Saad Alam: Hone Health - Hormone Optimization for Men

Hey everybody, welcome to the Future of Fitness, a top-rated fitness industry podcast for over three years and running. I am your host, Eric Malzone, and I have the absolute pleasure of talking to entrepreneurs, innovators, and cutting-edge technology experts within the extremely fast-paced industries of fitness, wellness, and health sciences. Please stop by futurefitness.co to subscribe and learn more. One of the most important and undeniable trends in our industry is the ever-growing consumer demand for personalization. That personalization is driven by health data. If you are a consumer-focused health and wellness company, you know that acquiring and making use of that health data is traditionally expensive, complicated, and full of friction for the consumer, but not anymore. Thanks to the good people at Sprint, a camera-enabled digital biomarker platform that connects any app to the human body. Formerly known as Elite HRV, the patented technology behind the Sprint platform leverages a decade of research into physiology, behavior, and health insights, including collaboration with 117 universities and analysis of more than 4 billion biomarkers across 20 million user sessions. Using the smartphone as the sensor, Sprend's evidence-based machine learning algorithms deliver actionable biomarker insights such as body composition, HRV, stress, recovery, progress tracking, and more, all through easy-to-integrate STK and API. Health and wellness companies are integrating Sprint to better understand their users' holistic health, make their apps more personalized and adaptive, demonstrate measurable progress, and empower their members to understand their bodies and make well-informed decisions for their well-being. Go to Spren.com and learn more. That is Spren.com. To live your healthiest, longest life possible, you need to understand what's going on inside your body. People age at different speeds, and generic annual blood work doesn't properly evaluate your biological age, but Insight Tracker does. Created by leading scientists in aging, genetics, and biometrics, Insight Tracker analyzes your blood, DNA, and fitness tracking data to identify where you're optimized and where you're not. You'll get a daily action plan with personalized guidance on the right exercise, nutrition, and supplementation for your body. Add interage 2.0 to any plan to calculate your true biological age and see how you're aging from the inside out. For a limited time, get 20% off the entire Insight Tracker store. Just go to insight tracker.com forward slash future. That's insight tracker.com forward slash future. All right, we are live. Saad Alam. Welcome to the future of fitness.

Thanks, Eric. Yeah, I couldn't be more excited to be here right now.

I'm fired up you have you. I'm very eager to get into the topics that we have today. You know, you and I have had a couple conversations uh previous to this and you know, hormone optimization, health optimization. I love it. I've been talking about forever. And, you know, I'll set the table just from my own personal perspective as well, and then we can get into your background. But, you know, I've been um I'm 45, I'll be 46 in two months, right? I've uh called myself an aging athlete. That's what I address myself as nowadays. But, you know, I went pretty hard for a while, especially as a small business owner and a CrossFit gym owner, and you know, trying to do all the things of running a business, um, you know, training really hard, thinking I was still going to be competitive in that sport, and you know, ultimately got myself in a hole. And when I hired a really good coach, uh, we took some blood samples and panels and realized that, you know, my my T levels, my testosterone levels were through the floor and a lot of other health markers that really needed to be addressed. And uh I'd made the personal decision, not to the suggestion of anyone else, but going to a clinic in Santa Barbara, California and uh getting on, you know, a whole regimen of not just testosterone replacement therapy, but also um, you know, vitamins and all kinds of things. And man, it worked. It works. Like it worked. I felt, you know, within weeks, uh, not only was you know, I started to sleep better, um, libido was up again, my gut started keeling. There was a lot of things that came about. And so I'm a believer. I didn't stay on it for a while because of some of the probably the the beliefs that I had at the time, which we'll, you know, hit straight on today. So I'm I'm not naive to it, and I do know the the benefit of it firsthand, and that's why it it excites me as a science and a field for optimizing health. So without further ado, let's let's talk about you saw. Give us a little bit of your background, how'd you get to be the the founder of Home Health?

