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What to know about testosterone replacement therapy

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What to know about testosterone replacement therapy

US Secretary of Defense Pete Hegseth speaks during a press briefing at the Pentagon in Washington, DC, on April 8, 2026.

Mandel Ngan | Afp | Getty Images

Testosterone replacement therapy has shifted from the doctor’s office to the center of a massive cultural phenomenon focused on performance, longevity and men’s health. 

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Now, the treatment is back in the spotlight after Defense Secretary Pete Hegseth announced last week that the U.S. military will begin testing service members’ testosterone levels and make replacement therapy available to those who qualify, saying the goal is to help troops operate at their “absolute best.” The effort also builds on a larger push by the Trump administration to promote and expand public access to testosterone replacement therapies, which are made by pharmaceutical companies such as AbbVie, Pfizer and Marius Pharmaceuticals.

The announcement puts a new focus on a treatment that has grown increasingly popular in recent years, fueled by men’s health clinics, telehealth companies and online influencers, who promote testosterone, or “T-maxxing,” as a way to address fatigue, aging and declining performance. Health and Human Services Secretary Robert F. Kennedy Jr. has also touted testosterone therapy as part of his anti-aging regimen.

Prescriptions rose from 7.3 million in 2019 to more than 11 million in 2024, according to healthcare research firm IQVIA. But there has long been a debate around the safety of taking synthetic forms of testosterone, the hormone that affects sex drive, mood and other health factors. 

While some research has shown benefits for patients who qualify, including improvements in bone density and muscle mass, questions remain about the therapy’s long-term risks and its use among men without a clear medical need. 

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The concern is significant: up to a third of men taking testosterone have never been formally diagnosed with testosterone deficiency and may not benefit from treatment, according to the American Urological Association.

Physicians also stress that testosterone therapy is not a universal solution for low energy or normal aging. It is generally intended for men with clinically confirmed testosterone deficiency, and experts say determining who qualifies requires more than a single blood test — which appears to be the military’s plan. Excess testosterone can also carry risks, including reduced sperm production.

“I’m not saying that testosterone is bad. It is good for people that need it,” said Dr. Adrian Sandra Dobs, an endocrinologist at the Johns Hopkins School of Medicine. “But to overreplace it – we have to be very careful about that.”

As testosterone therapy enters a new national conversation, here’s what doctors say we know – and don’t know – about its benefits, risks and who should consider treatment.

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Who is the therapy intended for? 

Testosterone replacement therapy, which is commonly administered through injections, gels, implantable pellets and oral medications, is intended for a more narrow population than social media may suggest.

Physicians say it’s generally reserved for men with clinically diagnosed hypogonadism –  a condition in which the body does not produce enough testosterone.

That generally means persistently low testosterone levels alongside symptoms such as reduced sex drive, fatigue, erectile dysfunction, depressed mood, low bone density, or loss of muscle mass and strength.

Dobs said low testosterone can stem from several causes. While testosterone levels naturally decline with age, that alone does not typically qualify as a deficiency. Certain conditions can also suppress testosterone production, including sleep disorders such as sleep apnea, damage to the testicles, pituitary disorders, some cancer treatments and chronic illnesses. 

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Ayo888 | Istock | Getty Images

In some men, doctors may diagnose what’s known as functional hypogonadism, in which testosterone levels fall because of potentially reversible factors such as obesity or chronic disease, even though the reproductive organs are structurally intact.

“Obesity, stress, fatigue, and poor sleep are very common and these conditions can reduce testosterone,” said Marcus Goncalves, director of the Holman Division of Endocrinology, Diabetes and Metabolism at NYU Langone Health. “The correct solution is to improve those aspects and let testosterone naturally come back up, but that is easier said than done.”

But diagnosing the condition typically requires more than a single blood test, Goncalves added.

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Because testosterone levels fluctuate throughout the day, medical guidelines generally recommend confirming low levels with two separate morning blood draws and evaluating patients for potential underlying causes before considering therapy, he said.

