How you benefit from testosterone therapy with Shalin Shah-Ep 137
Guest Bio
Shalin Shah is the CEO of Marius pharmaceuticals and a driving force behind the development of Kyzatrex (Rex), an FDA-approved oral testosterone treatment offering an alternative to injections or topical applications. With nearly 10 years of deep involvement in metabolic health, Shalin specializes in testosterone and testosterone replacement therapy. Coming from an investment background, he became involved with Rex during its phase three trials and led the company through FDA approval and commercialization. He is passionate about helping a broader population through accessible testosterone therapy and addressing the stigma surrounding it. Shalin advocates for reevaluating testosterone medication regulations and aims to reshape public perception and education on testosterone therapy, emphasizing its vital role in overall health. He is actively exploring the intersection of GLP-1 agonists and testosterone therapy for muscle preservation and overall health improvement, and is currently supporting a study examining this combination. Shalin also aims to make longevity medicine more accessible and applicable to everyday life, focusing on "livable longevity."
Prostate Podcast Media
Show Notes
Episode Summary:
Imagine a world where testosterone therapy isn’t limited to needles or messy gels—but comes in the form of a convenient, safe, and effective pill. In this game-changing episode, Dr. Geo sits down with Shalin Shah, CEO of Marius Pharmaceuticals and the strategic mind behind Kyzatrex (Rex)—the first FDA-approved oral testosterone replacement therapy (TRT).
Shalin shares his remarkable journey from the world of investment into biotech innovation, how he led Kyzatrex through its Phase III clinical trials, and the uphill battle of gaining FDA approval for a therapy that defies outdated stigmas around testosterone. Together, they dive deep into the real science behind testosterone, the misunderstood role of SHBG (sex hormone-binding globulin), and why most men don’t get their hormone panels tested—despite it being one of the most critical markers of overall health and aging.
This episode also explores the future of livable longevity, including the potential synergy between GLP-1 agonists (like Ozempic) and testosterone to preserve muscle mass during weight loss and aging. With a focus on education, empowerment, and practical solutions, this conversation is essential for anyone interested in optimizing their hormones, energy, and vitality.
Key Takeaways:
The Science Behind Oral TRT: Why previous oral testosterone treatments failed, and how Kyzatrex uses a novel lymphatic absorption method to bypass the liver and deliver stable, physiological testosterone levels.
Unique Benefits of Kyzatrex:
Substantial increase in free testosterone, not just total T.
Significant reduction in SHBG levels, enabling more bioavailable testosterone.
A lower incidence of common TRT side effects like elevated hematocrit and red blood cell count.
Encouraging early data suggesting it may help preserve fertility compared to injections.
Who Should Consider Oral TRT: How oral testosterone could be a game-changer for men hesitant about injections or transdermal therapies.
Stigma vs. Science: Why testosterone is misunderstood and how better education and hormone testing can empower men to take control of their health.
Combining Therapies for Better Outcomes: The exciting potential of combining GLP-1 agonists with oral TRT to combat muscle loss during weight reduction—a common issue with GLP-1 use.
Livable Longevity: Shalin’s mission to make longevity science practical, accessible, and sustainable—not extreme or experimental.
What Doctors Often Miss: The critical role of free testosterone, estrogen balance, and hormone ratios—not just total T—in diagnosing and treating low testosterone.
Inside the Pharmaceutical Process: A behind-the-scenes look at the years of research, regulation, and persistence it takes to bring a treatment like Rex to market
Curated Transcripts
[00:00:00] Dr. Geo:
So what if there’s a pill that can increase testosterone? I’m not talking about herbal remedies—though those can help with functional testosterone. Today, we're talking about a pharmaceutical pill that may actually work. Historically, oral testosterone has failed due to liver metabolism issues. But our guest today, Shalin Shah, is here to discuss a breakthrough called Kyzatrex.
Meet Shalin Shah
[00:01:00] Dr. Geo:
Shalin Shah is a leader in metabolic health and longevity medicine. As CEO of a pharmaceutical company, he was instrumental in the development of Kyzatrex, a novel oral testosterone therapy for men with low testosterone.
[00:02:00] Dr. Geo:
He’s also an advocate for better education around testosterone therapy and an influential voice in longevity science. Let’s get into it. Shalin, welcome!
Shalin’s Background & the Birth of Kyzatrex
[00:04:00] Dr. Geo:
You’re not an MD, but your depth of knowledge is better than most medical lectures I’ve been to. Tell us how you got into this space.
[00:05:00] Shalin Shah:
Thank you, Geo. I started with an investment background and became involved in this project when testosterone therapy was being misunderstood—especially during the FDA’s labeling changes around cardiovascular risks.