So I guess I have I've been a tech entrepreneur now for about 12 years, and I only build companies that are what I'll call mission-driven, meaning based on problems that I've gone through myself that have some kind of large societal impact. And the the reason I do that is because if I don't, if I don't believe in the problem, I honestly I can't dedicate my life to it, frankly. And like when you build these companies, you almost have to like give a part of your soul to it to a certain extent. And so my background's really interesting. Um, you know, I was a, we'll call it a med school dropout, ended up going working and running a large pharma brand at one of at a top 10 pharma company, built then it kind of got into entrepreneurship right away. But kind of like the personal background of myself is I've been obsessed with with health and fitness for my entire life, right? And you know, most people can't see me, but probably from my name, they can probably realize that I'm not native or I'm not, I wasn't, I'm not American. And so, you know, I was born here, first generation Pakistani. And, you know, luckily my parents, they could really coach me on excelling in academics. But as a young kid, all you want to do is you want to fit in. And so I learned how to play sports at a really early age, and it just became so much of my identity because it was finally the way I got accepted by a lot of my peers. And that became the thing that gave me confidence in my life, if I'm being perfectly, perfectly honest. And that then turned into, you know, a lifelong passion for for exercising. I've worked out probably six days a week for the past 25 years of my life. I eat perfectly, I meditate twice a day. As you can see, right, I have an infrared sauna, I have a hyperbaric oxygen chamber next to me. I've got, I do have a cold plunge out on my patio. Um, and I'm just, I love it. Love it more than anything because it's helped me maintain so much of my youthful feel as now I'm approaching kind of like 40, which is like super young now when I think about it. And and really what ended up happening is five years ago when I turned 35, the first thing I started to notice is my energy level started to kind of decrease ever so slightly, right? And most people they kind of just chalk it up to, oh, you know, I'm past 30, I can't go out and drink as much anymore. And you know, it just makes me take me a little bit longer to wake up in the morning. And then all of a sudden, I think it was really when my mental acuity and my stamina started to change. And all of a sudden I couldn't remember things as well as I could, and I couldn't do mathematical equations in my head the way I could, or couldn't couldn't um recall people's names, and I was always slipping for them. And then I started to gain weight, right? I started to put quite a bit of extra weight around my midsection, and then my libido was gone, right? And I don't mean kind of gone, I mean the plumbing didn't work. And as you can imagine, I the conversations with my girlfriend were really hard. No, no pun intended, actually, the opposite of that. And and but and they sounded completely cliche, like, hey, hey, baby, it's not you, it's me. And she'd be like, no, listen, you're cheating on me. I was like, no, listen, I swear on my life, like I love you and you're my girl, there's just something wrong with me. And it was right around then, it was probably like seven months in, it started gradually getting worse, that I went to a primary care physician. And my primary care physician, he was a concierge-level doc, so arguably, like I would say, probably like a higher-end primary care physician. And he takes my blood, he takes a look at my my biomarkers, and he says, Well, Sad, there's nothing wrong with you, man. And he said, like, you are a shiny example of health. And he said, You know, look, you take care of yourself. And then, and then he started to kind of go in another direction, which is he said, you know, most men of Middle Eastern descent, they tend to age a little bit faster. And frankly, this could just be the beginning of old age. So if I were you, I'd just keep on eating healthy and working out and just deal with it because this is life. And I was like, Listen, I'm telling you, there is something dramatically wrong with me right now. And he said, You know what? You are a little bit obsessive. I can I can tell that from your personality. He says, Maybe it's just a little bit of like millennial existential angst working its way up. I said, Are you serious? Like that's the biggest bullshit ever. And I left his office, and that's what really began this journey, right? I started meeting, I didn't know where to necessarily go. So I started seeing different specialists, right? I went to endocrinologists, I went to urologists, I went to dermatologists, and probably around the 10th physician I met, I met a group of hormone optimization and regenerative physicians, and they took a look at my blood work. And within two seconds, they said, Sod, you've got the testosterone levels of an eight-year-old man. And on one hand, you have this relief, right? You're you're like, oh, right, I figured out what the problem is. On the other hand, you're like, oh, the T-word. That sounds, that sounds like really stigmatized and kind of like back alley. And I started thinking about like late night infomercials. And and the next thing they said, which was really interesting, is a large majority of our patients are younger guys just like you. And I said, huh, that's fascinating. And and so that kind of started the kind of like sparked my my curiosity, and I started doing research. And so what I found is that our father's generation had 25% more testosterone and 50% more sperm. Right? You're talking about three decades ago, those kind of swings are just so absolutely large that I said, well, why the hell is this happening? And when I started digging into that, the answer is almost going to sound kind of conservatorial, right? I mean, the the the people I was talking to, it felt like I was writing a script for like the handmaid's tale part two. But really, what we found is that when you look at all the plastics, the phylates, the fertilizers, and our food and our drinking water, for men, they resemble these estrogenic compounds. And those estrogenic compounds, they get into our body increasing concentration, and they tell the hormone regulating centers in our brain to shut down natural or what we call endogenous production. And so, really, it is in these large urban environments that are just polluted or with the food we drink, the deodorants we wear, that are really kind of poisoning our bodies and are causing us to have lower testosterone rates year after year. And the thing that's scary is that a lot of these are what we call epigenetic. So you can actually pass some of these on to your offspring. And so theoretically, right, in this conservatorial initial kind of framework that I was looking at, it's the next generation should have even lower numbers, right? And so I got I started looking at that and I was like, oh, this is such a fascinating problem because 40% of men over 35 suffer from these problems. 40%. Like that's a huge number. And I said that this is the kind of problem I could dedicate the rest of my life towards, but first I had to go see if it actually works. And so I went on treatment. And Eric, just like you, I mean, it fundamentally changed my life in the most profound ways. I literally wouldn't be here building this company had I not gone on treatment. And so, really, what our job is is we help other men have confidence as they age, and shortly after soon we'll be helping women as well, too. But it is arguably like one of the most rewarding companies I think I've built because once again, right, like mission-driven, helping dudes exactly like myself go through the same exact problems. And it's like so deep because right, these are yes, it's testosterone, but really it's identity. Like you're losing a part of yourself as you're aging because you're not the same person you were when you were younger, and you're trying to find that again.

Yeah, so it it's interesting to me because there's some people will have a fundamental thing, be like, well, that's that's the way your life is supposed to go, right? That's just the natural cycle of being a man, right? Being human. What what do you how do you address that? And then we'll get into some of the other big question marks around this as well.

