Category Archives: Testosterone Shots

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I REMEMBER EXACTLY what my first shot was like. I was terrified as the nurse at the Mazzoni Center in Philadelphia handed me the syringe. She had carefully instructed me on how to inject the testosterone, extracting the viscous liquid from the vial, then pinching my skin below my abdomen. I stared up at her, asking, Are you sure? She smiled at me and assured me I could do it. So I did, and with that moment, my life changed in every way possible.

Truthfully, the hesitation was from the unknown. Being born biologically female, I certainly had no experience with testosterone, and how it would specifically affect me and the rest of my body. However, what I did know is what made me feel good, what made me feel like myself, and that made the decision to begin transitioning far easier. The well-educated doctors at the Mazzoni Center have been with me every step of the way.

Each week, I inject .35 mL of testosterone subcutaneously. After three years, its just a part of my routine. Initially, I was still unsure of myself doing my shot alone, but over time I became more comfortable with the process. Prior to all of this, I did my research. I looked at the experiences of other transmen, and reached out in several instances to gain further insight. What I gathered was that while there were some general similarities, each individual had a different experience, simply because of their journey.

My protocol for taking testosterone was personally tailored to me. This is why I was fortunate to have worked with the medical professionals at The Mazzoni Center. They analyzed my anthropometric measurements, medical history, and future goals, both physical and emotional. My doctor wrote a prescription for me that would allow my body to transition in a safe and healthy manner. Since beginning hormone replacement therapy three years ago, the amount of testosterone has never changed. The human body does not work well under extreme conditions or wide-ranging fluctuations. We are more adapted to gradual and consistent change, which is exactly how my testosterone protocol was designed.

The support, or at least a consultation with an affirming medical team or provider, is essential before making any type of medical change. I would never suggest that anyone do this alone. There are dangers in taking too much, and the amount you take is dependent on environmental factors and characteristics, such as age and body composition. Additionally, I know several transmen who wanted to transition at a slower pace, and "microdose" testosterone. Taking less testosterone in this way is not dangerous, but changes will happen at a noticeably slower pace. The nice thing about this process is that you can transition in a way that aligns with your personal goals and health needs.

I realize now that as humans, our instinct is to look for comfort from who and what we know. However, that is not a definitive truth. That is our observation, our perspective, which can lead towards a path of false representation. So, through my own observations, I took what information I could to benefit my scenario, and surrendered the rest to another mans path. Several individuals, such as Cody Harman, Nikias Tomasiello, and Logan Dub, provided positive support through their social platforms, and were kind enough to answer my questions and address my concerns. I began to realize that I was surrounded by many others, simply looking to connect with the inner vision of themselves. The start is summoning up the courage to make connections, reaching your hand out and knowing that someone will grasp it.

The first changes were my body temperature. I used to be cold most of the time, but I noticed that my core temperature began to feel almost hot. I suddenly was operating like a self-heated furnace!

Hair growth took a bit longerit was probably around six months before I noticed differences there. I was ecstatic! I will never forget that moment and the friend I shared it with immediately. I was also fully aware of the thickening of my vocal cords, which altered my voice.

There were some changes that really surprised me, such as the change in my facial structure, and the noticeable increase in my bone density. I remember visiting my chiropractor, who I had not seen since before transitioning. As he worked on my face and neck, he told me that my bone structure felt more defined. In my head, I imagined that I would change in the stereotypical way, enhancing my masculinity and general physical construct, but not to that detail. These types of changes really excited me. I felt reborn, figuratively speaking, and I guess I was in a way.

Some changes I noticed would hit me suddenly. Others came with the territory, such as altering my hair and wardrobe. I loved changing my wardrobe, and buying the clothes I liked, rather than the ones I thought I "had to have" based on my perceived societal constructs of gender norms. For me this experience was liberating on so many levels. All of these changes, in every manner that they appeared, were small celebrations, reminders that I did it; I was living in the truth, and no one could take that from me.

What I had not thought about were the changes I would face from a social and emotional place. Certain physical and emotional challenges scared me. I had to relearn how to behave socially in the world as a man. And, from a physical standpoint, I knew that just because I was taking testosterone did not mean that I would suddenly take on the figure of a man. I still had underlying body dysmorphia, present from my past, and working through that was challenging. Taking on the male gender norm from a social standpoint was also a large task for me. I had lived my life as a female for many years, and taking on new responsibilities as a man was daunting to say the least.

I had to recognize that testosterone could potentially make me more aggressive, or change the way in which I react to the environment around me. Thankfully, I did not notice aggression in this way, but I did notice confidence and a boost in self-esteem. This was not only due to hormone replacement therapy, but the validation I felt in aligning my internal identity with my external frame. My presence felt stronger, and intuitively, I began to trust in who I was as a person.

Admittedly, when I started transitioning, I worried about regretting my decision. This is not something I could take back, or "reverse," and naturally, that made me question myself. However, what I know is that I would have regretted living a lie more. That is also something I could not take back.

Additionally, I found it important to remind myself that just because I was taking testosterone and was changing my life in a positive way, my life would not be perfect. Testosterone did a lot for me, but it did not take away my limitations, past failures or regrets. I am still the same person, but an expanded version of who I was. I still struggle just like everyone else. Testosterone is not perfection, nor does it slow time. It is not an emotional cure for what keeps you up at night. For me, it was how I found the part of myself I believed could not exist.

Testosterone had allowed me to take on a new identity, one that felt whole, complete. I now look upon the last three years of my life through a lens of pride. It takes courage to change the course of your life, especially when you feel alone. It takes bravery to fight against the stream that channels you to a set course. I made a choice to start testosterone, and I know that was the right choice.

Bari Glassman is a graduate student at Immaculata University studying Dietetics, and he intends to combine his passion for nutrition, and fitness, with his interest in cultural diversity, as a future professional practice.

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As a Transgender Man, Testosterone Shots Made Me Feel Reborn

Sometimes people are afraid to start testosterone therapy because they think it means they will have to continue testosterone therapy for the rest of their lives. Nothing could be further from the truth. The length of time that any single person needs to be on testosterone replacement therapy varies, based on your symptoms, age, sex and weight.

Generally speaking, testosterone therapy is given over a course of a few months. Typically, for a first time prescription, you will be prescribed a 10 week or a 20 week program of testosterone therapy. You should start feeling a difference in the first four to six weeks (Sometimes in as little as 2-3 weeks). You will feel the most significant improvements to your energy levels, your strength, moods and sex drive, within the first two to three months of testosterone therapy.

Testosterone therapy can be prescribed as testosterone injections, patches or gel. Most doctors agree that spending a few months on testosterone injections is the most effective method. Testosterone injections are prescribed as testosterone cypionate. Testosterone cypionate lasts in the body for about 7 to 8 days, so regardless of your recommended dose of testosterone, you will probably need to take your testosterone shots once a week, or twice a month.

The length of time that any single person needs to be on testosterone replacement therapy varies, based on your symptoms, age, sex and weight. Generally speaking, testosterone therapy is given over the course of a few months.

The reason that testosterone therapy is given over the course of a few months, is that it takes time to be effective. Be patient, onset of results varies a lot from person to person. To better understand how long you need to take testosterone, there are a few other things you need to realize about the results of testosterone therapy.

Number one, testosterone therapy is most successful when it is prescribed for your particular individual needs, lifestyle and goals. As such, that means that no two testosterone therapy patients will have an identical experience. Your results will be tailored to meet your unique goals and lifestyle.

The other thing you need to understand about testosterone therapy is that while you will see results, you will not suddenly have the physique of Captain America after your first injection. The whole reason why testosterone injections are to be taken over the course of a few months, is that their effects are cumulative, and take time to be achieved.

