Men’s testosterone levels have been declining over the last few decades, and no one knows exactly why. But South Florida doctors and researchers offer new ways to combat the problem.

When a man’s level falls below normal, his sex drive, energy levels, body hair, and muscle size are affected. Low testosterone also can be a trigger for depression.

A simple blood test  — at home or in a lab — can reveal whether testosterone levels are low.

South Florida doctors say they now have many options to raise testosterone levels: shots, gels, patches, and more recently, pills.

Pembroke Pines urologist Maury A. Jayson says he treats many patients for low testosterone. “It’s a huge health issue,” he said. Jayson advises against patches (they tear up the skin) and topical gels (they run off as men sweat in hot South Florida).

“I use mostly injections or self-injections,” he said. “There have been new formulas.”

Another newer option is pellets. “I insert testosterone pellets under the skin twice a year,” he said. Jayson said with the pellets the dosage is customizable, and the effects are long-lasting. “It’s convenient for men who are busy, and the levels stay elevated consistently over four to six months,”

Treatments for low testosterone typically have side effects: One side effect can be infertility. For older men, this may be less of a concern than for younger men who are still planning to have children.

At the University of Miami, researchers studied a nasal testosterone gel in a clinical trial. The results proved promising for younger men looking for a method to raise their testosterone levels without infertility.

The nasal gel is short-acting and doesn’t cause the body to maintain high testosterone levels throughout the day. Because it’s short-acting, it preserves the production of hormones from the pituitary gland responsible for sperm production.

“We did a trial to see whether nasal gel would maintain sperm production, and it did,” said Dr. Thomas Masterson, assistant professor of clinical urology at UM. “There was still some sperm production decline, but the overwhelming majority maintained sperm count while on that drug.”

In the last few years, the U.S. Food and Drug Administration has approved oral medications to boost testosterone — Jatenzo, Kyzatrex and Tlando. However, they have side effects that include an increase in blood pressure, and possible liver injury. “Because they are so new, our experience with these drugs is still somewhat limited,” Jayson said.

“I don’t prescribe those as much because of insurance issues,” Masterson said.

Doctors say supplements such as vitamin D, zinc and magnesium may also help to boost testosterone.

“When there is a sea of options, we want to tailor these medications to the patient,” Masterson said. “I pick and choose what may work better for each patient.”

Urologists advise looking at your health as a whole, rather than rushing to take testosterone boosters. “Low levels can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems or diabetes,” Masterson said.

 

Royce Lewis had no idea what Pablo López had in store when the starter told him before Thursday night’s game that somebody had to hit a home run.

But, Lewis said, “I figured it would be something cool.”

When Carlos Correa finally did go deep in the seventh inning, Lewis had a chance to see what the starter had been planning for the past few months. After Correa returned to the dugout, he was greeted López at the top step, holding a custom-made Prince-themed vest for him to slip on. It was accompanied by an inflatable guitar and a purple fedora.

It was the latest in the long line of creative and fun things that López has introduced to the clubhouse. For the veteran right-hander, introducing new ideas to help promote team bonding has become important to him as a team leader.

The 2023 season’s home run vest, now retired and behind glass in the Twins’ clubhouse, was bought by starter Pablo Lopez at a local sports store. (John Shipley / Pioneer Press)

“I’m all for doing activities for the team,” López said. “I’m all for finding things sometimes not related to baseball that can bring us closer not only as players but also as people, as friends, as brothers. I always like finding little things, little opportunities to make something cool happen.”

López was the one behind the celebration fishing vest that the Twins wore last year, heading out to a sporting goods store to purchase the vest during his free time and also providing a toy rod. Twins home run hitters wore that from May on before retiring it, sending López back to the drawing board.

He contacted a website this spring to have the Prince vest custom made, then waited. It arrived when the Twins were in the middle of the rally sausage craze, so he held off on bringing it out until Thursday, which was appropriately Prince Night at the ballpark.

Last year, López played a big role in helping plan the team’s rookie dress up, gathering knowledge about his teammates throughout the season and then thinking up costumes that would be specific to them. Earlier this season, when the team had a free night in Detroit, he hosted Bingo Night at the team hotel, planning and catering the event, which was attended by nearly the entire traveling party.

And at the beginning of the homestand, López introduced his new Wheel of Fortune. It sits in between the empty locker next to his, under a sheet when not in use. After Twins wins, it comes out. A player and pitcher of the game are identified and then play rock paper scissors for their chance at spinning the wheel. The winner then gets a prize. Chris Paddack, the first winner, took home a pair of eye massagers, which he said were “legit.”

“I think it just brings us together a little bit, closer as a group,” Paddack said.

