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May 9, 2020

Only the Best for Test: Dr. Mistry and Donna Lee Discuss Testosterone Testing and Treatment

Speaker 1: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 

Hello and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here with my cohost, Donna Lee.

Donna Lee: 

Hello everybody! Happy day!

Dr. Mistry: 

Happy day! I am a board certified urologist. This is a men’s health show. For those of you that don’t listen regularly, shame on you.

Donna Lee: 

Oh, boo! We haven’t mentioned the podcast at all this hour.

Dr. Mistry: 

Man, we need to mention the podcast.

Donna Lee: 

It’s free.

Dr. Mistry: 

If you find this interesting or infuriating and you want to get even more mad at the things that we talk about and discuss, or if you want to learn about intimate men’s health issues and less intimate men’s health issues, please subscribe to our podcast. It’s the Armor Men’s Health Hour. You can find it wherever you find your podcasts.

Donna Lee: 

That’s right. And if you’re mad about learning about wellness, you just got some other issues.

Dr. Mistry: 

Well, you know, people learn differently. You know, some people…

Donna Lee: 

And they listen differently.

Dr. Mistry: 

…like to be…some people like to read, some people like to see it on YouTube, some people like to be lectured in an audience.

Donna Lee: 

That’s true.

Dr. Mistry: 

Some people like to discover it like they’re seeking the Holy Grail on their own.

Donna Lee: 

Columbus podcasts?

Dr. Mistry: 

And it’s hard to always kind of match a person’s learning style with what we can provide. When we see you in the office, we like to be a little bit more engaging and try to understand what you’ve learned and try to help direct your own education. You know, I do send a lot of people to the internet, but I try to give them specific jumping off points where they can start doing their own research. I.

Donna Lee: 

You don’t just say, “Go to Google.”

Dr. Mistry: 

Please go to Google, Dr. Google. A urologist is a surgeon. We are trained in the surgical aspects of genitourinary surgery. In the clinic, we deal with a number of topics that don’t involve surgery like hormone replacement, like…

Donna Lee: 

Sex therapy.

Dr. Mistry: 

…like sex therapy, erectile dysfunction. We’ve had a lot of interest over the last several weeks for shockwave therapy.

Donna Lee: 

Oh boy.

Dr. Mistry: 

Although we’re trying to come up with a better name.

Donna Lee: 

Penis pulsing, give me a stick with that: “Penis pulsing therapy.”

Dr. Mistry: 

This uses ultrasound energy to help with erectile dysfunction.

Donna Lee: 

It does not hurt.

Dr. Mistry: 

It does not hurt. It takes about 30 minutes per session, for 6 sessions. That’s $2,000. I’m very up front about pricing because I think that you should know what you’re getting into.

Donna Lee: 

Right, and we have patients, they’re now calling because they’re price checking, because they’re trying to compare apples to apples, but I don’t think they know what apples to apples are because other clinics are calling it something else.

Dr. Mistry: 

That’s right. And so anytime anyone describes a therapy in which they’re using energy waves to help regenerate the corporal bodies or the erectile tissues of your penis…

Donna Lee: 

Right, and saying things like “We’ll fix your ed with no medication guaranteed…” those sorts of words, it’s probably the same discussion.

Dr. Mistry: 

That’s right. And if your doctor says “guaranteed,” I wouldn’t trust that person because there is no guarantee in medicine.

Donna Lee: 

Right? That’s a weird word for.

Dr. Mistry: 

…because there’s very few guarantees in life, actually. If they do other things like hair and nails, but also treat your erectile dysfunction, I might give them a second thought, too. Go to a place that treats the condition, not just provides the service–that’s my overarching mantra. You can put as much money as you want to in the marketing to try to convince people, but then when things don’t work out right, they can’t, you know, they may not be able to do it.

Donna Lee: 

Right. And testosterone therapy is just a great example for your copay, if you have insurance, we’re giving testosterone prescriptions are down to like 30 bucks a month!

Dr. Mistry: 

It’s very inexpensive.

Donna Lee: 

It’s incredible.