A low testosterone result also does not always mean someone needs treatment. Testosterone levels can temporarily decline during periods of severe stress, illness, weight loss, or intense physical exertion and may return to normal once those factors resolve, said Dr. Richard Auchus, professor of internal medicine at the University of Michigan.

“It’s not that easy to tell whether someone is sufficient in testosterone and whether that is kind of a functional and reversible situation, or if that is an irreversible permanent problem,” Auchus said.

What are potential benefits and risks? 

The benefits of testosterone replacement therapy can be real for the right patients. 

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“I would say that we try to limit the treatments to people we know are going to benefit,” said Auchus.

For men with clinically confirmed testosterone deficiency, treatment can increase sex drive, improve erectile dysfunction, help restore muscle mass and bone density, and boost energy levels and mood. It can also improve bone mineral density, reducing the risk of osteoporosis and fractures in men with low hormone levels. 

But experts say it is less clear whether raising testosterone in people who already have normal or only mildly low levels provides meaningful benefits for energy, cognition, athletic performance or overall health. Evidence supporting testosterone as a broad anti-aging or performance-enhancing treatment remains limited, they added. 

“It doesn’t make you any smarter. It won’t make you a better pilot,” Dobs said. 

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Even for appropriate patients, physicians say testosterone therapy carries risks and requires ongoing monitoring.

One concern is that the treatment can increase red blood cell counts, potentially thickening the blood and raising the risk of complications such as blood clots, NYU Langone’s Goncalves said. 

While earlier studies raised concerns that testosterone therapy might increase cardiovascular risk, more recent evidence has been reassuring. A major 2023 trial – the largest and most comprehensive to date – found no higher rate of heart attack, stroke or cardiovascular death among men receiving testosterone therapy than among those given a placebo. 

Researchers did observe higher rates of certain conditions, including atrial fibrillation, acute kidney injury and pulmonary embolism, underscoring the need for careful patient selection and monitoring.

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The treatment can also suppress the body’s natural production of the hormone, reducing sperm production and potentially affecting fertility, he added. Physicians generally discourage testosterone therapy in men who may want to have children. 

Other potential side effects include acne, breast tenderness or enlargement, fluid retention and worsening symptoms of untreated sleep apnea.

How might this apply to the military? 

The military’s plan to test service members’ testosterone levels raises a key question: How should doctors interpret hormone levels in people undergoing extreme physical and psychological stress?

Goncalves said that intense military training, sleep deprivation and prolonged physical exertion can temporarily suppress testosterone production. In one study of U.S. Marines undergoing Survival, Evasion, Resistance and Escape, or SERE, training, testosterone levels fell by roughly half during the exercise before recovering afterward.

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“There is no evidence that restoring [testosterone] levels during that period improves performance,” he said, though he added that the question would be worth studying.

That also highlights a challenge for any large-scale testing program, some experts said. A low testosterone reading may not reflect a permanent deficiency requiring treatment, but rather a temporary response to demanding conditions.

Auchus also cautioned that testosterone therapy can create long-term issues for otherwise healthy service members. Because treatment suppresses the body’s natural testosterone production, men who remain on therapy for extended periods may become dependent on it to maintain normal hormone levels, he said. 

Auchus said that raises questions about what could happen if a service member receiving testosterone were suddenly unable to access treatment during a deployment or other military operation.

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More broadly, experts say testosterone replacement therapy should not be viewed as a shortcut to improved military performance.

“Testosterone is not going to make men more macho or better fighters,” Dobs said. “You need brains to win a war.”

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Five people dead in apparent mass drowning in Ohio river

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Five people dead in apparent mass drowning in Ohio river

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Full Hints and Clues Plus the Solution to Todays Puzzle #1858

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Nancy Guthrie

Wordle players looking for help with today’s puzzle can find hints, clues and the full solution below for Wordle #1858, the daily word puzzle released Tuesday, July 21, 2026.

Wordle challenges players to identify a five-letter word within six attempts, with the game providing color-coded feedback after each guess to indicate which letters are correct and properly placed, which letters appear in the word but in the wrong position, and which letters do not appear in the word at all. A new puzzle becomes available daily at midnight local time, meaning players around the world receive access to that day’s word at different moments depending on their time zone.