Testosterone injections are prescribed as testosterone cypionate. Testosterone cypionate lasts in the body for about 7 to 8 days, so regardless of your recommended dose of testosterone, you will probably need to take your testosterone shots once a week, or twice a month.

You will not see overnight results from your testosterone therapy. Your prescription for testosterone therapy will be designed for your body to react to the increases in testosterone slowly over time. However, the benefits of testosterone therapy basically impacts four major areas of your life:

Each of these areas will improve after you have been taking testosterone therapy for some time.

Again, since testosterone therapy is prescribed on a very individualized basis, results do vary. However, many patients say they start to see improvements in strength and energy in as little as two weeks. Many patients notice emotional or mood changes earlier than major physical changes. In as little as 3 to 4 weeks of taking testosterone injections as prescribed, patients report feeling more calm, less anxious, less depressed and less irritable.

Here is a month by month breakdown of the benefits you can expect from testosterone therapy.

Month One After about one month to six weeks of taking testosterone you will experience significant increases in vitality and energy. You should also start to see:

Month Two After completing two months on testosterone, your ability to focus and concentrate will be greatly improved. As you enter the second month of testosterone replacement therapy this is when you will really start to notice a before and after look in your mirror. Belly fat will be significantly reduced and you will appear more toned. In addition, after two months of testosterone therapy you should expect to see:

Three to Four Months As you enter your third and fourth month of taking testosterone, in addition to continued improvements in strength, vitality and sexual performance, you can expect the following additional benefits of testosterone:

Five to Six Months Once you are close to completing your first course of testosterone therapy, in months 5 and 6, you will start to experience all of the many positive benefits listed above, of testosterone replacement therapy, and an overall improved quality of life.

Once you have achieved the above benefits, we will help you to use your increased strength, energy and motivation, to help you to keep your testosterone levels where they should be, even once you stop testosterone therapy.

After you have stopped taking testosterone some of the lifestyle changes you should make to avoid a subsequent drop in your testosterone levels are:

After you stop testosterone therapy, you will likely also be put on a regimen of vitamins and nutritional supplements designed to stimulate your body to increase your natural testosterone output.

It is possible that you may have heard some horror stories regarding withdrawal symptoms from stopping testosterone replacement therapy, or that serious side effects can happen once you stop taking testosterone. Most of these stories are rumors, and the results of misinformation, and people who have misused or abused testosterone. It is true that your body can have withdrawal-like symptoms once you stop taking testosterone. However, such negative impacts of stopping testosterone almost always occur when you stop suddenly, without your doctors authorization. It is not a good idea under any circumstances to stop cold turkey. If you feel you are experiencing side effects, or not getting the results you want, from your testosterone therapy, do not just stop. Call you doctor, your dose of testosterone may need to be adjusted.

This is why, who you get your testosterone therapy from makes a big difference. At our testosterone replacement centers, you will be working with doctors and a support staff who have decades of experience in applying modern, state-of-the-art techniques to testosterone replacement. You will be completely monitored during the entire course of your testosterone replacement program.

When it becomes time to decide how long you have to be on testosterone therapy, your therapy will always be done slowly and with complete medical supervision, so that any possible side effects of testosterone therapy will be kept at an absolute minimum.

Any doctor can prescribe and tell you how to take testosterone injections. But, if you want to achieve the maximum results of testosterone replacement therapy, your best bet is to work with a skilled and experienced testosterone doctor. If you want to get the most you can from taking your testosterone injections, you want to work with a specialist who has a proven track record in administering hormone replacement therapies for men.

At our treatment centers, our doctors and staff are dedicated professionals with years of experience in treating the problems of age-related hormone decline. Your testosterone therapy will be tailor-made to suit your individual needs and wellness goals. At our clinics, you will always be treated as an individual, and never like just another number on a prescription pad. When we get to know you as a person, we can prescribe the best testosterone therapy for you, and you will be able to count on significant before and after results. Its time to step up and be proactive in your health and bodily appearance. You can make a difference to help yourself. This can be your time!

Testosterone therapy is most successful when it is prescribed for your particular individual needs, lifestyle and goals. As such, that means that no two testosterone therapy patients will have an identical experience. Your results will be tailored to meet your unique goals and lifestyle.

See the article here:
How Long Do You Have to Stay on Testosterone Therapy? - Kingsberg Medical

It is very important that you learn where to give your testosterone injections.

Testosterone injections are intramuscular, which means that they are given into the muscles. The very vascular muscles of your arm, your thigh, or the glutes are the most common injection sites. The needles used to deliver low testosterone treatments are very thin, much like the ones diabetics use to deliver insulin. Once you learn how to give yourself your testosterone injections, you will find them easy to do, and quite painless.

Testosterone injections are intramuscular, which means that they are given into the muscles. The very vascular muscles of your arm, your thigh, or the glutes are the most common injection sites.

When done correctly, testosterone injections should not hurt. And yet many men report discomfort when giving testosterone injections. Here are a few ways to give testosterone injections and reduce the potential for pain. Where to give testosterone injections is the most important thing to consider when trying to keep testosterone injections as painless as possible. Selection of your testosterone injection site is critical to minimizing discomfort.

Testosterone injections should be given deeply into vascular muscle tissue. The deltoids, the vastus lateralis, and gluteal muscles are the most common intramuscular (IM) injection sites. Those are your arm, thigh, and buttocks respectively. Some of these sites, are more prone to pain then others. Generally speaking, the areas with more muscle and less subcutaneous fat, tend to be the least painful injection sites for testosterone. The modern needles that are manufactured today are made with extraordinary sharpness and precision that allows them to be relatively painless, as compared to the needles of the past.

However, wherever you choose to give your testosterone injections, it is best to rotate, or alternate sites every other injection or so to avoid pain, inflammation and other possible complications of your testosterone injections. Be sure to favor and select sites that have the greatest abundance of muscle.

Once you learn how to give yourself your testosterone injections, you will find them easy to do, and quite painless. Where to give testosterone injections is the most important thing to consider when trying to keep testosterone injections as painless as possible.

Other than where to give testosterone injections, the other things you need to consider for the proper administration of testosterone shots are:

Typical needle size to give testosterone injections is a gauge of between 22 and 25. Some testosterone users suggest that you should use one needle to draw the testosterone dose into the syringe, discard that needle, and then use another to give yourself the actual testosterone injection. The rationale behind this is that the tip of the needle could get blunted pushing through the stopper of the testosterone vial, and therefore possibly cause a more painful injection. There is nothing wrong with this practice, however, there is also little evidence to suggest that it is true. From a convenience standpoint, using a larger needle to draw the testosterone can be easier & faster but ultimately, the choice is yours.

If it is possible to split your testosterone injections into more frequent smaller dosages, less volume in each testosterone injection, can result in less pain.

As far as technique, to minimize pain of your testosterone injection, keep the needle straight, and the faster you inject usually means less pain.

Because there are different types of testosterone in the various brands of testosterone injections, and there is some variation on how they work, some should be massaged in after they are injected, and some should not be. Consult the literature that comes with your testosterone injection kit or ask your prescriber if your particular type of testosterone needs to be massaged in or not.

While taking your injections correctly will minimize discomfort, and maximize results, there are a few other things you need to understand about the results of testosterone injections.

Number one, testosterone injections are most successful when they are prescribed for your particular individual needs, lifestyle and metabolism. As such, that means that no two testosterone therapy patients will have an identical experience. Your results will be tailored to meet your unique goals and lifestyle.

The other thing you need to understand about testosterone therapy is that while you will see results, you will not suddenly have the physique of Superman after your first injection. The whole reason why testosterone injections are to be taken over the course of a few months, is that their effects are cumulative, and take time to be achieved. Be patient, you will see the benefits of testosterone therapy soon!

