Hello Dr., After watching your recent videos on more thyroid related topics, I would like to know more about this. Even if we have never been told by doctors that something is wrong with our thyroid, it was my first time learning from your videos that some sort of deficiency or problem with thyroid can be concluded from simply feeling chronically tired. Would you say that similar to testosterone, thyroid hormone has become a issue in recent years compared to the many generations before? I have been categorizing my own chronic tiredness at times, especially from going outside in and social situations, as just being "introverted". I feel fine when going to the gym or exercising on the other hand. Perhaps this is something that most people have and just haven't been told about? I would love to know more about the function of the thyroid, how to self assess if its working properly, whether we need exogenous thyroid hormone based on specific feelings of exhaustion, and if there are any side effects with taking thyroid hormone (negative or positive effects as well). I'm glad that you started making more videos about this as I likely would not have learned about this topic otherwise. Thank you

Hello Dr. Ty, just a repost from before where I wanted to hear your thoughts on this topic. Mainstream advice usually describes LDL as “bad,” HDL as “good,” and saturated fat and dietary cholesterol as unhealthy. At the same time, the mainstream ApoB model argues that greater lifetime exposure to ApoB-containing particles directly causes plaque. I've also heard the warnings against red meat, eggs, and other high cholesterol foods for similar problems. Could you explain how you believe atherosclerosis actually develops? What roles do LDL-C, ApoB, HDL, small dense LDL, oxidized LDL, inflammation, insulin resistance, blood sugar, and endothelial damage each play? Is a high ApoB particle count dangerous by itself, or mainly when combined with glycation, oxidation, and metabolic dysfunction? From a practical perspective, what should people actually watch throughout their lives to prevent atherosclerosis? Which blood markers and lifestyle factors matter most, and which commonly discussed cholesterol markers are misunderstood or given too much importance? I would also like your opinion on the carnivore diet. Do you believe eating only meat and other animal foods is the optimal human diet? Are fatty meat, eggs, saturated fat, and dietary cholesterol generally healthy even when they raise LDL-C or ApoB? Some carnivore advocates argue that plants contain natural pesticides, anti-nutrients, and potentially carcinogenic defense chemicals that may gradually harm humans over many years, even if there are no obvious short-term symptoms, and that humans spent long periods of the Pleistocene eating a heavily animal-based diet and became well adapted to it, whereas agriculture greatly increased our reliance on domesticated grains and carbohydrate-heavy foods in more recent years (of human history). I also remember hearing that 4–5 grams of glucose circulates in the blood at a given time, and that the body can manufacture the glucose it needs without dietary carbohydrates. Is that being interpreted correctly? Does it mean repeated large glucose and insulin spikes from high-carbohydrate foods are harmful, or does that confuse the amount circulating at one moment with the body’s total glucose use?

Hello Dr. Ty, I really like your TRT framework and the way you think about optimization. After watching your videos, I just went to an online TRT clinic recently and am waiting for my first dose to come in, so I’m excited to get started. At the same time, I want to be cautious and make sure I’m thinking about the science and health markers correctly. I had a few questions: 1. For long-term targets around 1500–2000+ ng/dL, what evidence best supports that range as not just subjectively better, but also healthy/safe long term compared with more conventional TRT ranges? I know you aimed for your patients to be around this range, but I often see so many forum posts often from bodybuilding circles where high dosing T leads to many bad side effects - organ enlargement, generally cardiotoxic and leading to heart disease, etc etc. I know it may be propaganda, but honestly I am a bit scared of jumping straight to 450 mg a week and keeping that indefinitely. On that note - would you ever recommend starting at 250 and titrating up until 2500 ng/dL is reached on days before injection? 2. On hematocrit, you’ve said testosterone-induced high Hct is different from polycythemia vera and is not something to worry about. What studies or data best support that position specifically for testosterone-induced erythrocytosis? Is there any Hct level where you personally would reduce dose or intervene? Is it truly truly safe to have very thick blood (extreme case hypothetical). 3. For cardiovascular risk, what markers do you care most about when deciding if someone is safe to proceed or needs to adjust — blood pressure, ApoB/LDL, Lp(a), urine albumin/protein, hematocrit/hemoglobin, estradiol, DHT, PSA, liver enzymes, kidney markers, etc.? Asking very respectfully. Again, I love your frameworks and will start TRT hopefully this week. Thank you so much.

Questions thus far have primarily been related to BHRT, mainly TRT and thyroid. I have expertise in essentially all areas of health and medicine, and welcome questions regarding any topic in this area. Metabolic disorders, autoimmune diseases, current health trends and fads, medical myths, childhood diseases and disorders, whatever. I have a team together now to develop this site and coordinate other social media, so content should be coming more regularly soon. I would like to do live Q&A sessions periodically, maybe every other weekend or a good weekday when it's evening for most people. I would like feedback regarding what days/times work best for people and the time zone to which you are referring. I am in Hawaii, which shares a time zone with almost nowhere else (the Aleutian islands and maybe another random island in the Pacific here and there). We are currently six hours earlier than the east coast of the U.S. and about 12 hours behind Western Europe. My schedule tends to be very flexible, and I don't mind being up unusually late or early depending on what works for the most people.

Hey Dr. Ty, I’d like to get your general thoughts on this topic. A lot of mainstream health advice historically warned heavily against cholesterol-rich foods like eggs and red meat, but from what I understand, the picture is more nuanced now and these are extremely healthy foods (from my understanding). Some foods that were treated as unhealthy seem to be much more context-dependent, and HDL is often described as “good cholesterol,” while LDL is described as “bad cholesterol.” I’m trying to understand what “bad cholesterol” actually means. Is LDL itself inherently dangerous, or is the risk more about things like ApoB, oxidized LDL, particle number, inflammation, insulin resistance, etc. In other words, is the mainstream concern around LDL mostly valid, or is it oversimplified/misleading? I’m also wondering how this applies to TRT. It seems like TRT, especially at higher doses, can sometimes lower HDL and potentially worsen LDL/ApoB or other lipid markers. If that is a real concern, how do you think about monitoring it in someone on TRT? Which markers matter most to you: LDL-C, HDL-C, triglycerides, ApoB, LDL particle number, or something else? And then for something like oxandrolone/Anavar, since it seems to have a stronger reputation for lowering HDL, would that change how closely you monitor lipids or cardiovascular risk? Basically, I’m trying to understand whether cholesterol changes not just from HRT, but in everyday life are a real risk to take seriously, or whether they are often misunderstood the same way a lot of other medical knowledge is (TRT/HRT being an example). Another quick question. Would you say that there is an upper dose of T that you feel like is too much? As you've mentioned, the burden should fall on the prosecution, but what if someone wants to blast doses of 1K+ a week for a few months for bodybuilding, or 2K, etc. Is there a limit that you feel gets too high? And for managing estrogen, I get that we should use anastrozole within the first few weeks to get our markers in good ranges. But once there, does the body adapt and we no longer need the anastrozole, or do we have to take it indefinitely ?