Testosterone: Beliefs vs. Science with Dr. Keith Nichols | Part 1 of 3

Why “Normal” Isn’t Always Optimal with Dr. Keith Nichols

In Part 1 of this three-part series, Dr. Keith Nichols, Medical Director and CEO of Tier 1 Health & Wellness, deep dives into one of the most misunderstood topics in men’s health: testosterone.

Dr. Nichols breaks down why testosterone levels have declined over time, how lab reference ranges have shifted, and why many men are told their numbers are “normal” even when they are experiencing symptoms consistent with testosterone deficiency.

Dr. Nichols discuss the difference between population-based reference ranges and individual physiology, the importance of free testosterone, the role of SHBG, and why a single lab value should not be the only factor used to determine whether a man is healthy, optimized, or appropriately treated.

This episode is about challenging dogma, questioning outdated assumptions, and returning to the evidence.

Topics discussed in this episode include:

Testosterone levels declining across generations

Why lab reference ranges have shifted lower over time

The problem with using one universal testosterone threshold

Total testosterone vs. free testosterone

How SHBG affects testosterone availability

Why “normal” does not always mean optimal