So when you look at your when you look at like what happens to your body over the course of time, that is not an untrue statement, right? From the age of 30 onwards, your body stops naturally producing one to two percentage points of testosterone per year. So by the time you're 40, you could be down 10 to 20 percent. But there's no one that says you can't have as much as you had when you're 30. And there's no one that when you get to 50, you probably lost 30 to 40 percent. Now, my belief set is actually very different, and we touched upon this before. We're about ish the same age. I think that you and I will live until we're 110 or 120. I think the generation, I would say younger people, they may potentially even live longer. I literally watched my father who had went progressed from type 2 diabetes into type 1 to kidney disease to multiple strokes, he lived on 20 years of borrowed time because of technological advances, and this is like right starting in the 90s. And when I say to myself, when I when I when I extrapolate that, I'd say the technological advances that'll be in place by the time we're that age, they're gonna keep us alive far longer. But the more important thing is when you start to think about the fact that we're 40 and we may live for 60 or 65 good years, forget about the crappy years at the end. That means that we may have two good lives ahead of us, maybe even three. And so it fundamentally just changes the definition or the arc of someone's life. And you start thinking about well, if I'm 40 at 60, I want to be feeling as good as I'm 40. And if it's possible, why wouldn't I want to give myself that advantage? And what's really interesting is I've gotten into this world is the people that take care of themselves really well, right? And it's not just pump themselves full of hormones. You've got to sleep right, you've got to have the right mindset, you've got to make sure you have little stress in your life, or you have to make sure you understand how to handle it. You have to make sure that you are eating appropriately, you have to make sure you have the right relationships in your life. Those people, when they're 60, which is also very young, or even 70, look like they're in their 40s. And before I even got started with this, I interviewed almost 200 people for an hour, all guys between 40 and 70 years old. And the most interesting thing that I found is the men that believed they were young, right? This is completely a mindset. They looked 10 to 20 years younger than the other people. And so it began to understand like there's this huge component of mindset. And the people that believed they were young and took care of themselves, God. It's like they could run, they could run for hours and for days. And and I would argue, right, like 40, just turning it and being taking care of myself for the past 20 years, I still feel like I'm in my 20s, right? It's it's arguably like the best gift you can give to yourself that legitimately compounds over time. So that's probably my my standpoint, my viewpoint on it.

Yeah, and it's uh, you know, it's a there's some philosophical pieces to this, right? And I think that's uh anytime you start to get into the conversation of you know lifespan versus health span, which is, you know, Dr. David Sinclair, you know, addresses it in a lot of different ways. And you know, I also look at this in three different categories. If we have per, you know, we have our traditional um, you know, Western healthcare, which is just responsive, right? It's just we just react to right. And then we have preventative, which is now becoming more problem. And then we have on the other end of scale, we have optimization, right? Of like how do we get the absolute most? We're not just preventing, you know, things when they can be prevented, but we're also looking at, you know, how do we get the most out of the years that we have and maybe extend a few years as well. And it's it's it's an interesting, and it's all all indicators are are pointing that way. That's what people really want. So I guess before we get ahead of ourselves too, so let's let's get into what exactly does hone health do? Um, I know it's just from you know, primarily for men at this point, but you you know said that it may be for women in the future. Um yeah, talk it, talk to us about the process and how you work with with your clients.

Okay, so if I go back to my own personal story, right, the challenge was my primary care physician almost laughed me out of the room, which is an experience a lot of other guys have. And then in order to get myself one treatment, I had to bounce around the system with 10, 11 physicians. That means driving to them, waiting in the waiting room, talking to them, going to labs, getting lab work done, going back to them, going to another one, waiting for time to get booked. It's incredibly inconvenient. The other thing, too, is that when you get to them, they're quick conversations, two, three minutes in and out. They don't want to spend a lot of time with you and really help educate you. So, what we said is how can we make it the most convenient, the safest, and what I'll call the higher touch kind of service that helps educate men and helps them actually get on treatment and stay on treatment. So basically, we have a kit that you can purchase, it's $45. It goes out to your house, you prick your finger, and you're gonna give us several drops of blood. You're then gonna put that blood on what's like a looks like a fancy piece of filter paper, and then you're gonna put that into the mail and it's gonna go to one of our labs, and we can analyze that for eight different hormones. You then do a 30-minute audiovisual consult with a physician. So this is like right first 10 minutes is reviewing you just talking about who you are, what you want out of life. It's very much like a cathartic kind of time that guys have because a lot of men, since we hold this so much in, are being able to talk to someone about this for the first time in five, 10, or 15 years. And so first 10 minutes is just really getting to know you. Next 10 minutes is saying, these are what your biomarkers look like. Let's educate you on them as deeply as we can. And the next 10 minutes is okay, let's talk to you about if you need treatment, because we might just suggest that you go eat better, stop smoking, stop drinking. And if you qualify for it, then we're gonna go over the risks and the benefits. And I say risks and benefits in that order because we want you really to understand what you're getting yourself into. Because in many instances, because you're starting to modulate hormones, this can be, I'm not gonna say a lifelong decision, but a long-term decision because you're dealing with a chronic problem. We then send medications out to the patient. And then every 90 days, if you want to continue receiving treatment, and we are very serious about this, you have to continue testing and you have to continue seeing a physician for 15 to 20 minutes. And the the reason why that's so important is it really takes about six months to a year to dial you into a true hormone optimization protocol where you're feeling good about yourself. And then the other thing that we've started to introduce, we've started to introduce what I'll call longevity products, products that help you prevent long-term product diseases. And really at the end of the day, what our customers and patients tell us is that they're care about increasing their energy. And so we're now bringing forth far more, I would say, robust energy management solutions.