Dr. Mistry: 

So there’s no reason to go somewhere and spend thousands of dollars a month thinking that you’re getting something magical.

Donna Lee: 

And we still use amazing compound pharmacies. We’re not using just some generic Joe blow overseas. We have amazing partnerships with compound pharmacies.

Dr. Mistry: 

For sure, and they’re all bio-identical. So don’t be fooled by nomenclature. Really go to a place that will take your condition and your questions and concerns seriously. Vasectomy reversals are another great example. You know, if all that doctor does the vasectomy reversal but doesn’t treat male infertility, it may sound weird, but there are people that do that. They just reconnect the tubes and they don’t necessarily treat men’s fertility. And so that’s what we do. We treat men’s fertility and we do vasectomy reversals as part of that part of that package.

Donna Lee: 

Because it goes hand in hand.

Dr. Mistry: 

Because you gotta know what you’re doing. And what goes hand in hand also are the questions that people provide us.

Donna Lee: 

Hey, nice segue!

Dr. Mistry: 

It really, really pushes this show forward and, and really helps us address those questions that are on your mind.

Donna Lee: 

Right? And we know what you’re thinking and the other listeners are probably thinking the same thing. So we had another question, anonymously, we will answer these every single week. “Dr. Mistry, I just by chance stumbled on the radio show,” –this is a shout out to us–“and I’m finding it very enjoyable as well as informative.”–probably due to me, Dr. Mistry.

Dr. Mistry: 

That’s right.

Donna Lee: 

“I just got my yearly blood work back with great numbers and I believe my first PSA checked.” He goes to see Dr. Stephanie Sypniewski with Brushy Creek Family Care–shout out to Dr. Sypniewski.

Dr. Mistry: 

We love her.

Donna Lee: 

She’s adorable.

Dr. Mistry: 

At Brushy Creek Family Practice up here in the Northern part of Austin and Round Rock…

Donna Lee: 

…and Cedar Park.

Dr. Mistry: 

…is a wonderful partner, wonderful physicians.

Donna Lee: 

They’re all so nice!

Dr. Mistry: 

Excellent, very responsive to patients.

Donna Lee: 

Dr. Goode.

Dr. Mistry: 

Dr. Goode there is excellent, just a great, great group of doctors that we love getting patients from.

Donna Lee: 

Yeah. And they’re a fun group.

Dr. Mistry: 

They are.

Donna Lee: 

We’ve met with them. There are just hysterical. Super amazing folks out there. The rest of his question is, “I’ve thought about getting my testosterone checked. It doesn’t seem like it used to. About to be 51 and work out quite regularly until Covid hit. Thank you.”

Dr. Mistry: 

Well that’s a great question and it gets to a couple aspects of testosterone therapy and testosterone measurement that I think are very common amongst men. It is a natural phenomenon for testosterone levels to kind of decrease or really free testosterone levels to decrease as a man ages.

Donna Lee: 

Can we blame Netflix?

Dr. Mistry: 

We can’t. We can blame our diet, maybe. What you’ll notice as your testosterone levels kind of kind of trail downwards is going to be diminished libido, diminished rigidity of your erections or erectile function. You’re going to notice diminished energy, sometimes sleep patterns, increasing depression and worsening cognitive development and muscle mass loss. So if you’re working out the same but not getting the same gains or finding yourself having longer and longer times to recover, you know, hormonal etiology might be something to consider.

Donna Lee: 

Right?

Dr. Mistry: 

A lot of men are surprised that testosterone is not a standard part of a screening panel for a yearly physical exam.

Donna Lee: 

Why?

Dr. Mistry: 

But it isn’t.

Donna Lee: 

Well it should be.

Dr. Mistry: 

Well…

Donna Lee: 

I mean it is with us, but I guess…

Dr. Mistry: 

I think, and that’s really it. You know, we really focus on the mind, body connection. We want to make sure that you’re hormonally intact for a number of your different conditions. We have found over the years that patients with chronic pain conditions, irritable bowel conditions, things that you wouldn’t necessarily associate with low testosterone, they often get better when you have an appropriately maintained testosterone level.

