PT 2

DHT and Testosterone: Benefits and Risks - Peak Testosterone

Most men know that DHT (dihydrotestosterone) is largely responsible for male pattern baldness and, all too often, that’s about all they know.  This can lead to tragic consequences as we will show below, because it is just assumed that only testosterone is the “Male Sex Hormone”.

However, nothing could be further from the truth. Below we are going to show you some of the huge benefits of DHT, many of which will be very reminiscent of our old friend testosterone:

1. Orgasm Frequency. One study examined a variety of sex hormones in male military personnel (the estrogens and testosterones).  The researchers found this surprising fact:  the only one that was related to orgasm frequency was DHT.  In fact, the authors stated that “an increase in concentration of 1.36 nmol/l (about 2 SD) corresponded to an average increase of one orgasm a week.”  Nice, eh?

2. Sexual Function and Morning Erections. Yet another study found that giving topical DHT to senior men with low or lowish testosterone levels lead to dramatic improvements in sexual function. [2] For example, both morning erections and the ability to maintain an erection were improved by the supplemental DHT.  Again, limiting DHT does not sound like such a good idea.

3.  Regular Erections. Again, an animals study showed that both testosterone and DHT were effective at restoring regular erections in castrated animals. [6]

4.  Libido. One interesting animal study showed that castrated animals given DHT (and a metabolite of estrogen) had indistinguisable sexual behavoirs from castrated animals given testosterone.  In other words, the down stream metabolites, or byproducts of testosterone (which includes DHT) can be as powerful as testosterone itself. [5]

This list could go on as DHT is involved in penile neuronal activity as well:  it play a very key role in the development of both penis and prostate for example.  So you get the idea:  this is not a good hormone to mess with and DHT is definitely a “Sex Hormone” as well.

NOTE:  You may also be interested in my link on How to Increase DHT (Naturally and Otherwise) for some additional information. For example, there are a few supplements and dietary means to raise DHT more naturally.

Unfortunately, this is a lesson we all had to learn the hard way.  Two drugs came out to treat BPH (enlarged prostate) and hair loss.  The thinking at the time was that DHT was responsible for both and so finasteride (Propecia) and dutasteride (Avodart) for BPH and hairloss (off label in the case of dutasteride) were created as 5-alpha reductase inhibitor.  As many of you probably know, 5-alpha reductase is the enzyme that converts testostosterone into DHT and so someone got the bright idea that reducing DHT would be a miraculous cure for men everywhere.

Instead, we have found these medications to a disaster and many men have what is termed Post-Finasteride Syndrome, which is permanent or near permanent loss of testosterone with related symptoms including nipple soreness, mood disorders, gynocomastia, etc.  Some of the men that have shown up on The Peak Testosterone Forum have complained of this syndrome and attribute their hypogonadism to prior Propeica use. For example, look at the comments of this poster:

“I just recently encountered your article regarding Post-Finasteride-Syndrome, and I could share some advice from my own experience and recovery processes. I started taking the drug, in the Proscar form, about a year ago when I was 18. My doctor prescribed it to me, and unfortunately, neglected to warn me of the potential consequences. Of course, just two weeks in, I began to experience the described sexual side effects including numbness, shrinkage, testicular pain, dysfunction, etc. I stopped taking the drug immediately, but things only seemed to get worse. After a month off, my system “crashed”, causing severe androgen deficiency and I was experiencing the full myriad of sexual and mental side effects, so add depression, fatigue, anxiety, insomnia, lack of motivation to the list of symptoms.” [3]

This poster was able to partially recover his testosterone, but many men have not been so lucky and seem to suffer permanent damage.  This issue I have actually covered in some detail in a link called The Risks of Propecia Use. The point, though, is that DHT is intimately tied to your libido and sexual function and this is something that doctors do not adequately explain to their male patients. Often by the time they give you the medication, it is too late.

Let’s move, though, to another issue that concerns many men going on HRT (Hormone Replacement Therapy or testosterone therapy):  hair loss.  The reasoning behind the concern goes like this:  some testosterone is converted into DHT via 5-alpha reductase and thus, if you increase testosterone levels through testosterone therapy, you will increase DHT as well.  This, it turns out, is true.  For example, one study of men on pellets, standard injections and testosterone undecanoate noted that   “5α-dihydrotestosterone (DHT) levels appeared to parallel those of T on the three forms of therapy.” [4] In other words, as testosterone went up, so did DHT.

However, it is a huge stretch to say that simply because DHT increases that one’s hair will fall out. In fact, here are a few facts to consider:

1.  Steroid users, who push their testosterone levels artificially high, do not report acclerated male pattern baldness.

2.  None of the HRT users on The Peak Testosterone Forum have complained of hair loss.

3.  I know of no study that forewarns men on testosterone therapy to be concerned about greater risk for hair loss on HRT.

Does this mean that HRT never causes hair loss?  No, it very likely does in some sensitive inidividuals and it is an occasionally reported side effect.  So, if you’re really worried about your hair, talk to your physician first and get his or her insights.  I do know that if the side effect occurs to you, the stats don’t matter. In addition, you may want to check out these links on Hair Loss Factors and Hair Loss and Male Pattern Baldness.

1)  Testosterone Undecanoate (Nebido).  In the above study, testosterone undecanoate did lead to the highest levels of DHT. [4]

2)  Scrotal Patches. And in the U.S., Testoderm has a scrotal testosterone patch that may lead to elevated DHT with respect to other forms of testosterone therapy.  One small study examiningg scrotal testosterone patches concluded “that transdermal [scrotal] testosterone therapy is an effective long term treatment for hypogonadism in men. It is, however, associated with high serum DHT levels, whose potential long term effects on the prostate and other tissues need to be investigated.” [7] This is also verified by a study where topical testosterone rubbed on the scrotum led to greatly increased DHT levels. See my page on Testosterone Therapy and the Scrotum for more details.