I'm reflecting too. I had for people who want to go back and listen, you and I talked about this, I had uh, I think it was two, three years ago, one of my most highly downloaded episodes was with Dr. Jeffrey Drobot. Uh, he's out of uh, I believe Scottsdale. And the the title of the episode was The Beautifully Complicated World of Hormone Optimization, right? And he really gets into one of the things that he addresses and he puts it into a way that I I stuck with me personally was that listen, you know, you may have the motivation, right? Like I may say, you know, you know what, when I turn 50, I'm gonna go run my first marathon. Now, I doubt I'll do that because I don't really like running that much anymore. But just for for sake of it, right? And when he talks to people who are doing that, like, listen, it's not just your willpower, right? It's do you have what you need in the tank to do that and you know, be a business owner or be, you know, effective at your job and you know, have a you know, a productive relationship and family life and social life and all these things. Like, do you have enough in a tank? And that's the way I look at it. It's not everyone's individual and everyone has different factors of stress and you know, genetics and all kinds of things. And now you know, we're talking about all these external factors of you know, the food we eat. In the water we drink in, uh, you know, just the general atmosphere that that we live in. So there's a lot too. And I think people, the stigma of like, hey, it's it's not, you know, two out of five men you said, you know, have issues like this. Like it's you're not alone with this kind of stuff. And I think that's, and guys, let's be honest, like, we're we're not good at talking about shit to each other, to anyone else, right? We're just not. I'm horrible. You know, I'll just let things boil up forever. So it's it's uh, you know, there's some philosophical points to it, but there's also it is it is quite effective. So so I want to get into, I guess, you know, what most people, what holds most people back from, you know, at least investigating this. And there's there's a couple big ones, right? Um, the big one is, okay, well, you know, let's say that I do, you know, do testing and I qualify for, you know, specifically, you know, the TRT, the testosterone replacement therapy, you know, do I have to do that forever? Is this a forever thing? Like what happens if I, you know, do it for a while and I want to, you know, step off it for a while. Like what do you say to those people thinking that right now?

So I actually, as I said, you know, like the foundation of everything is education, right? And I think that if you educate someone and give them the information in a way that they can make an assessment, they can make a decision on to themselves. And so I would I would say let's first quickly go over the biology of how testosterone works, right? And so basically the right way to think about it is you have this uh gland in your head. It's called your uh your pituitary gland. And your pituitary gland actually sits on type of your hypothalamus, and the two of them together is what they call your hypothalamic pituitary access or your HPA axis for short. And the combination of them acts like a thermostat essentially for your body's hormones, right? Now your pituitary gland sends out this hormone called LH, it's a luteinizing hormone. It travels from your pituitary gland between your eyes, down your body, and then it sees these cells in your testes, and they're called latex cells. And it basically activates the latex cells, and those latex cells create testosterone. Now the testosterone turns into a bunch of things, but for purposes of this conversation, some of that testosterone it transforms into estrogen. Then what ends up happening is the testosterone and estrogen you have in your body travels back to your pituitary gland and your hypothalamus, and it basically says, hey, this is how much it's currently in your body, and then that regulates how much LH is coming out. Now, so that's kind of like what we'll call your your feedback loop of your body. LH feeds your testes, testes produce testosterone, testosterone creates estrogen, estrogen and testosterone tell your hypothalamus how much LH should be created. Now, if you are a younger guy and you are afflicted by what's happening to a lot of younger guys, chances are your LH level is decreased right now. And so what basically means is there are products that you can take that are not testosterone, maybe something like Clomid, which is actually a fertility drug that's been used for the past 30 years, that tells your pituitary to increase your that LH signal, you can take something like that. Now, the great thing about that is it basically kickstarts your system. You can take it for three to six months, it increases your testosterone levels, and then you stop taking it after a while. And you maintain your fertility. It's also a very important part of it. Now, when you get older though, what ends up happening is, and I kind of referred to that fact before, which is at 30 years old, your testosterone starts to naturally decrease. Well, what happens is those LADIC cells you have in your testes, they stop to function. And it's like almost imagine there are lights that are on, and over the course of time, those lights slowly start to turn off. So if you don't have as many of those lights on in your testes, and I tell you to increase that LH signal that from your pituitary, nothing happens, right? Because it's just like fundamentally the engineering isn't there anymore. The engine doesn't work. Now, if you're a little bit older, that means you have your body doesn't have its natural ability to produce testosterone as much anymore. And so that means that you can't take that drug called clomin. And so you most likely have to take exogenous testosterone, which means right, a shot, a troche, or some kind of testosterone cream. Now, what ends up happening is because you're putting all this excess testosterone into your body, your HPA access is basically seeing that and going, Oh, I should stop any of the LH that's being produced. So what ends up happening is the latig cells you have in your testes, they start to be inactivated. And so then what ends up happening is after you stop taking exogenous testosterone, you're no longer producing any by yourself anymore. And so if you take something like that cloma drug and try to increase it endogenously, it just doesn't work. And so basically, what we tell people, right? We have a chart, we show them the whole chart, we say generally, if you're older, we'll call it 50 years and above. And keep in mind, I'm not a physician at all. If you're 50 years and above and you take testosterone, you are probably signing on something that's a little bit longer term because we can't kickstart your body and force it to produce testosterone naturally anymore. However, if you're younger, 30, 40 years old, you're probably not signing yourself up for something where you have to be on it indefinitely. Now, can you get off it? Yes. People get off it all the time. Will they probably go back to feeling worse than they were? Theoretically, yes. But it's also, I think it also is comes down to a framing perspective. If if you look at low testosterone as a chronic condition that gives you a lower quality of life, and you have to take a medication for the rest of your life that's actually going to improve not only the way you feel, but actually improve your chances of, I'll say it'll decrease your chances of cardiovascular disease in the long term, it'll decrease chances of diabetes, depression, it'll decrease your chances of dementia. I would want to continue taking that myself as well, indefinitely, frankly, so long as it wasn't hurting my body. It's the same thing a diabetic would do. Now, the diabetic obviously has a far more kind of like dire if you don't take it, you may die kind of uh deal attached to it. But if you if you switch the perspective or the way you frame it, it makes you, it gives you the information to say I either do or I don't want to take this chance in my life.

