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DIM and Estrogen Metabolism on TRT
At Alpha Performance Clinic, we focus on optimizing hormones for performance, recovery, and long-term health—not just hitting a single lab number. One area that often gets overlooked in testosterone replacement therapy (TRT) is how the body processes estradiol, not only the total estradiol (E2) level. This is where DIM (diindolylmethane) comes in. What Is DIM? DIM is a natural compound formed when the body digests indole-3-carbinol, a substance found in cruciferous vegetables
David Cesarino, PA-C, MPAS
5 days ago3 min read


The FDA Just Rewrote the Rules on Testosterone.
If you've been on the fence about testosterone replacement therapy (TRT) — or you've heard secondhand warnings about heart attacks and prostate cancer that made you hesitate — the conversation just changed. On June 18, 2026, the U.S. Department of Health and Human Services and the FDA announced a major request to update the prescribing labels on every testosterone replacement product on the market. This isn't a minor footnote. It's the most significant shift in TRT regulation
David Cesarino, PA-C, MPAS
Jun 225 min read


The Silent Threat: What Low Testosterone Is Really Doing to Your Body
Most men chalk it up to getting older — the fatigue, the brain fog, the stubborn belly fat that won't budge no matter what they do. But what if aging isn't the enemy? What if the real culprit is something measurable, treatable, and far more dangerous than most men realize? Low testosterone — clinically known as hypogonadism — affects an estimated 4 to 5 million American men, yet the vast majority go undiagnosed. That's not just a statistic. It's millions of men operating belo
David Cesarino, PA-C, MPAS
Jun 55 min read
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