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Scott Webb (Host):  I’m 51 and my kids tease me about all the pills that I take. Truth be told, it’s really only two but I take them because I know my numbers, my doctor prescribed them, and I want to see my kids grow up. And that’s the bit take away from today. Men need to know their numbers, what they mean and who best can help them. My guests today are Dr. Bill Reilly, National Medical Director for the Low T Center and Dr. John Osborne, head of Cardiology for the Low T Center.

This is Age is Just a Number by the Low T Center. I’m Scott Webb. Gents, thanks for joining me today. Dr. Reilly tell listeners about the Low T Center, you do more than treat mean for low testosterone, right?

Bill Reilly, MD (Guest):  That’s correct. Low T was founded over ten years ago by Mike and Mickala Sisk and Mike experienced signs of low testosterone, saw his personal doctor who said, "You know you are just growing old; you’re depressed." So, Mike did a lot of research and found a center in Memphis. He’s from Tennessee. He was diagnosed with low testosterone. It’s an interesting story because as he describes it, he was given a bag of testosterone, some needles and syringes. They showed his wife Mickala how to give him one shot and sent him on his way.

To make a long story short, initially Mickala was giving him a little bit too much and then about the eighth shot, she put it smack dab in his sciatic nerve. Mike describes laying on the floor, flopping around like a fish and he decided there’s got to be a better way to do this. So, he found a doctor who would be interested in supervising, being the medical director. He found a physician assistant and he opened up the first center over ten years ago.

Since that time, it’s grown to 47 centers across 11 states in the country. Mike made the decision several years ago that we were going to evolve into a wellness center which we are now. So, mainly and we’ll be talking about it later, the comprehensive health assessment. We treat various conditions now. We’ve assembled an unbelievable medical team. Dr. Osborne, who is on this call, is a premiere preventative cardiologist. He really supervises and get our preventative cardiology aspect in the program going. We have Dr. Vidya Pai. Dr. Pai is a Harvard trained sleep medicine doctor and over the last year, we’ve instituted a sleep medicine program where we send people home with a home sleep test and we are able to treat sleep apnea.

So, we’ve evolved to a wellness center and our whole goal really, is to get our patients feeling as good as they can while preventing or slowing down the progression of major diseases.

Host:  I had no idea that you had that many facilities and saw that many patients. Dr. Osborne, what’s your experience been like at the Low T Center?

John Osborne, MD (Guest):  Well it’s been really fantastic. The concept has changed from just treating hypogonadism or low T of course as we call it here to really men’s wellness. So, to give you some perspective, our average guy that we see in our 47 centers is about 48 years of age, of course feels badly enough, tired, fatigued, erectile dysfunction, you know all those things that can go along with low T but also thyroid issues, sleep apnea. When we evaluate someone, we’re going to evaluate them for not just low T but all of those other issues that can mimic low testosterone as well but the other thing and that’s where I come into play is that if you think about it, and do the statistics and the epidemiology of heart disease; is that heart disease is a condition, the most common manifestation of course of the fatty plaques and blockages that build up in the blood vessels but that process, starts really in many people in their teenage years or in their early 20s, sometimes even earlier than that and festers if you will in an asymptomatic way for the next 20 to 30 years.

So, if you look at our average 48 year old guy, his major medical issue that can come “out of the blue” is a cardiovascular event, a stroke, a heart attack, finding out he has blockages and needs stents or balloons or bypass surgery. So, if you look at that 48 year old guy, his major medical issue over the next ten to twenty years is really going to be cardiac and that was really the brilliance behind the concept and the idea of taking this from just low testosterone to really understanding all of the medical issues that guys have and really being very proactive in the preventative space to help identify these problems early and then to counter and rectify these things. So, not only are our guys feeling better and living longer but also living stronger. So, as I like to say the goal here at the Low T Center is living long and living strong.

Host:  I love that. Living long, living strong. I’m sensing a T-shirt opportunity. Dr. Reilly, along those lines to accomplish that goal of living long, living strong we need regular health assessments. What does that mean? What’s involved?

Dr. Reilly:  The comprehensive health assessment as we call it is our gateway into the wellness program. The comprehensive health assessment involves obtaining a comprehensive medical and social history on the patients, their family history. We draw a lab panel and then we put them through a pretty extensive physical examination. All this is done so that we can formulate a plan and the plan is formulated both by the patient and the provider to achieve the goals that I previously mentioned. So, it’s paramount that the patient participates in the plan and because that will make it successful. The patient has to be dedicated. He has to have the dedication to change his lifestyle to a healthy lifestyle.

Host:  And Dr. Osborne why is it important to establish baseline labs and biometrics across a variety of health indicators, even if you feel fine today?

Dr. Osborne:  A lot of these issues are there, they are preexisting but you feel okay- ish as I like to say and so, you can have prediabetes, you can have elevated blood pressure. These are the things that we call the silent killers because you feel okay generally or else you say well, I’m tired, I’m fatigued, my energy isn’t as good, my strength isn’t as good. And you go well, I’m just getting older. When in fact, there probably are some pretty serious things happening under the waters if you will that we can begin to better analyze and realize once we get some data. So, we have a comprehensive lab analysis that we do that focuses on a whole variety of different things that are important for our guys to identify what’s happening long before we get into major trouble. So, again, screening for diabetes, and blood sugar issues, electrolyte problems, thyroid issues, liver issues, kidney issues, cholesterol of course and the hormone issues as well. So, it’s a very comprehensive lab analysis to allow us to understand what’s going on at this moment in time and predict that so we can change the trajectory going forward.