You will not see overnight results from your testosterone injections. Your prescription for testosterone therapy will be designed for your body to react to the increases in testosterone slowly over time. However, the benefits of testosterone injections will basically impact 4 major areas of your life:

Each of these areas will improve after you have been taking testosterone injections for a while.

Again, since testosterone therapy is prescribed on a very individualized basis, results do vary. However, many patients say they start to see improvements in strength and energy in as little as two weeks. Many patients notice emotional or mood changes earlier than major physical changes. In as little as 3 to 4 weeks of taking testosterone injections as prescribed, patients report feeling more calm, less anxious, less depressed and less irritable.

Here is a month by month breakdown of the benefits you can expect from correctly given testosterone injections.

Month One After about one month to six weeks of taking testosterone injections you will experience significant increases in vitality and energy. You should also start to see:

Month Two After completing two months on testosterone injections, your ability to focus and concentrate will be greatly improved. As you enter the second month of T-therapy this is when you will really start to notice a before and after look in your mirror. Belly fat will be significantly reduced and you will appear more toned. In addition, after two months of testosterone therapy you should expect to see:

Three to Four Months As you enter your third and fourth month of taking testosterone injections, in addition to continued improvements in strength, vitality and sexual performance, you can expect the following additional benefits of testosterone:

Five to Six Months Once you are close to completing your first course of testosterone therapy, in months 5 and 6, you will start to experience all of the many positive benefits listed above, of testosterone replacement therapy, and an overall improved quality of life.

If you follow the tips and techniques stated above of how and where to take testosterone injections, they should be relatively painless, and risk free.

Like any kind of therapy or medical treatment, however, testosterone therapy does have some potential side effects. In 2013, published studies in Jama and PloSone 2014 raised concern about risk of CVD. These studies resulted in much fear and a reduction in testosterone usage. The concern then centered around the increased central obesity, diabetes, loss of muscle mass and osteoporosis with the sudden cessation of testosterone therapy. Since then, further meta-analysis supported by the NIH found no increase in Stroke and Cardiovascular Disease (JAMA 2018). The many positive benefits you will get from testosterone therapy far outweigh any potential risks.

If you have been diagnosed with low testosterone, and do not begin taking your testosterone injections as prescribed, your testosterone will only continue to decline, and your symptoms to worsen.

On the other hand, if you work with your doctor to achieve the many positive and lasting benefits of testosterone therapy, you will have made a good decision!

What you can expect from testosterone therapy is:

If you need testosterone therapy, and you do not take your testosterone injections, all you can expect is a life filled with more weakness and depression.

Any doctor can prescribe and tell you how to take testosterone injections. But, if you want to achieve the maximum results of testosterone replacement therapy, your best bet is to work with a skilled and experienced testosterone doctor. If you want to get the most you can from taking your testosterone injections, you want to work with a specialist who has a proven track record in administering hormone replacement therapies for men.

At our treatment centers, our doctors and staff are dedicated professionals with years of experience in treating the problems of age-related hormone decline. Your testosterone therapy will be tailor-made to suit your individual needs and wellness goals. At our clinics, you will always be treated as an individual, and never like just another number on a prescription pad. When we get to know you as a person, we can prescribe the best testosterone therapy for you, and you will be able to count on significant before and after results.

Testosterone injections should be given deeply into vascular muscle tissue. The deltoids, the vastus lateralis, and gluteal muscles are the most common intramuscular (IM) injection sites. Those are your arm, thigh, and buttocks respectively.

See the rest here:
How to Properly Give Yourself Testosterone Injections - Kingsberg Medical

Testosterone injections are prescribed on a very individualized basis. Therefore there can be a lot of variation in the dosages of injectable testosterone prescribed. The most common form of injectable testosterone therapy contains testosterone cypionate which is the oil-soluble 17 (beta)-cyclopentylpropionate ester of the androgenic hormone testosterone. This is commonly referred to as DEPO-Testosterone or merely DEPO.

DEPO testosterone injections are usually prescribed in vials of 100 mg/mL solution or 200 mg/mL solution. But, no matter what brand or dosage of injectable testosterone you are prescribed, it is vitally important that you learn how to safely and properlyadminister testosterone injections.

Testosterone injections are given into the muscles, therefore, a testosterone injection is known as an intramuscular injection, or IM injection. IM injections are easy to self-administer, and relatively safe and pain-free, once you know all of the steps and procedures to properly administer testosterone injections.

No matter what brand or dosage of injectable testosterone you are prescribed, it is vitally important that you learn how to safely and properly administer testosterone injections.

The first step in learning how to administer testosterone injections correctly, is to choose your injections site. IMs are given into thick muscular areas to effectively enter the bloodstream, while minimizing pain and discomfort. This is because the thick muscles of your forearm, buttocks, or outer thigh, are very vascular, and also can accommodate the relatively thick needles of testosterone injections with little discomfort. Once you have selected your injection site, the most important thing to learn about how to self-administer your testosterone injections, is how to maintain sterile conditions through the various steps of the process. The rare problems that occur with testosterone injections, such as pain, inflammation, or an infection at the site of injection, are almost always caused by failing to observe sterile protocols, and/or using improper injection techniques.

Testosterone injections are given into the muscles. They can be easy to self-administer, and relatively safe and pain-free, once you know all of the steps and procedures to properly administer testosterone injections.

Testosterone injections are given much like any other IM. You may receive specific instructions from your doctor, or from the package insert of your particular prescription. Always follow your prescribers instruction on how to inject your particular dose of testosterone. The following should be taken only as an overview of the 10 basic steps to administering a testosterone injection, simply to give you an idea of the process. These steps to injecting testosterone, should not be taken as specific instructions on how to give a testosterone injection.

Gather all the supplies needed for your testosterone injection, and place them on a clean and sterile staging area. Be sure you are well aware of your prescribed dose of testosterone. Taking additional injections, or more than your prescribed dose of testosterone, will not improve your results, and in fact, can be dangerous. Carefully check the expiration date on the vial of testosterone. Never use testosterone that is expired.

Make sure your hands are clean, and that you are wearing rubber gloves. Now clean the top of the vial with one of the alcohol swabs that came with your testosterone injection kit. Pull back on the needles plunger to draw air to the graduated number line on the syringe that corresponds to your prescribed dose.

With the vial still on the table in the upright position, insert the needle through the top of the vial and inject the air into the solution. Now, with the needle still in the vial, invert and lift the vial, so you can draw the testosterone down, into the syringe.

Pull back the plunger of the syringe, again to your desired dose, this time drawing the liquid testosterone into the syringe.

Remove the needle from the vial. Flick the side of the needle with your finger to make sure there are no air bubbles. Injecting air into your body, can cause a serious complication known as an air embolism. Squirt a tiny bit of the testosterone out of the tip of the needle. This will further ensure that you have removed all of the air bubbles, and also lubricate the tip of the needle, making injection of the testosterone a little easier.

Clean your selected injection site with another alcohol wipe. Most users of testosterone injections find that the heavy muscle of the outer part of the upper thigh is the easiest injection site to access, and to administer the IM.

Squeeze about 1 inch of muscular tissue between your forefinger and thumb, as seen above.

In a firm swift motion press the needle into the injection site.

Pull up slightly on the plunger and check for blood in the syringe. If you draw up any blood you have stuck the needle into a vein, and not muscle tissue. Remove and try again in another area, until you are sure there is no blood.

In a steady push, trying to keep the needle at a 90 degree angle, inject the testosterone into the muscle.

Withdraw the needle. Clean the injection site with another alcohol wipe, discard the needle appropriately, and properly store your testosterone vial for the next injection.

