenic seeking men. 200 mg per week of testosterone is a normal dosage in his clinic. I was a patient of Dr. Lipshultz from 2014 to 2020. Many of the men that I knew at local gyms in Houston were patients of his as well.

He regularly deals with bodybuilders and prescribes bodybuilding dosages for contest preparation. In my last show that I prepped for in 2018, I had him write me a script for 450 mg Test Prop per week and 50 mg of Anavar daily.

An old workout partner of mine - 25 years old at the time - had a prescription for 350 mg test Cyp and 200 mg nandrolone per week from Dr. Lipshultz purely for muscle growth (I.e. he wasn’t a bodybuilder and just wanted to gain muscle). This was not a short-term dose regimen either. He ran this for 2 years.

His is a knowledgeable doctor, but low and slow is certainly not his approach.

 

[madman]

No disrespect to Dr. Lipshultz, but he is widely known as catering to high dose anabolic/androgenic seeking men. 200 mg per week of testosterone is a normal dosage in his clinic. I was a patient of Dr. Lipshultz from 2014 to 2020. Many of the men that I knew at local gyms in Houston were patients of his as well.

He regularly deals with bodybuilders and prescribes bodybuilding dosages for contest preparation. In my last show that I prepped for in 2018, I had him write me a script for 450 mg Test Prop per week and 50 mg of Anavar daily.

An old workout partner of mine - 25 years old at the time - had a prescription for 350 mg test Cyp and 200 mg nandrolone per week from Dr. Lipshultz purely for muscle growth (I.e. he wasn’t a bodybuilder and just wanted to gain muscle). This was not a short-term dose regimen either. He ran this for 2 years.

His is a knowledgeable doctor, but low and slow is certainly not his approach.

Most definitely!

He is known for being generous when it comes to dishing out those high-end dosed T protocols let alone other AAS.

Even then there are many men he treats that never jump on the high-end dose from the get-go let alone dabble with other AAS.

He has a large clientele and has treated 1000s of men (young and old) over the years many of which are prescribed much lower doses.

Unfortunately, he and Dr. Rand are gung-ho when it comes to dishing out those cookie-cutter protocols you know that 200 mg T/week with an AI thrown in to boot.

 

[Nelson Vergel]

Good to see it out now. He had told me over dinner about this interview. He enjoyed Lee.

 

[Deleted member 43589]

No disrespect to Dr. Lipshultz, but he is widely known as catering to high dose anabolic/androgenic seeking men. 200 mg per week of testosterone is a normal dosage in his clinic. I was a patient of Dr. Lipshultz from 2014 to 2020. Many of the men that I knew at local gyms in Houston were patients of his as well.

He regularly deals with bodybuilders and prescribes bodybuilding dosages for contest preparation. In my last show that I prepped for in 2018, I had him write me a script for 450 mg Test Prop per week and 50 mg of Anavar daily.

An old workout partner of mine - 25 years old at the time - had a prescription for 350 mg test Cyp and 200 mg nandrolone per week from Dr. Lipshultz purely for muscle growth (I.e. he wasn’t a bodybuilder and just wanted to gain muscle). This was not a short-term dose regimen either. He ran this for 2 years.

His is a knowledgeable doctor, but low and slow is certainly not his approach.

I have no idea about what Lipshultz does since I have never been patient. But IMHO, I am glad that there is a doctor who is helping athletes do what they do safely. Most all athletes for decades have hidden what they do and would never discuss this with a doctor. Its much better that they are being medically supervised and by an expert in the field As I said before, when I started competing in 1980, doctors supplied steroids up until 1989, most knew very little about anabolic steroids other than how to write a script. Unfortunately back then we didn't do a lot of blood testing but at least we at least got prescription meds and were being kind of monitored by a medical professional. For the next 25 years we were on our own. We went from buying stuff from Walgreens, to buying stuff from from a steroid dealer from Mexico, to Russia, Europe, and then China, never knowing exactly what we were using and not knowing whether or not we were healthy doing it. It's just been the past few years that athletes have been able to get orders for blood tests on line to self monitor. While I am not a patient of Dr. Lipshultz I do appreciate the fact that he is open to help those who are going to do larger doses with or without his assistance. He most likely has an influence over these guys that may stop this more is better idea some have developed and keep guys from doing 2g of test a week combined with tren and other steroids. I have never had a problem with guys doing steroids just to gain muscle, no matter what their Testosterone levels are. Asthetic medical purposes, heck take a look at the plastic surgery industry and this is legal. Lipid injections in the butt? Botox. After 27 years of competition, I wish I had been able to have access to a guy like Dr. Lipshultz.