And then of course if upon questioning, as an example if we find that we’re suspicious that sleep apnea is going on which is incredibly common in our guys that we see and also a major issue with respect to both quality of life and quantity of life too; that we can evaluate that and then do appropriate testing to understand what’s going on if they have sleep apnea. Another important tool and all of this is very guideline based and evidence based, really using some of the most recent guidelines and tools from all the important organizations in this arena particularly in my world of cardiology, the American College of Cardiology, the American Heart Association; is to use a tool particularly in the cardiovascular space called a coronary artery calcium score. That’s a fantastic tool if the I like to call it the cardiac colonoscopy. It gives us an idea years before you have trouble. So, when I say trouble, I mean strokes, heart attacks needing stents and balloons and bypass surgery; we can figure out if there’s early what we call preclinical or asymptomatic plaque beginning to develop in your heart long before it ever causes trouble.

In fact, the big issue is this 40% of us will die of atherosclerosis and plaque either manifesting in blockages in the neck causing strokes or blockages in the heart causing heart attacks or needing stents or balloons or bypass surgery. So, that occurs in 40% of us. Of course many people and kills 40% of us in the US currently. That’s come down quite significantly but still, it is the leading cause of death that kills more people in 2019 than the next seven causes of death combined. And to make that matter worse, not only does it kill 40% of us; but on top of that, in half of men, two thirds of women by the way, the first symptom of this disease of atherosclerosis or plaque is it kills you. So, you don’t have symptoms. You don’t have chest pain. You don’t flunk your stress test. Instead, in half of men, the first symptom of heart disease is it kills you.

And so that is why I’m a dedicated preventative cardiologist that says that is no longer acceptable that 40% of us die of this disease and even the American Heart Association which is very conservative; argues that at least 80% of all heart disease and heart attacks are preventable. I would say that number is probably even higher particularly if we use state of the art tools such as we are using to identify heart disease and early plaque, much earlier than we have ever had in the past.

Host:  Yeah, there’s just no doubt that prevention is key and the work that you all are doing at the Low T Center is really amazing. Lastly today, let’s talk about the role that hormones can play in overall health, our wellbeing, longevity, how we feel and ultimately in the behaviors that drive longer term health status in a variety of areas. Dr. Reilly, why don’t you take that one first.

Dr. Reilly:  As we age, we lose testosterone. Starting at age 30, we can lose one percent of our testosterone. We wake up one morning and we find out that you know something’s different and we just don’t feel the same. I don’t have that energy; I don’t have that drive. I go to work, by 10 o’clock, 11 o’clock, I can’t focus on my job. By one or two I’m ready for a nap and I get home and I grab dinner, I play with the kids a little bit, by 9 to ten o’clock, I’m ready for bed. I just don’t know if I’m just too tired or just not interested in the wife anymore. I mean something happens. And that is the loss of testosterone. By replacing testosterone; we restore the energy, we restore the drive, we restore the focus, we restore the strength that we had back in our younger college days.

So, in our program, that enables our patients to focus on very important issues. One is exercise. Exercise is one of the best medicines there is. There was a great study performed by the Sports Academy where they looked at over 4000 patients and divided those patients into quintiles of fitness and they did it by med-equivalents as to how much they can exercise over a given period of time. The people in the lowest quintile, if I could take them from the lowest quintile to the next quintile, the next 20% and that’s just by taking them to a med-equivalent of about six which is 20 minutes on an elliptical; I can have their overall risk of dying from heart disease and I could reduce by 33% their all cause mortality. That is significant. That’s just exercise. All medical conditions, age, were eliminated. That’s just the effect of exercise.

To get the guys back to the gym, we restore their testosterone level. That is significant in changing your lifestyle. You want to eat properly. You don’t want to have your belly hanging over your belt. You start looking in the mirror. You are fired up again. It’s amazing the changes that we see these guys go through in a six week period. So, that’s still an important part of our program. But, as Dr. Osborne says, the number one killer in this country is still heart disease. So, we focus on that. So, testosterone helps us get our people activated to get back to the gym, eat properly and follow the treatment plan.

There are multiple studies showing that men with low testosterone just don’t live as long, higher incidence of heart disease, higher incidence of diabetes, metabolic syndrome. So, by restoring testosterone; we can improve the overall quality of their life.

Host:  That’s great Dr. Reilly. Dr. Osborne, you get the last word today.

Dr. Osborne:  We do know that low testosterone by itself is a very strong and important independent risk factor for heart disease. So, we think of things like high blood pressure, high cholesterol, tobacco use, family history, all of those factors, right, that I think most of us appreciate as being risk factors for heart disease but importantly, one of the under looked risk factors is low testosterone. So, when I was offered the opportunity to head up cardiology and really preventative cardiology for this very large organization and be able to design the algorithms, the protocols, the procedures, the screening tools to identify cardiovascular risk in our patient population and then be able to integrate a very effective guideline based evidence based approach to managing and reducing cardiovascular risk; obviously I was extremely happy with that.

Host:  Drs. Reilly and Osborne, thanks for joining me today. That’s Dr. Bill Reilly, National Medical Director for the Low T Center and Dr. John Osborne, Head of Cardiology for the Low T Center. Call 866-806-8235 or go to www.lowtcenter.com for more information or to book an appointment. And thanks for listening to Age is Just Number by the Low T Center. If you found this podcast helpful, please share it on your social channels and be sure to check out our entire podcast library for topics of interest to you. I’m Scott Webb and we’ll talk again soon.