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Built In Real Life - Ep 5 - What Happens To Men After They Become Dads? · Built In Real Life

• Mike Miller: Everybody, welcome back to Built in Real Life. I'm here today with Gary. Gary, welcome to the sets. Gary's first time on the podcast. We're very excited about it. Today we're going to be talking about what happens to men after they become dads. A lot is the answer. Or nothing happens. That is a loaded question. It really is a loaded question. So everybody talks about what happens to women after a baby, but what actually happens to the guy? What are some of the changes that a man might experience when, you know, last episode we were talking, Melody and I about the changes in a marriage that occur. you know, when children are introduced into the mix, it absolutely has a lot of changes. But what about for a guy? I mean, there's a lot of support that we need, and I don't think that we know what we need really. We just think we're tired because life is crazy and we got a newborn and stuff like that. But what about like a couple of years in when you still feel tired? Like, what is that about? So I mean, there's a there's a lot of challenges to that too, because men don't typically talk to each other the way that women do. So the support part of that just isn't there. And I think that there's a a push for men to feel like we have it all under control. And that's what we have to present to the world. Yeah. we're supposed to have all the answers. And a lot of times we're equally as afraid as as the next guy that we're going to mess something up. so yeah, I mean, it's it's a lot of transitions. you know, from a a medical standpoint, even though there's a lot of data out there in in these long-term studies where they actually found that. over time and in not just in the United States, this is this is worldwide. You can find that that there's a pretty consistent trend where testosterone goes down, especially early fatherhood. And so there's a lot of dynamics there because even outside of fatherhood, people hear about testosterone coming down and and why there seems to be a societal trend over the past 30 or 40 years, why it why it's happening at younger ages. And then you also throw into the mix. Now we're talking about a specific subpopulation, new fathers. so a lot of the the thought on that was maybe it's because, you know, we're tired and you know, being fatigued, lack of sleep are definitely contributors, whether or not you're a father. For sure. stress all plays a role there. but it actually goes a little bit further than that. there are studies that show that testosterone actually starts dropping before. The birth. Really? Yeah. Yeah. So it's it's there's much it's more nuanced than just we're tired and it's just life is getting to us and it's it's causing some changes in us. the big question that's still not really answered. I mean, this is an observational study. We're we're seeing a trend, and then what we always want to do, you know, is scientifically in a medicine, there's a there's a tendency to want to explain something that we observe. So there's a lot of A lot of maybe disagreement about why that's happening. And again, nobody really knows for sure, at least not from the studies that I've seen. So people kind of extrapolate from that and say, okay, well, we see this trend. So it must be cause and effect. I think it's more complex than that. But one of the theories that seems to be popular here is that as you know, think about somebody with with your classical, even though it's not accurate, high testosterone. Is that, is that the person that you want to hand an infant over to? So the thought is maybe this is something that's going to prepare the male for bonding instead of seeking out the next mate. and then I was I was kind of looking through some of these studies, and as I'm thinking about, I'm like, the more I talk about this, nobody's gonna want to be a dad. So Yeah. here's your contraceptive speech, and it's it is something hard to accept. And it's not to say that you're being demasculated. Sure. but I think that it is an important shift because women's hormones change, you know, in in early motherhood throughout the pregnancy for sure. it makes sense that there's going to be some hormonal changes for the male too. Yeah, absolutely. And I mean, even if it sounds like it's a primal thing, it doesn't really sound like obviously it's a conscious decision to lower your testosterone and everything. But I remember, welcoming our first child. And I probably had low testosterone at the time, knowing myself now. But I find myself being softer and trying to play my part and be gentle and do all that. So your habits change and you start to slow down a little bit. You want to be more present to those things. And I think maybe the changes in behavior and habits might lend itself a little bit to that too. There's like the betting down process that happens. women go through the nesting phase. And I think men probably go through that as well. And you are anticipating that. And I just I remember what that felt like for me a little bit of just getting ready for what a house with a baby would feel like. And it did feel a little bit softer. I know watching football on Sundays was a little bit different. I'm not allowed to yell and hoot and holly everything started to change. And so the things that I was used to doing naturally I needed to suppress sometimes just There's a new environment. There's a baby in the house. I've never been around that. I need to drill out a little bit. Yeah. It is crazy. It's it's definitely different. So, so on that point though, too, there actually the data goes farther than just what happens in and when the infants around. They actually followed these fathers over time. And what they