REFERENCES:

1)   BMJ, 1995, 310:1289, “Contribution of dihydrotestosterone to male sexual behaviour”

2) The Journal of Clinical Endocrinology & Metabolism, Apr 1 2002, 87(4):1467-1472, “The Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study”

3) https://peaktestosterone.com/forum/index.php?topic=214.msg1655#msg1655

4) Clinical Endocrinology, Aug1984, 21(2):97-107, “WHICH TESTOSTERONE REPLACEMENT THERAPY?”

5) Science, 19 Octr 1973, 182:283-285, “Copulation in Castrated Male Rats following Combined Treatment with Estradiol and Dihydrotestosterone”

6) Physiology & Behavior, Mar 1980, 24(3):463–468, “Hormonal regulation of penile erection in castrated male rats”

7) The Journal of Clinical Endocrinology & Metabolism, March 1 1988, 66(3):546-551, “Transdermal Testosterone Therapy in the Treatment of Male Hypogonadism*”

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Testosterone Therapy and DHT

Concentrace: Just What Is It? - Peak Testosterone

Many men have been asking me, “What is Concentrace?”  Concentrace Trace Mineral Drops is a product that I have used from time to time, because it a source of 1) ionized minerals for maximum absorption and 2) a broad array of minerals, including the trace ones that the body needs in minute amounts.

Our modern soils are so depleted of minerals of virtually all types that this certainly seems attractive, since there are many common issues that can interfere with mineral absorption, including low hydrochloric acid levels in the stomach, black tea, soy, etc., etc.  In other words, quite easy to still end up deficient even if you are conscioustious and eat a well-rounded, whole foods diet.

The problem that you’ll find with Concentrace Trace Minteral Drops is to out just exactly how much of what minerals is actually contained in the standard dosage prescribed on the bottle. However, in an obscure location of their site, I did find the Concentrace Analysis Summary, which has a complete list of mineral concentrations. [1] You can see some of this in Table I below at the bottom of this page.

So the bottom line is that their concentrations may have changed a little over time, but I still think we can draw some interesting conclusions, both positive and negative:

1.  Magnesium.  Concentrace is clearly a FANTASTIC choice of easily absorbed  magnesium.  Magnesium can help with sleep, which in turn can improve testosterone levels.  Magnesium can also help improve heart disease, which can help erections.  Magnesium is simply a ubiquitous molecule that is involved in 100’s of different metabolic pathways.

2.  Boron.  Getting about a mg of ionic Boron is excellent as well.  As I document in my link on Testosterone and Boron, you get about 1.5 mg/day of boron on average probably and the experts recommend up to about 3 mg/day.  So this amount should be a nice addition to your (hopefully) well-rounded, whole foods diet.

3.  All Other Minerals. What was surprising is the very low amounts of virtually all other standard minerals.  For example, the daily requirement for potassium is about 4,700 mg, but 40 drops will only provide about 5 mg.  Calcium and selenium are also less than a mg.  Thus, with the exception of magnesium and boron, Concentrace Trace Mineral Drops provides very low amounts, well below 1% of RDA or AI.

4. Exotic Minerals.  Concentrace does provide some of the more exotic minerals that the body does need in trace amounts.  Rubidium is a classic example.  There is no RDA or AI for rubidium, yet your body does use it in trace amounts for, among other things, the CNS (Central Nervous System).  Studies have shown that low rubidium levels can negatively lead to mood disorders and depression in dialysis patients, who are known to have depleted rubidium levels. [2]

However, even here, it seems hard to get excited, because Concentrace provides such a low dosage.  We eat between 1 mg and 5 mg per day of rubidium in our foods.  Even coffee and tea have a good supply.  The very minute amounts in 40 drops seem, quite frankly, to be almost negligible.

5. Heavy Metals. CAUTION:  And here is where I see the problem with the Trace Mineral formulation:  it has a number of heavy metals, including cadmium, arsenic lead, mercury and aluminum. Now, admittedly the amounts are very small.  But I do not think of all the dosages can be so easily dismissed. For example, the dosage of arsenic in Concentrace is about 2.07 parts per million, which is in the area of rice, something that many experts are concerned about.

So, yes, it is a great source of magnesium, but you could simply use ZMA as a well-absorbed alternative and get a nice dose of zinc as well.  I simply do not see the big advantage in using Concentrace daily and risk some of the heavy metal exposure.

TABLE 1:

REFERENCES:

1) “Concentrace Analysis Summary”, https://themineralfoundation.com/documents/ research/ConcenTrace%20Analysis%201.pdf

2) Kidney International, 2001, 60:1201 1201, “Depression in dialysis patients: Rubidium supplementation before other drugs and encouragement?

3) https://chriskresser.com/arsenic-in-rice-how-concerned-should-you-be/

Check Out These Manly Drinks! - Peak Testosterone

Okay, I love the taste of beer as much as the next guy.  But let’s start with a simple fact that I cover in my link on Beer and Your Hormones: beer lowers testosterone and raises estrogen (estradiol).  Period. When I found that out, I started looking for some other beverages that were actually going to help me in the bedroom and improve my long term health as a male.

Let’s say it’s Friday night and I’m looking for a little amore. Wouldn’t I want to pull out a drink that is going to boost my nitric oxide levels and improve blood flow without negatively impacting my T and E2? That would be Viagra-in-a-bottle, would it not? Well, such drinks exist, but most men just do not know about them and so instead they pull out a hormone-hammering beer instead.

Below I am going to show you Five Blow Flow Boosting Beverages and, yes, you’ll thank me later:

1) Black Tea. Black tea has a great property: the more you drink, the more your blood pressure lowers according to the studies. [1] Yes, this means that the more you drink, the greater the blood flow, and more truly pumped you will be.  Now you don’t want to go crazy with black tea because of the tannins, which can reduce mineral absorption, and fluoride, which can be hard on the brain if too much is consumed.