I had a very good doctor who went private after the invention of Obama care who knew I was doing steroids. While he never offered to write a script he did offer to at least help me stay healthy while competing. He told me you keep doing what you are doing and I will make sure you stay healthy. I went through a few to find him and walked out of appointments many times when the fingers started wagging.

@DS3, no doubt we have run into each other here in Houston. I have been here a while and kind of well known and trained at most every gym here. Put on quite a few powerlifting meets here in the area for over 10 years and my wife is a retired IFBB pro BB'er.

 

[Fernando Almaguer]

I'm in Houston too. Dr. Lipshilyz I'd good. I switched to seeing nurse Amy

 

[DS3]

I have no idea about what Lipshultz does since I have never been patient. But IMHO, I am glad that there is a doctor who is helping athletes do what they do safely.

I don’t disagree with this at all. If guys are going to do this, having a doctor who will help then achieve their goals in as responsible of a manner as they can is an incredible resource from a health and safety standpoint. It is nice to be able to talk to a doctor like Dr. Lipshultz and share previous experiences with AAS and have him listen without judgment. In fact, he listens more with interest more than anything. It’s also nice to know that if I ever aspire to compete again, I know he will support that endeavor.

 

[JimGainz]

Thank God for progressive doctors like this. When I was having low T symptoms in my mid 40’s I could‘t even get a doctor to test my levels. “Welcome to middle age“ they said, “ you don’t need Testosterone“. Finally, I found a good Urologist who recognized my levels were crap.
I found it interesting in the video that in all the young men he sent to a cardiologist as a pre screening they found no issues of cardiac problems with guys taking steroids. He attributed the body builders dropping dead in their 40s and 50s to all the combination of stuff they take and the massive weight gain.

 

[Deleted member 43589]

@JimGainz, this all goes back to so many doctors that treat numbers and refuse to treat symptoms. If you have all the symptoms of low T and you serum T level is 500, then you need to be treated.

There was a study done in Australia of guys who were bodybuilders and died suddenly. Most all of the deaths were caused with guys doing steroids and recreational drugs.

Darke S, Torok M, Duflou J. Sudden or unnatural deaths involving anabolic-androgenic steroids. J Forensic Sci. 2014 Jul;59(4):1025-8. doi: 10.1111/1556-4029.12424. Epub 2014 Feb 19.

Abstract
Anabolic-androgenic steroids (AASs) are frequently misused. To determine causes of death, characteristics, toxicology, and pathology of AAS positive cases, all cases (n = 24) presenting to the New South Wales Department of Forensic Medicine (1995-2012) were retrieved. All were male, and the mean age was 31.7 years. Deaths were mainly due to accidental drug toxicity (62.5%), then suicide (16.7%) and homicide (12.5%). Abnormal testosterone/epitestosterone ratios were reported in 62.5%, followed by metabolites of nandrolone (58.3%), stanozolol (33.3%), and methandienone (20.8%). In 23 of 24 cases, substances other than steroids were detected, most commonly psychostimulants (66.7%). In nearly half, testicular atrophy was noted, as was testicular fibrosis and arrested spermatogenesis. Left ventricular hypertrophy was noted in 30.4%, and moderate to severe narrowing of the coronary arteries in 26.1%. To summarize, the typical case was a male polydrug user aged in their thirties, with death due to drug toxicity. Extensive cardiovascular disease was particularly notable.

In two-thirds of the cases the post mortem showed that the men had died from accidental drug toxicity. In one of every three cases, the death was the result of a fatal combination of steroids and stimulants such as cocaine [chemical structure on the right], amphetamines or XTC. In thirty percent of the cases it was a combination of steroids and opiates that was the cause of death.





Damaged organs
While doing the post mortems the pathologists noticed damage to the organs in many of the deceased, which was probably the result of substance abuse. Almost half of the steroids users no longer produced sperm for example [Arrested spermatogenesis], had undersized testicles [Testicular atrophy], or had testicles in which healthy tissue had been replaced by connective tissue [Testicular fibrosis].

Interestingly, the pathologists also found crystals [birefringent material] in the lungs of a quarter of all of the deceased. This was probably evidence of material that the deceased had ingested via injections or the oral route.

Conclusion
"In summary, the typical case in this series was a male polydrug user, aged in their early thirties, with drug toxicity the being most common cause of death", the researchers summarize. "Extensive cardiovascular disease was a particularly notable feature."

You would be absolutely schocked at how many top level BB'ers also use psychostimulants, opioids, and benzodiazepines. Sad but true.

https://newsroom.unsw.edu.au/sites/default/files/documents/Paper%20published%20online%2019%20Feb.pdf

 

[bixt]

You would be absolutely schocked at how many top level BB'ers also use psychostimulants, opioids, and benzodiazepines. Sad but true.

