Low T, Low Life

I grew up on the mat. Wrestling wasn't just a sport—it was a way of life. From the time I was a kid, training was relentless, competition was fierce, and energy was never a question. I became Germany's national champion in freestyle wrestling, and even after my competitive career ended, I didn't stop moving. My body was built for this. It craved it.

For years, I trained like an athlete, worked like an executive, and lived like I had unlimited fuel. Then something changed. By my mid-30s, I felt different. It wasn't dramatic at first—a little more fatigue here, a little less drive there. I wasn't recovering either; my workouts felt heavier, and no matter how much I trained, the edge I once had wasn't there.

At first, I blamed stress, workload, and bad sleep, but the feeling didn't go away. So, I did what I always do when something doesn't make sense: I dug into the data, ran tests, and looked for answers. The culprit? Testosterone.

I still lived in the US back then, and my doctor didn't hesitate. TRT. Testosterone Replacement Therapy. A few weeks in, I felt it. The energy came back. The recovery improved. The drive returned. It worked. But it also made me question everything I thought I knew about testosterone, aging, and what's really happening in men's bodies today.

Here's the thing, though: testosterone isn't just a male issue. Women need it, too—for muscle strength, cognitive function, bone density, and libido. And while men experience a slow decline over decades, women face a dramatic drop around menopause. Yet, testosterone in women is rarely discussed, rarely tested, and rarely treated.

So let's talk about it. What actually happens to testosterone as you age? Is TRT a solution—or just a Band-Aid? And is there a way to keep testosterone levels optimized naturally?

The Silent Decline: Why Testosterone is Dropping Faster Than Ever

Testosterone peaks in your early 20s. After 30, it starts dropping by about 1% per year. That part is normal. What isn't normal is how fast levels are declining in modern men.

In the last few decades, studies have shown that average testosterone levels have dropped by up to 20-25% compared to previous generations. Men today aren't just experiencing the usual age-related decline—they're seeing T levels crash much earlier and much harder.

The reasons? More body fat, less physical activity, chronic stress, bad sleep, environmental toxins. All of it adds up. By the time most men start feeling the effects—fatigue, brain fog, loss of drive, sluggish recovery—it's already been declining for years.

And here's the kicker: Most doctors won't even check for it.

The Symptoms Doctors Ignore: How Low T Feels in Real Life

Low testosterone doesn't announce itself overnight. It's subtle at first, and because it's gradual, most men just assume they're "getting older." That's the mistake.

It starts with lower energy, reduced motivation, and feeling slightly off. Workouts don't hit the same. Recovery slows down. Sex drive drops, body composition shifts, and mental sharpness takes a hit. You could brush it off. You could adjust. But over time, it compounds.

The worst part? Doctors often dismiss it. They'll tell you you're fine because your total testosterone is "within range." But range doesn't mean optimal and certainly doesn't mean you feel great. If your energy, drive, and body change, your T levels should be investigated properly.

TRT: A Miracle or a Trap?

Testosterone Replacement Therapy works. There's no denying that. For men with clinically low T, it can be life-changing. The problem? Too many men jump on it without fully understanding the long-term consequences.

Here's what TRT actually does:

• It shuts down your body's own production of testosterone. Once you're on, your testicles stop making T on their own.
• Fertility takes a hit. If you want kids, TRT can reduce sperm production—sometimes permanently.
• It's often for life. Coming off TRT isn't as simple as stopping—it requires a full post-cycle protocol to restore natural function.

And then there are the risks that still aren't fully understood. Some studies suggest TRT increases cardiovascular risks, while others argue it improves heart health. The prostate cancer link? Likely a myth, but it's still debated.

For some men, TRT is the correct answer. But if you start it too soon, without fixing the lifestyle factors killing your T in the first place, you're treating the symptom—not the root cause.

The Testosterone Industry: Why Most "T Boosters" Are BS

The second testosterone drops into the conversation, and the supplement industry kicks into overdrive.

99% of the over-the-counter "T boosters" are garbage. D-Aspartic Acid, Tribulus Terrestris, and Maca Root sound good in theory, but they don't move the needle in practice.

What actually works?

• Zinc, Vitamin D, Magnesium—key micronutrients for testosterone production.
• Tongkat Ali, Fadogia Agrestis—some research suggests mild T-boosting effects, but long-term data is lacking.
• DHEA, Ashwagandha—potential benefits, but not game-changers.

If you want actual results, stop looking for a magic pill.

Testosterone Isn't Just a Man's Problem—Women Need It Too

Testosterone gets labeled as the "male hormone," but it's just as crucial for women.

In men, T drops gradually over decades. In women? It plummets around menopause. This rapid decline can lead to fatigue, brain fog, lower libido, weight gain, and mood swings.

The problem? Doctors rarely check testosterone in women. Even when symptoms scream hormonal imbalance, it's rarely tested or treated.

And here's where it gets tricky: There's no FDA-approved testosterone therapy for women. Women who need it are left navigating an unregulated world of off-label prescriptions and compounding pharmacies.

Testosterone isn't just about sex drive and muscle. It's about cognitive function, metabolism, and long-term vitality—for men and women.

The Testosterone Playbook: What to Actually Do

If your testosterone crashes, so does your performance, energy, and long-term health.

Here's how to fix it:

1. Get Tested Properly → Free testosterone, not just total T. Multiple tests, early morning, on different days.
2. Fix Lifestyle First → Strength training, a high-protein diet, quality sleep, and stress control matter more than supplements.
3. Optimize Key Nutrients → Zinc, Vitamin D, and magnesium are non-negotiable.
4. Consider TRT—But Only If Necessary → If everything else fails, TRT can be life-changing. But don't use it as a shortcut.

Back to My Story: What I Learned After TRT

After my TRT experience, my natural instinct kicked in. This wasn't a long-term solution, so I had to figure out a better way.

So, I started digging deeper—researching, testing, and optimizing every factor that influences testosterone naturally. And today? I'm not on TRT anymore. Instead, I follow the same plan I just outlined.

Because testosterone isn't just about pills, injections, or lab numbers. It's about how you feel, how you perform, and how you show up in life.

Stay healthy.

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A note for new readers:

I’m a trained reconstructive facial surgeon, medical doctor, and dentist by training. Before launching my newsletter, I had a varied career: I was a competitive freestyle wrestler, a management consultant (McKinsey), an entrepreneur (Zocdoc, Thermondo, and docdre ventures), and a corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.

If this is your first time here, welcome. I’m excited to share what I’ve learned—and will continue to learn—with you.

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DISCLAIMER:

Let’s get one thing straight: None of this—whether text, graphics, images, or anything else—is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.

Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.

If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in Health, Redefined. Be smart. Do your research. And, as always, take care of yourself.