Donna Lee: 

This is the chicken/egg thing you referenced earlier.

Dr. Mistry: 

That’s right. The problem with just randomly checking testosterone levels, people and men, especially goal-oriented men, get so focused on just having a certain number. If you see on the piece of paper that normal testosterone is between 220 and 750 and your number’s 260…I mean, that’s almost like, that’s almost like getting a D. That doesn’t sound right.

Donna Lee: 

A D for…

Dr. Mistry: 

I didn’t fail that. I didn’t fail that test, but maybe I need to be at a higher level.

Donna Lee: 

…maybe I’m not doing well.

Dr. Mistry: 

On the other side…

Donna Lee: 

But on the same side of that, when a patient’s that sees 800 is he like, “Yeah!” I got an A!

Dr. Mistry: 

Maybe, but maybe his 800 is for some other physiologic reason, and the number, although there’s a “normal” range, it doesn’t necessarily mean that it’s normal for you. You know, we see patients all the time with very, very common textbook symptoms of low testosterone and a low normal testosterone.

Donna Lee: 

Right.

Dr. Mistry: 

And we’ll see patients all the time that’ll come in and say, “Well, I had my testosterone level checked. I’m still feeling real, you know, like I have low testosterone, but my number is technically in the normal range.” Now the only place that that really plays an important role is whether your insurance will pay for the testosterone, but the testosterone is cheap. So it’s not even like, it’s not even like that’s the most expensive part. We often in a very safe, monitored manner, we’ll try it for a few weeks. There’s physiologic effects that are potential side effects of testosterone, but those are things that we will educate you on and manage very effectively. And we have thousands of men that we treat for low testosterone, and not everybody improves. Not everybody’s weight magically disappears. Not everybody’s desire to work out magically appears. I mean this is, it’s not, it’s not a magic medicine. It is just something that’s necessary for some people to feel and function better.

Donna Lee: 

That can help.

Dr. Mistry: 

And so if you are certainly over the age of 50, and you are starting to feel yourself not having the same physical mental, sexual performance that you’ve had and you haven’t had your testosterone level measured, you should get it done. But getting your test done is another easy, small little step. It’s really the appropriate interpretation of those numbers in the context of your symptoms that’s really going to decide whether treatments needed or not. You don’t want either end of the spectrum. You don’t want people that never treat your testosterone because they don’t believe in it, and you don’t want to go to somebody that will always treat with testosterone because they think it’s the magic bullet for everything. You want to go to a provider that’s going to be individualized to your specific condition because you’re an individual. You’re not, you know, you don’t represent the population. You’re a member of the population. You’re a member of the people that made up that normal distribution curve. But your particular symptoms in your particular circumstance and your weight and your physical activity, that needs to be all considered when somebody is considering a testosterone program for you. Managing side effects, giving you the most effective treatment for your particular circumstance–that requires education and and finesse.

Donna Lee: 

That’s right, and one of our partners, our compounding pharmacies, they prescribed or they send out a prescription for testosterone and one of the patients asked me the pricing, I said “$70” and she said, “Really? That’s really less expensive than I thought it’d be for my husband, $70 a month.” I said, “No, that’s for 3 months and free overnight shipping.”

Dr. Mistry: 

That’s right. That’s right. We try to be transparent about pricing. If you have questions about pricing, don’t, don’t hesitate, but you know, ask us on email. We’ll definitely kind of let you know as far as we can how much things are gonna cost you because we want you to know what you’re getting in do when you go to the doctor.

Donna Lee: 

That’s right.

Dr. Mistry: 

So Donna Lee, why don’t you tell people how to get ahold of us?

Donna Lee: 

You can email us your questions, any of the questions to armormenshealth@gmail.com. Our website is also armormenshealth.com, and you can send questions through the website as well. Call us during the week at (512) 238-0762. We promise to get to your questions and I’ll respond to them all. Armormenshealth@gmail.com.

: 

The Armor Men’s Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.

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