found, there was actually a pattern there. So the more involved the father was with ladies, But the reality is the more time and the more involved that father is in the day-to-day care of that infant and and and even toddler, the more likely they are to have low testosterone or lower testosterone than they did at their baseline. so yeah. Yeah, you have three kids. I mean, I I'm surprised you're still standing. well, I am standing now because of you. I am standing now because of you. But So before we transition to this next thing, and I'll talk about my journey a little bit today too. But what concerns do you hear most from men in like their late 20s and early 30s that maybe are new fathers? Are they constantly complaining, obviously, about being tired? They're probably attributing that to lack of sleep, but I don't know. My kids started sleeping pretty good after a couple of years and I still felt tired. What do you hear from patients most about this early phase of fatherhood? Well, it does it does follow that pattern. So I guess backing up a little bit to say, well, once you're a father, your testosterone declines, that actually does tend to recover over time. so you have to keep it in context with whether or not you have kids, how old you are when you start having kids. And so that kind of muddies the water a little bit because men aren't having, you know, couples are not having kids as young as they were. So now you have fathers who naturally would be at a lower level, just naturally at that age, you know, mid-thirties, we see it drop off now. so how much of that is because of the adjustment to fatherhood and how much of that is just that's natural where it's gonna be or a combination more likely thereof. So outside of the psychological impact, and obviously there's going to be some things that happen that change in your life when you have a kid. What physical changes do men actually experience? What are some of the things that this lowered testosterone that we're experiencing through this early, fatherhood journey, what sort of physical impacts does it have on the body? What everyone experiencing? One of the the biggest things you you'll notice is being tired. And we we dismiss it because, well, I'm supposed to be tired and and we joke about it. You know, we we everybody says, you're you're you're a new parent, you're gonna be tired and and sometimes there's even a temptation to wear it as a badge of honor. Like I know that I'm doing my job and if I'm tired, that means I'm doing the right thing. I'm contributing enough. And so as long as we're both tired, we're we're on the same team and on the same page on this. because it's not gonna feel great to say, I feel awesome, but you know, she's over there, you know, struggling through it. so you feel like you're doing as part of the team. But then there comes to be a point where now, the baby's sleeping through the night, there's not really a great as as much of a reason to be able to pinpoint and say, Well, I'm tired because I only slept three hours last night. I'm still tired, even though I'm sleeping more. And this is whether or not you're you're a father or not. Once you start going down that road. So we all everybody talks about cortisol, you know, stress hormones. And the interesting thing, they've actually done studies on this too, just taking the sleep component of it. So if you go five days with just five hours of sleep, which for a lot of us is actually the standard or even good for some people, that precipitously drops testosterone levels. Just the sleep. Just the sleep part of it alone. And then if you I can't remember the exact number, but it is dramatic. If you go one night without sleep, you're up all night, that one night by itself dramatically, I mean I think it's around 30% production of testosterone reduction just from that one night because when you sleep, that's that's the majority of your testosterone production is happening then. Wow. So if you're missing sleep, you're missing the prime opportunity for testosterone production. so you're you're directly interfering with the body's natural rhythm with that. And then as things go on, and then to come back to the cortisol, I think cortisol is a little overstated as far as as the cause for weight loss and how much it impacts stress. And I know that's going to be controversial, but when you have truly high levels of cortisol, I mean there are there are pathological, there are disease processes that we know of. And you can almost I mean you can tell part of the character are characteristics for people that have this chronically high cortisol. A a good example is somebody that is on, you know, corticosteroids like prednisone long term. the weight gain and and all those things that go along with it, you can see it in people that when they start predazin they have to be on for a long period of time, it's almost expected. So, but it's to a much, much lesser degree. But yes, it is important. but and here's the interesting thing. If you look at cortisol, you say, well, cortisol interferes with testosterone production and cortisol rises and cortisol makes you gain weight. So if you're not sleeping well, cortisol will rise. Well, if you take if you control for cortisol and you just disrupt sleep or you just add stress, that right there can cause low testosterone. So it's not that you have to have all these ingredients for it to be a perfect storm. You can separate them out and they all contribute independently to lower testosterone. Jeez. And the compound. So it's a lot of different factors driving it down kind of all at the same time. Exactly. And they all interplay. There's this huge interplay. So it's a really it's a it's a I think we like to As as a society and even as medical professionals, we when there's when there's a straightforward answer because