Bridging Medicine, Athletics, and Optimised Health
Dr Khashayar Farzam, a renowned physician and athlete, discusses testosterone therapy, performance-enhancing drugs, and men’s health. He shares expert insights, clinical experiences, and the importance of evidence-based medicine in optimising well-being.
Dr Khashayar Farzam is a physician, athlete, and author whose contributions to the field of men’s health extend far beyond the walls of the emergency room. As a full-time emergency medicine physician, a diplomate of the American Board of Obesity Medicine, and a Clinical Assistant Professor, Dr Farzam possesses a rare blend of academic knowledge and hands-on clinical expertise. Yet, his impact is not confined to medicine alone—he is also a Team Canada athlete and a three-time Guinness World Record holder, embodying the very principles of performance and endurance that he advocates.
In his groundbreaking book, The Doctor’s Perspective: Testosterone, Wellness, and Performance, Dr Farzam addresses one of the most pressing yet often misunderstood topics in men’s health—testosterone replacement therapy (TRT) and performance-enhancing drugs (PEDs). Drawing from both clinical practice and personal athletic experience, he navigates the complex intersection of medicine and sports science, offering evidence-based insights that challenge misinformation and bridge the knowledge gap for both medical professionals and the general public.
His work is particularly crucial in an era where misinformation on TRT and PEDs is widespread, often propagated by unverified online sources. With a commitment to science and patient education, Dr Farzam provides a balanced, responsible approach, empowering readers with accurate information while addressing the realities of performance optimisation. His expertise in both the medical and athletic arenas allows him to offer a uniquely informed perspective on optimising health, managing risks, and ensuring longevity—whether for elite athletes or everyday individuals looking to improve their well-being.
In this exclusive Reader’s House interview, Dr Farzam shares his insights into the evolving landscape of men’s health, the role of evidence-based medicine, and the motivations behind his work. His ability to distil complex medical concepts into accessible, engaging narratives makes him not just a leading voice in the field, but also an invaluable resource for anyone seeking clarity in the ever-evolving world of health and performance.
Dr Khashayar Farzam is a brilliant physician, accomplished athlete, and dedicated author who transforms complex medical knowledge into accessible, life-changing insights.
How did your experiences as an emergency medicine physician and men’s health consultant influence the content and perspective in “The Doctor’s Perspective”?
I think it had significant influence and in fact was a major driving force in my perspective. Clinical context is everything when it comes to medical content; as an academic topic needs to be transformed into a clinical topic. As doctors, we need to take what we know academically and apply it to real patients.
There are generally multiple levels of evidence in medicine. The best type of evidence is one drawn from a meta-analysis. Unfortunately for performance enhancing drugs (PEDs), we do not have that type of evidence available yet. Hence, we need to rely heavily on expert opinion when it comes to these medical topics and that’s why drawing from my personal experiences was crucial in writing this book.
In “The Doctor’s Perspective,” you discuss testosterone replacement therapy and performance-enhancing drugs. What motivated you to address these topics in your writing?
It’s really a missing gap in medicine, at least for PEDs. TRT does have reasonable guidelines now available from various professional societies but there are definitely some overlapping aspects with PEDs in this world. There aren’t many studies out there and there’s even less legitimate expert opinion. A lot of the information people use comes from Facebook groups or online message boards. Now some of this information is indeed accurate! But there’s no authority on it. I thought I could help fill in that gap.
Another key part was the large demand from other doctors. While the target audience in the book is more so the average person, the information is incredibly useful for doctors. I currently also do e-consults which is providing digital consultations to family doctors for their patients on TRT, PEDs or other related topics. During this time, I’ve learned that there is a major demand from other physicians to learn more and that was a big motivation to write this book.
As a competitive powerlifter and Guinness World Record holder, how do you integrate your athletic experiences into your medical practice and writing?
Great question. I think competing in a strength sport, and previously track and field as a sprinter, at a very high level gives you additional perspectives. It shows you why some athletes or even recreational lifters choose to use PEDs. While I’m drug-free myself, over the years I’ve of course known many people on PEDs. You need to understand the “why” behind the motive to better be able to utilize a harm reduction clinical approach when it comes to patient care. This is also reflected in my writing as I recognize that side effects and blood tests won’t necessarily lead someone to fully stop using PEDs.
Your book explores the science behind testosterone and wellness. How do you balance complex medical information with accessibility for a general audience?
One of the main things I tried to do with my book, as well as my patient care teaching, is to write or talk without complex medical jargon. At least to an extent that the content can be understood by the average person.
Given your background in both medicine and athletics, what unique insights do you offer readers seeking to optimize their health and performance?
It’s very important that everyone gets routine health maintenance check ups that are endorsed by their doctor and national health organizations. But high performance athletes do indeed have higher health maintenance needs that are not fully captured by clinical data. There are no large scale guidelines that heavily utilized high level athletes in their research data, for obvious reasons. This means clinical judgement is very important when it comes to those who want to push their body in the gym or on the field.
How do you envision the role of evidence-based medicine in shaping public perceptions of men’s health and wellness?
I think we need more studies and more data. We need to highlight bad outcomes, side effects, good outcomes and lack of side effects. Even more case reports or case series publications for those on PEDs would be very helpful. We also need more studies on TRT due to inconsistencies on side effects from current clinical data.
What advice would you offer to aspiring authors aiming to write about complex medical topics for a general audience?
Know your audience and topics and aim to make it easy to understand for the average person.