[00:06:30] Shalin Shah:
Despite the stigma, I saw the data and the need. Testosterone, if discovered today, would be considered one of the most valuable molecules in medicine. That’s what drove us to keep going.
Why Oral TRT Was So Hard to Crack
[00:14:00] Dr. Geo:
Why has it taken so long to develop a viable oral testosterone?
[00:15:00] Shalin Shah:
Good question. Early orals were liver toxic. Later versions required high-fat meals and frequent dosing. Kyzatrex is different. It uses lymphatic absorption, bypassing the liver and delivering effective doses with standard meals.
What Makes Kyzatrex Unique
[00:16:30] Shalin Shah:
We use phytosterols in our formulation—plant-based lipids that aid in absorption. That innovation allowed us to create a pill that’s both safe and effective.
[00:17:30] Dr. Geo:
Let’s talk side effects. Injectables often raise hematocrit and red blood cell count dangerously. What are you seeing with Kyzatrex?
[00:18:00] Shalin Shah:
With injections, around 66% experience hematocrit issues. With Kyzatrex, it's under 2%.
Preserving Fertility & Hormonal Balance
[00:20:00] Shalin Shah:
We also see lower suppression of LH and FSH, which may preserve fertility—something we’re studying now in a pilot trial at Baylor.
[00:23:00] Dr. Geo:
That's huge. And it aligns with what I see—patients are hesitant about shutting down their own production.
Free Testosterone & SHBG
[00:25:00] Dr. Geo:
Total testosterone means little without sufficient free testosterone. SHBG binds too tightly and prevents T from being bioavailable. What does Kyzatrex do there?
[00:29:00] Shalin Shah:
In our trials, SHBG dropped by up to 30–50%, which means more free T. We saw a 2x increase in free testosterone—without needing to spike total T to 1500 or more.
Real-World Dosing & Absorption
[00:32:00] Dr. Geo:
What’s the real-world dose?
[00:33:00] Shalin Shah:
Most patients take 400mg twice a day with food. Our absorption is stable across low, medium, and high-fat meals—though some fat helps.
GLP-1 Agonists + TRT = The Future?
[00:38:00] Dr. Geo:
What about combining Kyzatrex with GLP-1 agonists like Ozempic or Mounjaro to prevent muscle loss during weight loss?
[00:41:00] Shalin Shah:
Exactly. We’re starting a study on that. We’ll track muscle mass, grip strength, and VO2 max. GLP-1s help with fat loss, but cause lean muscle loss. Kyzatrex may solve that problem.
The Bigger Picture: Livable Longevity
[00:48:00] Shalin Shah:
Our mission is livable longevity—not extremes. Just practical, sustainable strategies. Testosterone, muscle, metabolism—these all matter as we age.
Final Thoughts
[00:49:00] Shalin Shah:
Get your hormone panel. Don’t settle for just total T—ask for free testosterone, SHBG, estrogen, and FSH/LH. You’ll understand your health so much better.
[00:50:00] Dr. Geo:
Well said. Thank you, Shalin. Everyone, check out Kyzatrex.com and RethinkTestosterone.com to learn more.
Resources
Kyzatrex – Official Product Site
Learn more about the oral testosterone therapy featured in this episode.
🔗 https://www.kyzatrex.comRethink Testosterone – Educational Resource
A disease awareness website with science-backed information on testosterone deficiency and treatment.
🔗 https://www.rethinktestosterone.comDr. Geo Espinosa – Official Site
Get Dr. Geo’s newsletter, podcast updates, and expert insights on men's health.
🔗 https://www.drgeo.comShalin Shah – Instagram (@themetabolicceo)
Follow Shalin for insights on testosterone, longevity, and metabolic health.
🔗 https://www.instagram.com/themetabolicceoGabrielle Lyon Podcast
The podcast where Dr. Geo first heard Shalin speak on testosterone science.
🔗 https://drgabriellelyon.com/podcastProLon Fasting Mimicking Diet – Endorsed by Dr. Geo
A plant-based 5-day nutritional program designed to mimic fasting for longevity benefits.
🔗 https://prolonfmd.comT.R.A.V.E.R.S.E. Study
Major study referenced regarding cardiovascular safety of testosterone therapy.
🔗 NIH link to Traverse Study abstract (or search PubMed using keywords: "Traverse Study testosterone")LabCorp – Direct Access Lab Testing
For patients seeking hormone panels outside of a traditional provider.
🔗 https://www.labcorp.comRequest A Test – Affordable Hormone Testing
Another platform to order testosterone and hormone panels directly.
🔗 https://www.requestatest.com