If you are correctly following this basic outline, and your testosterone prescribers specific self-injection instructions, you should be able to give yourself your testosterone shots with little or no pain. If you are experiencing pain on a regular basis, try alternating your injection sites. If discomfort continues, contact your prescriber. You may have to have your testosterone injection dosage adjusted, or be retrained on how to take your testosterone injections, or perhaps switch to another brand of injectable testosterone.

When learning how to administer your testosterone injections, there are a few other things to consider, such as:

Once you are comfortable in correctly knowing how to give yourself testosterone injections, and start taking them, you will be on your way to achieving some remarkable benefits. The many benefits of testosterone injections include:

Do not expect to see these benefits immediately after you first testosterone injection. It takes time for your body to get used to the impact of increased testosterone in the blood. You will start to feel all of the above benefits, cumulatively, over the course of the weeks and months of your testosterone injection therapy.

So, now that you know how simple, safe and easy administering testosterone replacement shots can be, why dont you contact us today and see of testosterone therapy is right for you!

The rare problems that occur with testosterone injections, such as pain, inflammation, or an infection at the site of injection, are almost always caused by failing to observe sterile protocols, and/or using improper injection techniques.

Go here to read the rest:
How to Self-Administer Testosterone Injections

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You've probably heard of a professional athlete having to receive a cortisone shot to fight through an injury. You may even know a friend, a family member, or a co-worker who's undergone the procedure. But for many of us, the treatment is outside our realm of direct experience.

Even though they're administered relatively frequently, cortisone shots are typically reserved for significant discomfort. In the 60-plus years since the treatment was introduced, it's helped an incalculable number of people gain relief from pain and inflammation, particularly in their joints. And even though cortisone shots are common among professional sports players, you don't have to be a hard-charging athlete to benefit from this injectable medication.

Despite the effectiveness of cortisone, it can come with some considerable side effects. Let's take a closer look at the treatment, its uses, and its potential drawbacks.

What Is Cortisone?

Cortisone is a type of man-made steroid that mimics the effect of cortisol, a hormone naturally occurring in the body. This is what distinguishes the medicine from anabolic steroids, which mimic testosterone.

Corticosteroids, as they're also called, can be extremely helpful in alleviating pain for patients suffering from a range of conditions, including:

Rarely does a physician select a cortisone shot as the initial treatment. In many cases, the doctor will first recommend less invasive steps such as weight loss, physical therapy, exercise, or over-the-counter medications like ibuprofen.

If a physician does think corticosteroids are the best option, shots are typically injected directly into a particular area of the body for local relief. Shortly after a cortisone injection, the anti-inflammatory action reduces swelling and pain. Within several days, the relief can be nearly complete, even for those suffering from extreme pain.

However, the effects aren't permanent; they can last anywhere from a few weeks to six months. In that sense, cortisone does not represent a cure, merely a temporary way to mitigate pain and swelling.

The Downsides

Cortisone shots' ability to almost fully alleviate extreme pain is extraordinary, but there are some negatives to consider. The side effects that a cortisone shot can trigger may counterbalance or outweigh its ability to reduce pain and inflammation.

According to the National Institutes of Health, the side effects from cortisone shots include:

Some side effects can be serious. These include:

Side effects can vary from person to person. They could be mild or severe. They might appear with short-term use or never show up at all. Long-term, repeated administration of cortisone shots can be particularly problematic, as frequent injections in the same joint can damage it, as well as the surrounding soft tissue.

It's important to remember that cortisone injections alter your immunity function, lowering the inflammatory response that your body mounts to fight injury and infection. This will reduce pain and swelling, but it can leave you open to infections and other issues.

While it's true that the list of possible side effects is long, the advantages of corticosteroids can be significant. If you or someone you love is suffering from a condition that may require a cortisone shot, be sure to talk to your physician about the pros and cons. Discuss how other medical conditions you or your loved one have may affect the use of cortisone. It's an important decision, and you don't have to make it alone.

Continued here:
Dignity Health | The Pros and Cons of Cortisone Shots

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If youre a regular lifter, the idea of juicing has probably crossed your mind. After all, you've been putting in the work, so why not reap the rewards?

In fact, most steroid users are just regular guys who just want to bulk up, according to findings published in Endocrine Reviews. Specific numbers are hard to come by, though estimates suggest that up to 20 percent of men who do recreational strength training have taken anabolic steroids at some point in their lifting history.

The number one reason I see people choose to use anabolic steroids is in hopes of more rapid muscle gains from their workout program, says Vijay Jotwani, M.D., primary care sports medicine physician at Houston Methodist Hospital. And the temptation can be big, especially if you see other guys at the gym taking them with huge results.

But just because steroids are popular doesnt make them safe. Here are seven side effects of steroids every lifter must know.

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1Acne.

Steroids wreck your skin in two ways. First, they cause oil glands to produce more fat and cholesterol, which makes your skin greasier. At the same time, they also prompt your skin to ramp up production of bacteria, explains Hallie Zwibel, D.O., director of the Center for Sports Medicine at New York Institute of Technology College of Osteopathic Medicine. And that combo can clog your pores and lead to pimples.

While the oil and bacteria productionand the zits that come with itwill go away after you stop juicing, you could be left with lifelong damage. Acne caused by steroids can be severe, which ups the risk for permanent scarring, Dr. Zwibel says.

2High blood pressure.

The hormones in steroids cause your body to retain sodium and fluids within a matter of days. That puts extra stress on your blood vessels, which can lead to high blood pressure.

In fact, when researchers measured the BP of regular steroid users, their numbers were, on average, 8 to 10 millimeters of mercury (mm Hg) higher compared to guys who didnt take steroids. That might not seem like much, but over time it can take a toll.

Chronically high blood pressure can cause your heart muscles to stiffen, Dr. Jotwani says, which can lead to heart disease or heart failure. And while the effects can be reversed within a few days of stopping steroids, if your heart muscle has already sustained damage, that could lead to a permanent increase in your diastolic blood pressure (the bottom number), because your heart has to work harder to pump blood through your body.

3Heightened heart attack risk.

In addition to raising your blood pressure, steroids can increase your LDL (bad) cholesterol and lower your HDL (good) cholesterol.

Both of those things cause atherosclerosis (when your arteries become more narrow with plaque), which can lead to a heart attack. This happens because steroids alter the production of hepatic triglyceride lipase, an enzyme in the liver thats responsible for cholesterol regulation, explains Dr. Zwibel.

Experts cant say for sure how long youd need to take steroids for your heart attack risk to increase. But findings published in the journal Circulation show that male weight lifters who regularly used steroids for more than two years had irreversible damage to their arteries.

4Aggressive behavior.

Steroids dont just make you irritable and short-tempered. They can send you into a full-on rage and make you do things that normally youd never dream of. They can also make you more anxious: you might perceive more people as threatening, and you could end up responding violently in an effort to protect yourself, Dartmouth researchers have shown.

The flood of testosterone hijacks your central nervous system and suppresses the production of the feel-good neurotransmitter serotonin. As a result, youre more prone to feeling angry or stressed.

5Breast growth.

You might be skeptical that male hormones could give you man boobs. But they canwithin months or even weeks. Thats because certain enzymes in the body can convert testosterone into estradiol (a form of estrogen), which promote the growth of breast tissue, explains Dr. Zwibel.

Worse, the results will be permanent, even if you quit juicing. Once your breast tissue expands, itll never go back to its original size, Dr. Zwibel says.

6Baldness.

You might notice some of your hair thinning within weeks or months after starting steroids. High levels of testosterone are the hormonal factor that induce alopecia, or baldness, Dr. Jotwani says. And since anabolic steroids send your testosterone levels through the roof, they usually cause hair loss.