that's easier to explain to somebody that sits down and says, tell me why I'm feeling this way, what is happening in my body? And it's not that straightforward. Yeah. that can turn into a two to three hour long conversation. And then even that's just assuming the data you have in front of you is correct. It's a it's a huge cross path between your biology and your lifestyle. Because you're forced into the lifestyle of the newborn lifestyle. And then, like you said, as you phase out of that, you kind of have to consider, well, wait a second, I am getting rest, I am getting sleep now. I'm not getting rest maybe, but I'm getting some sleep. Why is this still happening? And it's interesting that most people don't think about testosterone because of all the surface causes. You know, there's a million different things. I'm stressed because of the baby, I'm stressed because of life, I'm whatever. so that must be Not sleeping because of the baby. I'm not sleeping because of this. Well, that must be why. I feel like testosterone is one of the last things that a person will consider. A man, especially. I've now come to learn testosterone is like the elixir of life. Like it literally gives you everything you might feel like you're missing. But at the time, and I remember the first time I sat down with you, I did not think I had a problem with my testosterone. I had never got my blood checked. I had no individual way to know that it but I was like, I'm meeting the demands of life. I'm good. I'm still chasing after my wife. I don't have love testosterone. And I was like the mid 200s. I was shocked. I'm like, there's no way. but I remember what that felt like. I remember getting to the point where it was like, all right, I'm just gonna be a tired dad. That's just like I got three young daughters, I'm running a business with my wife. This is just the way life is. One day they'll grow up, they'll go to college, and maybe I'll get my spike back. Like I'll get my verb, my energy back then. But I'm gonna be, you know, almost 50 years old then. Like I just always thought that that was something that I could have later on. I really had just written it off. mind that it just was not something I could have now. It just felt like this is a new way of life. Have you had the experience eating habits alone? You mentioned you know changes in your behavior. Yeah. Have you did you find, you know, when the when the kids were infants that you replaced your plate for just eating over the sink? for sure. So are you not going to finish that, right? And then eating, you know, a pile of chicken nuggets over the sink. For sure. So it's like for sure. Yeah. Nutrition dropped it. I'm not eating good foods and good healthy meals either. I'm not cooking up salmon, at 10 30 when I'm finally done. That is true. That is true. so that is part of it. But once you I mean they call dad bod for a reason. That's true. I mean, you know, it's not something to aim for. but once you do start putting on that weight, that that's a that's a downward spiral. For sure. And I think that an ugly another ugly side of all of this that, unfortunately some people may not address is we're really only talking about the the general day-to-day things. There's also maybe unhealthy coping mechanisms. You're talking about the dad bod thing. a lot of guys don't know how to deal with their feelings, or maybe they're frustrated by the way that they're feeling and they can't nail down why they feel the way that they do. They turn to substance abuse and things like too. And that also gonna play a fact big factor in drive not only driving down testosterone, but also Amplifying the cortisol, the weight gain, the stress, all of that really compounds. And I think at a certain point, as men, I think we owe it to ourselves and to our family to take a look at ourselves and say, like, hey, maybe I need some help, or maybe there's something that I can do to like be a little bit better, do a little bit better. And I think that you don't know what you don't know until you find out, you know. And I like I said, I did not know that I had low testosterone and doing just a quick blood test with you and finding out what was possible. It changed my life. It really did. And the other side of all of these negative things that we're talking about, there's just a world of possibility and potential. And I I just my job now is to try to tell as many men as I possibly can, hey, you need to be on some sort of hormone therapy. but hormone therapy is also a range for men too, right? Like I I don't know that every man needs to be using a needle or if there's a cream or what do you find is the most effective thing, sorry, for For men to capitalize on the testosterone. If somebody wants to get started on this journey, what is step one? Step one is different for everyone. Okay. But I I think that the first thing you need to do is try to figure out why you're feeling the way you are. And that's the whole, the whole premise here. When you specialize in a certain field of medicine, everything, you know, if you, you know, if if you're good at hammering nails, you know, everything, everything becomes a nail. If you have a hammer, everything's a nail. And we we do this. I think I can safely say that when you subspecialized or you get into a certain field. We try to box everything into that. So if if you if you're doing hormone replacement and you see somebody that's tired or frustrated or not sleeping well and brain fog and all of these things, it's really easy to say, well, that that's my thing. I that's I I fix that. It's not always that somebody needs to answer your question, not everybody needs testosterone injections. So let's say we're talking to somebody, you gain the way you your lifestyle is out of check, and you're trying to get that back. first of all, somebody that's