About Hormones with Dr. John Thomas
"The dosage is based on each individual's activity. So, if they are a triathlete, they burn a lot more. So, I always tell people hormone is just like gasoline in...
"The dosage is based on each individual's activity. So, if they are a triathlete, they burn a lot more. So, I always tell people hormone is just like gasoline in...
INTRODUCTION: Welcome to Qualgen's podcast where we talk about all things health and wellness related, including hormones, pharmaceuticals, health trends and ways you can help better your life.
Jennifer: Hi everyone! Thank you for taking time out of your day to listen in. I am joined with Dr. John Thomas again – if you missed our first podcast together, make sure to go back and listen to it. It is filled with great information about hormone pellets – Dr. Thomas thank you for joining me!
Dr. Thomas: Hey, thank you, Miss Jennifer for having me.
Jennifer: Absolutely! Dr. Thomas is here to talk with us all pellet implant release rates and the differentials that may apply to different situations in terms of pellet release rates. In case anyone missed our first podcast together - Can you tell us your background in hormone pellets and how you have gained the knowledge that you have?
Dr. Thomas: You know, I'm a surgeon by trade. In my surgery, my sub practice specialty was doing endocrine surgery. So, I would take thyroids, pancreas, adrenal glands and then a majority of my patients, for cancer reasons, I would follow them. And so, I always had hormone management part of my treatment regimen for my patients. And I love data. So, every 10 years I look at my numbers and when I looked at my thyroid numbers, I have 120 different thyroidectomies, about 15% of cancer. And so there's a big difference between my cancer thyroid patients and my non cancer thyroid patients in which my cancer patients were a lot better off because I was treating them aggressively with making sure that TSH thyroid stimulating hormone is almost zero because I know the pain it is to go back into somebody's neck after taking the thyroid out and you go back in there, you'll get the parathyroid that controls the calcium or you'll get the recurrent laryngeal nerve that controls the voice box and no one likes them not to talk. Maybe the spouses might, but you know, as a physician that's a great liability. So, I would super manage them by treating the symptoms. But the benign patients, I would just say, “well, your numbers look good.” The thyroid ranged from 2.2 to 4.8 and maybe 2.3 and they gained 20 pounds in the last five years. I've been following them and they're cold, their hair is falling off, they’re miserable, their depressed, but your number looks good. You’re 2.3 – so, lose weight, exercise, do the right thing, but when I looked at my number, I said, I could not justify this.
And that's what opened my eyes into hormones, and I thought there has to be a better way to manage. The other thing is that I was looking at my patients, again I love data, and I have a lot of patient’s loyalty that stay with me - if I do the gallbladder 10 years ago and they get a hernia, they'll come back to me. And I was looking at my patient profile and in 5, 10 years nobody was getting healthier. They were getting miserable. They were taking more medicine. They were gaining weight. And I said, man, is this how I'm going to age? Well, this looks awful. And that's what opened my eyes into - Let's fix the causes, not put a band aid on the symptoms.
Jennifer: Absolutely. So how long have you been doing the pellets for? How did you get introduced to hormone pellets?
Dr. Thomas: So, you know, because again, when I realized there's more to it, so I started doing research about, how do you optimize hormones? So, therefore 2013 is where, it was a personal journey because I was having difficulty with my memory. And I've always, always been my greatest strength was I could remember phone numbers, names, and I was walking encyclopedia. And I was struggling because I would struggle to ask for an instrument in surgery. And so, I started enquiring, said there's more to it. So, I know one of my friends in Dallas, she's a gynecologist and she told me, hey, you know, maybe check your hormone. Typical male response - I said, man's hormone should be fine if they can have sex. And so, I told her my hormones are fine. She said okay, then you're having dementia, maybe it's cause you've got Alzheimer's, Parkinson's, live that way. So, she was the one who opened my eyes into hormones, and I got my hormones checked was like 440 or so and then I got [hormone] pellets done, and it really changed my life. I started sleeping better, became less irritable, I didn't think everybody is that stupid and I had more grace. That's my personal experience. And that's what made me look more into it. In 2013, when I started offering service to others.