2) Raw Unprocessed Cocoa.  Raw cocoa is one of the best drinks to turbocharge your sex life.  However, as with some other things, it tastes pretty nasty in its raw form. I cover this in my link on The Power of Raw Cocoa Powder. Many studies have shown the power of the flavonoids in raw cocal, but look at what just one researcher wrote:

1) J Hypertens, 2009 Apr, 27(4):774-81, “Black tea consumption dose-dependently improves flow-mediated dilation in healthy males”

2) Journal of Hypertension, Dec 2003, 21(12):2281-2286, “Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans”

3) https://www.peaktestosterone.com/forum/index.php?topic=63.msg107#msg107

“Cocoa can contain extraordinary concentrations of flavanols, a flavonoid subclass shown to activate nitric oxide synthase in vitro…Four days of flavanol-rich cocoa induced consistent and striking peripheral vasodilation.”  [2]

NEWS FLASH AND WARNING:  Consumer Labs recently found that many of the raw and retail cocoa powders are very high in cadmium. This was extremely disappointing to me as I found that the cocoa I had been consuming in order to improve my health was high in this very toxic heavy metal. Until the industry cleans up its act, I am putting cocoa purchases on hold myself. Consumer Labs has a few cocoas they do recommend, so you may want to read their analysis.

Now this is what I call a manly drink. Vasodilation means, of course, that it opens up your arteries, allowing more blood flow.  And this will mean more blood flow everywhere, including your brain, muscles and even penis.  Hard to beat that, eh?

You do have to watch out for one thing though:  the standard cocoa powder that you buy in the stores is NOT “flavonol rich”.  The reason?  Consumer and food product companies do to cocoa what they do best:  they boil the crap out of it until it is unrecognizeable and loses all of its health properties.  They do this to improve the taste and it works and make you happy.

3) Beetroot Juice. Researchers are all over beets and the reason is simple:  they are probably the highest nitrate-containing food readily available.  Recently, researchers have discovered that beets boost nitric oxide, lower various cardiovascular risk parameters and improve athletic performance.  Many elite and Olympic athletes are now using beet formulations before competition.  And you can use beets before your big event for increased performance if you know what I mean.

What makes high nitrate foods so special?  It turns out that they bypass the normal arginine cycle that boosts nitric oxide in healthy males.  The problem is that most of us are not healthy males:  we have significant arteriosclerosis, making it difficult for our arteries to pump out precious nitric oxide.  This leaves many of us struggling to achieve even low levels of nitric oxide.  Beets and other high nitrate foods are a dream-come-true for us and I cover this in my link on A Review of Beet the Odds. See also my link on The Power of Beetroot Juice. Get your beets for a few days and you will very likely notice a nice improvement in hardness factor, refractory period and other erectile parameters.

4) Smoothies with Nitrates. I mention this separately, because it is not just beets that are high nitrate. Many other foods, such as spinach, lettuce and celery have substantial nitrate content as well. You may have dissed your wife’s salad, not realizing that it packed with nitric oxide boosting nitrates.  Many men on the Peak Testosterone Forum have commented on the remarkable ability that daily Smoothies have on their sexual and general health. Try to go organic if you can and make this a part of your daily routine.

5) Pomegranate Juice. This powerhouse lowers just about every heart disease risk factor that you can think of. But it’s not just long term cardiovascular issues that it protects you from: it has same day coverage as well, boosting nitric oxide and blood flow right away. This juice is so powerful that one study shows that it can clear out arterial plaque in some men. Imagine a drink that cleans out your artieries while you’re busy doing more important things, oh Weekend Warrior. Manly, yes, and you can read more about it in my link on https://www.peaktestosterone.com/pomegranate.

One forum member attributed getting his morning erections back primarily to drinking smoothies twice a day. [3] He said he got the equivalent of eight servings of fruits and vegetables by doing this. “About a month and a half ago I started drinking about a quart of green smoothie every day. About 1/3 to 1/2 fruit (berries, apple, banana, peaches – whatever), a little juice, and the rest greens (kale, romaine, spinach, chard, broccoli – whatever).” Not bad for just a few minutes of work, eh?

And, most importantly, give it your woman also!  It will pump up her nitric oxide, and, yes, her sexual health and general health is very dependent on nitric oxide just like you, something I discuss in my link on Female Libido and Viagra.

There are many other Manly Drinks (and foods) that can help you in a similar manner, but it is too lengthy to cover in one web page. I have place these in my book https://www.peaktestosterone.com/ for those interested. The important thing is to get started: put down the beer and pick up something that is really going to help you.

Morning Erections: Critical for the Erectile Strength

Few things are morning important to your penile health than those morning erections. Why?  Oxygenation.  Oxygenation.  Oxygenation.

I get emails all the time from men that have lost their morning erections for months or even years.  This is a tragic situation, because morning erections, through oxygenation, help maintain healthy erectile tissues. Without that oxygenation, researchers have noted that “fibrosis” sets in, which means a hardening and aging of the structures. [1]

This is why I insist that men, if they no longer have morning erections, must somehow, someway make sure they get several erections during the day. By the way, this is one of the reasons that sex is so good for males:  it literally helps to maintain their sex life.  “Use it or lose it” as they say.

NOTE:  Morning erections, or the lack thereof, can be a good way to begin troubleshooting if you have psychological (or psychogenic) erectile dysfunction.  The idea is that if you can achieve an erection by any means, nightime or otherwise, then your issue is probably not physical (organic). In fact, this has been used by diagnosticians for literally decades as an starting point tool. [4] In fact, one study noted that “the single best predictor was the presence or absence of early morning erections as reported by the patient.” [5] (Now my opinion, and I cannot back this up with a study, is that this might be confounded by depression and other mood disorders. Perhaps depression can suppress morning erections before an underlying testosterone or nitric oxide issue has developed.)