a that's a a new parent and you may get disagreement about this depending on on who you ask. My first thing is not to say, Well, you're a father, so therefore we should be giving you testosterone just because testosterone is down. That that's we already talked about that. There's a reason, the biological reason for that to be the way it is. And I think we have to accept. some we have to accept nature is doing what it's supposed to do. I mean, it does have a role there. But there also comes to be a point like what you're saying. It's like now your your kids are growing up and you're still in this perpetual state of I'm tired, I'm fatigued, irritability is one that's hugely overlooked. And we explain that while I'm I'm stressed out. You know, I've got kids, I'm always running all over the place. But I can say from from my experience, even, you know, when the kids are little and and You have a tendency to find yourself getting into this rut of snapping at the kids. They're doing something now, you're irritable, and then you don't like yourself. Yeah. or you're you're trying to get through the day, you're trying to do all the things that you're supposed to do, being present for the kids, being, you know, the end of the day, you want to spend some time, you know, you talk about purposeful parenting and and creating that that time for your kids so you can actually be present. And by the time that in the evening that rolls around, you're Done. You're cooked. Yeah. And the only thing you want to do is sleep. you know, I I can remember even just kind of looking out the window and be like, I have this to do, I have this to do, I have this to do, I need to be a, I need to provide, I need to take care of my household responsibilities, I need to be a good parent, I need to be present for the kids and in a good mood for them too, and give them my best emotional state. And if you're if your hormones are Are out of whack. If your testosterone is low, anybody that's been through this is going to tell you that's that's nearly an impossible feat. Yeah. And then that cycles. And then it's not meant maybe this for everybody, but I think as a male, when you go to bed and you lay in bed and you think about your day and you start thinking about all the things that you didn't provide, the things you didn't accomplish, or I didn't do that well. I wasn't present enough. And you start to feel like a failure. Do you ever feel that? I do. I think that that daily rundown happens for me right as soon as I lay down because I can't really relax until I get the chance to kind of run through that discography of what the day felt like. And sometimes it does feel like I didn't really hit the market everywhere I needed to. And it is hard. That's another I'm really grateful for you saying the the mental aspect of it because you can do everything right, but if you're not present mentally or You mentioned being in a good mood. even maybe tipping the skills even to the positive mood a a bit too. That's really hard. It's hard to maintain all of that at the same time. So yeah, I've definitely had those moments of reflection when it's like, damn, like I I really could have done that better. For me, a lot of times it comes in the way of like parenting guilt, reactions to the kids or maybe not seeing that in that moment it was just a kid being a kid and it wasn't how I perceived it to be. And I know that that sort of reaction still kind of happens for me. So yeah, for sure. I'm dad at that moment for sure. Yeah, and that that creates a dynamic then between you and the kid. Not that every time you have a bad interaction, but if that's the repetitive cycle, that that child is also going to start interacting with you differently because of the way you're parenting. so it just that creates a cycle outside of our our body. Now your your relationships are changing and and you and your significant other are having a dynamic. And then your dynamic is affecting it. Nothing is isolated. it's there's nothing isolated here. so the first thing to do When you're feeling like, something's off. I I think we know when something's off. It's just admitting that, yeah, maybe I should get this checked out. Yeah. you know, getting getting some data behind it's helpful. But in the the realm of of testosterone replacement, even you should never just be looking at a number. that's that's so well known. And and anybody that's doing that is doing you a disservice. if you're just checking the number and saying, okay, well, this meets the criteria, this this is low enough. No. You gotta talk to somebody and and find out, do the symptoms match, you know. And what if what if the number's fine or even close to optimal and you're still feeling that way, you can't just brush your hand and say, Well, it it must be something else. Good luck. You gotta dig into it. so regardless, you getting that ball rolling is talking to somebody that that's capable of and willing to dig into it. When So I I'd like to talk about the process in a moment, but before you embark on the course of BHRT care for a man, are there any other things that you would rather have them do first? Is there any lifestyle factors you expect them to change or fix or adapt to before they get into that hormotherapy treatment? before someone starts BHRT, are there any preventive or intermediary measures that you'll ask them to do, whether it be lose weight beforehand or get your diabetes under control or blood pressure or something else? So Yeah, I mean I think taking, you know, doing the general health maintenance is really important. and and this is a that's a that's a loaded question. So my answer is not to be evasive of that. That's a very individual thing. So that's where we make a a mutual decision and and there's a lot of factors here. So for instance, somebody that's especially