Dr. Gluck’s Wellness Center

Dr. Gluck’s Wellness Center ✍️ Stanford, UCLA Med School + Harvard Uro
👨‍⚕️Board-Certified Urologist and Sexual Wellness MD
💼 Private Practice - Boston, MA
(2)

03/03/2026

If you think PCOS and menopause are only about hormones and insulin, we’re not deep enough yet.

At the cellular level, PCOS is a disorder of mitochondrial efficiency and intracellular signaling.

Long-standing hyperinsulinemia alters PI3 kinase signaling, reduces GLUT4 translocation, and pushes glucose storage toward visceral fat. Visceral fat then becomes hormonally active tissue, releasing inflammatory cytokines that worsen insulin resistance.

Now layer in menopause.

Loss of estradiol reduces mitochondrial biogenesis, impairs nitric oxide production, and decreases ATP efficiency. Fatigue increases. Central fat accumulates. Metabolic flexibility declines.

Add thyroid.

Thyroid hormone regulates mitochondrial transcription factors and basal metabolic rate. Even “normal” labs can mask impaired metabolic throughput in women with PCOS.

This is not separate systems.

It is one integrated metabolic circuit:
• Insulin resistance
• Ovarian androgen production
• Hepatic SHBG synthesis
• Thyroid signaling
• Cortisol rhythm
• Mitochondrial output

If you treat only one node, the network compensates.

If you treat the circuit, metabolism shifts.

That is what true PCOS-menopause management looks like.

This conversation is about cellular physiology not symptom chasing.

02/28/2026

Magnesium is one of the most important minerals in the human body, but one of the biggest misconceptions is that all magnesium is the same.

It’s not.

Different forms target different tissues and physiologic systems. And choosing the wrong form often means you don’t get the result you’re looking for.

Magnesium supports more than 300 enzymatic reactions, including:

⚡ Cellular energy production (ATP stabilization)
🧠 Brain signaling and nervous system balance
💤 Sleep regulation and relaxation
💪 Muscle function and neuromuscular control
🩸 Insulin signaling and metabolic health
🌞 Vitamin D activation

But here’s the key - different forms serve different purposes:

🧠 Magnesium L-threonate
Supports brain function, memory, and sleep initiation

😌 Magnesium glycinate
Promotes calmness, reduces muscle tension, supports anxiety and stress physiology

🚽 Magnesium citrate
Helpful for constipation and bowel regulation

💊 Magnesium oxide
Common and inexpensive, but less bioavailable for raising tissue magnesium levels

Magnesium deficiency can contribute to:

• Poor sleep
• Anxiety or overstimulation
• Muscle cramps or tension
• Insulin resistance
• Difficulty optimizing vitamin D
• Stress-driven symptoms

Magnesium is foundational but only when the form matches the physiologic target.

That’s precision medicine.

If this was helpful, share it with someone who takes magnesium but isn’t sure which type is right. 👇

02/26/2026

Let’s clarify something important about the HPV vaccine.

HPV is not a female virus.
It’s a human virus and it causes cancer in men too.

Most people associate HPV with cervical cancer. But in men, high-risk HPV strains are linked to:

• Oropharyngeal (throat) cancer
• A**l cancer
• Pe**le cancer

These are not theoretical risks. HPV-related throat cancers in men have been increasing for years.

The vaccine used in the U.S. - Gardasil 9 - protects against the most important high-risk strains, particularly types 16 and 18, which are responsible for the majority of HPV-related cancers.

Here’s the key concept: persistence.

Most HPV infections clear on their own. Cancer risk develops when high-risk strains persist silently for years.

Vaccination helps prevent infection with the strains most strongly associated with cancer before exposure occurs.

This is not about judgment.
This is about cancer prevention.

If we have a safe and effective way to reduce future cancer risk, it’s worth understanding.

If you have sons, nephews, or young male patients, this conversation matters. 🩺

02/24/2026

I keep seeing something that concerns me.

Men are being diagnosed with prostate cancer and they’ve never even heard of HIFU.

Not once.

High-Intensity Focused Ultrasound has been used around the world since 1994. Tens of thousands of men have been treated. This is not experimental medicine it’s established technology.

So why isn’t it routinely discussed?

When prostate cancer is diagnosed, most men are told about surgery or radiation. Some are offered surveillance. But focal therapy - organ-preserving treatment - is often not even mentioned.

HIFU works by delivering highly focused ultrasound energy to a precise area of the prostate, destroying cancerous tissue without removing the entire gland. No incision. No radiation. Image-guided targeting.

In properly selected patients, clinical trials show cancer control outcomes comparable to surgery, with lower rates of urinary incontinence and better preservation of erectile function. 📊

That doesn’t mean HIFU is right for every patient.

But informed consent means knowing all reasonable treatment options.

If you’ve been diagnosed with localized prostate cancer and HIFU hasn’t been discussed, it’s reasonable to ask why.

Understanding your options matters. 🩺

02/22/2026

When it comes to supplements that actually work, creatine is near the top of the list.

But delivery form matters more than marketing would have you believe.

Here’s the clinical breakdown:

✔ Powder = most efficient and cost-effective
✔ Capsules = same creatine, higher cost per dose
✔ Gummies = often under-dosed with added sugar

What do I recommend medically?

✔ Creatine monohydrate powder
✔ 3–5 grams daily
✔ No loading phase required
✔ Consistency matters more than timing

And let’s clear common concerns:

❌ No evidence of kidney harm in healthy individuals
❌ No strong clinical evidence linking creatine to hair loss

What does the research support?

✔ Muscle performance
✔ Cognitive resilience
✔ Bone health
✔ Metabolic function

Simple. Studied. Effective.

