Daniel Kim, PA-C

Board-Certified Physician Assistant offering pharmaceutical-grade peptide therapy to Arizona patients. No RUO. Romans 8:28

[Daniel Kim, PA-C @DanielKimPAC1]

A patient in her 70s thanked me today.

For years she was told by her PCP and endocrinologist, “Your labs look fine. Nothing is wrong.”

But she didn’t feel fine.

She was struggling with hot flashes, poor sleep, weight gain, and loss of muscle.

We looked at the whole picture. Not just whether her numbers fell inside a reference range.

Now she’s sleeping better, her night sweats are significantly improved, she’s losing weight, and we’re working on building muscle at 78.

That’s what “rethinking what it means to be healthy” means to me.

Treat the patient, not just the numbers.

And whenever possible, prevent disease before you have to treat it.

[Daniel Kim, PA-C @DanielKimPAC1]

Today I turned 38.

The Lord has blessed me beyond what I deserve with a godly wife, the cutest son, and so many incredible relationships. My cup is full, not because of the material things I have, but because of the people I get to do life with.

But I’ll be honest. some of the material things are pretty fun too. 😂

There’s something wild about getting things done with Grok Bot while my Tesla drives us to date night, sipping electrolyte water with one hand and massaging my wife’s shoulder with the other.

What a time to be alive. This technology is crazy.

[Daniel Kim, PA-C @DanielKimPAC1]

@opendoor8282 I don’t buy shares directly anymore
I feel like I have more than I need personally
I just like to play with selling puts and calls and make premiums while waiting for the stock to move up

[Daniel Kim, PA-C @DanielKimPAC1]

Thank you Anthony
I discovered $OPEN last year because of this tweet
$OPEN is the biggest bet of my life in the stock market
This is a generational company

[Anthony Pompliano 🌪 @APompliano]

Wow.

$OPEN CEO Carrie Wheeler just stepped down.

Power to the people.

[Daniel Kim, PA-C @DanielKimPAC1]

@ZachShurtleff I’m ready to prescribe this

[Daniel Kim, PA-C @DanielKimPAC1]

Strive paving the way..you love to see it
Oral testosterone LPT is very affordable too

[Dr. Alex Tatem @DrAlexTatem]

🚨 Hot take: Oral T will replace injectable T in the next 3 years. Maybe.

Hear me out… 👇👇👇

THE PROBLEM

Testosterone taken orally isn’t liver toxic, it just gets chewed up by the liver.

Over 90% is instantly degraded and, because the liver is CHOCK full of 5-alpha reductase, you get skewed T:DHT ratios. And the half-life sucks.

THE FIRST FAILED ATTEMPT

So, in 1936, enter METHYL-testosterone.

The first 17-alpha alkylated oral steroid, methyl T survives first pass metabolism through the liver via steric defense.

The problem? Causes major slowdown of bile efflux from the liver, sooo the liver slowly digests itself. 0/10 do not recommend.

THE SECOND (ACTIVELY FAILING) ATTEMPT

So oral T is out…but what about oral testosterone UNdecanoate?

Oral TU has a few commercial options, Jatenzo, Tlando, and Kyzatrex. But they all work via the same mechanism.

Basically, the undecanoate ester is FREAKING HUGE. It’s 4 carbons bigger than enanthate.

That doesn’t SOUND like a lot, but the ability for it to prefer lipid partitioning (aka lymphatic absorption via chylomicron incorporation) versus aqueous partitioning (absorption into serum) is LOGARITHMIC.

So it’s essentially FORCED into lymphatic absorption…provided you combine it with a fatty meal.

But that’s where TU falls apart. Lymphatic absorption is inefficient (800 mg a day needed for Kyza 😬), unpredictable, and highly variable between patients. It’s a dice roll every time I prescribe it. Nice when it works, but not guaranteed.

And it doesn’t help that TU is way overpriced for most patients.

THE SOLUTION

What if we had an oral testosterone delivery mechanism that could be absorbed more broadly? Not JUST in the portal system or via lymphatics???

Enter LIPOSOMAL T.

Liposomes are basically just tiny fat droplets. But they allow INCREDIBLE drug delivery via buccal mucosa thereby BYPASSING the portal venous system and first pass metabolism.

So the liver can’t chew it up, it isn’t hepatotoxic (not 17-alpha alkylated), and matches the natural pulsatility of endogenous T. But unlike TU, it has INFINITELY more uniform performance across patients and appears to be 50+ times more efficient.

So WHY SHOULD YOU CARE??

This (theoretically) means: preserved FSH/LH, preserved fertility, better regulation of sympathetic drive, less E2, less RBC production.

We (MIGHT) be able to sidestep EVERY major problem with T I’ve spent years learning how to accommodate.

And it’s available NOW via @strivepharmacy.

I have NO financial relationship here. I’m just a TRT doc (and patient) always looking for a better solution.

We *might* have that solution…before we even fully understand it. Studies are ongoing. My personal experimentation is ongoing.

But the results I’ve seen so far…unreal.

Buckle up. TRT may look RADICALLY different (and better) in the next few years.

Follow for more biochemical musings.

[Daniel Kim, PA-C @DanielKimPAC1]

GOAL is minimum 24K homes sold in 2027
My guess is the market will figure this out in Q4 2026 and as it always does, front runs to at least $10 per share by eoy

But hey, even just running it up to $6 won’t be too bad from here $OPEN

[Kaz Nejatian @nejatian]

@HHGF99 @Aubermark @Davo0820 @Scottsdale_Tem It isn't 6K sales in Q4. Goal is ANI profitable 12-month go forward at the end of the year. To do that, we need to average about $9B in revenue in 2027. That's about 24K homes in 2027 or 6K a quarter average next year.