Yeah, well said. So and you brought it up, so let's talk about uh fertility, right? How does how do these type of therapies, how do these levels of optimization uh work with with male fertility?

So we generally, if someone's young and they want to have children, we will highly, I would say we would we would tell them that they shouldn't be taking exogenous testosterone because we want to maintain or preserve as much of their fertility as possible. At the end of the day, they're open to make their own choice. And keep in mind these are patients that what I'll call what I call hypogenadal or have clinically low testosterone. So at the end of the day, if they're willing to take the choice, we'll the physicians we work with will prescribe it for them. But if they decide to go off or they decide to want to have children, we do what we call like post-psychotherapy. They have to take something that helps them naturally come back on. I'm one of those people that's a perfect example. My girl and I are trying to have a child right now. So I came off the testosterone and I'm taking multiple medications to increase my sperm count. Now, thank God not gonna wood. It seems to be working. And so generally we tell people there is a some probability that if you go on testosterone and you're still trying to have children, you may not be able to, right? You have to be very open and very honest with that. That probability, very, very small, but you don't want to be part of that probability, right? And so at the end of the day, you have to make your own decision. And I am one of those weird individuals. I have my my sperm stored at five different sperm banks just in case. Uh so that's that's the way I decided to go about it. Because frankly, like I said, I wouldn't be here working in this capacity if I hadn't taken my medication.

Right on. Uh, and you know, one of the the last things we'll tackle and we'll get into um other or some other topics around this, but the what do we have in this area as far as long-term studies, right? Peer-reviewed, published studies on uh hormone replacement therapies. What is that looking like nowadays? It's been a while since I've asked someone, it's been about four years.

Eric, I think I you lot I got lost you for a second. Did you say peer-reviewed long-term studies?

Yes, that's correct. Yeah, where are we at with that?

Okay. All right, so this is a very important qualifier that I'm gonna give you. For men that have normal testosterone levels that just want to optimize for optimization's sake, the long-term efficacy studies I'm not gonna say aren't positive, but aren't well established. The studies I'm gonna talk about are specifically for men that are hypogenadal that have low testosterone, right? That's the most important thing. And that's the only group of people that we actually prescribe to. When you find men that have clinically low testosterone and they take testosterone, what you're beginning to see is they have fewer comorbidities, they have lower mortality rates, generally they have lower depression rates, they have fewer cardiovascular problems, they have lower incidence of diabetes, they have uh because testosterone produces estrogen, estrogen has a protect effect both on the bones and the brain, low rates of dementia, higher bone mineral density. Um, and so it for the people that are low, it really is like this very interesting hormone that is used in every one of the cells in your body to actually help give you longevity to a certain extent, right? And it's and I use that word very, I try tread very carefully when I say it. It's for a group of guys, they wouldn't live as long because they aren't as active and they have far more problems. And for the ones that end up taking it, they just tend to live healthier lives and they're happier as well.

Yeah. Yeah, it's interesting. So talk to me about the industry, right? Like the the I guess we'll just call it uh what do you call the industry that you're in? What how would you address that?

It's it's uh I laugh when I say this because I could say some people might call us a testosterone clinic in the cloud. Um, one way I describe it as like an online hormone clinic. And really where we're moving, which is more important, is we're kind of giving guys the playbook or people the playbook to have more confidence in the age from multiple different angles. Um, hence why I said we're going into longevity and disease prevention and energy, because testosterone by itself, if we're being completely candid, it has a negative connotation associated with it. And so the what we're trying to do is we're saying, yeah, look, people are going to purchase testosterone from us regardless, and we're really good at it. And we do it in an incredibly compliant way and it's very sophisticated, and we care about our patients. But the reality is like that's actually only one part of the problem. Right? Generally, when when most people come to us, right, most people, what's interesting is they think that testosterone is a muscle and sex drug, meaning I want bigger muscles and I want to have more sex, which by the way, you get both of those things while you're on it. So it's like a wonderful added benefit. But the reality is most guys are coming to us and they're saying, I can't get on the ground and play with my kids anymore. They're saying, I can't have a real relationship with my spouse or partner because I don't have the patience to sit down and talk to them. Or I can't go to work and earn more money because I just can't focus anymore. And really, because of those things, I've lost my care, I've lost my identity, I'm a shell of the man I was. And so we really kind of say to ourselves, if that's what you're coming to us as your principal complaint, and it's all the symptoms of hypogonadism, if we do the analysis and we look at your biomarkers and it isn't low testosterone, but you still have those problems, what are the other ways that we can actually help you? And so the kind of like the the category that we're kind of like starting to look at is like this is just modern wellness, right? Like every 35, 40, 45-year-old guy and and woman, they're gonna go through this process. And we want to be the company that's there to help them figure out how to kind of get their mojo or that excitement back in their life.