So what causes morning erections?  They seem quite mysterious in many ways and even “automatic” and “random” at times, i.e. they occur even without an erotic or sexual dream involved. However, researchers have noted many lines of evidence and studies that show morning erections are primarily androgen-dependent, i.e. they are regulated by testosterone and DHT. [3]

In My Book on Testosterone I point out that several studies have shown that when testosterone falls far enough, you are likely going to lose and/or greatly diminish the number of your morning erections. That doesn’t necessarily mean that you won’t still be able to “get it up” during the day, however.  The reason is that a normal erection is achieved through a different pathway involving the senses of touch, sound and sight. However, if you allow your testosterone to remain at low enough levels for a long enough period of time, you are opening the door to Venous Leakage and other erectile difficulties.

CAUTION: Some men think that DHT (dihydrotesteosterone) doesn’t really matter and just causes hair loss.  However, DHT is an incredibly important androgen and has been shown to be partially responsible for morning erections. [2]  Before you take any DHT-blocker, be it Saw Palmetto or a drug, read this link on Propecia Risks.

Morning erections are not just dependent on DHT and testosterone, however, and the evidence points to the critical role of nitric oxide as well.  Nitric oxide within the corpus cavernosum, the “erection cavity” within the penis is what dilates the penile arteries and causes the morning erections.

1)  The Journal of Sexual Medicine, Nov 2005, 2(6):771 784, “Testosterone and Sleep-Related Erections: An Overview”

2) The Journal of Clinical Endocrinology & Metabolism, Apr 1 2002, 87(4):1467-1472, “The Effects of Transdermal Dihydrotestosterone in the Aging Male: A Prospective, Randomized, Double Blind Study”

3) Journal of Sex & Marital Therapy, 1983, 9(1), “Serum testosterone and prolactin levels in erectile dysfunction”

4) Journal of Sex & Marital Therapy, 1975, 1(4), “The assessment of nocturnal REM erection in the differential diagnosis of sexual impotence”

5) ARCHIVES OF SEXUAL BEHAVIOR, 1987, 16(2):125-137, “Use of sexual history to differentiate organic from psychogenic impotence”

6) International Journal of Impotence Research, 2007, 19:200 207, “Relationship between chronic tadalafil administration and improvement of endothelial function in men with erectile dysfunction: a pilot study”

7) Journal of Andrology, 18(5):522-527, “Relationship between sleep-related erections and testosterone levels in men”

8) Journal of Andrology, 13(4):297-304, “A long-term, prospective study of the physiologic and behavioral effects of hormone replacement in untreated hypogonadal men”

9) Phytotherapy Research, Mar 2009, 23(3):297-302, “Improvement of seminal parameters with Prelox : a randomized, double-blind, placebo-controlled, cross-over trial”

9) The Journal of Clinical Endocrinology & Metabolism, Mar 1 1990, 70(3):792-797, “Testosterone Replacement Therapy and Sleep-Related Erections in Hypogonadal Men”

10) Urology, Dec 2000, 56(6):906-911, “Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study”

And that leads to this important question:

“What can one do to get his morning erections back?”

Below we give you few ideas:

1.  Testosterone. This may seem obvious, but many men don’t make the connection:  you have got to have adequate testosterone levels in order to fire off those morning erections during REM sleep.  One’s “morning wood” is really linked to a different system than standard waking erections and requires adequate testosterone as a sort of fuel.  For example, one study showed that when levels fall below about 200 ng/dl, men can expect issues. [7]

Further verification comes from the fact that several studies show that testosterone therapy (Hormone Replacement Therapy or HRT) steadily restores nocturnal erections in men with low testosterone. In fact, one interesting study took a bunch of hypogonadal men and gave them a hefty shot of testosterone cypionate. They then monitored the men over the coming weeks during sleep and watched the morning erections spike and then slowly decrease to about half the frequency. [9].  The researchers (somewhat cruelly) let the men’s testosterone levels shrink to almost nothing and by the end of 8 weeks, the men’s rigidity had gone from 770 to 590 g, a loss of almost 25%! Yes, these men lost their superpowers and their nocturnal erections at the same time.

Of course, there one doesn’t necessarily have to go on HRT (TRT) if you find that you are low testosterone and lacking in morning erections.  Check out my pages on Common Causes of Low Testosterone and How to Increase Your Testosterone Naturally for more information.

NOTE: It can take time for the restorative process.  One study noted a year of continuous improvement in REM-related erections. [8] Read this link on Venous Leakage to understand how testosterone helps erections via two primary pathways: 1) increasing eNOS (the “nitric oxide enzyme) activity and 2) restoring the internal structures and tissues of the penis.

In fact, improving nitric oxide can have dramatic effects on nocturnal erections as one Cialis study showed.  Cialis has a long half life and its efficacy is considered to be about 36 hours in most men.  One study showed that men who used 20 mg every other day had dramatically increased morning erections. [6] The authors commented that “chronic treatment also produces a dramatic increase in morning erections, which determines better oxygenation to the penis, thus providing a rationale for vascular rehabilitation.” (The PDE5 Inhibitors like Cialis also have a long list of side effects, some very serious.  We have had men on the Peak Testosteorne Forum with long term and probably irreversible hearing and vision damage.)

A Viagra study using 100 mg nightly for three nights showed some impressive results as well on men with erectile dysfunction. [10] The primary change seen in the case of this PDE Inhibitor were prolonged morning (nocturnal) erections – in fact, about 60% longer.

Am I advocating taking PDE5 Inhibitors in order to get your morning erections back?  That, of course, is between you and your doctor, but every attempt should be made to take only the minimal dose necessary and ideally for only the short term.  Remember, one can also experience PDE5 Inhibitor Resistance and PDE5 Inhibitor Dependency, so you want to be careful with these medications.  Finally, it is important to rely as much as possible on Exercise, Erectile Foods, gradual Weight Loss and Sleep to boost your nitric oxide and restore you endothelium.

