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Chapter 9 · Ali Gilbert

TRT and Hormone Replacement Therapy Philosophy

February 20, 2026

moving on to other aspects of HRT and that sort of thing, how do you know when to start looking into that realm and start pulling more levers then like, again, like in my opinion, like, sure, go get some sunlight, do all these other things. But like, I really, really, no pun intended, want to move the needle. Um, so when do I pull those levers for a client or sorry, maybe not for a client, but like, again, a client maybe comes to me and they want to pull those levers. How do I know when it's okay to do so to pull like the TRT leader? Yeah. And that's really the big one. Right. And refer them to somebody. Yeah. I try to get everybody to if they will but I also like I

I always tell guys, look, I've done TRT. I'm on TRT. I've done steroids, obviously. I've always been transparent about that. I mean, at one point I was 270 pounds and I was like 16, 17% body fat. And I was dead lifting like 730 and squatting 700. Let's bring that guy back. No, I'm too old for that now. That was 20 years ago. So I'm a big fan. And I'm a big fan of personal responsibility, ownership, and YOLO. Like if you want to do this shit, cool. Like it's your body. It's your choice. Right. We always say that about women and abortions and stuff, but men should have that option too. It's my body, my choice. If I want to jack myself full of trend and I don't hurt anybody, then except myself, fuck it. But I'm also, I'm also a proponent of like less is less is always more. So if guys come to me and they go, Hey, do you think I should get on? Like a lot of my guys are in their mid thirties, forties, fifties. and they're working 80, 90 hours a week. Same type of client that these physicians would have except minor coaches. So they might have a staff of 10 or 13 people. They're sleeping five hours a night. I already know your testosterone is going to be low. Let's just go get it tested. And if it is, go to a private lab. And then if it is, then we'll find a physician for you through Silverback. Dave is a good advocate for me in Australia. I've sent a lot of clients to Primal. And then some of the guys in the UK, Ross, those guys sent people to them as well. But I think every guy these days in their 30s should at least go get their panel done because I think they're going to be real fucking surprised. Like, I've been on TRT since 36. You're not 36. And, you know, I don't know. Mine wouldn't have been lifestyle in the way that a sedentary population. Mine would have been lifestyle as I was a former competitor in strongman and powerlifting and bodybuilding. And there's only so many times you can push your body to those extremes before she doesn't want to come back on. And so, yeah, I'm a big proponent of that, especially if you get guys who they're doing everything right. And there's just so slow of their results. It's like, all right, let's just get comprehensive labs and just see if there's some type of problem where we can get some external help from a physician. and everything's going to be way better. And I've not had a single person get mad about getting on charity. They're always like, oh, my God, I should have listened to you four years ago. And I'm like, I know. I've heard the stories where like, yeah, I just want to try it out. I'm like, dude, as soon as you turn that lever, you're going to be so happy that you're going to be upset that you didn't do it sooner.