Jennifer: I think it's huge when providers start offering a service because it helped them first. I mean it just goes to show that it really works and you're doing something to actually help people because it helped you. So, I think that's awesome.
Dr. Thomas: And the other thing was - I was the very first one in west Texas to do this, or East of Mexico to do this. So, I felt like I was John the Baptist eating Locusts and you know, eating honey and people call you crazy. And then I pelleted my nurse practitioner back then in 2013 and my wife and made a big impact in their lives. I've never had any kind of marketing strategy, one person at a time and now in west Texas, I have the biggest hormone practice because it's word of mouth. We don't have any Facebook ads, or we don't try to con patients to come get free cheese if you get pellets, no. But it works because there are people coming from all walks of life and driving as far as 6-7 hours to get to me to get the hormones optimized by me.
Jennifer: Yeah, we always hear that, you know, the wife comes in and it changes her life so she goes back home and tells her husband and then he comes in and then they tell their friends and it just spreads like wildfire. What are the benefits hormone pellets have in terms of hormone replacement therapy compared to other forms of therapy?
Dr. Thomas: Well, you know, like optimizing hormone by itself and I'm talking about optimizing your thyroid, your testosterone, estrogen, progesterone, and I consider vitamin D as a hormone - a pro hormone. So optimizing all those things, you know, you will have increased energy, you decrease your risk of heart disease, you decrease the risk of breast cancer, you burn more fat because you increase your metabolism, you know, testosterone by itself, increases blood flow by 30-35% to tissues like brain, intestines, muscles, joints. So, chronic inflammatory patients will get better. I have treated patients with plaque psoriasis with this increasing blood flow and you know, you increase your use of glucose. So, if a diabetic because of three medicine becomes diabetic on one medicine and you sleep better. I've had patients that their mental facility gets better to think clearly – their mild depression becomes manageable by just better coping skills rather than drugs. So, you know, again it has multi, multi-level of benefits to our body.
Jennifer: And how do you determine what dosage each individual needs?
Dr. Thomas: So, the dosage is based on each individual's activity. So, if they are a triathlete, they burn a lot more. So, I always tell people hormone is just like gasoline in a vehicle. If you're a V4, you'll get you better mileage. But if you're a V4, hauling a trailer, you'll burn more gas. So, it comes down to you as a person and your emotional, physical, psyche in the world you live in. And so, the dosage is what I get to pick based on what they do, but the frequency, how much they get it, how often they get it is based on who they are as a person.
Jennifer: So how do you determine if you have a new patient, what do you, how do you determine their initial dosage?
Dr. Thomas: You know, and there's some dosing sites commercially available that people can put the height, the weight, you know, the testosterone level, the estrogen level, the PSA for guys and ask questions like any history of breast cancer, or if you have polycystic ovarian syndrome, and stuff like that and they can come up with [a dose]. But I know I've been doing this for so long, you know me, I use from my guidelines, everything. The height/weight matters because we talked about an increase of blood flow. Fat has no blood flow, muscles do.
So, somebody who's 5’2” and weighs 400 pounds, I'm not going to give them for the weight of 400 pounds. But, if I have a 6’5”-10” volleyball player that comes to me and she weighs 160 pounds, she's full of muscle so she might get more. And also, what activity do they engage in? Are they somebody that works out four times a week, they go skiing every weekend, or they go water skiing? Are they active, you know, are they just a sea lion plopped up in sofa all day long waiting for their trust fund money to come in?
So, I look at their basic metabolism, their activity, and also their stressful environment they're in. A single mother with three kids that got shipped everywhere or somebody's you know husband is in military in Afghanistan, or some other place, and stressors and stuff like that. So, all those things matter and that's where I personally get to my dose on my patients.