Hints for today’s Wordle

For players who want a nudge in the right direction without having the answer fully revealed, several outlets covering today’s puzzle offered a series of progressive hints. According to those hints, today’s word contains just one vowel among its five letters, a relatively uncommon structure that can make the puzzle trickier to solve through standard guessing strategies. That single vowel, the letter I, sits in the third position of the word.

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Today’s word also contains one repeated letter, with both instances of that letter appearing consecutively at the very end of the word. The puzzle begins with the letters “SH,” the same opening combination found in common words such as “share,” “shout” and “shrug,” a detail that several outlets suggested could help narrow down potential guesses.

A definitional clue

Beyond the structural hints, coverage of today’s puzzle also offered a definitional clue tied to the word’s meaning, which centers on deception or hidden promotional motives. According to that hint, the word describes someone who secretly promotes a product, scheme, or point of view while presenting themselves as an impartial or unaffiliated observer. The term is commonly used in discussions of online scams, influencer marketing, and situations involving undisclosed sponsorships or hidden financial incentives.

Today’s Wordle answer

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The answer to Wordle #1858 for July 21, 2026, is SHILL.

As both a noun and a verb, “shill” refers to someone who poses as an enthusiastic, impartial customer or supporter of something, such as at an auction, a street game, or an online promotion, while secretly working on behalf of the seller or organizer to encourage others to participate. As a verb, to “shill” means to act in that deceptive promotional capacity, or more broadly, to promote something in a misleading way for personal gain.

The word has seen a notable rise in everyday usage in recent years, particularly within the context of social media, where undisclosed sponsored content and hidden brand partnerships have brought increased public attention to the practice of “shilling” products or ideas without full transparency about financial or personal incentives involved.

Puzzle difficulty

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According to Wordlebot, the New York Times’ internal tool that analyzes daily Wordle difficulty based on aggregate player performance, today’s puzzle carried an average difficulty rating of 4.4 out of a possible 6 guesses, suggesting most players needed a moderate number of attempts to reach the correct answer. The puzzle’s relatively unusual letter structure, featuring only a single vowel and a doubled final consonant, likely contributed to that above-average difficulty level for many solvers.

About Wordle

Wordle, now owned and published by The New York Times, has become one of the most widely played daily word games since it first gained viral popularity in early 2022. The game’s simple format, one puzzle per day shared by all players regardless of location, has helped fuel its continued popularity, as solvers frequently compare results and maintain personal solving streaks across social media platforms.

Players looking for extra help with future puzzles can typically find daily hints and starter word suggestions published by various gaming and puzzle-focused outlets shortly after each day’s Wordle becomes available, offering a way to work through the puzzle with partial guidance rather than having the answer revealed outright.

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Other daily puzzles

For players interested in additional daily word and logic puzzles beyond Wordle, The New York Times also publishes several other games on a similar daily schedule, including Connections, a puzzle that challenges players to identify hidden groupings among a set of words, and Strands, a word-search-style puzzle built around a central theme, or “spangram.” Tuesday’s editions of both games, Connections puzzle number 1136 and Strands puzzle number 870, were also published alongside today’s Wordle, offering solvers additional options as part of their daily puzzle routine.

With today’s Wordle answer now solved, a new puzzle will become available at midnight local time Wednesday, continuing the game’s now-familiar daily rhythm. Players looking to maintain their solving streaks or simply enjoy the daily challenge can expect a fresh five-letter word and accompanying set of clues from various outlets to help guide their next attempt, regardless of whether today’s puzzle proved to be a quick solve or a more challenging one given its unusual single-vowel structure.

