In this episode, Dr. Ravi Gupta breaks down what every man needs to know about testosterone — why levels decline, which symptoms actually matter, and how to rebuild your hormonal foundation the right way. From lifestyle fixes to lab testing, boosters, TRT, and peptides, this is a practical, evidence-based guide to feeling stronger, sharper, and more resilient.

• Start with lifestyle. Nutrition, sleep, stress management, and resistance training are the non-negotiable foundation before any medical intervention.

• Labs guide everything. FSH/LH levels help pinpoint the cause of low testosterone and determine whether boosters or TRT are appropriate.

• Boosters vs. TRT. Enclomiphene supports natural testosterone production and preserves fertility. TRT is powerful but suppresses endogenous production and carries fertility risks.

• Peptides as advanced tools. Options like BPC-157 and GH secretagogues support repair, recovery, and performance when used strategically.

1. The Problem: Testosterone Decline & Symptoms

• Testosterone naturally drops beginning in the 30s; muscle mass declines ~1% per year after 40.

• Common symptoms: fatigue, brain fog, low libido, poor strength gains.

• Clinical low is <300 ng/dL, but most men feel optimal between 600–1000 ng/dL.

• Free Testosterone matters most — high SHBG can bind up circulating T and require higher total T.

2. The Foundation: Lifestyle & Supplements

Before labs or prescriptions, dial in:

• Whole-food nutrition + high protein

• Resistance training ≥3x/week

• 7–9 hours of quality sleep

• Stress reduction
  Foundational supplements include zinc, vitamin D, magnesium, and omega-3s. Most men benefit from a 1–2 month lifestyle-first approach.

3. Medical Options: Boosters vs. Testosterone Replacement

Labs to order: Total T, Free T, SHBG, FSH, LH, Estradiol (test before 10 AM).

Enclomiphene (Booster):

• Increases natural FSH/LH → boosts endogenous testosterone.

• Best for secondary hypogonadism (low T + low FSH/LH).

• Pros: preserves fertility, reversible, mild side effects.

Testosterone Replacement Therapy (TRT):

• Direct hormone replacement; suppresses natural production.

• Best for primary hypogonadism (low T + high FSH/LH).

• Pros: very effective for severe deficiency.

• Cons: infertility risk, potential long-term suppression, requires careful physiologic dosing.

• Monitoring labs: Total/Free T, Estradiol, H&H.

• Does not increase prostate cancer risk.

4. Advanced Tools: Peptides

Peptides assist with targeted physiologic functions:

• BPC-157: tissue repair, gut healing

• Sermorelin / GH Secretagogues: sleep, recovery, natural GH release

• KPV: anti-inflammatory support
  Typical cycle: 8–12 weeks on, 4 weeks off. Use only high-quality, third-party tested sources (≥98% purity).

Menopause isn’t a sign that you’re broken—it’s a natural transition, just like adolescence. In this episode of the Peak Health Podcast, Dr. Ravi Gupta is joined by Dr. Harpreet Gujral, integrative nurse practitioner and women’s health expert, to demystify perimenopause and menopause.

From hot flashes and brain fog to mood swings and libido changes, we cover the top 10 questions women have about this life stage. Learn how hormones, lifestyle, and evidence-based treatments like hormone replacement therapy (HRT) and natural alternatives can help you thrive—physically, mentally, and emotionally.

Whether you’re noticing subtle symptoms or looking for strategies to support your long-term health, this episode provides clarity, empowerment, and actionable guidance.

🔹 Who Should Listen:

• Women experiencing perimenopause or menopause symptoms

• Women considering hormone replacement therapy or natural alternatives

• Professionals balancing career, family, and self-care during midlife

• Anyone interested in understanding the science behind menopause and actionable ways to thrive

Suggested Timestamps:

• 00:00 – Introduction & why menopause matters

• 02:30 – Perimenopause vs. menopause explained

• 06:15 – Common symptoms and what to look for

• 12:00 – Long-term health risks of unmanaged menopause

• 18:30 – Lifestyle interventions & natural remedies (maca, flax seeds, black cohosh)

• 24:45 – Hormone replacement therapy: benefits, dosing, and safety

• 33:00 – Managing mood, sleep, libido, and cognitive changes

• 38:30 – Debunking WHI study misconceptions

• 42:15 – Personal empowerment and embracing this life transition

• 46:00 – Closing thoughts & encouragement for women

To ensure accuracy and support informed decision-making, we’d like to clarify two brief moments from the conversation:

• At 25:25 – 25:27, Hormone Replacement Therapy (HRT) was referred to as “the gold standard.” This was said in a general context, but it does not apply to women with a history of certain cancers.

• At 44:45 – 45:55, there is a reference that may imply HRT can be continued indefinitely.
  To clarify: According to the North American Menopause Society (NAMS), most women use HRT for 5–8 years, with longer use considered only on an individual basis in collaboration with a healthcare provider.

  NAMS guidance states:

  “There is no single ‘right’ time to stop hormone therapy. Women may choose lower doses or switch to non-pill forms. Decisions about duration should be made together with a healthcare professional. Longer-term use may be appropriate in cases of persistent symptoms such as hot flashes or night sweats, osteoporosis prevention, or improved quality of life. Because risks may increase with age and longer duration, ongoing reassessment with your clinician is essential.”

Disclaimer: This content is for educational purposes only and is not medical advice. Always consult your healthcare provider before making treatment decisions.