Browse all answered questions from Josh on Beyond The Pills.
Recently Answered
I'm on TRT and my numbers look great, but I still feel exhausted and unmotivated. What am I missing?
While testosterone levels are important, they are often just 'amplifiers' of your existing health. Josh notes that many men with normal lab values still feel exhausted and stuck because they are operating in a state of chronic stress or lack of purpose [06:08]. True vitality is often 'uncovered' by slowing down and addressing these internal misalignments rather than just adding a supplement [05:05].
What is one simple habit I can start today to help regulate my nervous system?
Josh recommends practicing the 'art of doing nothing' [09:10]. Try turning off your phone for just one hour and sitting with your thoughts; while it may feel uncomfortable at first, it allows your nervous system to move from 'fight or flight' into the 'rest, digest, and repair' state necessary for healing [09:40].
Why is sleep so critical specifically for men’s testosterone levels?
Testosterone is naturally produced while men sleep and typically peaks in the morning [05:36]. Without adequate sleep to rejuvenate, the body doesn't have the opportunity to make the messengers it needs to regulate mood and energy throughout the day.
How do you define 'vitality' if it's not just about a lab value or a prescription?
Josh defines true vitality as being in alignment—when your life is moving in the same direction as your soul and purpose [10:41]. It's not just the absence of disease or a number on a lab result; it’s a physical, mental, and energetic state that comes from being present and connected [10:10].
What questions should I be asking myself if I want to get my 'edge' back?
Josh suggests shifting focus from 'How do I raise my testosterone?' to 'Where am I leaking energy?' [08:00]. This involves looking at whether your job, relationships, or lack of adventure are draining your nervous system and keeping you in a constant 'fight or flight' state [08:09]. Removing things that no longer serve you can be a more powerful prescription than adding a new protocol [09:10].
I always start a diet but quit after two weeks. How do I make it stick?
True health transformations usually require a change in identity—deciding "I am a person who eats real food"—rather than just following a temporary diet [18:45]. Being part of a community where this behavior is the "norm" makes it much easier to stick to healthy habits long-term [19:15].
Why do I crave processed snacks even when I know they aren't good for me?
The "Bliss Point" is a specific sweetness level engineered by food scientists to make products like soda and chips highly addictive without being "too sweet" to stop [26:41]. Because these ultra-processed foods are designed to hijack your dopamine system, it's essential to shift your focus to whole foods that don't have these engineered "cravings" built in [27:20].
I'm starting to feel the 'mid-thirties' slump. Is this just a normal part of aging?
Health is often a slow decline where people gain a tiny bit of weight each year until they face a crisis, but you can reverse this by prioritizing real, whole foods [03:02]. Movement doesn't require hours in the gym; simple habits like walking before or after a meal can be incredibly effective for metabolic health [09:15].
Can I just take a supplement or get a prescription to fix my energy, or does lifestyle really matter that much?
Testosterone isn't a quick fix that replaces healthy habits. Dr. Zafrani emphasizes that chronic stress "kills" the body's hormonal makeup, and lifestyle factors must be addressed even if you are on therapy [27:26]. Proper sleep, weight management (specifically reducing visceral fat), and stress management are the foundations that allow hormonal restoration to actually work long-term [26:26].
I feel fine right now in my late 20s—is there actually a reason to get my testosterone checked?
Getting a baseline blood test early is crucial because most men reach age 40 and have no idea what their "normal" used to be [19:49]. Ideally, you would test these markers in your 20s when you are vital, so that in your 40s or 50s, a clinician can personalize your restoration back to your original biological vibrant health rather than just aiming for a generic lab range [21:21].
I'm worried TRT will just turn me into a bodybuilder or make me aggressive. What are the actual benefits?
It's not about becoming the Hulk; therapeutic restoration is about getting your "edge" back. Dr. Zafrani explains that proper optimization improves libido and erectile function, but also dramatically impacts energy levels, motivation (which often transforms one's career and business success), and cognitive focus [14:46]. He even shares that it can mellow out agitation, making men more present and loving with their families [22:52].