Yeah, and I know I have good friends who have been on uh, you know, HRT hormone replacement therapies for for quite some time. I mean, gosh, man, Joe Rogan, right? The biggest bogcaster in the world, huge, very open advocate of, you know, he doesn't say it's you know, not saying it's for everybody, it's for me. And he likes the benefits of it because that guy drives hard, right? I mean, if you look at how many things he does, how many hours he must work and uh and the lifestyle he lives, you know, and you know, having a good friend who uh came from the jujitsu community as well, is like, and they're very uh they're adopters of of HRT for sure. But you know, it's his as we were golfing one day, is like, you know, I I wanna I wanna be a good golfer now, not when I'm 70, right? I want to do the things now. And that it's it's just a philosophical thing in life. Like you gotta have your own, you know, life philosophy when you come around. Like, hey, am I gonna optimize right now? Um, am I just gonna see how things unfold in the future, right? Like, when do I engage with this if I engage with it at all? So it's it's you know, I like modern wellness and I think it's just a great option for people to explore. And you're right, education is key, right? You gotta know what you're getting into. And traditionally, with this stuff and the stigma that comes around it is what's the first thing you think of is some guy in a gym locker room shooting up, you know, 10, 100 times more than he actually needs, right? And then, you know, coming off it later in life and having a lot of real big issues, right? Because they just done. And that that's not what it is anymore. Now there's, you know, I think a potential for a sweeter balance that allows people to live better, longer lives. And that's that's kind of the the deal. So anyway, uh modern wellness, let's talk about that. I mean, that puts you into a very large category of a very big industry, right? Um, do you do you say that you have competition in this area, like legitimately?

Because you know, most of the time, I think I told you about this the other day, is like there's this guy who just keeps calling me like every six to 12 months, but hey, this is so-and-so from you know, so-and-so's testosterone replacement, like checking out what you're doing. I'm like, lose my number, right?

Um But how as as particular niche of the modern wellness industry, what what are you seeing in in this area? Is there growth, is there traction, is there competition, uh, is there investment? What do you what can you report to us?

So let's let's first take the actual testosterone industry per se, right? Because I think that's an interesting one that we can kind of talk about how that's evolved and where I think the industry's going.

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There's one large brick and mortar chain. Um, there are a couple, we'll call it like online clinics that are probably $20-ish million dollars in revenue. The brick and mortar chain is about $100 million of revenue. And then you've got a ton of mom and pop shops, meaning like individual physicians. Now, a lot of them are have been practicing maybe for five years, 10 years, but they're doing the same thing over and over again. They're not taking the collective learnings of the the entire country and saying, how can I actually improve care? Right. And so exactly, I get I get mom and pop's calls all the time from different shops. And really, it's like probably guys that hooked up with a physician that did work at a gym that think it ever thinks that everyone wants tests, and you know, they're just smiling and dialing all day long, and they can probably create a book of business and maybe get to like half a million dollars, a million dollars of revenue, which actually, by the way, is a wonderful business because the margins are great in it. But they're not they're not concerned about like customer safety. We over test because we legitimately believe in safety, and really like customer experience in terms of how can you get them to the the outcomes they need as fast as possible. And so then you kind of we'll just call like you have the testosterone industry per se, right? And it's I would argue it's kind of like a little bit of like a back alley industry because it is stigmatized, frankly, right? Certain states far more accepted, Texas and Florida, because there's far more education, it's been around longer. Then you have what I'll call like optimization clinics, which are slightly higher-end companies that are also packaging peptides, maybe they're doing some Botox, maybe they're doing some Gainswave as well, too. But all and slightly obviously a little bit larger, maybe they get to like $2 million of revenue. Um, but there isn't, and there are a few kind of what I'll call optimization brands that are hyper-regional. But the reality is like once again, too, they haven't figured out how to create a real engine that becomes smarter over time. And so the thing that we've done, and why we really are a true technology business, is I've probably invested four million dollars into creating a very specific EMR or what I'll call an electronic medical record system, both for physicians and patients, right? And so the the punchline of that is I probably have like one of the most complex longitudinal patient measurement systems in the country. And what that basically means is if you can imagine, right, patients come into us, they want to do at-home testing, they could, or they can go to Lab Core, or they can go to Quest, maybe they can use their insurance. We have to have a system in place that allows for that seamlessly. Then we've got to have a system that allows them to go to one of our hundreds of physicians across 38 different states, right? Uh seamlessly. We then have to have a system that makes sure that it captures the biomarkers, it tests it when they're tested at the lab, if they're the appropriate biomarkers, it moves them on to the physician. And then if they're the wrong biomarkers or if it fails, it sends them back out of kit and redoes this without the with the minimal amount of intervention. Then we have to build a system, and we spent two years talking to doctors and saying for every single, we basically worked with a hundred different physicians to say what is the most perfect EMR specifically for hormone optimization that you would build. And we built that. So that is it takes the the smallest amount of administration time, and I can spend that 30 minutes focusing on the patient and providing the best care possible. Then once you do that, you have to make sure that that system integrates with multiple pharmacies across the country because you want to diversify your supply chain. Then you've got to make sure you build a system that uh can get medications out to the patients on time and shipping controlled substances state by state, very different, right? Then you've got to make a system that basically knows when to send patients medications and checks against like what I'll call like a national PDMP, which is a database to make sure patients aren't abusing the medications at another provider. Then you've got to make sure that every 90 days they get another test plus another physician consult. And keep in mind, right? The biomarkers are changing based upon the medications you're on, and then the products are changing based upon what the physician recommends, and so you've got to figure out how that whole loop works. But the most important thing is at every single one of those touch points, we are extracting data out of the system, right? Biomarkers, patient-reported outcomes, physician-reported outcomes, medications, how the medications are working. And now all of a sudden, what we can do is we can take the you know, the large number of patients we have, and we can start to draw some really interesting insights out of it to give to our physicians to change prescribing behaviors. And I'll give you a really interesting one. So most physicians think that when a patient comes in and they have low, really low testosterone and high estrogen levels, that a patient should go on testosterone, clomid, and anastrazole. And they believe that a patient should go on those three medications because it increases the testosterone number the most over the course. Of six months. So generally a patient comes in at like 280 nanograms per deciliter, which is a measurement of low testosterone for us. Over the course of six months, they'll probably increase about 340 points. So right, they'll be 620, 640 kind of range. Their self-reported efficacy measures, and I'm just making this up right now, uh, just to make it make it useful for your audience, they'll be uh 10 and their depression scores will be uh we'll call it a nine. But what we found is that when patients with that same exact kind of problem set come in and the physicians just prescribe them with two medications instead, their testosterone level may not go up 340 points. Maybe it'll only go up 280 points. But the most interesting thing is their self-reported efficacy measures, instead of being at 10, will be at 13. And instead of their depression score being at nine, and this is going to work in the reverse way, it'll be at six, so it'll be a 30% improvement. And so then we're able to turn around to our physicians and say, hey, look, I know you like prescribing your patients all these medications, and it seems like it's the most efficacious, but we have data that shows us otherwise. You make your own independent decision at the end of the day, but this is the way we can add value to you and make sure the patient gets their outcomes even faster. Now imagine, right, you're doing that with testosterone, then you throw longevity medications into that, and then you can kind of you're running these long-term efficacy trials in the real world with a combination of those both of those medications. Then you throw thyroid into this, right? Thyroid has another eight biomarkers you're going after. And so now all of a sudden you have this data set that no one has and that no one can compete with because you can get your patients feeling better faster than anyone else. And I'd say that that's actually like the real value in what we're building. Yes, it's more convenient. Yes, it uh it can work, it can get you medications faster, but it's really at the end of the day, and we're just at the in the first inning, at the top of the first inning. We will be able to get you better outcomes.