3.  Sleep. The importance of sleep to morning erections is often ignored.  Nocturnal erections occur during REM sleep and some men with erectile struggles report that they seem to be able to achieve nocturnal erections if they sleep long and thus get that last all-important REM cycle.

4.  Sitting. One reader has a novel approach, where he sat slightly erect, and found that his morning erections re-commenced.  See this link on A Novel Approach to Morning Erections for an example.

5. Pycnogenol. Studies of Prelox, which is just Pycnogenol with a low dose of L-Arginine, show an increase in morning erections. [9] Of course, Pycnogenol is known for improving erectile dysfunction, increase nitric oxide and decreasing inflammation.  See my links on Pycnogenol and Erectile Strength and The Pros and Cons of Arginine for more information.

6. Stress.  Anecdotally, men have reported to me increased morning erections after taking any of the cortisol reducers (Vitamin C, S-PS, etc.)  As you know, if you have been looking around the site, I frequently recommend regular (non-religious) medititation and/or Progressive Muscle Relaxation for the same reason.

A Supplement Better than Viagra? - Peak Testosterone

I had one reader write in with a supplement cocktail that he had created to help get him over “middle-aged erectile malaise.”  He was having mild erection problems but was very disturbed at the problems. To help get him over the problems he was having, he read through my site and then wrote me the following:

“I started the diet Tuesday and, man, I’m starting to feel a difference already. I also made a trip to the grocery last night and the [big-chain vitamin store]. I took one of each of the Horny Goat Weed, Maca, L-Arginine, Pycnogenol and Ginseng and man let me tell ya, there was a difference this morning when I woke up! I felt 16 again ! Lets just say that the wife now knows that it wasn’t all in my head. 14 years together can sometimes make ya forget details. Ok enough of that but WOW!”

NOTE: Always check with your doc first.  Some supplements, such as Horny Goat Weed, can interact with certain medications for example.  Also, this man put all these supplement together at once, but it is better to try one supplement for a two weeks separately and then add another if necessary and so on.

Lets go over the erectile “cocktail” that he created.

1. Maca.  This Peruvian superfood works on your libido (and semen volume). Scientists are not sure exactly how it works. For details see my links on The Power of Maca and The Effects of Maca.

2. Horny Goat Weed.  HGW (epimedium) has a PDE5 inhibitor in it (Icariin) that works on the enzyme that dissipates Nitric Oxide in a manner similar to Cialis and Viagra.  Again, I have given this supplement a fair amount of coverage in my links on Horny Goat Weed and Icariin.

3. Korean (Panax) Ginseng. Production of Nitric Oxide by the endothelium is only step one in the erectile process. As the Nitric Oxide spreads into the blood and smooth muscle cells. Once inside the muscle cells, it triggers the release of an enzyme called guanylyl cyclase that in turn increases cGMP levels and it is cGMP that induces the relaxation response in your arterties, allowing them to expand and blood to enter the penis for an erection. What does this have to do with Ginseng?  Several studies have shown that Ginseng increases cGMP. For more information, see my links on Ginseng and Erectile Dysfunction and The Many Benefits of Ginseng.

4. Pycnogenol. Pycnogenol works on yet another pathway. Nitric Oxide is released in the endothelium by shear forces and from various receptor sites, acetylcholine probably being the most prominent. Pycnogenol boosts significantly the Nitric Oxide released due to its action on this acetylcholine pathway. [2] This same study found a 42% increased relaxation of the arteries from Pycnogenol as compared to controls. [3] (Read this link on Pycnogenol and Erectile Dysfunction for more details.)

5. L-Arginine. L-Arginine is the precursor, i.e. the building block for Nitric Oxide and so it would stand to reason that consuming L-Arginine directly would increase Nitric Oxide levels. ADMA competes with L-Arginine and so consuming L-Arginine also increases the all-important L-Arginine to ADMA ratio for middle aged and beyond males. CAUTION: Please read my L-Arginine Discussion for potential side effects with L-Arginine.

So taking a supplement cocktail makes some sense in that these enhance your artery-relaxing, erection-boosting at every step along the way. Of course, for many guys this may be overkill because improving just one or two pathways may be sufficient.

In fact, the most important point in the regard is that many foods boost Nitric Oxide as does exercise.  Thus, taking supplements for many guys is simply a cheap substitute for eating right and exercising.  However, some guys need some short term help while they’re getting back in shape and transitioning their diet and a cocktail such as the above may be worth considering.

NOTE:  Putting together several synergistic supplements to improve your sex life is the subject in the latter half of my book Peak Erectile Strength Diet .

Can You Restart Your Testosterone? - Peak Testosterone

One fairly common question on the Peak Testosterone Forum is whether or not one’s low testosterone levels can be restarted. Of course, some of us feel that we have always had low testosterone since puberty and thus there is nothing to restart.  However, the majority of hypogonadal men coming to this site feel that they once had solid T levels, but something unknown happened and their testosterone dropped for one reason or another.  These men can actually consider seeking out a restart, i.e. a methodology to actually restore naturally their old testosterone levels.

Will it work?  The answer is simple: there is no way to know unless you try. The reason is that there are three types of true hypogonadism (clinically low testosterone): a) primary or testes-based, b) secondary or pituitary-based and c) tertiary or hypothalamus-based. Of course, if you are primary, i.e. your Leydig cells are actually damaged or genetically malformed, etc., then you cannot restart. This could happen if a man contracted adult-onset mumps and his testes were damaged. He simply will not be able to be restarted. Perhaps in the future we will have some way to generate new Leydig cells via stem cell therapy or some other miraculous means. But, as it stands now, that is out of our reach.