Jennifer: And what happens to pellets after they are implanted?
Dr. Thomas: That's a great question because you know we are in this culture of lab lab lab lab lab, you know, so I get a lab to get a baseline. Where did you start? And then everybody of my 6,000-7,000 patients has gone through me for the last 8-9 years I get a baseline lab. So, if you started at testosterone 12 for a girl, I want to know where to go up to and also, we have a great symptom checklist they fill out. Then we can see that these are the symptoms they got relief from in four weeks when the labs come back. And so what you'll see is that an average woman of 12 will go up to anywhere from 125 to 200. That's where they'll go to. You know, their four-week lab draw will show. And so, what that guides me is this, their mountaintop is 200. So, average woman will consume about 15 points of testosterone every week, but some can consume 45 - somebody that works out five times a week they will burn a lot more. And I've had a lot of patients that have had, they were injectors, they will inject themselves, and they will come and say man when I switched to pellets, I feel good for 3-4 months. Really good.
So, it's a sustained release. It releases higher in the morning, and it shuts off in the evening. That's a lot of people that get the hormones, they start to say man, I'm sleeping much better because the peak of energy of the testosterone starts winding down as you're ready to go to sleep based on its circadian rhythm.
Jennifer: And then the pellets just completely dissolve, right?
Dr. Thomas: Completely dissolve, because I have a saying in my clinic is that you know, I don't give everybody a different scar. Some patients have been with me for eight years and they have maybe two or three scars on each side of the butts for ladies, because if they want to be a nudist, I don't want to be the reason why they can be a nudist. So, you know you can't feel on girls where the last pellet was, sometimes you'll feel scar tissue, so I change the direction and men sometimes you can see a scar but never a pellet.
Jennifer: And how can the release rate of the pellets vary with each individual. I know we kind of talked about the dosing but does the release rate, like you were talking about, does that change based on the individual?
Dr. Thomas: Yes, because the release rate is going to be based on the usage. So, if you're somebody that's running and running 30 miles a day and it increases the blood flow to the muscle and the testosterone has receptors in the muscle, receptors in the gut, you know? And so therefore the release has some greater demand. I have patients, we live in west Texas and it's a farming community. So, about two winters ago, a lot of people's cotton was sitting on because there's a bad cold/bad snow, they could not harvest it and I would say 10-15% of my farmer patients, they brought their dually and got me picked me up and said John, I need my pellets. Because stress made them release the hormones. They’d call me [and say] my pellets gone; it's disappeared. It's only three months. So again, the usage controls, who you are as a person controls what you use. So again, if you're V8 engine and hauling huge horse trailer and going up the mountain, you use a lot more gas.
Jennifer: How do you make sure that these pellets that the hormone levels remain in a safe range?
Dr. Thomas: That's a great question, Jennifer. So, a lot of people's misunderstanding - who is the king of deciding what the range is? When you think about labs, labs are drawn on sick people. And so, the lab range to define for men is from 251-1100 there’s no age specification at all. So, if you are 35 years old and your testosterone is 251, you're normal. If you're 90 years old in a nursing home with one foot in the grave with one foot on a banana peel 251 and it's still normal. Well, I say it's not, that's not true. The range is not decided by any one of us. So, I'm not, you know, again, I have patients that if I treated the range, they'll go doc, I feel miserable like I did before. So, our goal is not to fix the lab, which was drawn inappropriate to the years of history and have have data points. Our job is to fix the symptoms of fatigue, irritability, insomnia, depression. You know, married people in the mid-forties having no sexual desire. You know, the wife saying that I'd rather have a husband going on an oil rig and stay there for three years that would be great.