In fact, testosterone is so good at causing hair loss that hair-restoring drugs like Propecia actually work by blocking the hormone, adds Dr. Jotwani. And once your hair is gone, it wont come backeven after your roid run ends.

7Infertility.

All that extra testosterone from the steroids can shrink your testicles and zap your sperm count. Too-high levels of the hormone can suppress the production of luteinizing hormone and follicle-stimulating hormone, which tell the testicles to produce sperm, explains Dr. Jotwani.

Problems with sperm production affect around half of all steroid users, estimates the National Institute of Drug Abuse. Itll reverse itself eventually once you stop juicing, but it can take months or even years for things down there to get back to normal, Dr. Jotwani says.

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7 Side Effects of Steroids - Steroid Shots Side Effects

How Long Does A Testosterone Shot Last?: What You Need to Know

Face it, getting everything done in a daily routine takes a lot of effort. For every item on your to-do list, there is a corresponding prep and execute list. Taking things off the list and living worry free is a fever dream.

Well, almost all of that is true. Taking care of your health means less stress and more enjoyment. Take some items off your list by finding solutions that last for weeks, not a day.

The best testosterone shots last weeks and wont need daily administration or thought. This gives you more time for living your life, not structuring it.

How long does a testosterone shot last? What are the metabolic processes involved? Read on to find answers to these questions.

To understand the duration of an injection, you need to understand what type of testosterone is in use. Typically, the question, How long does testosterone stay in your system? comes down to the ester type.

Each of the various esters has a different half-life. Esters are the bonding chemicals that allow artificial testosterone to work with your system. Chemically, they form from OH (hydroxyls) and -O- (alkoxy groups).

Then well cover the differences between drop-off symptoms and withdrawal. So youll know what to expect when going through a replacement process.

This list covers the most common forms of testosterone used in therapy (with a quick primer on production). Well include information about the different compounds used in hormone replacement therapy (HRT).

Well also go over bioidentical hormone therapy (BHRT) and the processes noted differences to traditional HRT.

Testosterone cypionate lasts longer than other ester compounds. The lengthy half-life owes to the octo-carbon bond. The effects of cypionate hit harder and last longer. This gives the most immediate and highest testosterone injection results.

The compound stays in fatty tissue, which is a reason for direct intramuscular injection.

You see effects within 2 days. After that, it levels off around 12 days and persists in the system for upwards of 21 days. It takes 44 total days for cypionate to leave the system. So implied is the testosterone cypionate half life would be 22 days.

During a treatment regiment, cypionate gets administered roughly every 8-10 days. This makes it the most popular treatment option because it takes the least amount of time and effort to maintain levels.

Testosterone propionate lasts the shortest of ester compounds. The total lifespan persists a maximum of 72 hours. Testosterone, like other estrogen compounds, absorbs poorly and metabolizes quickly. Propionate leaves the system entirely by day 16.

The short duration of propionate makes it time-consuming. It is the most work-intensive ester compound for treatment regiments. Injections need to be done daily to maintain levels and drop-offs occur in as little as 2 days after stopping.

Propionate compounds are used by bodybuilders or athletes. It has a discernable effect in building muscle mass. It also leaves the system fast enough to avoid doping test issues.

Enanthate works as a middle ground between cypionate and propionate. Effects hit between 24 and 48 hours, like cypionate. The duration lasts 4 days of peak and 10 days in total.

You need to inject enanthate every 3 days, maximum, to maintain consistent levels.

Enthanate compounds stay detectable in the system for 22 days.

Bioidentical hormone replacement therapy isnt as easy to understand as artificial esters. The tests for anabolic steroids, of which all the previous esters qualify, look for the ester bonds. With BHRT the hormones in questions have identical markers so they dont come across in tests.

To find the duration of a BHRT duration you need to test for a baseline hormone level and then for when that baseline returns. When undergoing BHRT as part of a hormone optimization plan, these levels get tested frequently in saliva or blood tartrate tests.

BHRT hits less hard, as a process it is about steady function, not peak performance. Typically injections get performed every two weeks. This provides double the duration of the cypionate ester.

BHRT also has the benefit of being indiscernible from natural testosterone production. This best testosterone injection keeps levels in the upper range of normal to benefit you. You dont need to suffer from hypogonadism to see a drop off in testosterone production.

Drop-offs occur after the age of 20 and accelerate after 40. Worse, by 40 levels are half of what they were at 20. This is one of the reasons testosterone level testing has become important to mens health in the last decade.

Low testosterone (Low T) diagnosis have risen from better testing methods. They have also risen from awareness of the underlying processes.

Testosterone controls a lot of systems for men (and some for women, mostly from adrenal production). Long-term health concerns from lack of muscle mass and bone density have made monitoring levels important. Fat metabolization and usage are also keys to avoiding diabetes and heart disease.

On the mental side, issues of mood and especially depression have emerged. Low T leads to a lower quality of life as physicality drops off and mood deteriorates.

Each of these problems alone is a cause for concern. When put together, they form a brutal loop for men. The lack of physicality increases as the desire to stay active declines.

Once they physicality tapers enough the ability to stay active in important life activities like work and home fades. These increase the mood drop-off while complicating efforts to alleviate the problem.

Normal drop-offs from age come gradually. This gives you plenty of time to adjust to the changes and keep going. It is perfectly fine to lose some testosterone production as you age.

Life has stages and they are necessary. It is when the drop-offs occur suddenly that problem spirals occur.

Remember, if you are looking at an HRT or BHRT regiment that stopping will return levels to a baseline. A baseline doesnt always feel great but it is also normal. Resorting and maintaining baseline prevents problems.

This is why reputable BHRT centers carefully monitor levels and do frequently testing.

What isnt normal are signs of withdrawal. Lets go over what those entail.

Unlike normal drop-offs, withdrawal occurs when systems become damaged from improper treatment. People have a tendency to associate withdrawal with addiction. This is why the WHO defines withdrawal.

Using artificial ester compounds for purposes of building mass often lead to withdrawal. This is because production goes outside of normal range. You can look at any super jacked body and know the answer to, Do testosterone injections work?

The problem is, they work too well. Once the body detects that too much testosterone is in the system, it stops making its own. This process occurs through a combination of organs.

The pituitary gland and penial gland both stimulate testosterone production in the adrenal and the testes. Human growth hormone stimulates and regulates some of this production. When the liver finds itself making a lot of enzymes to break down the excess testosterone, it tells the brain.

Once the brain knows that too much testosterone is present, it shuts down the testes first and the adrenals second. On top of that, the penial gland can be damaged from excess.

This is why you see ex-dopers in the condition they are in. The lack of production in the now shriveled testes leaves them shrinking and frail from bone mineral density. The frequent mood swings and instability come from the damaged penial and overall lack of testosterone.

Proper HRT avoids withdrawal because the systems remain undamaged. This is also a reason to work with a doctor in maintaining a treatment program. Supplements and injections found online might seem worry-free, however, they are anything but.

Now you have the essential information to understand what makes the best testosterone injection. Dont go it alone, but find a treatment center that will work with you to achieve your best health.

Looking for more information on testosterone and other hormonal health? We have a blog just for that.

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How Long Does A Testosterone Shot Last? | Androgenix

How many milligrams of Testosterone do men naturally produce?

3-10 milligrams per day, with the average being 6-7 milligrams per day.

When bodybuilders refer to Testosterone Replacement Therapy (TRT) dosages theyll often state that 200 milligrams is a therapeutic dosage.

This is typically not a therapeutic dosage at all, and is more like a small supraphysiological cycle being used year round.