It's fascinating. So that that brings me to my my next question, too, is when you look at let's just put a time horizon on it, so like next 10 years, right? How do you see this playing into the greater healthcare continuum? And by what I mean by that is like, you know, will this become an option for primary care? Because in context like the clinic I worked with when I was in Santa Barbara and I was, you know, talking anecdotally about my experience in the beginning of the podcast, they served as also not just, you know, uh an optimization factor, but like my primary health care. Like if I had a sinus infection, you know, I had to go in there every two weeks anyway. So I talked to the doctor, be like, oh yeah, you know, then write me a script if I needed it, or just give me some hints on how I could, you know, feel better due to allergies in the area, right? So it was like I had a relationship more than I ever have with most of my primary care doctors. Um, so there's an opportunity there, but you know, do you think this is something that's gonna be just you know prescribed out, you know, as an outsourcing things as a specialist, uh, you know, by primary meds within the insurance network? Or yeah, give us give us an example. How do you see this evolving within that that sphere?

So I think there is a to your point, I like the words you use continuum, right? There are people that have different preferences in life. The majority of people, they go to the physician right now when they have a problem. And usually it's when the problem is bad enough where they can't deal with it by themselves at home anymore. Now I think what's starting to happen, and it's really happening with our generation, if if I'm if I'm thinking about this deeply, we've watched our parents go through a lot of chronic conditions. We've also realized that at the age of 45 and 40, life's little dirty secret that no one tells you about is you still feel like you're a 20-year-old in your head and you don't want to give away your youth. And you think you have a whole lot more, you've got a whole lot more to give in that tank. And I think the combination of those two things, plus the the internet, which is disseminating ideas about what's acceptable around age, is starting to come into mainstream, like you said, right? 45-year-old crossfitter probably still gets after it pretty hard, probably outworks a lot of the 20-year-old guys that in there too. You have a very different mindset on the way that you approach life. And the more time that you spend around like-minded people plus people that may not be like you, you are only giving them new ways and inspiring them to live differently. And so when you say 10 years from now, I think that an incredibly large percentage, and let's when I say incredibly large, let's say it's maybe 3% of the overall population right now, maybe it's 15%, right? Which you argue is a very fast growth rate. And they say to themselves, I don't have to live that way. The traditional primary care route, that's not for me. I want to go figure out how to be the best version of myself. I want to continue growing, I want to have the right mindset. And there has to be someone there who's done it, that has the data, that has what we'll call like research-backed protocols that has trust, and that's who we intend to be. And so, and literally, right? The life that you live, the life that I live, that's what we're trying to give to a larger group of people, right? And it's what's interesting is that we both probably still have a whole lot of problems and shit in our life, frankly. But because we've been spending time really fixated on our health and our mindset, I'm a whole lot happier than most other people out there. And I feel completely blessed. And it takes a lot of work to get there, right? I've got really shitty days, but because I've had the right mindset, because my health is in place, generally I feel grateful even on shitty days. And so I think that over the course of time, more people start to realize they don't have to live the life their parents live, and there is a completely different approach. Now, then when you say 20 years, right, from now, 20 years from now, I think the whole world is different. I think there's a large percentage of the population that just realizes that when you get into your 30s and 40s or your 50s, there's a tune-up that's required. And I almost hesitate to say 50s because I think the ideas start to move even further downstream, and people say, like, I want to do this thing earlier on, because there's no reason for me to kind of have that downward lull before I have to figure I have to pull myself back up.