somebody's a younger, you know, younger male father or not, somebody's younger and they just kind of maybe let themselves go, or it's just life got to be what it is. They put on some weight. So what happens is as you get that, you know, men carry their weight around the abdomen. and that's dangerous because then we have the visceral fat, the dangerous fat around the organs that's under the muscle. and then you also have, you know, the fat that we can pinch. The visceral fat's particularly dangerous because that's inflammatory. Yeah. Inflammatory, the cardiovascular disease, it's high risk for that. And once you start that inflammatory process, you know, you have these inflammatory cytokines and and that directly reduces testosterone production. About half of the people, once you get to the point of obesity, half the men that have obesity have severely suboptimal or deficient testosterone, half. Severe obesity, it's probably cl it's not probably they think it's closer to 75%, or already way down on the scale. so that if you're able to get yourself moving, and some of this is preference, how much do you want to do to try to to get your own production up a little bit? you hear a lot of a lot, there's always sales for this supplement will give your testosterone, we'll get your testosterone back on track. There's a little bit of truth to a couple of them that that we've studied, but you're not gonna pop a supplement and bring your testosterone up, some over-the-counter supplement. I've seen a lot of people try and they spend many hundreds of dollars with which is the idea. And these are the same supplements that I remember seeing when I was, you know. the 18, 19, 20 year old thinking that I needed more testosterone, because it's like, well, I'm going to the gym, so I should probably get some more testosterone. I'll take these. Gas station pills. Yeah, the gas station pills. And they're the exact same ones. They're just relabeled. But if you look at the ingredients, the exact same thing. You see it now with this this next generation coming through. They're doing the same things that we did back then. That they're convinced that if I I can get I can make myself into an anabolic producing machine. You know, it's like, no. Yeah, you're just keeping somebody in business. Yeah. And I know that there are people like that out there, especially the younger group that want that. They're that's not what we're doing, right? That's different than these guys that are constantly hitting the gym. They want all the testosterone they could possibly inject into their bodies. we're not a testosterone mill. that's not what's happening. No, not at all. Not at all. So somebody comes in and says, What should I do if I wanna I want to give myself a fair chance? The the trap that you run into, yes, I I will always support being healthier is is great. But the the the problem that people run into is, well, I gained weight and now I have visceral fat. and by the way, because I have obesity, now I've I'm starting to develop insulin resistance. So I'm on my way to pre-diabetes, you know, diabetes. Well, that insulin also causes a decline in testosterone directly and indirectly. not to get too technical, but there is an explanation for that. we have this sex hormone binding globule and SHBG. If anybody really is into testosterone, they're going to know what that is. That's your body's way of transporting testosterone. Insulin lowers that. So your sponge, what you can do to hold on to carry around testosterone, that just by nature of having higher insulin at baseline is lower and you have a lower capacity to hold on to testosterone. And we know, looking at long-term data, that the lower your testosterone is. The more likely you are to develop insulin resistance and gain weight and lose muscle mass. And so around and around we go. So it's really hard once you've gotten to that point to break that cycle independent. and you know you go to the gym and you're not losing the weight, you're not putting the muscle on. And it's like you are stacking your body is stacking the deck, the deck against you as you're moving on. So it becomes, it's like quicksand. The more you struggle and the more you go through life and you're trying to work your way out of it. Sometimes you need to, maybe you need to correct the weight first. And maybe we, you know, that might be in some people, that's a good approach, is let's get the weight off first and we can help you with that. I'm all in favor of do it the right way as best you can. Sure. so a common question that comes up should I lose the weight first or should I deal with a testosterone first? Ideally you do both. Yeah. But if you're doing weight loss, you know, especially with the GLPs, I think it's pretty clear that if you don't do it properly, You're going to lose a lot of muscle mass. not everybody does. I mean, there's ways to preserve it for sure. But hey, get on testosterone. If your testosterone's low and that's an issue that needs to be addressed simultaneously, you preserve your muscle mass better. You're going to grow, you know, you're going to add muscle. You can definitely add muscle while being on a GLP if your hormones are straightened out. Yeah, it makes sense to support both processes because as you lose weight, your testosterone will improve because your insulin will. Like that. So I just feel like you you'll benefit from both. And then as far as a general lifestyle factor, I feel like everybody's conscious of their weight. It's just like the thing that's always drilled into us. But people don't realize how much their weight maybe actually impacted them. It's not always just an aesthetic thing. It's not you feeling uncomfortable in that sweater once a year, it's the visceral fat thing. And it's really interesting what you described is exactly where