The Armor Men's Health Show

EP 649: Health is Wealth: Invest in Preventative Medicine to Bank "Life Credit" and Boost Returns on Health, Happiness with Victory Medical

• Dr. Sandeep Mistry and Donna Lee

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In this episode, Dr. Mistry and Donna Lee are joined by Urology Specialists' own Dr. Christopher Yang and special guest Dr. Billy Franklin, founder of Victory Medical. Dr. Franklin is a pioneering primary care physician who focuses on both disease prevention and treating the underlying causes of disease. His practice utilizes next-level testing to measure factors that affect longevity, such as blood sugar metabolism, inflammation, and sleep disturbances. Today, Dr. Franklin explains the risks and benefits of hormone therapy and its impact on health span, or the number of years you remain healthy and free from disease. Listen in to learn how adding simply adding testosterone supplements to a balanced diet and targeted exercise can help you live a longer, healthier, happier life! To contact Dr. Franklin, call 512-462-3627 or visit Victory Medical online today!

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Phone: (512) 238-0762

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Speaker 1:

<silence>

Speaker 2:

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 3:

Oh , and welcome to the Armor Men's Health Show. This is Dr. Mystery , your host joined as always by my wonderful co-host Donnel Lee .

Speaker 4:

I'm liking these compliments these days. Thank you.

Speaker 3:

Donnel Lee is very popular. A lot of our listeners get to , uh, call in and talk to her. Uh , if you do that , uh, you can sweeten her up and she'll send you a shirt. It's true. One of our amazing shirts, I really like the Make America Pee again shirts.

Speaker 4:

Yeah, those are really popular. I thought they would not be for some reason. I don't know why, but they are <laugh>. Even some of our staff who I'm sure would not agree with some of those ideas, want the America Make America Pee Again shirt.

Speaker 3:

It's a wonderful logo. Uh, we can't wait to put on our Make America pee again. Um, uh, events , uh, around town , uh, which we hope to have once a quarter, where , uh, it's kind of like a prostate carnival. That's where's , right , where you get to learn more about all the things that we do for urinary health, not just in men, but also in women , uh, when it comes to their incontinence and other kinds of issues. Mm-hmm . <affirmative> . So we're looking forward to putting those events together. Uh , Donna, if people want to become patients of ours at N A U Urology Specialists, how do they do that? That's

Speaker 4:

Right. If you wanna make America pee again, call us at (512) 238-0762 our website, armor men's health.com, where you can see our shining little faces there. We're located in Round Rock, north Austin, south Austin in Dripping Springs, Texas.

Speaker 3:

Uh, a big part of what we do in Men's Health is to testosterone management and hormone management. And I have two wonderful guests with us today, Dr. Christopher Yang, one of our urologic partners at N A U Urology Specialists, and Dr. Billy Franklin, founder of Victory Medical, one of the most progressive and , uh, forward-thinking men that I know , uh, primary care provider and really created an amazing conglomeration of medical , uh, services , uh, here in Austin. Uh, Billy Chris, thank you for joining me today. Glad

Speaker 4:

To be here. Thanks

Speaker 5:

For

Speaker 3:

Having us. So , uh, I thought I would , uh, talk a little bit about the different types of testosterone options , uh, that patients have and , uh, uh, Chris, maybe you could talk to us about like the more traditional ones. And then Billy , I'd love to hear your thoughts on some compounding options and other kinds of things like that. So what , what are the most traditional ways that people are getting testosterone nowadays?

Speaker 5:

Yeah, so the, the easiest ways, the ones that have been out the longest is probably the topical testosterone. Typically that's like a gel or a cream. And then there's patches as well. There are testosterone injections, testosterone ate . That's the one that you can get at your retail pharmacy. And then there are pellets , uh, the one that is covered by insurance, sometimes it's called testopel . And then there are a couple of newer ones on the market, oral testosterone pills. Uh , there's one called Denzo and there's one called Tolando .

Speaker 3:

There's also like a nasal cream is in there. Mm-hmm. <affirmative>

Speaker 4:

Nasal gel. Right.

Speaker 3:

That's kind of an

Speaker 5:

Interesting one. Yeah. That's another type of, it sounds weird to me. Topical. You have to, you have to smear it on the inside of your nostril

Speaker 3:

Twice. A twice a day. Yeah .