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Park Aerospace Corp. 2027 Q1 – Results – Earnings Call Presentation (NYSE:PKE) 2026-07-21

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OneWater Marine Inc. (ONEW) Q1 2026 Earnings Call Transcript

This article was written by

Seeking Alpha’s transcripts team is responsible for the development of all of our transcript-related projects. We currently publish thousands of quarterly earnings calls per quarter on our site and are continuing to grow and expand our coverage. The purpose of this profile is to allow us to share with our readers new transcript-related developments. Thanks, SA Transcripts Team

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Amanda Healy teams up with Maroomba Airlines execs for new charter aviation services

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Amanda Healy teams up with Maroomba Airlines execs for new charter aviation services

A charter airline owned by local aviation executives and Warrikal founder Amanda Healy has hit the skies of Western Australia.

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Developers reimagine Freo’s heritage

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Developers reimagine Freo’s heritage

The adaptation of heritage buildings is gaining favour as new builds become more difficult to stack up.

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(VIDEO) NYC Mayor Mamdani Says Netanyahu Arrest Warrant Should Be Enforced, Contradicting Trumps Vow of Safety

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New York City mayoral candidate Zohran Mamdani, seen here on the day of the Democratic primary June 24, 2025, has little experience but has energized followers with a leftist campaign

New York City Mayor Zohran Mamdani said Monday that the International Criminal Court’s arrest warrant against Israeli Prime Minister Benjamin Netanyahu should be honored, directly contradicting an assurance from President Donald Trump earlier the same day that Netanyahu would face no arrest while in the United States.

Speaking at a press conference, Mamdani reiterated his position on the warrant in direct terms. “If someone is charged with a warrant by the International Criminal Court for these kinds of crimes, that’s something I believe should be honored. And I’ve also said that we will follow our local laws,” Mamdani said.

Trump’s assurance to Netanyahu

Mamdani’s comments came hours after Trump posted on Truth Social that Netanyahu “will not be arrested, in any way, shape, or form, while in the United States of America.” Trump’s post did not name Mamdani directly, though it came amid the mayor’s continued public statements about the ICC warrant, and credited Israel with assisting the United States in its ongoing military conflict with Iran.

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Trump later told reporters that he had no tension with Spain’s prime minister, Pedro Sanchez, despite having ordered a halt to trade with Madrid and criticizing Spain as a partner within NATO, remarks made during the same public appearance in which he addressed the Netanyahu situation.

Mamdani’s escalating rhetoric

Mamdani went further in describing the basis for his position, characterizing Netanyahu in stark terms tied to the war in Gaza. “We’re speaking about someone who’s the subject of an International Criminal Court arrest warrant. And he’s the subject of this arrest warrant for alleged crimes against humanity, for war crimes, and he’s the architect of the genocide against Palestinians in Gaza as Israel’s prime minister,” Mamdani said.

The mayor’s comments Monday represented a continuation of positions he first articulated during his mayoral campaign, when he said he would direct police to arrest Netanyahu if the Israeli leader set foot in New York City, framing the move as straightforward enforcement of the existing ICC warrant. Since taking office, Mamdani has confirmed that his administration’s legal department is actively reviewing whether the city has legal authority to act on the warrant, particularly given that Netanyahu typically travels to New York each September to address the United Nations General Assembly.

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In an earlier interview published Saturday, Mamdani had used even more direct language regarding where he believes Netanyahu should ultimately face justice. “I believe that Prime Minister Netanyahu belongs in The Hague,” Mamdani said at the time.

A position rooted in international law, Mamdani says

In prior public comments, including a Fox News interview with anchor Martha MacCallum, Mamdani has framed his position as grounded in a broader commitment to international law rather than a personal grievance against Netanyahu specifically. “I’ve said that this is a city that believes international law, and this is a city that wants to uplift and uphold those beliefs,” Mamdani told MacCallum, who noted in response that the United States itself does not recognize the ICC’s jurisdiction. Mamdani acknowledged that the U.S. has not signed the treaty establishing the court, but maintained that New York should nonetheless honor the warrant, comparing it to a separate ICC warrant issued for Russian President Vladimir Putin. Mamdani has said he does not intend to create new local laws to facilitate any arrest, but rather to exhaust existing legal options available to the city.

