Dr. Ty, I am currently on trt and tirzepatide, do you have any recommendations for peptides that can optimize weightloss and help me save muscle.

I’m 45, on TRT and nandrolone. After increasing my TRT dose about a month ago, sensitive estradiol jumped to 181 (from 46) and total estrogen reached 473 (first time testing). I’m one week into a 30 day rosuvastatin trial for reducing LDL (128) and ApoB (108) at 10 mg and have been holding anastrozole so I can isolate the statin’s overall impact. My concern is that starting both could create overlapping fatigue or joint pain and be hard to isolate which is causing what. No current side effects or issues. Wondering if I should start the AI now or is waiting another three weeks reasonable (verify rosuvastatin impact, if any and run blood work)? Thank you.

Have you been put on testosterone… and still feel like something's missing? If that's you, I want you to know why, because I inherit a lot of women from other practitioners, and they almost always have the same thing missing. They came in tired, foggy, no drive, not healing well. Their doctor saw a low testosterone number and did the "obvious" thing: loaded them up on testosterone. Now they've got some facial hair and acne to show for it… and they still don't feel right. Here's what almost nobody told them: in a woman, the foundational androgen isn't testosterone. It's DHEA. Women only need a fraction of the testosterone men do, so DHEA quietly does the heavy lifting for strength, energy, focus, resilience, and your ability to heal and repair. And here's the part that changes everything: almost all of a woman's testosterone is made from DHEA in the first place. Give a woman the right amount of DHEA, and her body can build the testosterone she needs from it, the math is massively in her favor. So why does everyone skip it? Because DHEA is cheap and available over the counter. The compounding pharmacies that train most practitioners can't sell it to you at $300 a month, so it barely gets a mention. I sat in those seminars. I watched it happen. A few things I get into in this video: → Why "estrogen dominance" can happen at a normal estrogen level (it's about balance, not the number) → Why I give most postmenopausal women progesterone and DHEA without even testing → How I optimize DHEA first, then reassess, and the ~20% of women who genuinely need testosterone added → Why the same lab number means completely different things in different bodies The one line that I always come back to: your symptoms and your story come first. Two women with the identical number can need completely different things. Optimize the foundation, and the whole picture changes. 💬 So let me ask you: have you ever been handed a hormone and told "this is the fix," only to feel like it wasn't the whole story? Tell me in the comments, I read and answer every single one.

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?

Most women who come to me for hormones show up with a stack of Dutch tests going back 10 years, and I usually set them aside. Not because the lab is doing anything wrong. Because of what a urine test actually measures. Here's the part almost nobody explains: When you test urine, you're measuring what your body threw away, not what it kept. It's like judging your home's water quality by testing the toilet. There's a real, documented pattern where a woman wastes estrogen in her urine, so her "levels" look totally normal, while she's sitting there with hot flashes, night sweats, brain fog, and every deficiency symptom in the book. The test says she's fine. Her body says otherwise. If you keep on trusting the test over her, and you'll just keep on "confirming" she doesn't need estrogen. That's how people get sent down the wrong path for years. A few things I unpack in this video include: → Why the 24-hour collection is genuinely great for cortisol, and marginal for everything else → The dilution problem that quietly skews your results based on how much water you drank that day → Why saliva testing is, mathematically, the weakest of the three → The reason I can predict a patient's hormone panel ~80% of the time before the labs come back The line that I care about most in medicine: the patient is the most reliable data you have. The labs are there to confirm the story, not replace it. More data isn't better data. I'd take a little bit of reliable information over a mountain of unreliable numbers every time. If your hormones have been "normal" for years but you still don't feel normal, this video is just for you. 💬 Questions? Drop them right here in the comments. I read and answer every single one, that's what this space is for. 📞 Want me to look at your full picture? If you're ready for a one-on-one, tap the Book a 1:1 Call button and let's talk through your symptoms, your history, and what's actually going on.