That’s exactly what López intended when he introduced the idea.

As a young player in Miami, he was around veterans like Martín Prado, Curtis Granderson and Neil Walker, who he said helped teach him about developing winning cultures within the clubhouse. He took notes.

“Those guys were all about doing things that would involve the entire team, the entire staff, bringing everyone together,” López said. “I would sit down, participate and then just (think), ‘It’d be cool to do those things one day. It’d be cool to be that guy.’ ”

The Twins (40-32) have won five straight, and 7 of 9 overall, heading into a three-game series against Tampa Bay (34-38) starting Tuesday night at Target Field.

It’s no surprise to manager Rocco Baldelli that López has become that guy within the Twins’ clubhouse. He’s both thoughtful and organized, Baldelli said, and in a lot of ways “he’s like the team director.”

“He’s a guy that gets ahead of it all and then executes, just like he does on the mound,” Baldelli said. “That’s kind of the way he approaches stuff off the field, too. … There’s nothing shocking about Pablo López taking the time to set something up that he thinks is going to be fun and help the group and be a blast. He’s a good party planner.”

And his efforts certainly don’t go unnoticed.

Within the clubhouse, his teammates appreciate him for not just for what he does on the mound, but for what he does off it.

“He’s a special human being,” Correa said. “The fact that he goes out of his way to bring the team together means so much. You need guys that not only pitch well, but also bring the team together. He’s definitely one of those.”

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St. Paul city planners are considering further restrictions on fast food drive-thrus, which critics say make neighborhoods more hostile to pedestrians and cyclists.

A city study released for public comment in March drew a wide range of reactions. Proposed zoning amendments would limit where future drive-thrus can be installed while also heightening design standards.

Among the questions pitched to the public: Should St. Paul prohibit future fast food drive-thrus altogether? Or perhaps the city could just ban them downtown and in mixed housing and retail “T2 traditional neighborhood” zoning districts, with the goal of promoting walking over driving in mixed-use areas.

Those options, still being considered by the St. Paul Planning Commission, are opposed by the St. Paul Area Chamber of Commerce and Hospitality Minnesota, the state’s lodging and restaurant association, as well as individual restaurant owners. During a June 7 hearing before the Planning Commission, a representative of Border Foods, which operates almost every Taco Bell in the state, said drive-thrus account for up to 80% of their business.

Some retailers say that given crime and safety concerns, the alternative to a late-night or all-night drive-thru isn’t a more pedestrian-friendly, walk-in experience — it’s to add parking and close their fast-food eatery earlier.

They also recalled that drive-thrus were integral to surviving the coronavirus pandemic, when the state imposed restrictions on on-site dining.

“The reason I’m sitting here today and still in business is because of the carry-out business I had,” said Eddie Sharif, a proprietor of Burger Moe’s on West Seventh Street, addressing the Planning Commission.

In order to encourage business growth, real estate attorney Brian Alton said, “just like we’ve done with housing choices, we should be less restrictive, not more restrictive.”

St. Paul already limits new drive-thrus by requiring eateries in most zoning districts to seek city approval, through a conditional use permit.

Bill Lindeke, a former planning commissioner, said what makes retail areas like Snelling-Selby and Grand Avenue distinct from the suburbs is pedestrian access between bakeries, coffee shops and other retailers. Once a drive-thru business is installed, it bisects pedestrian foot traffic, he said.

“It almost becomes an island,” he said, recalling a drive-thru that created infamous traffic backups from a Selby Avenue Starbucks into the busy intersection at Snelling Avenue. Former Minnesota Senate Majority Leader Amy Koch required wrist surgery in October 2019 after getting hit by an SUV outside the location. After years of controversies, the drive-thru was replaced with a patio.

Some business advocates argue drive-thrus benefit the disabled, as well as parents with small children and others with mobility challenges. Lindeke argues just the opposite. “Drive-thru curb cuts, once cars start going over the sidewalks with snow and ice, it’s almost impossible to get the ice off the sidewalk,” he said. “It becomes the slipperiest part of anyone’s trek.”

Planning Commissioner Simon Taghioff echoed that sentiment. “I am a young parent,” he said. “I often hear in these debates young parents co-opted into this assumption that we can’t walk. … In Manhattan, they seem to have a bunch of Taco Bells and other fast food joints. And none of them have drive-thrus. I wonder how those operate?”

Minneapolis in 2019 banned new drive-thrus, calling them unfriendly to pedestrians and the environment.

St. Paul officials counted 77 drive-thrus in the city, mainly at restaurants and banks but also several pharmacies and two coffee shops.

The Planning Commission is likely to revisit the drive-thru zoning study this summer before the issue goes before the St. Paul City Council around August.