Speaker 4:

Doesn't it feel like something smeared on the inside, inside of your nostril at

Speaker 3:

That point? <laugh> , we use it, but the commercials make it look like the guy's, like a cocaine user because he's like sneaking s in the bathroom and like putting into his nose doesn't

Speaker 5:

Sleep for three days.

Speaker 3:

But, but there are some, some different ways that testosterone can be administered. If somebody didn't wanna take testosterone. What are some other ways that we can prove pharmacologically, somebody's testosterone level?

Speaker 5:

Yeah, so we can look at their, their estrogen level and sometimes if too much of their testosterone is being converted over to estrogen, we can block that conversion with , with a pill.

Speaker 3:

Dr. Franklin, you , you've been doing testosterone replacement therapy for a long time. What are some of the considerations that go into deciding what's the right kind of therapy for the person?

Speaker 6:

Well, I think a lot of it is what works for the person. I've always had sort of a predilection to use H C G simultaneous to any other kind of testosterone therapy. 'cause it

Speaker 3:

Keeps , what does H C G do?

Speaker 6:

It basically keeps your own autonomous production active. 'cause what would happen ordinarily and take testosterone is it suppresses the pituitary in a way that it doesn't release hormones to stimulate you to produce more testosterone. But if we give a c g , you continue to produce no matter what the kind of testosterone replacement that you use.

Speaker 3:

And I think that gives some comfort to , um, to patients to know that what they're taking is not necessarily like irrevocably altering their , uh, own own physiology. What is your dosage of H C G that you use?

Speaker 6:

You know, we base it on the response a lot of the times. 'cause it doesn't just keep things going. It also has a summation effect and creates a higher testosterone level . So, you know, we'll use 500 units three times a week or something along those lines. Again, it kind of depends on the , the patient and, and their response. And also it's a cost issue. Some people really can't afford it. Like you said though, if if someone's using the , um, IM injection form of testosterone, they don't use H C G , they're gonna be turned off forever once they start that process.

Speaker 3:

And I think a lot of our younger listeners need to be reminded that that turning off of your autonomous system can negatively impact , uh, your ability to have children. Uh, Dr. Yang, what are some , uh, common complications or risks that testosterone , uh, supplementation can have?

Speaker 5:

Yeah, so one thing that, you know, I'm sure any testosterone provider does is, you know, we wanna make sure we don't overshoot your level. If testosterone gets levels get too high, patients can experience more anger, more, you know, moods changes. And that's something that they might not necessarily notice, but their partners, their , their coworkers might notice. We also keep an eye on their estrogen level, like we talked about earlier. That can make your estrogen level too high and that'll make the testosterone not work as well. We also monitor their blood count. Uh, the hemoglobin hematocrit taking testosterone is one of the oldest ways to, to juice for , uh, performance athletes. And , uh, normal people like me and you , uh, we probably don't need very high levels of oxygen carrying capacity. So, you know, and that increases risk of , um, blood clots among other things. So we do keep an eye on your blood count.

Speaker 3:

So , um, you know, in practice I've noticed that. And , and so if you're a listener out there and you're taking testosterone and then somebody told you to go donate blood because your blood count got too high, that's the risk factor and the complication that we're talking about. And , um, uh, we do a lot of sleep apnea testing in our office because I have found that the majority of those patients that have high blood counts on testosterone actually have underlying sleep apnea. Uh , Dr. Franklin as a primary care provider, what would you say? Like kind of the undiagnosed like amount of sleep apnea that is out there? There's

Speaker 6:

A, he , I'm glad you brought that up. 'cause there really is a huge amount of undiagnosed sleep apnea. And we were talking early about how sleep is a major determinant of longevity as well. So sleep apnea is something that puts you at greater risk for heart disease, stroke and, and early death as well. But it's an underdiagnosed phenomenon along with blood pressure. Blood pressure increases frequently as patients get older. We're talking about the over 70 patient . It , it's probably as frequent as 50% of patients in that age category, but most people don't look for it or test for it. And it's another thing that can cause a lot of risk. Interestingly enough, there is an association of higher blood pressure in older patients with low testosterone levels.

Speaker 3:

Well, I think that , um, uh, you know , uh, we've, we've talked about what the general population thinks about when it comes to risk for , uh, testosterone replacement. Uh, in terms of your own reading of the literature, do you think testosterone replacement increases , uh, cardiovascular risk or risk of prostate cancer?