A therapeutic dosage of Testosterone is a dosage that would bring serum Total and Free Testosterone levels in the blood up to what you would produce naturally if you werent hypogonadal.

Delving into the clinical data, we can see that the true milligram equivalent is actually far less than that.

Before delving in deeper, keep in mind that ester weight and the milligram amount per milliliter stated on the vial of your prescription doesn't necessarily equate to how many milligrams of Testosterone per milliliter your product truly contains. Let me elaborate on that.

Testosterone is the principal circulating androgen.

In men, it is secreted primarily by the Leydig cells in the testes at a daily production of about 6-7 mg [R].

Other clinical data corroborates this as well.

A more broad and accurate range is 3-10 mg per day [R], but in general, the average daily production is approximately 6-7 mg per day in healthy men.

The difference between 3 mg per day and 10 mg per day is massive, as you would logically conclude.

However, this is not reflected in the therapeutic reference ranges you will see in your blood work.

Depending on the lab, the healthy range of natural Testosterone production could be as low as 240 ng/dL on the bottom, and 1000 ng/dL on the high end.

Some labs are even worse.

It doesnt take a rocket scientist to realize that a Testosterone level 4x higher will not equate to the same quality of life, muscle building potential, etc.

However, 90% of doctors still are so far behind the curve that they truly believe that a 250 ng/dL Testosterone level is just as good as a 1000 ng/dL Testosterone level.

Based on the daily average production in milligrams, we can calculate that weekly the average healthy male produces between 42 to 49 mg per week.

A ton of men using 200 mg per week probably think that number is far too low and isnt accurate.

However, what a lot of guys don't consider is that the ester itself takes up a significant portion of the milligram content per milliliter.

After administering Testosterone, your body has to cleave the ester from the molecule to free up the Testosterone to actually be bioavailable in the body, and that ester accounts for a significant portion of that milligram/milliliter amount.

The only exception to this is Testosterone Base and Testosterone Suspension, which are just straight up Testosterone products with no ester attached, but you would never get a prescription for that as the half-life is so short it would require multiple administrations per day.

The Cypionate ester has a high molecular weight and accounts for 30% of the milligram total stated on a TRT prescription.

For example, if your TRT prescription was 200 mg of Testosterone Cypionate every week, despite the vial being labeled as 200 mg/ml, the Cypionate esters molecular weight takes up 30% of that mg content, and cleaving the ester from the Testosterone molecule in the body leaves only 140 mg/ml, which is 70% of the stated label dosage.

There are vastly different perspectives on hormone levels in the TRT community and the bodybuilding community.

There are many men (mostly bodybuilders) who believe that 200 mg per week is the bare minimum for high-end TRT, and dosages of 250 mg or even 300 mg per week are justified as within the realm of natural production still.

There are doctors who will corroborate this too, which to me is pretty baffling.

Very, very seldom does somebody actually need 200 mg a week to maintain the equivalent of healthy endogenous production.

Usually, those guys are essentially running a cycle year-round.

This is something Ive been saying for a while now, as I used to actually believe that 200 mg per week was therapeutic (until I started really monitoring my blood work closely).

My TRT is currently 125 mg per week, and even that is pushing into supraphysiological territory when you actually split that shot into seven micro shots to keep more stable blood serum concentrations.

Splitting a large dosage/administration of 125 mg per week into 7 administrations/micro-doses of 18 mg per day increases Free Testosterone more relative to a large weekly dosage, decreases the amount of aromatization to Estrogen occurring in the body, and maintains more stable Testosterone blood serum concentrations.

Often times, doctors will prescribe their patients 100 200 mg of Testosterone Cypionate every 7-10 days, and then advise them to administer it in one giant dosage once per week, or even once every 2 weeks.

This is insane and reflects on how completely inept the majority of physicians are when it comes to hormone management.

When you administer yourself with a large dosage at once, you spike your Testosterone levels to supraphysiological levels, often 2x or even 3x as high as they should be for a few days, which obviously has an equivalent amount of aromatization occurring in parallel to this.

Following this, levels slowly crash down as hormone levels decline in the body, and often times patients will fall back down to the low end of the reference range while waiting for their next shot.

The end result is a constant roller coaster of fluctuating Testosterone levels going from way too high, to way too low, over and over again, with far too much Estrogen aromatization occurring, resulting in completely unnecessary side effects.

These side effects often then need to be mitigated with an Aromatase Inhibitor, which doctors know even less about how to prescribe and mange correctly, and will often crash their patients E2 levels into the ground and leave them feeling like complete trash and ruining their lipids.

AIs are not something you want to be on long term as they are not healthy, and E2 management can be done via lifestyle and diet changes more often than not in the context of therapeutic TRT.

There are constant arguments about what the optimal replacement dose of Testosterone is.

There's a small camp of guys who believe that 10 milligrams of Testosterone Propionate per day is ideal for most men, and I'm inclined to agree with them far more than the guys who believe that dosages as high as 200 mg per week are necessary.

This will of course vary depending on a variety of factors, but typically 10 mg of Testosterone Propionate per day will put an individual at top end of the Testosterone therapeutic range.

I find that when men talk about ideal dosages being closer to 125 150 200 mg per week, the ester weight often isn't taken into account (Cypionate, Enanthate, Propionate, etc. all have different molecular weights), and they are often individuals who administer large dosages at once, let their levels spike way above the therapeutic limit up to supraphysiological levels for a few days, and slowly crash underneath that until their next shot.

If you get your blood drawn during a trough and the results show that you have a 850 ng/dL Testosterone level, you may not be accounting for the fact that right after you administered your fat weekly (or even bi-weekly) dosage, your levels probably skyrocketed upwards of 1500 ng/dL.

I found this statistic very interesting as 50 milligrams a week really is not much whatsoever in contrast to what most guys are injecting weekly believing they are just replacing their natural production.

There are a lot of massive bodybuilders, including IFBB pros, who maintain massive physiques in the off-season and in retirement with just 200 mg of Testosterone per week.

They're able to maintain physiques that are blatantly not maintainable naturally.

If top bodybuilders who are pros at 240 pounds plus are maintaining those physiques with just 200 mg per week, its pretty transparent that the 200 mg per week dosage is actually more than the therapeutic amount in most situations, and the clinical data backs this up.

Personally, I used to believe I needed 200 mg per week to maintain my physique, and I was SO wrong.

200 mg per week for most individuals is the equivalent of running a cycle year round, and certainly is not therapeutic in any capacity.

There are caveats to this, with SHBG, ester choice, body composition, diet, lifestyle factors, and many other things playing a significant role in how much Testosterone actually becomes usable in the body, consequently influencing how large of a dosage an individual would need to achieve healthy Free Testosterone levels.

But in general, true therapeutic TRT would be as simple as replicating the natural daily production of 6-7 mg with an exogenous source after factoring in the ester weight.

P.S. I do all of my daily TRT injections with an insulin pin now in my glutes and ventro glutes.

With such a low volume of daily oil, its something I can get away with daily without creating a lump of oil that doesnt absorb properly, which would occur if you tried to jab a large amount of oil too shallowly with a short needle.

No more harpoons for me.

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Intense physical activity may not be as helpful in losing weight as you may hope. Catherine Falls/Getty Images hide caption

Intense physical activity may not be as helpful in losing weight as you may hope.

It's an eternal question: What diet is best for weight loss? Or, what should we eat (or avoid) to stay healthy?

Devotees of paleo or keto will talk your ear off about why their diet is the most sensible. People choosing vegan diets (no animal products, including dairy) make a compelling case for both personal and global health.

Herman Pontzer, an evolutionary anthropologist at Duke University, argues that human metabolism has evolved to the point where how we eat and expend our calories is more important than all of our collective obsession with what to eat.