And in medicine - simple and well studied is usually the right choice.

02/20/2026

When it comes to supplements that truly work - not hype, not branding - creatine is at the top of the list. 💪

But when you go to buy it… you’re overwhelmed with options:

• Creatine monohydrate
• Creatine HCl
• Buffered creatine
• Micronized powders
• Capsules and gummies

So what actually matters scientifically?

Creatine is a naturally occurring compound that helps regenerate ATP: your body’s primary energy currency. That means it directly supports:

⚡ Power output
🧠 Brain energy metabolism
💥 Muscle contraction
🔋 Mitochondrial function

But here’s the key takeaway:

Creatine monohydrate is the gold standard.

It is:
✔ The most studied form in medical literature
✔ Proven to increase muscle creatine stores
✔ Stable and effective
✔ Safe and inexpensive

Other forms may dissolve differently or cost more but they have not been shown to outperform monohydrate in meaningful clinical outcomes.

More marketing does not mean more effectiveness.

Understanding physiology helps you choose based on evidence not advertising.

02/18/2026

All testosterone therapy delivers the same hormone: bioidentical testosterone.

Injection, gel, cream, pellet, nasal, oral…
the delivery system changes. The molecule does not.

From a biochemical standpoint, testosterone is a fixed 19-carbon steroid hormone. Once it enters circulation, your androgen receptor cannot tell how it arrived - only that it is testosterone.

That means TRT decisions are not about “which is real testosterone.”
They are about pharmacokinetics and how the body absorbs, releases, and maintains stable levels.

✔ peak-to-trough variation
✔ conversion to DHT
✔ hematocrit response
✔ blood pressure effects
✔ lifestyle fit
✔ adherence and convenience

Different delivery. Same hormone.

Understanding this helps patients make informed decisions based on physiology not myths.

If this clarified something you’ve wondered about, share this with someone who needs to hear it.

02/16/2026

PCOS treatment must begin with physiology not habit.

Many women with PCOS are not reliably ovulating.
That means progesterone is often low, even when cycles appear normal.

At the same time, insulin resistance can overstimulate the o***y to produce excess testosterone.

Effective treatment focuses on:

✔ Improving insulin signaling
✔ Supporting ovulation biology
✔ Stabilizing progesterone production

When these signals are corrected, symptoms often improve naturally.

PCOS is not just a reproductive condition it is a metabolic and hormonal signaling disorder.

02/13/2026

Your thyroid does far more than “control metabolism.”

It regulates the energy production of nearly every cell in your body: including brain function, hormone signaling, cardiovascular health, temperature regulation, and tissue repair.

But here’s what many people don’t realize:

You can feel profoundly unwell even when your thyroid labs are labeled “normal.”

Fatigue
Brain fog
Weight gain
Cold intolerance
Low mood
Hormone symptoms despite normal labs

These are not random. They’re signs your cells may not be receiving adequate thyroid signaling.

TSH is only one piece of the picture.
True thyroid function depends on:

✔ T4 to T3 conversion
✔ Reverse T3 balance
✔ Cellular responsiveness
✔ Metabolic and inflammatory stress

Reference ranges describe populations.
They do not define optimal physiology.

When thyroid signaling is properly supported, improvements often occur across multiple systems at once — energy, cognition, metabolism, and hormonal balance.

Your cells respond to signals, not lab labels.

02/11/2026

Oxidative stress doesn’t just “age you” it disrupts blood flow at the cellular level. 🧬

The endothelium is the thin inner lining of your blood vessels.

Its most important job? Releasing nitric oxide, the molecule that tells vessels to relax and allow healthy circulation.

When oxidative stress rises:

• Nitric oxide production drops
• Inflammation increases
• Vessel flexibility declines
• Blood flow signaling weakens

This is why erectile dysfunction is often one of the earliest warning signs of vascular disease - that tissue is highly dependent on nitric oxide signaling. ⚠️

Healthy function is vascular first, hormonal second.

Understanding the mechanism changes how we treat the problem.

02/09/2026

Polycystic O***y Syndrome (PCOS) is one of the most misunderstood hormonal conditions in women because it isn’t a single disease.
It’s a communication problem between the brain, the ovaries, and metabolism. 🧠🩺

Here’s what actually happens:

• The pituitary releases too much LH and not enough FSH
• This drives excess ovarian testosterone and disrupted ovulation
• Adrenal androgens like DHEA-S can worsen acne, hair changes, and weight gain
• Insulin resistance amplifies testosterone production and lowers SHBG
• Low progesterone confirms chronic anovulation - even with “regular” cycles

PCOS is diagnosed clinically.
You do not need ovarian cysts to have it.

Most importantly: PCOS is not just about fertility.
It’s a lifelong metabolic and hormonal condition and when you understand the signals, you can treat the cause, not just the symptoms.

🧠📊 Knowledge changes outcomes.

02/06/2026

PSA is often blamed on things that don’t meaningfully affect it.

Digital re**al exams, ej*******on, and bicycle riding are commonly cited, but they do not cause sustained or clinically significant PSA elevation.

The most common meaningful cause of PSA rise is prostate inflammation, particularly prostatitis.

Inflammation can raise PSA substantially and is often associated with urinary symptoms, pelvic discomfort, or pelvic floor tension.

Effective treatment requires addressing both infection and pelvic floor dysfunction. When inflammation resolves, PSA often comes back down.

The right question isn’t “what did I do wrong?”
It’s “what is my prostate telling us?”

Address

72 Sharp Street, Unit A-10
Hingham, MA
02043

Opening Hours

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Tuesday 7am - 3pm
Wednesday 7am - 3pm
Thursday 7am - 3pm
Friday 7am - 3pm

Telephone

+17813376737

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