The ICC warrant’s origins

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The International Criminal Court issued arrest warrants for both Netanyahu and former Israeli Defense Minister Yoav Gallant in November 2024, citing allegations of war crimes and crimes against humanity connected to Israel’s military campaign in Gaza. The ICC, established in 2002 to prosecute genocide, crimes against humanity and war crimes, operates under jurisdiction that Israel rejects, and neither Israel nor the United States is a member of the court.

Israel’s response

Israel has firmly rejected both the ICC’s authority and Mamdani’s remarks. In a statement reposted by Netanyahu himself over the weekend, his office described the ICC as “a kangaroo court that has no jurisdiction over Americans or Israelis.” The statement went on to characterize the warrant against Netanyahu as “bogus,” attributing it to what it described as a discredited former ICC prosecutor, Karim Khan, who the statement said issued the warrant shortly before allegations of sexual misconduct against him became public, characterizing the move as an attempt by Khan to divert attention from scrutiny of his own conduct.

Netanyahu’s office also accused Mamdani directly of using the arrest threat to distract from what it characterized as his own failed policies as mayor. The Trump administration has separately imposed sanctions on Khan and roughly a dozen other ICC staff members, in what officials have described as retaliation for the warrants issued against senior Israeli officials over the Gaza war, as well as separate ICC investigations involving U.S. personnel in Afghanistan.

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A clash with national implications

Monday’s exchange underscores a broader and increasingly public divide between Mamdani’s administration and the Trump administration over how the United States should engage with the International Criminal Court and its rulings involving allied foreign leaders. With Netanyahu expected to travel to New York in September for the UN General Assembly, as he has in previous years, the dispute over whether the city could or would attempt to act on the ICC warrant is likely to remain a closely watched flashpoint in the coming months.

With Trump having now publicly guaranteed Netanyahu’s safety from arrest while in the United States, and Mamdani continuing to insist that the ICC warrant should be honored under international law, the two leaders’ starkly opposing positions appear likely to remain unresolved heading into the fall, when Netanyahu’s anticipated UN visit could bring the dispute to a more concrete test. For now, both sides have shown no indication of backing away from their respective positions, leaving the question of how, or whether, any attempt to enforce the warrant in New York City might actually unfold as one of the more unusual open legal and political questions facing the incoming mayoral administration.

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General Motors (GM) earnings Q2 2026

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GM lays off 500-600 salaried IT workers to cut costs

The General Motors global headquarters in Detroit, Jan. 12, 2026.

Jeff Kowalsky | Bloomberg | Getty Images

DETROIT — General Motors is set to report its second-quarter earnings before the bell Tuesday.

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Here is what Wall Street is expecting, according to average estimates compiled by LSEG:

  • Earnings per share: $3.20 adjusted
  • Revenue: $47.01 billion

Those results would mark a more than 26% increase in adjusted earnings per share and 0.2% decline in revenue compared with a year earlier.

GM’s 2025 second-quarter results included $47.12 billion in revenue, net income attributable to stockholders of $1.9 billion, and adjusted earnings before interest and taxes of $3.04 billion.

Aside from earnings and any changes to the automaker’s 2026 guidance, investors will be monitoring effects from tariffs, vehicle pricing and commodity costs, including dynamic random access memory, or DRAM, chips.

Barclays analyst Dan Levy said he expects both GM and its crosstown rival Ford Motor, which reports next week, to post earnings beats for the second quarter “and at least a soft raise.”

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“[Automakers] are benefiting from strong macro – US [seasonally adjusted annual rate] outperformed in 1H, while pricing has remained steady. Moreover, both Ford and GM have embedded conservatism in their guides,” he said in a July 8 investor note.

GM raised its 2026 adjusted earnings guidance in April to reflect a $500 million tariff rebate to between $13.5 billion and $15.5 billion, or $11.50 to $13.50 a share, up $500 million, or 50 cents per share, from its previous expectations.

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Asia stocks climb as easing oil rally supports risk appetite

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EV secures key processing plant milestone

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EV secures key processing plant milestone

It’s been a busy 24 hours for Subiaco-based EV Resources, which continues to move closer towards antimony production at its Los Lirios mine in México.