In his new book, Burn: New Research Blows the Lid Off How We Really Burn Calories, Stay Healthy and Lose Weight, Pontzer breaks down the science of metabolism and shares tales from his work studying caloric expenditure among hunter-gatherer societies.

One of the most startling findings is the notion of constrained daily energy expenditure. This is the idea that the human metabolism adapts to our activity levels to keep our daily calorie burn in a surprisingly narrow range no matter how hard you work out. But don't let that depressing fact hold you back from the gym it's crucial that you still get daily exercise for weight maintenance and overall health.

This interview with Pontzer is adapted from an interview for Public Radio Tulsa's Medical Monday program and has been edited for length and clarity.

In your book you debunk the common metaphor we use for caloric expenditure an engine or a machine. You say it would be more accurate to compare it to running a business. Why is that?

The engine view gets a few things right. We put fuel into our bodies in the form of food. And we do burn it off in all the tasks that our body does, the way that an engine burns fuel.

But an engine, like the engine in your car, doesn't get to decide how it burns the fuel. A car's energy burn is all about how hard you step on the gas pedal. Your body isn't like that. Your body is more like a business, as it has an overall goal like any business does. The overall goal of your body is to survive and reproduce, because that's what every organism has evolved to do. But there are many parts and pieces and departments that are in the service of that overall goal.

In a business you have finance, sales, human resources and security and everything else. It's the same with your body. You've got all these different organ systems that all work together. And like a business, when income is low, you can juggle things around. So you spend less on this or that task. And when things are good, you can ramp up the energy that you spend on different tasks. And so that kind of juggling or prioritization that businesses do is the same that your body can do with how it spends calories.

One fallacy with the engine model of calorie burning is we think, OK, I've got to burn more calories than I take in, either by eating less or exercising more or both. But as you point out, the metabolism adjusts, and it becomes harder to lose weight. So even though exercise isn't really a great weight-loss strategy, it's still very important for your overall health, right?

That's exactly right. If you're more physically active, eventually you don't burn more calories a day, but you change the way your calories are spent. If you spend your calories on exercise, what that means is you're spending fewer calories on other tasks.

And for most of us, that's a really good thing, because if we spend less energy, for example, on inflammation, we reduce our inflammation levels. If we spend less energy on stress reactivity, for example, our cortisol levels don't go up as high and our adrenaline levels don't go up as high, we achieve lower levels of stress response. And it seems that that exercise might also help keep testosterone for men or estrogen levels for women at a slightly healthier level. So that adjustment, that metabolic adjustment that we make is one of the reasons exercise is so good for us.

You've done extensive research with modern-day hunter-gatherers, like the Hadza people of Tanzania to better understand how human metabolism works. What did you learn?

The Hadza, to this day, don't have any domesticated crops or animals or machines or guns or electricity or anything like that. They live in grass houses in the open savanna in northern Tanzania. And every morning they wake up and women are off to get plant foods, such as berries and tubers. The men go off to hunt for a wild game using bow and arrow.

For somebody like me who studies how humans evolved, a community like that is just an invaluable way to ask what hunting and gathering does to our bodies. Because we humans evolved over millennia as a hunting and gathering species. And yes in a population like that, food can be scarce sometimes. And you're always spending lots of energy on physical activity. So your body really has to be good at prioritizing how it spends its calories.

The Hadza walk everywhere they go, and compared to us, are seldom sedentary. I'd assume they burn significantly more calories than we do in a day. Yet surprisingly, your work shows that their metabolism isn't all that different from the average American.

About 10 years ago, we went and measured how many calories men and women in the Hadza community burn every day. The Hadza are so physically active, we'd expect that their total calories burned every day would be much higher than we see in the U.S. and Europe and other industrialized populations. And instead, what we found was that actually, even though men are getting 19,000 steps today, women are getting 13,000 steps a day on top of all the other work they do, they aren't burning more total calories every day than we are in the West.

Physical activity ends up being another one of those things that the body can juggle and adjust. And so in the same way that your body can adjust to changes in your food environment, your body can adjust to changes in your physical activity. So for the Hadza, their "metabolic business" has adjusted so that they spend less on other body systems to make room for that big physical activity workload that they have.

What does this mean for someone who is trying to lose weight today?

If you or I started an exercise program tomorrow, we will burn extra calories from that exercise for a while. But after a couple of months, our bodies will adjust so that we're spending about the same energy every day as we were before we started the exercise. Your body adjusts how it spends its energy to keep the total calories burned every day within a relatively narrow range. It just speaks to how adaptable and flexible our bodies are and how we're not really in charge of our metabolisms the way we think.

You include a section in the book about the TV show The Biggest Loser in which contestants competed to see who could lose the most weight. What was the problem with that?

Contestants went on this show and were put under a brutal routine of intense exercise, coupled with near starvation. You can lose a lot of weight that way. But it's not sustainable. Your body pushes back hard by slashing its metabolic rate. Some of those contestants have been followed for years afterward. The folks that have been able to keep the weight off still have lowered metabolic rates from what they went through. A lot of the contestants gained the weight back.

It goes to show you the way to fix the obesity crisis societally or [to lose and keep weight off] individually is not some big, drastic crash approach. You've got to go more sustainably than that because the body will just push back if you push too hard.

So if your goal is to lose weight, nutrition will offer the bigger impact than exercise. But for maintenance of healthy weight, that's where exercise is essential?

That's right. Let's rethink what exercise is doing. I call it the rhythm section of your body. Exercise keeps everything on the same page, on the same beat, and it helps regulate how your body works. And so once you get to a healthier weight, once you are able to lose weight and get to a set point where you want to be, exercise is really key in keeping yourself there. Exercise changes the way that your body regulates how hungry you feel or how full you feel.

The paleo diet is based on the idea that when we were all hunter-gatherers, we ate a certain way, and we didn't have problems with obesity or Type 2 diabetes or high blood pressure. But based on your study of the Hadza, what is it that the paleo folks get wrong?

If you go out and have a chance to live with a group like the Hadza, you realize that a lot of the stories we tell ourselves about the past, including things like the paleo diet, just kind of fall apart. So there's this idea in the paleo diet world that there's one sort of single natural human diet, and that diet was very meat heavy, hardly any carbs at all and certainly no sugars.

[In reality] the Hadza have a mix of plants and animals in their diets. It changes day to day and year to year, but about half of the calories are coming from plants. And not only that but actually something like 10[%] to 20% of their calories every day comes from wild honey, which is just sugar and water, you know, which it would not be on any paleo diet person's menu. Another big part of their diet is the starchy tubers and these root vegetables, which you often aren't allowed to eat on some version of the paleo diet.

One last thing that stunned me from your book: You write about the metabolic cost of pregnancy comparing pregnant women to Tour de France riders.

You can push the body as in the Tour de France, where riders burn 7,000 or 8,000 calories a day for three weeks. But it also makes sense that pregnancy is pushing the same metabolic limits as something like the Tour de France. They both run your body's metabolic machinery at full blast for as long as it can keep it up. It just speaks to how taxing pregnancy is, for one thing, but it also speaks to how these things are all connected. Our energetic machinery gets co-opted into these different tasks and makes connections that unite all of these different experiences.

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How Humans Really Burn Calories And What That Means For Losing Weight : Shots - Health News - NPR

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CBS S.W.A.T. is ready to swing back into action, with a two-hour Season 4 premiere airing this Wednesday starting at 9/8c.

TVLine spoke with executive producer Aaron Rahsaan Thomas about the powerful, 1992 L.A. riots-themed season opener, which was postponed from last season but is only more relevant now (watch a sneak peek below), as well as the many personal storylines and tests ahead in Season 4.