I found myself in February of this year. I For years, two probably three years was eating right, portioning, staying away from things. I stopped drinking. you know, I was exercising and I couldn't lose a pound. I it felt like I was on a hamster with, but just constantly could not get ahead of it. And I didn't know why. I could not figure out why. For me personally, I just could not do it. and so for me, the big difficulty was. There's got to be something wrong. I'm getting frustrated, but everything else feels like it's okay. I'm sleeping okay. what is what is really going on here? And then when I found out it was because of my testosterone, it was it was a hard thing for me because I only thought it was a weight issue. I only thought it was because I was heavier. And at the time I was pretty heavy. It was right around 245. I was like 205 yesterday. So I know for sure things feel different than they did back then, but simultaneously I noticed that. Once my hormones got right, weight started to come off of me naturally. Like at the time, I was also pairing it with the GLP one, but just kind of dabbling in it really. It was, and I still tell people now, like my hormone health is what enabled me to really lose weight effectively. It was the one thing that was holding me back for so long because I was doing everything else right, eating right, you know, getting as best rest as I could and avoiding the right things. And it just none of it was working and working out, none of it was going. I could feel my muscles were okay. I felt strong. I had a strong body, but I wanted the fat gone. That's why I was doing what I was doing. It wasn't going anywhere. No. So is that just low testosterone or do you find that is that a higher estrogen level in your body too? what makes you hold the the weight as a man? Yeah. So when you have more fat, you have more aromatase. Aromatase is is what converts testosterone into estrogen. Okay. And that's a really debatable topic now too in the in the field of testosterone replacement is we need to some people say you you need to keep it in a certain range because when you do testosterone, estrogen, tends to rise along with it. And there is a natural tendency to say, well, we don't want that because that'll cause you to develop female characteristics. And we know now that that really isn't the case, but it can contribute to some of this process. so again. More fat tissue, more aromatase, higher estrogen levels. that's still a very there's a lot of debate over that. So I'm not going to get into it too much. but yeah, it's just one more piece of the puzzle that that does play a role here. So one thing I do wanna address is kind of like The stigma around a man needing testosterone, right? is it hard for a guy to admit that he doesn't have enough testosterone? there's this thing where you need the support, but you're not willing to admit it. Why? Why are men afraid to admit that they might need some help, especially in this testosterone area? It's a huge thing that will change your life and improve it drastically if you just break that cycle and make the first step. Why is it so hard for? Good question. I think we're we're taught that. And one, we're going back to we don't talk to each other. Yeah, that's true. and it's hard to admit that you're having a problem and being resistant to to getting the help that you need. so I think that it's it's multifaceted. There, there's kind of the shame there's something wrong with me. I'm less of a man because I'm not producing enough testosterone. I need help. Or I'm not performing well enough, or I'm doing all the right things and it's not working. So I'm failing at that now too. Yeah. I'm trying to get healthy. I'm trying to raise my own testosterone, but I can't do it on my own. so it's not necessarily all pride, but I do think that we've come a long way with it in the past, you know, few years or or so or more, where it's recognized that in the environment just our environment is not designed for us to be healthy. I we're just Bombarded. We talked about a couple of things that are contributory to low testosterone. But I think part of being more accepting of that is not to say, well, I'm a victim of my environment, but there there are so many things our lifestyle is is growing. We kind of wear I'm tired and I'm I'm busy as a badge of honor. And it's like, yeah, it's like you're working hard, you're hustling, but you're also not taking the time to recover and do what's good for your body too. For that hustle at the same time. Yeah. So, Gary, what does it look like to get started on this journey here at restorative? How does that work? What sort of first steps does a person need to take? It's really just having a conversation. So schedule an appointment, come in. My job is to have the discussion with you and figure out what is going to be the best approach for you. that's the advantage of being able to sit down and have, a a bit of a lengthy conversation to figure out how whatever treatment we're thinking about, or maybe not thinking about, what is going to be best for the individual sitting in front of me. And it's going to look very different for for for different people depending on the phase of life, depend depending on what your concerns are, how you're feeling. And then we can do some, we can do some direct labs to try to figure out if our suspicion is correct. I might already have a pretty good idea, but let's get some data behind it. Yeah. And then we meet again and and really finalize the plan and figure out what's going to work best for you. That's awesome. Yeah, I love that it's complete and total care, customized to each person. So thank you for joining us today, Gary. It was wonderful talking with you. Thanks for joining us here on Built in Real Life, everybody. We'll see you on next episode.