[Daniel Kim, PA-C @DanielKimPAC1]

Yup that’s how my day looks like daily

[InvestingDoc @InvestingDoc]

Primary care is the lowest-paid physician specialty.

Wanna see what my day looked like today?

And somehow I’m constantly doing specialist work because patients can’t afford the specialist, don’t want to go, or literally can’t get an appointment for months.

People on Twitter keep telling me AI is going to automate primary care.

Good luck. I'm more focused on how to get paid more appropriately for all the things that I'm doing.

Here was my day today. Nothing unusual. Just an average day in primary care:

1. High cholesterol follow-up + weight-loss medication management.

2. “Annual physical.” Found a suspicious skin lesion concerning for cancer. Also noticed word-finding difficulty → started a dementia workup.

3. Hospital follow-up after a recent heart attack complicated by cardiogenic shock.

4. New dysphagia + anxiety → started workup.

5. “Annual physical.” Also menopause + hormone replacement therapy management.

6. “Annual physical.” Also follow-up after discharge from an inpatient psychiatric hospitalization.

7. 72-year-old with unintentional weight loss + coughing up blood. Concern for a new cancer → started the workup.

8. “Annual physical.” Also severe agoraphobia. He has essentially isolated himself on his property in a bunker for two years. We talked about how to start getting him back into society.

9. Annual physical. An actual annual physical!

10. “Annual physical.” Also managing multiple side effects from chemotherapy.

11. “Annual physical.” Found another suspicious skin lesion. Also started weight-loss medication and hypertension treatment.

12. “Annual physical.” Also started treatment for alcohol use disorder and connected the patient with resources.

13. “Annual physical.” Also discussed pregnancy, a recent miscarriage, and the anxiety and stress surrounding it.

14. Annual physical for a healthy guy who wanted to nerd out with me over additional biomarkers.

15. Psychiatric medication issue because the patient can’t get into psychiatry. Concern for a manic/bipolar episode + lab follow-up.

16. “Annual physical.” Also anxiety treatment, weight-loss medication management, and hypertension treatment.

17. Pulmonary fibrosis with worsening shortness of breath and anxiety. Discussed end-of-life wishes. Signed an out-of-hospital DNR and arranged additional support.

18. STI visit and treatment.

19. Type 1 diabetes + insulin pump management because the patient can’t get into endocrinology. So now primary care is managing it.

20. Virtual visit for a newly diagnosed Parkinson’s patient. Starting treatment because neurology is booked out for the next NINE MONTHS.

That was one day.

Dermatology. Cardiology. Psychiatry. Oncology. Endocrinology. Neurology. Women’s health. Addiction medicine. Palliative care.

And buried underneath all of it: prevention, hypertension, cholesterol, obesity, diabetes, anxiety, medications, labs, and the actual annual physicals.

Primary care increasingly feels like the specialty that absorbs whatever the rest of the healthcare system cannot handle.

We’re paid less because what we do is labeled “primary.”

There’s nothing primary about it.

So yes, AI will absolutely change my job. I hope it does. There is plenty of administrative garbage I’d love to automate.

But replacing the person who has to walk into 20 completely different rooms, figure out what actually matters, recognize what doesn't fit, know when something is dangerous, manage what the patient can't get managed elsewhere, and then immediately reset for the next completely unrelated problem?

Good luck automating that day. Yes some of it can be automated ..but the majority..not anytime soon.

[Daniel Kim, PA-C @DanielKimPAC1]

Practical

[Ben Greenfield @bengreenfield]

For “untrained” folks who want to increase VO2max, you don’t need much: research suggests 2 to 5 cycling sprint interval workouts per week with 2 to 10 sprints (10 to 30 seconds long each), with a rest interval of 120 to 240 seconds between sprints:
https://t.co/Pxkl7LJGIz

[Daniel Kim, PA-C @DanielKimPAC1]

@DrAlexTatem @TheCryptoDaddi I didn’t know this
Now I know
Thank you

[Daniel Kim, PA-C @DanielKimPAC1]

@Davo0820 Exciting

[Daniel Kim, PA-C @DanielKimPAC1]

@opendoor8282 At the moment, over 100,000 shares.
Sold some covered calls so some shares might get called away

[Daniel Kim, PA-C @DanielKimPAC1]

@morganb @maelan_sdmr The future of home selling & buying experience is here

[Daniel Kim, PA-C @DanielKimPAC1]

@DrAlexTatem @AbudBakri 😳

[Daniel Kim, PA-C @DanielKimPAC1]

100%

[Siim Land @siimland]

Things that matter more for longevity than any supplement or food:
- VO2 max
- Blood pressure
- ApoB
- Blood sugar
- Visceral fat
- Inflammation status
- Muscle strength and power
- Sleep
- Not smoking
- Quality relationships

No single food or supplement will compensate for being weak in these fundamentals.

[Daniel Kim, PA-C @DanielKimPAC1]

Love this so much

[Michael Saylor @saylor]

Send more ₿ears.

[Daniel Kim, PA-C @DanielKimPAC1]

@TheHustleCritic I can see that you love God more than you love yourself

[Daniel Kim, PA-C @DanielKimPAC1]

@NocturnalNelly What’s your body fat%?

[Daniel Kim, PA-C @DanielKimPAC1]

@theficouple Have you tried FSD?
Please do. Your life will never be the same

[Daniel Kim, PA-C @DanielKimPAC1]

@MrNeverSell I love NLT. Easiest to understand.
I like going back and forth with NIV, ESV, TPT, and MSG.
Sometimes AMP and NKJV (Modern language for KJV)