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UTI AMC’s V Srivatsa warns against midcap valuation, says risk-reward better in largecaps

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UTI AMC's V Srivatsa warns against midcap valuation, says risk-reward better in largecaps
UTI AMC‘s Executive Vice President – Equity, V Srivatsa, believes investors may be better off leaning towards largecaps despite the superior long-term growth prospects of midcap stocks. With the midcap segment trading at a record valuation premium over largecaps, he said the risk-reward has turned more favourable for largecaps, whose earnings growth is improving while valuations remain around historical averages. Edited excerpts from a chat:

With valuations elevated in several pockets, how do you assess the broader market’s risk-reward proposition today?
While valuations remain in excess in certain pockets such as capital goods, consumer durables, defense and healthcare albeit this is led by better earnings visibility and growth, there are also pockets where valuations are below mean in sectors such as banks, insurance, information technology and telecom. Thus, risk reward remains balanced. The earnings growth for Nifty 50 for next year is around 14% as per Bloomberg estimates after two years of sub-par growth and valuations also remain below the last couple of years. With the oil price stabilising and rupee stabilising, we see more macro stability ahead coupled with the earnings growth should lead to positive risk reward going ahead.
Where do you currently see a better balance between growth and valuation: largecaps or midcaps?
The Nifty 50 trades at one year forward estimates of around 17x (as per Bloomberg) which is in line with the last five-year averages and the earnings growth of around 14% is respectable which is led by capital goods and services, telecom, metals and financials. The mid cap also is expected to grow in similar lines and trades at 50% premium to large caps. While the longer-term outlook for mid cap is superior to large caps, the valuation premium is at record high and there could be mean reversion especially when the growth is picking up for the large cap. Hence on a risk reward basis, a large cap looks superior. Which sectors offer the strongest earnings visibility over the next three to five years, and where are expectations running ahead of fundamentals?
In terms of sectors, power equipment, defense, electronic manufacturing services (EMS), healthcare and retail offers highest earnings visibility led by strong order book in case of capital goods and EMS players and strong trends in demand in healthcare and retail. In case of capital goods (power equipment/defense, EMS), while the order visibility is high, there could be peaking of orders in the next three years posing cyclical risks post three years and current valuations do not factor any medium-term weakness which is not ruled out as these businesses are pro cyclical. In case of healthcare and retail, valuations are fair and there could be a long tail of growth justifying the valuations.


Does AI represent a structural growth opportunity for Indian IT companies, or could productivity gains disrupt their traditional revenue model?
AI represents a very good long-term opportunity as the global companies embrace AI in their business, they would need the service of Indian IT service providers to integrate the AI into their systems, and this would present a significant opportunity for them. However, in the near term, there could be pressure on two counts, one is to incorporate AI to reduce cost of delivery and passing on the benefits to clients and second is possible cuts in IT services spending as AI hardware costs crowds out the IT services spending. Yet we believe that there would be long term benefits to the Indian IT services companies.
Capital goods companies have benefited from the investment cycle. What indicators would signal that the cycle is strengthening or approaching a peak?
The key indicators that we will watch to assess the cycle are changes in the government policies, upward or downward revision in government capex, global demand for global linked industries, weakening profitability in end user industries and capex announcements. Government policies and corporate profitability and demand would be the key signals to watch out for the capex order cycle.
What are the biggest risks to Indian equities today: earnings disappointments, stretched valuations, global uncertainty or domestic growth moderation?
Global uncertainty would be the biggest risk for the Indian markets as the geo political risks have increased manifold in the last few years and it has important bearing on the oil prices wherein higher oil prices can cause instability in the Indian economy and also high geo political risks affects global sentiment towards equities and flows trends towards safer assets .

If you have to start an SIP of Rs 10,000 as an investor with moderate risk appetite at this stage, how would it be spread out across various fund categories?
I would suggest a mix of flexicap or large mid cap funds and smaller allocations towards hybrid funds.

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