Now let’s jump to the case of pituitary damage. There are cases, admittedly quite uncommon, of men losing their testosterone through what is called empty sella syndrome and part of the responsiveness of the pituitary being damaged. [2] In this case the hypothalamus would send the signal to the pituitary for more testosterone, but the pituitary would not respond correctly in its signaling to the testes.  Again, in this case, a testosterone restart cannot truly happen.  However, it should be pointed out that something called HCG Monotherapy can do a quasi-restart. HCG is an LH analog that will trigger the testes to produce testosterone. However, the HCG must be continued indefinitely in this case, because the pituitary cannot self-heal. The good news is that one’s testes are actually being stimulated to start working again and one can quite often experience an actual increase in the size of the testicles along with a boost in testosterone. For many, this seems like a much more natural approach. We have a number of men on the Peak Testosterone Forum that have been this type of treatment and you can read their comment by using the Search feature there. However, one should not that HCG Monotherapy does shut down some pituitary function however, so it is not a true restart of the entire HPT axis.

What about the case of tertiary hypogonadism?  Well, this is where it gets interesting.  Again, if the hypothalamus is actually damaged, then there is little that can be done for a true restart.  That said, sometimes you can give a man Clomid, a SERM that acts upon the hypothalamus, and a man can be successfully restarted.  By this I mean that you can back off his Clomid dosage and then his entire HPT axis will work just fine with decent testosterone levels resulting.  In fact, this very situation happens all the time with steroid users.

Steroid users take their testosterone levels to 2500+ ng/dl and usually end up with their body’s own natural production shut down.  However, steroid users are usually young guys and their hypothalamus, pituitary and testes are all fine.  It’s just that somehow the “switch” got turned off.  And in their case, they can restart using Clomid.

But what about the typical non-steroid hypogonadal male, who wakes up one morning and realizes he’s not feeling good.  His libido is down; his morning erections are subsiding; he’s starting to get a little erectile dysfunction and is experiencing increased fatigue and anxiety.  He goes in one day to the doctor’s office and finds out he has low testosterone.  Can he restart?

Based on what I have seen the answer is usually not.  I have been running the Peak Testosterone Forum for a few years and no one has restarted his testosterone successfully to date.  A couple of guys have had a restart that seemed to last for a couple of months, but then their testosterone dropped down to their old hypogonadal levels.

That said, it is probably worth a try.  Dr. Crisler is one of the early pioneers and apostles of this technique and he has restarted some men using Clomid.  Again though, from all I have heard, it is a low percentage of men that successfully restart under these circumstances, but you have little to lose other than a little time and money, assuming you can find a reasonably priced doctor to work with you.

So what is the general protocol?  One of our posters gave a nice summary:

“Start at 12.5mgs Clomid per day. After 3 weeks, run these labs (which you ran before you started, BTW): TT LH FSH SHBG E2 (sensitive only) If you feel much better–the goal of therapy–you are all set. Even if your T levels don’t look great; that would mean you happened to catch your new production level at a trough. If you don’t feel much better, have your LH and FSH levels risen substantially? If not, increase the dose to 25mgs. A couple weeks later, the same labs again. You can go to 37.5mgs, then 50mg per day if necessary. Notice we are employing 1/4 tab increases, for convenience. If LH/FSH rose substantially, and T did not, and you still don’t feel well, look to testicular failure as your issue. Of note, some have gotten great results on only 12.5mgs every other day.” [2]

Again, this is not something you want to try on your own:  I encourage you to find a good doc to work with.

So has anyone on our forum successfully restarted?  Not really.  We had one man who went on Clomid and two months after quitting has raised his testosterone from 428 to 545 ng/dl, a 27% increase. [3] Of course, that’s just one guy and it was only two months afterward.

Nevertheless, it at least gives some hope, eh?  Well, unfortunately, that is not necessarily the case.  Look at the description from this young man who was okay for a couple of months but then drifted back down to his old levels shortly thereafter: [4]

“I have also tried clomid restarts which have lasted for about 6 weeks at 50 mg per day. My Free testosterone went from 11.3 pg/ml 9 AM to 16.5 pg/ml 5 PM. That’s pretty impressive if you figure the 16.5 pg/ml evening draw might have been roughly 30% lower than what an AM reading typically is. My levels like most men who are secondary also drop back down into the problem areas and I experience all the same symptoms. I will say though I have had levels stay elevated for close to two months once the SERM use is discontinued and thought “could it be possible my body has normalized” but the levels fall back again eventually. Symptoms once again reappear and the bloodwork confirms this.”

“This really sucks for many secondary men who respond to clomid but the clomid fails to reset the HPTA. However this points out some important factors that should be addressed. We know that our pituitaries will secrete LH in response to GNRH and we know our testicles still work, but it seems the hypothalamus isn’t sending adequate GNRH pulses without the pituitary being fooled by blinding it to estrogen detection with a SERM. There seems to be a malfunction between the hypothalamus and pituitary. I’m leaning more towards a damaged hypothalamus as being the culprit for many of us.”

And what if you get a big testosterone increase?  Is this a positive sign that a restart is likely?  Well, not according to the story of this young man who actually went supraphysiological with his Clomid dose but plummeted back down to earth almost immediately:

“I took Clomid back in July. 50 mg every day. Shot my levels up (1550), but 3 months being off Clomid, everything crashed back down and total testosterone is back in the 300s.” [2]

NEWS FLASH w PROTOCOL UPDATE: Some of our users have been looking at the latest protocols out there and are attempting a restart as I write this.  They are doing to some of the smarter and most experienced doctors out there, and here is what is being tried according to their description:

1.  Pretty Low Dose HCG at First: One of our men was put on 350 IU of HCG daily for a month to apparently fire up the testes and was told that Clomid would follow after that. [5] Still another poster said the usual was 100 IU MWF. [6]

2.  Clomid Next and Fairly Low Dose As Well. One of moderators was put on a protocol of 12.5 mg of Clomid every day.  He has only been doing this for a month, so results are still pending for his situation. [6]

One of our othe posters, who is on the steroid boards a lot, has pointed out that the steroid men use much higher dosages of everything, which seems a bit risky to me, because that much Clomid could cause side effects in some men. (See below.) But then steroid users probably have a much more severe hormonal profile and shutdown and may need hire dosages. He claimed that this type of protocol was common in Europe and worked well for them. It is always better to go to a physician who works with these kind of things day in and day out.