I'm in my late 30s and feeling tired all the time. Is this just what aging feels like?
Many men in their 30s and 40s simply accept declining energy, irritability, and poor sleep as "getting older," when it is actually often a treatable hormone deficiency [15:47]. If you feel like you have lost your "edge" or vitality, it isn't necessarily a natural part of the aging process; it's a sign that your biological systems need support or restoration [17:47].
Are there other ways to reduce needle stress besides just using numbing cream?
Research shows that "multimodal therapy" works best, meaning you combine different methods like numbing, vibration, and breathwork [24:45]. Using distraction techniques, progressive muscle relaxation, or simply taking deep breaths in tandem with a numbing patch can significantly reduce the nervous system's stress response [24:46]. Dr. Dawkins emphasizes that care should be a partnership where both the provider and patient work to make the experience less clinical and more human [13:37].
What can I do about the soreness and bruising that happens after a vaccine?
Post-injection soreness and bruising are often what "teach" our brains to avoid the next appointment [24:16]. Thimble developed a "Recover Patch" which is a plant-based adhesive containing turmeric and arnica that you wear for 48 hours after the procedure [23:55]. It works to alleviate tenderness and clear up bruising faster, addressing the physical discomfort that lingers after you leave the clinic [24:10].
I’ve always been told to 'suck it up' with needles—is my fear actually valid?
Biologically, our bodies perceive a needle as a threat—similar to a predator's tooth—which triggers an automatic fight-or-flight response involving about 1,400 chemical reactions [06:34, 08:04]. When this fear is dismissed with "suck it up" attitudes, it erodes trust between the patient and provider [07:20]. Acknowledging this response with "tangible compassion"—like asking what can make the moment easier—completely changes the patient's healing trajectory [07:44].
Why does it feel like doctors don't have time to be compassionate anymore?
The current healthcare system is increasingly transactional, with shorter appointment times that pressure providers to "close off their hearts" just to get through the day [10:05, 11:36]. This isn't because providers don't care, but because the system isn't designed for empathy [09:50]. To counter this, practitioners can practice "tangible compassion" through small interventions that acknowledge the patient's experience, which helps move the interaction from a transaction back to a healing…
How does the Thimble patch actually work to stop needle pain?
The "Prepare Patch" is a thin, sticker-like lidocaine patch that you apply to the skin 30 to 90 minutes before a needle procedure [23:05]. Unlike traditional creams that can be messy, this patch has a peel-out center that leaves a ring marking exactly where the skin is numbed, so the provider knows exactly where to insert the needle [23:30]. This simple step restores a sense of control and choice to the patient, which is vital for building trust [07:15].
Why should I care about my mitochondria if I'm just trying to stay healthy?
Mitochondrial health is foundational to almost everything, including brain health, heart function, and longevity. Research shows that mitochondrial dysfunction is linked to nearly every major chronic disease, including Alzheimer's, Parkinson's, heart disease, diabetes, and even fertility issues [12:36]. Furthermore, your mitochondria act as the 'battery' that decides whether a cell lives or dies, making them the ultimate control point for resilience and performance [13:37].
How much energy do my mitochondria actually produce in a single day?
The energy production from mitochondria, called ATP, is vital for every beat of your heart, which is why heart cells have such a high density of mitochondria—about 30% by volume. If your mitochondria stop making energy, your heart stops beating [06:04]. Humans produce approximately four kilograms of ATP every single day! And, because it is used as soon as it is made, your body mass doesn't actually increase [05:34].
I heard that I only get my mitochondria from my mother—is that true?
While most DNA is a mix of both parents, mitochondrial DNA is inherited directly and exclusively from your mother [11:36]. This makes maternal lineage a key factor in understanding your baseline cellular energy potential and risk for certain metabolic or chronic conditions linked to mitochondrial function.