how do I actually know when I'm optimized you know how you feel and sometimes you need to be reminded what I like to do is the Adams score that guys come in and answer a list of ten questions about their top symptoms which are essentially all common and and and non-low T symptoms what I like to do is on every follow-up appointment I like to react them the same questions that they answered yes to so if you answered yes to a decrease in energy if you answered yes to lack of erections or erection quality if you answered yes to low libido if you answered yes to inability to lose weight assuming you're doing everything that's conducive for weight loss which as we know is not generally hormonal it's a lot of other things but if you answered yes to all of these factors and then I can ask you these questions six months from now on the answer is no we know we've achieved the resolution for that specific condition the goal here is to get a no I'm all ten questions and the job is not finished until we've resolved all time and like I said earlier not all of them are specifically related to testosterone or even hormones in general some of them are lifestyle issues some of them require more patient education and other aspects like nutrition and exercise and sleep and stress relief and various different coping mechanisms there could be stress due to a relationship or a job loss or things that are not really related to your hormones but everyone likes to put their finger on their tea or tea and blame it for everything so once you really understand what these stressor or the stimulant for that particular symptom or sign is you can address it and I think that it's important to address all these things with patients outside of just saying look your hormones are great have a nice day deal with it you know we do try to help them in in every other area of life if we can so ultimately how are you gonna know you're gonna know because you came in because your quality of life was suffering if you feel that your quality of life has improved and you feel that it's improved significantly and your labs show that the factors that are known pathologically to be damaged by Lahti have improved now we know that we're on the path to either being fully optimized or perhaps we have been optimized and then it's a matter of staying the course and monitoring as your body changes over time to make sure that the changes that we perform are in fact conducive to support that goal because it's not like I hit the pause button and that's my protocol for the rest of my life things change but you'll know I mean you know you came in because you didn't feel well and if you feel better and the parts that bothered you the most have improved you're on the right track but some men might think they can always do better they can always use more energy they always can have a bill a bit of more libido when do you know that you're optimized more in the Jesus pelvis greener the grasses greener more does not mean better more libido does not mean better heck I could tell you from firsthand experience as well as with other guys there have been times where libido has been so intense that it actually impedes your work and impede your ability to do other things you know more is not always better this goes for everything if you feel that you're lacking somewhere and it's just a matter of curiosity you learn to be happy with what you got if it's legit an area where you are lacking then yeah you can always discuss an opportunity to improve but we always have to be conscious about the fact that does this mean I need a higher dose or does this mean I need to do a better job with my diet does it mean that I need to get better hours of sleep do I need to have a little more intensity and more frequency in my training sessions do I need to again alleviate some stress at home or at work there are always ways to improve your life and they're not always going to come down to your hormone therapy but again you know we're not Superman we are humans and we are going to have ups and downs and even the most optimal of people has a bad day just because they don't post about it on social media does not mean that it doesn't happen so the grass is always greener you always gonna look up some people and you're gonna say well I want to be like this I want to look like this I want to perform like this he has bad days too okay he just doesn't hit Send and publish it to you so understand that it's it's not that bad if you're feeling okay enjoy the ride okay you're only human and if you keep chasing more and more and more you run the risk of ruining what you have and not having an easy time getting back there okay [Music] [Applause] [Music] [Applause] [Music]