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Chris Joyner | The Atlanta Journal-Constitution (TNS)

It’s been 3 1/2 years since thousands of people marched from a rally by then-President Donald Trump to the U.S. Capitol, where many of them stayed for hours, fighting with police and parading through the building, delaying the certification of the presidential election and forcing members of Congress to flee.

But even as Americans prepare for another presidential election in November, the sprawling investigation into the Jan. 6, 2021, riot that followed lingers on.

According to the U.S. Department of Justice, at least 1,457 people have been charged with crimes ranging from misdemeanor trespassing to serious felonies, including assault on a police officer and seditious conspiracy. Among those are 33 defendants with ties to Georgia, two of whom are scheduled to go on trial Monday.

Phillip “Bunky” Crawford, 48, and Dominic Box, 34, are scheduled for separate trials Monday in U.S. District Court in Washington on felony charges related to their alleged actions in the riot.

Crawford pleaded guilty last month to one count of felony civil disorder, four counts of assaulting police and one count of violent and disorderly conduct on the Capitol grounds. But he chose to take the remaining five criminal charges against him to trial. Four of those remaining charges involve allegations that he used a dangerous or deadly weapon and could bring even more time in prison.

Unlike many of his fellow defendants, Crawford did not enter into a plea deal with federal prosecutors, which would have avoided a trial. In a lengthy May 31 interview on the streaming platform Rumble, Crawford described his decision as both a principled and strategic decision.

“I pled guilty to six counts because I realized (prosecutors) are not following the Constitution and people aren’t winning. I’m looking at the previous cases, and it don’t look good,” he said. “I took the plea to take responsibility for my actions, because I did put my hands on officers and they can hold me accountable for that. By the same token, (the officers) should be held accountable for their actions.”

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Crawford was among dozens of rioters who fought with police guarding a tunnel on the Capitol’s Lower West Terrace while members of Congress evacuated the building. The hand-to-hand combat between rioters and police was among the most violent moments of the day. Crawford defended his actions by saying he was attempting to reach a woman at the front of the police line whom he said was being beaten by police.

“I took action because what I saw was officers using excessive force. I’m not going to steer away from that,” he said. “When it is all said and done and my jail time is over, I can live with my head up.”

In court documents, federal prosecutors have repeatedly told the court that Crawford is unrepentant and believes in the “righteousness of his actions.” While Crawford portrays himself as a family man and a patriot, prosecutors also pointed to his history of arrests that include lying to police and violating parole as evidence of his poor character.

In the other trial scheduled Monday, Box faces charges of obstruction of an official proceeding and two counts of civil disorder, all felonies. Prior to the 2020 election, Box was known in Savannah as a prominent member of a group that spread conspiracy theories associated with the QAnon movement. On Jan. 6, Box livestreamed his march to the Capitol and portions of his time inside the building.

Box has a long history of drug and alcohol problems and was arrested in August on charges including DUI in Jacksonville, Florida, after police reportedly found him passed out in the driver’s seat of his car in the parking lot of a Mexican restaurant. He has been in jail in Jacksonville since his arrest awaiting trial on those charges.

Since the riot, two dozen Georgia defendants have either entered into plea deals or been found guilty at trial on Jan. 6 charges, receiving sentencing ranging from probation to years in prison. They join nearly 900 others from across the nation who have met the same fate.

“I think it’s safe to say that almost everyone who went to the Capitol that day knows someone who was arrested or got a door knock from the FBI,” said Jon Lewis, a research fellow at George Washington University’s Program on Extremism.

At the same time, Lewis said it is hard to see whether the investigation and prosecutions will have the effect of deterring more political violence in this coming election cycle. Lewis pointed to the recent example of convicted Jan. 6 rioter Brandon Fellows — sentenced to 3 1/2 years in prison for his role in the riot — who not only returned to the Capitol, but sat behind Dr. Anthony Fauci during a congressional hearing this month, making faces at the cameras.

“You have individuals who are looking at these arrests and these prosecutions and see it as nothing more than politically motivated theater,” Lewis said. “And yet we are still here just talking about the 1,400th low-level defendant who probably will not get jail time and whose statute of limitation will run out if they aren’t pardoned by a new Trump administration.”

Holding the rioters accountable in court is admirable, Lewis said. But the root causes of the unrest remain largely unaddressed.

“We can’t confuse that with strategic success,” he said.

Lewis said the rise of far-right “influencers” on social media over the past four years has kept alive many of the same conspiratorial themes that led to violence on Jan. 6. The “most damning part” is the lack of outrage from congressional Republicans who were evacuated on Jan. 6 as rioters breached the building, he said.

“We’re still talking about the same challenges we were four years ago,” he said.

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