TVLINE | S.W.A.T. is returning with the Season 3 finale that was postponed by the pandemic, which flashes back to the L.A. riots. Did that episode come out looking a bit different than you originally planned, given every single thing that has happened since?Whats been awesome is how our production team has been really great about being able to plan for this episode in advance. The proactive side of it has been is weve had enough time to really look at how we could still maintain the quality that we were going after in the COVID era. And having looked at the first cut of that episode recently, I can say that weve been able to get pretty much what we wanted. There are considerations regarding, you know, large crowd scenes, and certainly spacing is important. But as far as the material, were pretty much telling the story that we wanted to tell. Were still telling the scope of the story of current day S.W.A.T. dealing with the current political unrest, that tricky dance between the police and the community, and also telling the flashback story back to 1992 of some of the same parallel elements that the police and the community was dealing with at that time. That is all still very much in place.

Donald Dash and Rico E. Anderson play Hondo and Daniel Sr. in flashbacks

TVLINE | No one would have faulted you at all for going with archival news footage of the 1992 riots, because you cant put together a crowd scene the way that you need to. But youre saying you kind of found a way to sell that?Fortunately and unfortunately there are ample examples to pull from when were talking about civil unrest and uprisings in the history of Los Angeles. Theres a lot to pull from both current day and from 1992 that allows us to supplement the look of our episode. So, what weve done, with the help of our director/producer Billy Gierhart, is to in essence maximize our establishing shots based on the stock footage that we were able to get from archives, and then supplement that when we go in to shoot our people on the ground. Normally, if you can sell an audience on the scope of the event from the master shots then you tend to believe and be willing to go with that belief once you go in close. In close, we dont have nearly that many extras that we can or should use, but hopefully your mind is in the space that we actually are in that environment.

TVLINE | Did you slip in any up-to-date references? Like, are Hondo (played by Shemar Moore) and the team talking about George Floyd and Breonna Taylor?Yes and no. The tone of the story certainly shifts a bit, because at the time what we were talking about was how between the Watts riots of 1965 and the Rodney King riots there were 27 years that had passed, and the year 2020 had marked 28 years since Rodney King how maybe were making progress. But the original tone of the story was, Wow, weve learned something new, maybe this time weve gotten it right and then George Floyd happens.

What we tried to do is not necessarily focus on any one modern event or movement; our story is more about the overall legacy of a city, of Los Angeles. The fact is that the things are happening now are not unique and isolated to the year 2020. So, to answer your question: There are references to the current day situations that are happening, and in particular we have a really poignant few places where we reference these modern occurrences. But the overall focus of the story is how the [citys] legacy helps give context to the current day situations more so than the specific current day situation.

TVLINE | Will the premiere also juggle the dangling thread from the Season 3 finales Diablo storyline? Oh, yeah, we very much honor that. Theres something larger and unexpected that happens off of the El Diablo saga from last season. There are some twists and turns to that story that weve yet to play out, and certainly Diablos final lines about the city burning, those will not be in vain.

TVLINE | Are there any personal storylines youre going to hit at the beginning of the season? Like, is Luca (Kenny Johnson) back with the team 100-percent at this point? Also, Deacon (Jay Harrington) confronted his mental health, Tan proposed to Bonnie.All of the above well hit on in the premiere. Moving forward, were definitely going to see Deacon coming off of his arc off of last season and really getting into mental health and starting to counsel a new mentee, based on that idea of him being able to share his wisdom.

Well see definitely Tan (David Lim) and Bonnie (Karissa Lee Staples) examining what you know the next step is for them and Tan having to really consider whether the next step is the best thing or the thing that he wants to do in their relationship.

Luca has always been kind of the heart of our team, a good soldier, and he is going to be facing some leadership opportunities. He will examine whether or not leadership is anything that he wants to do, and why he hasnt considered it before, being a third generation in S.W.A.T. But we have a few twists with Luca, especially early on, where were going to have him working on a larger project that may take him out of the City of Los Angeles. But I dont want to reveal too much just yet with that.

TVLINE | And Street (Alex Russel), he was still dating the commanders daughter, right? Yet theres always something going on with him and Chris (Lina Esco), though we can never quite get a bead on it.Oh, yes, you have the ongoing relationship that Street has with Molly (Laura James), and that provides complications between Street and Hicks himself (Patrick St. Esprit). You know, Streets come a long way since Season 1 weve seen him mature, especially through the last season where he lost his foster brother Nate. But that tends to be, for some people, exactly where you start to backslide. So, Street at the start of the season is in a good spot, but that doesnt necessarily mean things are going to stay that way for him.

Chris, by the way, through the course of the season were going to take her through an emotional kind of whirlwind thats going to test her in a way that she hasnt been tested before. And certainly, her and Streets friendship will be affected by that.

TVLINE | Hondo and Nichelle (Rochelle Aytes) had just broken up.Nichelle went off to work on youth centers, but we really loved the chemistry between the two of them. Nichelle will come back into Hondos life, but that doesnt necessarily mean that theyre going to be romantic. Hondo has some things that he still has to figure out on the personal side before hes really ready to be in a committed relationship again. The two of them, theyre in a unique position in that you have Nichelle who works at a community center and you have Hondo who is a police officer and in the year 2020, they may have different opinions on certain topics. He needs to earn that friendship back and its really going to test Hondo in a way that we dont normally see.

TVLINE | Lastly, I wanted to ask about the statement that you and the writers put out over the summer about wanting to do better in exploring themes of racial injustice and inequality. Have you seen that effort manifest itself yet?What I can tell you is that from the storytelling end of things, we definitely buckled down and really try to make sure that were examining and getting as close to the truth as we can in the stories that we tell. Its a lot of responsibility, with Hondo being our essential character an African-American police officer who respects the job and respects the badge but also understands, having grown up in the community, what the challenges can be, and trying to bridge that gap. Weve had it baked into the DNA of the show from the very beginning from the pilot episode.

Everyone from Shemar Moore to [executive producer] Shawn Ryan to myself to [EP] Andy Dettmann, from the entire writing staff to our entire production and crew, we all have a responsibility to really lean into the show not only as a device for entertainment, but also as a beacon of hope. As an aspirational example of ways that we can improve communication using Hondo as an example of that. So from the opening frame of this season, youre going to see that Hondo is very much confronted by a community that questions his allegiance and he ends up being confronted as well by his police contemporaries who question where his heart is. You have a guy whos caught in the middle and has been since the pilot, but now so more than ever. Like, if you asked Hondo if we were making progress, he wouldve said yes.

TVLINE | Hes got to wonder now, though.Hes got to wonder now. Hondo definitely has that crisis of at least wondering if the efforts that hes making are actually making a difference, and also wondering if the fight is even worth fighting. Again, considering the legacy, considering how many times this has happened over and over again just in his city, much less the country, these are all questions that were leaning into.Were challenging him this season on multiple layers and rightfully so and were not confining it to one episode. Its not a very special episode and after the premiere well never visit again.

Our entire Season 4, pretty much every episode in some way is hitting on that dilemma and not always from Hondos perspective. Tan is a Chinese American in the age of xenophobia, so he has his own perspective thats going to be very unique from anyone elses. Like I said, were going to put Chris through an emotional ringer, and some of that is based on her own world of working in a very testosterone-driven environment. Well be dealing with white nationalists in the course of this season, and not everyone necessarily has the same perspective on how to deal with them.

Were going to be hitting on a variety of different topics, but as far as our proclamation to try to do better in front of and behind the camera, I feel confident that weve been putting in the effort.

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'SWAT' Preview: Will Season 4 'Do Better' Exploring Race and Policing? - TVLine