Speaker 6:

I actually think it reduces cardiovascular risk. Um, and although there's not a lot of random control trials, which just sort of the gold standard that we use here sometimes, unfortunately, 'cause those can take decades sometimes and can only look at one factor. But I I'm pretty confident it actually probably extends your lifespan along with making you feel better and being stronger.

Speaker 3:

I I , I think that , um, you know, for years , um, hormone replacement has been really considered more of a, a female kind of like issue because , uh, some of those signs are a little bit more obvious. Chris ,

Speaker 4:

What are you trying to say?

Speaker 3:

We're saying <laugh> , we're saying that we can tell that you look old

Speaker 4:

Or she's a hormonal. She's a hor in the mornings. <laugh> .

Speaker 3:

That's exactly right. I hear you. Thank goodness my wife doesn't listen to the show.

Speaker 4:

<laugh>.

Speaker 3:

Dr. Yang, what are some symptoms that men , uh, might start experiencing if they think they have low testosterone?

Speaker 5:

Yeah, so low libido is definitely a very common symptom. Uh , just feeling more tired, more fatigue, poor concentration , um, lower energy levels. All of those are fairly common for patients who have low testosterone. Now , there are other things that cause those symptoms, but you know, if you have some or all of those, it might be, you know, low testosterone that's causing

Speaker 3:

It. So , uh, Dr. Franklin, sometimes patients may be concerned about cost when it comes to managing their hormones or maybe they have some kind of, you know, false impression of what's going to be happening from an insurance standpoint. How do you advise patients that might be concerned about cost for evaluating and treating testosterone?

Speaker 6:

Well, it , it , it can cost money. And I think there's , um, a tendency to want insurance to pay for everything when sometimes they just don't. But from my perspective, you know, for the price of what a moderate priced car, you know, you can extend your life and feel better and happier and be stronger. It is well worth what a car might cost. We compound our medications so that even if insurance doesn't cover it, you can get it a reasonable price. And we, and we do some interesting mixes with our compounds, you know, we'll, we'll throw in an estrogen blocker or we'll throw in an steroid to try to help your hair with the testosterone. There's all sort of cocktails that we can create on a compound, and by putting them together, it makes it a little less expensive than having to buy individual components of that therapy.

Speaker 3:

I continue to be amazed every day at the innovations that , that you do <laugh> . I mean, you were one of the first medical providers to have your own pharmacy. Uh, you have cardiovascular testing, a real focus on , uh, the person making them feel better, live longer, and , uh, know everything about their health. I, I really have to take my hat off to , uh, the , the innovations that you've, you've created , uh, Dr. Franklin at Victory Medical. How do people be part of that innovation?

Speaker 6:

Well, they can call us at (512) 462-3627 . Thank you for being so generous.

Speaker 3:

And what is your website? Our

Speaker 6:

Website is www.victorymed.com.

Speaker 3:

I know that , uh, our guests are old when they have to say the www

Speaker 4:

<laugh> stop.

Speaker 3:

How do people get ahold of us? Don ,

Speaker 4:

You can call us if five , if you say

Speaker 3:

Www,

Speaker 4:

You can www dot armor men's health.com. Our phone number's (512) 238-0762.

Speaker 3:

Hello and welcome to the Armor Men's Health Show. This is Dr. Mystery , your host, board certified urologist, joined by my co-host Donnel Lee .

Speaker 4:

Hey everybody. Welcome to the show.

Speaker 3:

We handle everything from the nipples to the knees in our urology practice. Uh , very , we are very fortunate to be growing and being able to offer , uh, you as potential patients, shorter wait times to come see us. We would encourage you to make an appointment for that primary or second opinion, especially if you've been diagnosed with prostate cancer or kidney stones or low testosterone, or you want to have your hormones evaluated or your life improved. We also love taking your questions on the show. We , uh, give advice all the time to patients who are looking for new primary care doctors or orthopedic surgeons. And we think we have a wonderful stable of excellent collaborators that we can advise you on. Mm-hmm. <affirmative> , Donna, how do people get ahold of us?

Speaker 4:

Uh , first let me say, I was listening to this radio station in K L B J the other day and they have a testosterone clinic where you can go right there and have your labs done right on site , but it's just testosterone. So continuing the hormone discussions we've had, you might wanna consider a different clinic, but that's why we're here. Our website is armor men's health.com and our phone number is (512) 238-0762 . We're in Round Rock, north Austin, south Austin and Dripping Springs, Texas, where we will be more comprehensive than any low T clinic that you might encounter.