“STEROID USER PROTOCOL (NOT RECOMMENDED):  First stop all Testosterone (and other stuff he takes) Week 1

– Very High dose Clomid daily and 1,000 IU HCG EOD. Week 2. NOT RECOMMENDED: Clomid can have side effects.

– High dose Clomid daily, 1,000 IU HCG EOD Week 3. NOT RECOMMENDED: Clomid can have side effects.

– 1 x 50 mg Clomid daily 1,000 IU HCG EOD.”

After that, back to his cruise dose for 6 weeks and get new blood work. It seems that in Europe, this is the recommended way to do a reboot.”

REFERENCES:

1)  Recenti Prog Med, 1992 Feb, 83(2):73-6, “Primary empty sella syndrome and hypogonadotropic hypogonadism in young male patients”

2) https://peaktestosterone.com/forum/index.php?topic=2554.0  

3) https://peaktestosterone.com/forum/index.php?topic=2391.15

4) https://peaktestosterone.com/forum/index.php?topic=663.15

5) https://www.peaktestosterone.com/forum/index.php?topic=8212.0

6) https://www.peaktestosterone.com/forum/index.php?topic=8123.0

7) https://www.peaktestosterone.com/forum/index.php?topic=8299.0

The Testosterone RestartSTEP 7: Can You Restart Your Testosterone?

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Inflammation and High Fat (Low Carb) Meals - Peaktestosterone

I just had someone post on The Peak Testosterone Forum that he had recently quit a high fat diet.  And it’s no wonder:  high fat diets often do the OPPOSITE of what is expected and many men have men have no idea why.

First of all, what I am talking about when I say a “high fat meal,” I mean a meal where the fat calories are approximately 45-55% and above of the total calories and there are some carbs present.  Let’s take one of the typical ingredients in a low carb/high fat meal:  ground round.  Let’s say a man grabs some 90/10 ground beef.  The package says that it is 10% fat, but this is misleading, because 85 of its 182 calories are actually fat calories, which is right at 46%.  And, typically, other butters and oils are added to the meal on one form or another and the percent fat goes well over 50%. And, once you get near this 50% mark, things can get ugly really fast.

Don’t believe me?  Here are 7 Reasons You May Want to Rethink that High Fat Meal:

1. Testosterone (Free and Total).  One found a prolonged loss of testosterone (about 8 hours) after a high fat meal. [4] Furthermore, the study found the loss to be significant, 22% and 23%, in total and free testosterone, respectively.  Ouch! An earlier study found that it was likely that a high fat diet affected the testes as opposed to leutinizing hormone. [6]

2. Insulin Resistance. High fat meals have long been used by researchers to induce insulin resistance in laboratory animals! For example, one study wrote “chronic high-fat feeding in rats induces profound whole-body insulin resistance, mainly due to effects in oxidative skeletal muscle.” [2] Many men on higher fat diets assume that by lowering carbs, they are improving their MetS (prediabetes) or avoiding it.  However, this is not necessarily the case and in a signficant block of men the opposite will happen.

NOTE: The same study above also noted that “prior exercise, a single low-fat meal, or fasting all significantly increased insulin-stimulated glucose utilization.”  [2] In other words, exercise, fasting or a Low Fat Diet can all somewhat counteract a High Fat meal.  But one can’t help but ask the question, why do it in the first place?

1) J Am Coll Nutr, 2007 Apr;26(2):163-9, “Low carbohydrate, high fat diet increases C-reactive protein during weight loss”

2) Diabetes, Dec 1997, 46(12):2022-2028, “Diet-Induced Muscle Insulin Resistance in Rats Is Ameliorated by Acute Dietary Lipid Withdrawal or a Single Bout of Exercise: Parallel Relationship Between Insulin Stimulation of Glucose Uptake and Suppression of Long-Chain Fatty Acyl-CoA”

3) Lipids, 2008 Jan,43(1):65-77, Epub 2007 Nov 29, “Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation”

4) Metabolism: Clinical and Experimental, Nov 2001, 50(11):1351-1355, “Effects of a high-fat diet on postabsorptive and postprandial testosterone responses to a fat-rich meal”

5) Am J Clin Nutr, 2003 Jan, 77(1):139-43, “Effect of dietary antioxidants on postprandial endothelial dysfunction induced by a high-fat meal in healthy subjects”

6) Metabolism, 1990 Sep, 39(9):943-6, “Effects of a fat-containing meal on sex hormones in men”

7) The Journal of Clinical Endocrinology & Metabolism November 1, 2007 vol. 92 no. 11 4480-4484, “Dietary Macronutrient Content Alters Cortisol Metabolism Independently of Body Weight Changes in Obese Men”

8) Cell Metabolism, Aug 6 2009, 10(2):99-109, “Intestinal Cholecystokinin Controls Glucose Production through a Neuronal Network”, Grace W.C. Cheung, et. al.

9) Clinical Cardiology, May 2002, 25(5): 219-224, “Vitamin C preserves endothelial function in patients with coronary heart disease after a high-fat meal”

10) European Journal of Applied Physiology, Oct 2006, 98(3):256-262, “The effect of acute exercise on endothelial function following a high-fat meal”

11) Am J Clin Nutr, 2007 Nov, 86(5):1286-92, “A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation”

12) Arch Androl, 2000 May-Jun, 44(3):213-20, “Role of estrogens in human benign prostatic hyperplasia”

3. Endothelial Dysfunction. High fat meals actually increase endothelial dysfunction. Saturated fat, in particular, sludges the blood and lower nitric oxide levels.  Of course, if you’ve read much on this site, you realize that endothelial dysfunction is virtually synonymous with erectile dysfunction. [5] Now, admittedly, eating vegetables was found to partially overcome this in the study.  But, again, why risk it?  The high fat meal was found to reduce the ability of the arteries to expand and platelets were found to clump together more easily.

