# 155 | Hormonal Triple Whammy | Kyle Gillett, MD

Professional Grade Supplements for WiseAthletes About the guest: Dr. Gillett enjoys providing holistic individualized care to his patients. His practice includes preventative medicine, aesthetics, sports medicine, hormone optimization, obstetrics and infertility, integrative medicine, precision medicine including genomics, and aesthetics. He believes that each human is a unique creation that requires attention to their body, mind, and soul. He uses shared decision-making and an evidence-based approach. He firmly believes “food is medicine” and “exercise is medicine”. Dr. Gillett describes the “7 pillars of health”: exercise, diet, sleep, stress, social, sunlight, and spirit. These are more powerful than any medication or supplement. He enjoys spending time outdoors on the farm with his wife, two sons, daughter, and wolfhound. Kyle's website: kylegillettmd.com/ Gillett Health website: gilletthealth.com/ Kyle's YouTube Channel Kyle's Credentials: Dr. Kyle Gillett is a dual board-certified physician specializing in family medicine and obesity medicine. He earned his medical degree from the University of Kansas School of Medicine and completed his residency at Cox Family Medicine Residency Episode summary: Kyle walks me through the details behind: hair loss, BPH (benign prostate hyperplasia), and low T, what we can do to keep it from happening or stop it, and his perspective on choosing between finasteride and dutasteride....two of the major players in solving the big 3. Key Points: General recommendations for older m once a week 1mg dutasteride is a good preventative program (hair and prostate) with limited side effects (sunflower lethicin ) Low dose tadalafil EOD or daily  TRT if needed and risks (cancer) are low  Hair loss regiment ( 3 layers) anti androgen (dutasteride) growth agonist (minoxidil) micro needling Big 3: hair loss, prostate growth (and cancer), and low T. Related?   People with insulin resistance, higher IGF-1, more pronounced metabolic syndrome (pre-diabetes, type 2 diabetes) are more prone to issues  Metabolic syndrome and sleep apnea are the two leading causes of low total testosterone (but not necessarily causing low free testosterone) Free T and DHT matters more for athletic performance and body composition  Total T matters more for how you feel, and for delivery of androgens to the prostate (growth) Several different types of 5 alpha reductase enzyme; finasteride and dutasteride have different effects on each which is why they can have different effects.  It mostly about the ratio of testosterone plus dht vs estrogen. If the ratio changes you are more likely to have symptoms of high estrogen Free T = calculated with total T and SHBG (tightly binding) and albumin (loosely binding) Free T should be 2-3x lower than estrogen (in normal, not same units). If 4-5 lower estrogen too high.  free t of 15 ng/dl; estrogen pg/mil of 45 (45/15=3) Free T usually...