Speaker 3:

We are very fortunate to join

Speaker 4:

Today . Did you hear that shade? I threw? Yeah, I hear it .

Speaker 3:

Alright . I hear, I hear it . <laugh> . I didn't , I didn't hear you talk about any negative comments about pop-up shockwave clinics for Oh , that , that's the next segment. That's our next segment, <laugh> , we're joined by Dr. Billy Franklin, founder of Victory Medical, a pioneering primary care physician who focuses more on prevention than, I guess you know, the other one, which is, you know, <laugh> . What's the other one? The other one. The other thing. So , um, you know, more and more I um , uh, meet men who are on the opposite ends of the spectrum when it comes to their health as they're getting older. You know, what is the difference, you think, between the 70 year old guy that comes in that's robust and full of life on no medicines and the guy that has has 12 medicines. Like at what point did their trajectories start deviating in their lives?

Speaker 6:

Well, I think you mentioned the other ones, which would be conventional medicine. And unfortunately we've sort of leaned toward using pharmaceuticals instead of getting healthy. And medicine just treats symptoms. It , it never cures anything for the most part , um, in terms of longevity. But we've gotten to this place where we think you have a problem, you take a medicine and a lot of people will give lip service to things like exercise and diet, but exercise and diet can actually cure 90% of what we treat. And exercise in particular is an extremely potent preventative of disease. And people that eat right, people that exercise don't have to take a whole bunch of medication to treat the symptoms of disease. 'cause they won't develop those diseases.

Speaker 3:

I mean, it's rare to find a sedentary, overweight, 70 year old man not on meds. Right. <laugh>

Speaker 6:

<laugh> . Right. And at that age particularly , um, a lot of terrible things start to happen physiologically to those who haven't taken care of their body. And that's when disease really makes itself known in the seventies. So

Speaker 3:

Let's talk about various , uh, age ranges. So if somebody's out there in their twenties and thirties, what are some steps that they should start taking? Um, to think about either testing or looking for to, to kind of , uh, to try to get a longer life, a longer, healthier life? Because we both know nobody wants to be hooked up to machines till they're 150. Right.

Speaker 6:

I mean, the whole idea is to have a, a health span, which means not so much as just grow life life , right , right. But in the health span, you're healthy to a certain age and then, then you die. And to do that

Speaker 3:

<laugh>

Speaker 6:

To do that, then it's over. If you wanna start testing early, I think there's a movement toward looking at early metabolic dysfunction because that's where it starts. Once you have metabolic disease, insulin resistance, inflammation, that all begins very early in the process. And that can be looked at. Um, these days people will do things like get continuous glucose monitors, wear them, become acutely aware of what things cause insulin to be irregular. For example, you might find that you didn't sleep one night, you'll see that your sugar shoots up 'cause sleep is very important to longevity. You'll find that if you exercise, the sugar remains stable also. And so you can use these vi these fluctuations while looking at your sugar as sort of a reflection on how well you're doing toward your future and how long you're gonna last.

Speaker 3:

I think that sugar metabolism, as you mentioned, and inflammation are probably , uh, two of the biggest like future predictors of , uh, abnormal health. And, and you mentioned something fascinating. So those of you out there that are really, are health freaks and really wanna pay attention to your health, I , I love the continuous glucose martyr, you know, experiment for a week. See which foods make your in , you know, your , your sugar spike. See what again, you said sleep patterns , uh, see if your job stress is causing you to stress.

Speaker 6:

Absolutely .

Speaker 3:

Absolutely. Have , uh, have , have , you know, more cortisol and , and poor , uh, sugar metabolism because it's, it really is a very realtime, you know, indicator of h h h how our bodies are doing. So let's say somebody in their forties and fifties. What do you think are important kind of , uh, in , in that age range that people need to do to kind of avoid later term problems?

Speaker 6:

Well, I don't wanna sound superficial or cliche, but really exercise is critical. And, and I think the way it got driven home for me, 'cause I've heard it so many times over the years, I've exercised a lot myself. But it got driven home for me when there's a Austin physician who specializes in prevention by the name of Peter Attia . And he was pointing out that the benefits of exercise in terms of health would exceed the benefits of discontinuing smoking. In other words, it'd be better to smoke cigarettes and exercise than the other way around

Speaker 3:

<laugh> . But the ash keeps getting on my treadmill. <laugh>

Speaker 4:

<laugh> , it's so hard, it's so hard to be healthy <laugh> . That's right. It's a dirty place to

Speaker 3:

Be . My cheeseburger keeps getting on my

Speaker 4:

<laugh> on

Speaker 3:

My treadmill

Speaker 4:

Too . The dripping of the cheese, the dripping of the

Speaker 6:

Cheese . Well, and , and there's been so much conflicting diet information, I think people get confused. There's a million different ideas about what you should eat and protein's probably under recommended pretty significantly in, in the literature these days. You, you have to eat enough protein to make things work for your body and you have to do not just aerobic exercise, but weightlifting resistance exercises just important in terms of longevity. Well ,

Speaker 3:

Uh, when it comes to testing , uh, you had mentioned previously that there are tests that people can take to kind of understand, you know, and, and these may not be offered by a traditional primary care physician. What, what do you guys do at Victory Medical that could be considered kind of next level testing for factors that might impact longevity? Well,

Speaker 6:

What we used to do things like the G SS P , which is a real sensitive test for , um, glucose irregularity. But now I think the continuous glucose monitor is gonna be what we start going to. There's also some, some ways to test, if you're in the zone of exercise that really puts you in a preventive mode , you have to reach basically zone two for a certain period of time or zone three for a shorter period of time.

Speaker 3:

What does that mean?

Speaker 6:

It's about how hard you're exercising and it's different for each person to reach their sort of peak exercise.

Speaker 3:

Is it managed by, is it measured by O two or is it managed by blood pressure? How do you know what zone you're in

Speaker 6:

It ? It's by O two. Okay.

Speaker 3:

So, so when you , um, are your heart rate's at a certain rate , uh, then when your O two kind of your , the use of oxygen is a certain rate that gets you into a , a higher rate of exercise. So a brisk walk would get you into what kind of zone you say that'd

Speaker 6:

Be ? Well it depends on how fast you're walking . Mm-hmm. <affirmative> , it depends on the person too. 'cause uh , people respond differently. For example, you know, an Olympic athlete risk walking isn't gonna be doing very much exercise. Right. But if you're a completely sedentary person and you go risk walk, that's a heavy amount of exercise. And so there, there are actually tables to calculate whether you're in zone two, which would be moderate exercise like briskly walking or jogging versus running, which might put you into a zone one. Reaching your actual peak exercise gives you like more credit. If you're physiologically or young enough capable of exercising to that degree , you get sort of more lifespan credit for doing that as well, but not you have to do it to a certain amount of time. There's studies that have been really actually carefully performed. It can suggest the degree of exercise and how, how much of an impact it make on your life and health.

Speaker 3:

So as a primary care provider, you've, you've probably seen so many people as they're aging just on so many medications, I feel like a lot of the patients that I see just feel resigned to the fact that they're gonna be taking all these things forever and don't try to make any effort to try to get healthier and get better. And that's always a little disconcerting. Do you think it's reasonable for me to continue to tell my patients that if they started eating right and exercising, that maybe they could lose some of those medicines?

Speaker 6:

Absolutely. And I think unfortunately it's not just patients that are resigned to that, it's physicians too that are resigned to that. And the reality is you can get most people off their diabetes medications and most people off their hypertension medications in terms of primary care. That's what we see masses of . And , and the reality is not ever getting to the point where you need those medicines is the key to prevention That's a super healthy 70 year old .

Speaker 3:

I think that , uh, too often patients think that getting a preventative medicine doctor is going to be way too expensive or well out of their reach and that these kinds of things are only for other people. But you've created a practice in which that is not true. I mean, you see everyone, you take almost all insurances and your approach, I think to primary care is something that's filtered down to the tremendous providers that you have. So , uh, I really congratulate you on , uh, all that you've done. How do people become patients of Victory Medical? Well, you

Speaker 6:

Just have to call us up . <LAUGH> (512) 462-3627.

Speaker 4:

I always wanna jump in and go 4 6 2 docs,

Speaker 3:

4 6 2 docs, <laugh> . And, and you know, don't sell yourself short when it comes to your doctor. If, if , if they're not doing what you think is , um, next level care for you, then you need to find somebody else. And that's something that we agree with a time and time again. Donna, how do people get that next level urologic here with us? That's

Speaker 4:

Right. You can call us at (512) 238-0762 . Our website is armor men's health.com. We're in Round Rock, north Austin, south Austin, Austin in Dripping Springs. And don't forget to listen to our podcast wherever you listen to free podcasts.

Speaker 2:

The Armor Men's Health Show is brought to you by N a U Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.