So, symptomatic relief is what we're looking for. So, I know there's people that don't do this for a living. They're going lab super physiological level. They've never seen a patient, because I go back to my thyroid example I used earlier and my benign cancer patients, I knew there were benign, so I would never go back to the neck. I would treat them based on what the lab said, maybe 2.3, they're miserable. I said, nah, it's not, there's nothing wrong with my treatment regimens. It's your fault, You figure it out, do whatever you got to do, eat grass, sleep upside down, do whatever you got to do. My cancer patients, I knew the chance how difficult it is for me to go back on the neck. I would have them in a higher range and everybody felt better. So, I for sure know that a lab should never never predicate what you treat a patient with.
I'm a surgeon. I use pain control after big abdominal surgeries. I don't have a protocol that tells me how much morphine that you need. Every patient is different. So, when we give them the PCA, the patient-controlled analgesia, they get to press the button. If their pain, you got to sleep, they're not going to press the button. But if they're in pain they can press the button. Same thing goes here in the hormone world is that we have to change our flawed mentality, which is based out of labs from the doctors who sit there that don't treat real patients, that treat saying “the numbers is 2.2 that's good.” How much insulin does somebody need to bring the sugar down? Whatever it takes to bring the sugar down below 120. You don't go “I gave it four units. I can't do this anymore.” No.
Jennifer: It's not a one size fits all.
Dr. Thomas: It doesn't because a lab can measure testosterone, but the barrier might be that you might have a cellular resistance to testosterone getting in. You might not have enough receptors. So, you might have something doesn't mean it's getting in your cell level. But, when it gets in the cell level, what happens? Your symptoms improve, because I could not sleep, but being on hormones I sleep. And so, if that does work. So, I have patients that go, “Dr. Thomas, my four symptoms have gotten better, my sleep and my energy is still not there.” They might need more. It's not a lab thing it’s a symptom relief.
Jennifer: Makes total sense to me. I don't think you could explain it any better than you did. My next question was going to be, how can you measure the release rate of pellets, but it's all like you just said in the symptoms of the patient and if they're genuinely feeling better, not just a number. Because who are you to judge that my number is optimal for me and how I'm feeling?
Dr. Thomas: But you know how you're feeling. If you have symptomatic relief from your issues that you came for, that's the endpoint goal. That's the endpoint goal. How big a steak you want is how big your stomach is, because this little petite woman like you, you want a three-ounce steak. Don't give me that three-ounce steak, it'll go up my nose.
Jennifer: Absolutely. Well, I think that covered everything I have. Is there anything additionally you would like to add?
Dr. Thomas: I think, you know, time has come for us to treat patients, not based on protocols. I think we're in this culture, which everything's protocol and that's classically seen in the covid world. You have covid symptoms, but your test is negative or randomly test people with the asymptomatic. I'd never find a guy on the street and say, “I think you got appendicitis let's go test your appendix.” You got to come in. And so, the greatest thing is that for me in 8-9 years of doing this hormone therapy, I think I've made more people feel better. I've gotten people healthier. I've gotten people off medicines. I've drawn very little labs. I like the labs for baseline, but I was trained to be a hormone surgeon and so therefore I'm not asking everybody just to do this because after 7000 patients. I've become an expert of how to dose patients. So don't be cowboys and go, “I don't need a dosing site.” If you're learning this thing, please get trained, go to dosing side. Use the dosing side. It is a safety. It will protect you from doing something bad because you can never take testosterone out.
Jennifer: I know we have when we have providers come to us that are wanting to start pellets. You know, the procedure is the easy part, anybody, any of these doctors can learn how to do the procedure. It's the dosing that we’re like that's where you all need help and guidance, so I absolutely agree with that. Thank you again for joining me in the meantime, if anyone has any questions for Dr. Thomas you can find his contact information on his website at lindseysmedicaldayspa.com or on Facebook at Lindsey’s Med Spa. Thank you again, Dr. Thomas! I have really enjoyed talking with you.
Dr. Thomas: Thank you, Miss Jennifer. God Bless.
Jennifer: Thank you! Thank you everyone for listening! Please make sure to subscribe and follow us on social media to stay up to date on Qualgen! Have a great day!
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