Dr. Joel MD

02/03/2026

Vi**ra doesn’t fix the root problem if testosterone is low.

Chronic low testosterone causes structural changes in the p***s:
• Loss of healthy smooth muscle
• Increase in fat and scar tissue
• Poor blood trapping (venous leak)

Testosterone replacement has been shown to improve libido, erectile function, and arousal in hypogonadal men, including data from the TRAVERSE trial.

Testosterone also works synergistically with PDE5 inhibitors like sildenafil and tadalafil by increasing nitric oxide and improving vascular response.

Key takeaway:
In men with ED and low testosterone, hormone optimization comes first.
ED meds work better when hormones are right.

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Stop treating symptoms without fixing the cause.

**ra

01/25/2026

Same medication. Same dose. Different hormones. Very different results.

A recent observational study published in The Lancet showed that women on hormone replacement therapy lost about 35 percent more weight on tirzepatide than women not on HRT (19 percent vs 14 percent of total body weight).

After menopause, estrogen levels fall.
Estrogen helps regulate metabolism and how your body responds to GLP-1 medications.
When estrogen is low, the weight loss response may be blunted.
Replacing estrogen may restore that response.

Not a randomized trial, but the biology makes sense.

If weight loss feels harder after menopause, this may be part of the reason.

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Stop blaming yourself.

01/09/2026

Entrenando duro porque este año hay boda 😆🙈👰🏽🤵🏻‍♂️🤞🏽 💒💍

Your longevity Doctor & your Registered Dietitan practice what they preach 🩺🥗

01/07/2026

The new Dietary Guidelines push more animal foods and higher protein intake.
Some of that makes sense.

But the same guidelines still recommend keeping saturated fat under 10% of total calories, which is very hard to do on a diet built around steak, eggs, whole milk, butter, and full-fat dairy.

Saturated fat adds up quickly.
Excess intake raises LDL and ApoB, and elevated ApoB is causal for cardiovascular disease.

Eating more quality protein is a good idea.
But what you choose matters if you want to reduce long-term risk.

When nutrition advice sends mixed signals, the math needs to be explained clearly, not brushed off as “old dogma.”

Citations:
• Ference BA et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. Eur Heart J. 2017.
• Ference BA et al. Association of genetic variants related to LDL-C with cardiovascular disease. JAMA. 2016.
• Mensink RP et al. Effects of saturated fatty acids on serum lipids and lipoproteins. Am J Clin Nutr. 2003.
• Clarke R et al. Apolipoprotein B and cardiovascular risk. JAMA. 2020.
• JAMA Network Open. 2021. Ultra-processed food intake in U.S. children

01/06/2026

Watching Peter Attia give rapid-fire longevity takes and pausing where context matters.

• Rapamycin shows its strongest human signal in older adults, mainly immune function. Not proven for younger, healthy people.
• Microplastics matter, but hot exposure is the bigger issue.
• Hormone therapy is still widely misunderstood.
• Testosterone, when used correctly, can be transformative. For women, it is often the most effective treatment for low libido, even when labs look “normal.”

Big levers. Real data. Context over hype.

Educational only. Not medical advice.

01/01/2026

Peptides are here to stay.

Patients are going to explore whether doctors approve or not. Dismissing it doesn’t help anyone.

This space is still new. Limited regulation. Limited trial data. Variable purity and dosing.

That’s exactly why physicians need to get educated, monitor labs, and act as a safety net when complications arise.

Not anti peptide.
Pro guidance.

12/18/2025

Why cholesterol often rises during menopause 👇

Cholesterol is the starting material for estrogen, progesterone, and testosterone.
When estrogen drops, the brain and liver try to compensate.

• Higher FSH signals the ovaries
• The liver increases cholesterol supply
• The ovaries are less responsive

The result is higher cholesterol from a hormone bottleneck, not diet alone.

Save this and share it with someone confused about their labs.

12/15/2025

12/12/2025

The FDA is not banning testosterone.
They’re reassessing whether decades-old guidelines still reflect modern medicine.

No changes today. No loss of access.
Just a long-overdue review of the science.

Follow for evidence-based hormone education.