The biggest issue in hormone replacement therapy is that doctors are too lab-focused instead of patient-focused. How does this lead the medical community to overlook testosterone resistance? What are the different levels at which testosterone resistance occurs? What does “optimal” actually mean? On this episode, Dr. Keith Nichols talks about nuances of optimization that often get ignored.   Three Takeaways   Aging significantly affects our organs which leads to decreased tissue responsiveness. This impacts the metabolism of testosterone at a cellular level.   We need to stop treating for a number and start treating for symptoms. With injectables, the best delivery method is daily. It’s best for mimicking endogenous release. Second best is every other day, and third best is two injections 3 times a week. At the start of the show, Dr. Keith shared how his work in hormone optimization started with his own personal experience. Next we talked about the history of how the medical community went from being patient-centered to lab-focused. We also discussed how aging affects tissue responsiveness and a patient’s testosterone levels. We also discussed: Why physicians struggle to change their view on hormone optimization The downsides of trying to control estrogen   Hormone replacement therapy is really very simple, and there’s no need to manipulate a lot of variables to optimize a patient. What creates problems is when physicians are so obsessed with numbers instead of treating someone until their symptoms are under control. If we don’t do this, we’ll still see men with so-called “normal numbers” not getting treatment even when they desperately need it.   Guest Bio- Dr. Keith is a medical doctor at Tier 1 Health & Wellness. He is board certified in Physical Medicine and Rehabilitation. He has served as a team physician for the Nashville Predators of the National Hockey League, a ringside physician for Strikeforce and the Ultimate Fighting Championships, and has consulted in the care of many other high school, college and professional athletes, including the Nashville Kats of the Arena Football League and the Tennessee Titans of the National Football League. Go to http://www.t1institute.com/ for more information.