Absolutely true, even if taken just from the perspective of sleep. High doses in the grams of any steroids or even tiny amounts of tren decimate sleep. Tons and tons of threads on the BB forums of who's using what just to sleep.

 

[Marcel]

Hi guys!

Now if he owns a trt clinic then there is a bit of conflict of interest and also these interviews help him to self promote. That doesn't take away from him having a lot of knowledge. I keep seeing these experts (which conflict of interest seems to be an issue) can anyone point me to the most unbiased researcher/doctor?

 

[captain]

That would be an Endocrinologist, wouldn't it? Only a self-promoter can prescribe you what you can only get from a self-promoter.

 

[Marcel]

That would be an Endocrinologist, wouldn't it? Only a self-promoter can prescribe you what you can only get from a self-promoter.

How about studies from an unbiased researcher/doctor

 

[bixt]

Hi guys!

Now if he owns a trt clinic then there is a bit of conflict of interest and also these interviews help him to self promote. That doesn't take away from him having a lot of knowledge. I keep seeing these experts (which conflict of interest seems to be an issue) can anyone point me to the most unbiased researcher/doctor?

The best advisor could never be a strictly academic doctor with no medical practice. An experienced doctor will have far better field experiance.

If you needed heart surgery would you choose an academic professor with no actual surgery experience who published 50 papers, or would you choose a specialist with experience in over 5000 such operations and no papers published?

From that perspective alone, it makes most sense to follow doctors who treat a lot of patients. Just let the fact that they are self promoting their business go.

They all have their unique plans. Some like 200mg + 3mg AI per week, some like 100mg a week solo, some like creams which shoot your DHT and free T thru the roof and beyond, etc, etc.

They have observed these cookie cutter plans work for the majority of their patients I am sure. Thus they all come highly recommended by their client base and reach celebrity status. If all these docs were crashing peoples E2 with 3mg AI and making them feel like shit, they wouldn't reach such cult status. They would instead fall into obsolescence. But they haven't, and thats telling.

I recommend you follow them all, make a list of all the protocols and try them all until you find one that works.

The most unbiased doctor, if you found one, may by random chance suggest a protocol which simply doesn't work for you and then you will be too obstinate to change it due to your beliefs.

 

[JRos895]

I find it hard to believe that there is any one that feels good on 200mg and 3mg AI. I think they prescribe that so patients can just dose however they want accordingly.

 

[Fernando Almaguer]

I find it hard to believe that there is any one that feels good on 200mg and 3mg AI. I think they prescribe that so patients can just dose however they want accordingly.

I was wondering this but they don't tell you so you think thats what you are supposed to take. Very harmful

 

[Deleted member 43589]

Hi guys!

Now if he owns a trt clinic then there is a bit of conflict of interest and also these interviews help him to self promote. That doesn't take away from him having a lot of knowledge. I keep seeing these experts (which conflict of interest seems to be an issue) can anyone point me to the most unbiased researcher/doctor?

Dr. Lipshultz works at Baylor College of Medicine. It is not a stand alone TRT clinic that he owns. He is a urologist and works with all aspects of male reproduction including TRT. He is also a researcher and professor of urology at Baylor College of Medicine in the middle of Houston's Medical Center downtown. His background and list of publications is quite impressive. He doesn't need to promote his business. Not a client of his but as I understand it is very hard to even get an appointment he is so booked up.

Larry Lipshultz CV - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Curriculum Vitae Name : Larry I. Lipshultz, M.D. Address : Office: Baylor College of Medicine Scott Department of Urology O’Quinn Medical Tower at St.

www.larrylipshultz.com

Research - Vasectomy Reversal, Infertility, Hypogonadism Treatment, Urologist - Dr. Larry Lipshultz

Research Dr. Lipshultz' Current Urological Projects Overview Dr. Lipshultz' research is outstanding in the field of urology. Throughout his career his team has comprised of over 100 Academic Fellows, 100's of Medical Students, 100's of Residents, and several full time Research Coordinators...

www.larrylipshultz.com

 

[Deleted member 43589]

I find it hard to believe that there is any one that feels good on 200mg and 3mg AI. I think they prescribe that so patients can just dose however they want accordingly.

I spent most of my life on a minimum of 250mg of test enanthate and can honestly say I felt good (normal). Been on anabolic steroids for over 43 years. Never done AIs until the last year and it is very minimal. 2mg of anastrozole/month, when I can remember.

I honestly can say as a long time competitive athlete that I wished I had know Dr. Liphultz when I was competing. Medical supervision is so important to athletes that use AAS. After we were all forced underground by irresponsible actions by our federal government in 1989 we had to learn to do this on our own. Blood work was not even possible. The only supervision we had was bro-science.