Yeah, I it it is interesting. I mean, I was having a conversation with a client the other day, and we were talking about uh how I have probably have like three more obsessions left in my life. And what I mean by like, you know, like you you even careers, you can just look at it as careers. Like I have, you know, multiple things I still want to do that are, you know, not even probably adjacent to what I do now. Like I in physical obsessions, I went like right now, I'm completely obsessed with skiing. I think about on the dead of of summer, right? And uh, you know, who knows how long that obsession will last. And then maybe I'll move into something, maybe I'll start jujitsu, you know, again and when I turn 50. But I want that uh in my head to your point, like I'm super young, man. Like I'm ready, I'm ready to go. Um, but you have to face the realities of where the physical is out as well. So I I want to get into this uh because I'm just curious about an audience probably is too. We're we're and share what you can as far as numbers, but where is hone at as like a uh as a business at this point? I know you started, I believe, in 2019, so we're in what year three, am I correct in saying that?

Like, you know, three years, we've been in business for two and a half, two and a quarter years at this point.

Okay. Yeah, what about um I mean you guys go ahead.

So I can say this, right? We are probably from what I know the largest online hormone clinic in the country. Um and I think that I I am cagey about it just because uh we're still a private company and we we go out to raise capital and we keep our numbers kind of like close to the vest, but like well into the well into the eight digits uh and an incredibly luckily I would say like a very healthy business per se, um where we're not dependent upon capital anymore. But frankly, like if you want to go do things faster and if you want to move into additional modalities, then I think you've got to take on additional risk capital.

Yeah, uh that's great. Congratulations, man. That's whatever those numbers are exactly. That's that's a long way to come in two and a half years. That's uh that's impressive.

Thank you.

What do you what do you go for it?

I was just gonna say it's I I wish I could take any of the credit. It's really my team is just, I mean, fucking amazing.

Like that's always the way it is.

I'm just like the dummy that gets to talk on podcasts. And honestly, like my team is a bunch of like mission-driven killers. Like, I couldn't be more proud.

Right on, right on. It's good to hear. What what do you what do you need right now? Like, what are you guys looking for? You know, for people who are listening, who if you want to, you know, looking to collaborate, are you looking for partnerships? Are you looking for investors? Like, what are you guys looking for right now?

And this is uh just people know it's uh mid-August 2022 We're looking for people that that want to help tell the story and help break the stigma. That's first and foremost. Like spread the word, talk about this thing that's called testosterone or hormone optimization, isn't as scary, and it's actually like becoming very acceptable, and it creates a huge net positive in your life if you're the right candidate. The second thing is, and we talked this before, we are we're moving into insurance, and we're now also starting to think about partnerships, meaning what are other large, whether it's employers, whether it's gym chains, whether I mean you could even be a some kind of franchise that we can partner with to help get our services to patients even faster. What are ways that we can work ourselves into physician referrals? I think those are the things that we're really starting to think about right now. Hiring-wise, we're looking for, as I said, the the depth of the very intricate information we have on individuals. We're looking for people that understand how to work with it and how to do useful things with it. Um, those would probably be like the top three things that are on my mind right now.

Awesome, man. Yeah, that's a good place to be. And I think there's gonna be a lot of people who who hear this are gonna be interested in you know what uh what a partnership could bring or or collaboration can bring through it because it is, it's it's a growing field, it's very promising, and uh, you know, it's only gonna go more mainstream every day. Uh if people want to get a hold of you personally, Saad, or is there a or a place you want to send them online? What uh where do you send people?

So I get a ton of people that DM me through Instagram, actually. So my Instagram handle is M S A D Alum A-L-A-M at or just that's my Instagram handle. The other way to get a hold of me is uh just email me, right? Um, and that is s-a-l-a-m at salam at honehealth.com.

Awesome, man. Well, hey, congratulations on success so far. I mean, it's uh like I said, it's still a young company relative, right, to a lot of these businesses in the in the health and wellness industry. And uh I'm excited to see where you're going. Thank you for coming on and talking about the the harder conversations that are around this topic because I think it's the things that people just need to hit head on, right? I mean, we could talk about the benefits all day long, but you know, it's it's it's really critical to be, like you said, educating first and then letting people make their own decisions uh around that education. So great job, man. I really appreciate you coming on. And ladies and gentlemen, sad, alam.

Thank you so much, Eric. And thanks to your to your listeners for taking this hour with us to here.

Hey, wait, don't leave yet. This is your host, Eric Malzone, and I hope you enjoyed this episode of Future of Minute. If you did, I'm gonna ask you to do three simple things. It takes under five minutes and it goes such a long way. We really appreciate it. Number one, please subscribe to our show wherever you listen to it, iTunes, Spotify, Castbox, whatever it may be. Number two, please leave us a favorable review. Number three, share. Put it on social media, talk about it to your friends, send it in a text message, whatever it may be. Please share this episode because we put a lot of work into it. We want to make sure that as many people are getting value out of it as possible. Lastly, if you'd like to learn more, get in touch with me, simply go to the futureoffitness.co. You can subscribe to our newsletter there, or you can simply get in touch with me as I love to hear from our listeners. So thank you so much. This is Eric Malzone, and this is the future of fitness. Have a great day.