4. Blood Flow! High fat meals hammer endothelial function, as mentioned above, and correspondingly blood flow. Less nitric oxide, less expandable arteries and less fluid plasma all translate to decreased blood flow. And, yes, erections are all about blood flow, so this will not be good for your sex life. Knowledgeable researchers have known that this is a significant problem with high fat diets and have actually studied ways to try to cirdumvent the issues. For example, one study found that massive doses of Vitamin C helped heart patients retain their endothelial function post-meal. [9] Yet another study found that exercise can do the same in healthy adults who ate a high fat meal. [10] And, as I mention elsewhere on the site, walnuts have been found to partially do the same.

Doesn’t the fact that you have to so diligently protect yourself from the effects of a high fat diet tell you something?  How do you know you can exercise after a high fat meal?  It is much more safe to just not eat so much fat in my opinion!

5. CCK Resistance. Researcher discovered that that rats fed a high fat diet developed CCK resistance. [8] Cholecystokinin, or CCK, is the messenger to the brain which tells the liver to loeert blood sugar output.

6. BPH (Prostate Enlargement). As men age, they often struggle with an enlarged prostate and difficulty with urination.  What causes this?  Well, researchers have recently discovered that one of the key factors is insulin resistance and – you guessed it – a high fat diet is a risk factor because it induces insulin resistance.  These authors state that “a western diet, characterized by high fat consumption, predisposes men to BPH, while a diet rich in flavonoids and lignanes, containing phyto-estrogens, lowers this risk.” [12] Check out my link on BPH Prevention for more information.

7. Endotoxemia. Endotoxemia is a condition where harmful chemicals (antigens) released by bacteria in the gut raise inflammation levels in the body.  What causes endotoxemia?  Researchers found that a single high fat meal raised endotoxin levels by 50% and postulated that “low-grade endotoxemia may contribute to the postprandial inflammatory state and could represent a novel potential contributor to endothelial activation and the development of atherosclerosis.” [11] That’s right:  high fat could potentially harden your arteries, including the ones in your penis.

NOTE:  I am NOT attacking meat eating here, but rather a high fat diet based on modern, industrial meats that are nothing like wild game.  Almost all of the problems in this article vanish if one eats range fed meats.  I discuss many options in my page on Low Fat Meats.

Niacin: Potential Dangers - Peak Testosterone

1.  Megadosing. In order a major change in lipids, which is niacin’s mainstay, high dosages have to be taken.  Patients typically take at least 1,000 mg per day and that is about 1,600% of the daily RDA!

2.  Severe Flushing. One the guys on our site had a “bad trip” on niacin.  Taking the high dosages above will almost always cause severe flushing.  Check out this man’s description:

“Something weird happened today as well. I am taking niacing for the last 3 weeks. It was a slow release niacin, and if I take it with meal – no effect. If it is on empty stomach, I feel skin tingling, and hands show red rash. It is itchy sometimes, but goes away after 30-60 minutes. This effect is well know with niacin. Today I took a different brand, 500 mg, NON-slow release, in the morning, on empty stomach. On the way to work I felt nuclear tingling, my face and hands went purple. I went to bathroom – turns out my whole body was red as if I had a massive sunburn. Then heart went into racing mode. In about 2 hrs it all subsided, but it was rather scary s__t.” [9]

3. Liver Toxicity. Increased liver enzymes results in a small subset of patients.

REBUTTAL: These patients can simply lower the dosage or switch to a form (immediate release) that is less hard on the liver.  Furthermore, when under a doctor’s care, this appears to be a pretty rare issue:

“Although serious hepatic toxicity from niacin administration has been reported, it is largely confined to the use of slow-release formulations given as unregulated nutritional supplements.” [12]

5. A Rise in Uric Acid. Niacin occasionally causes an undesireable increase in uric acid.  Potentially this could lead to gout, although I have never read of that being the case.  One doctor treats this with allopurinol. [11]

6. Methylation. Niacin can lead to methylation issues in some men.  For example, men with certain MTHFR variants are cautioned to “use extreme caution when supplementing with niacin, which can dampen methylation.” [13]

7. Insulin Resistance. Thx to Torrential on the Peak Testosterone Forum for this one. I will quote from his post:

“I am bringing up this older thread to add another potential risk of long term niacin use. I have been taking 1,500mg Slo-Niacin daily for several months to help improve my lipid profile. It worked: Triglicerides way down, HDL up. I dropped down to 1,000mg daily and my Trig went up again; now back to 1,500mg daily. Liver enzymes fine btw. But my A1C level has been troublesome, creeping upward even as I clean up my act and take steps that should be driving it down. My new doc wants me on Metformin, which I will start soon.”

“However, today I found this on examine.com:”

“‘Current evidence suggests prolonged niacin supplementation increases insulin resistance because it hinders the ability of insulin to suppress glucose synthesis in the liver. This causes an increase in blood glucose levels, which leads to lowered insulin sensitivity over time, since the relevant receptor is eventually desensitized to the elevated glucose levels in the blood. https://examine.com/supplements/Vitamin+B3/‘”

“The article discusses not only higher fasting blood glucose levels but higher insulin levels. Well, crap. Those things are worse than high triglycerides. Should I drop niacin?”

8. Possible Increased Risks of Infections, Gastrointestinal Disorders and Bleeding. Okay, I usually like to give “short and sweet” summaries of information, but I think in this case the long version is the one that is appropriate.  The reason is that there are two recent studies of niacin that showed fairly similar adverse event profiles, i.e. increased risks of infections, GI and bleeding issues.  Fans of niacin like to discuss only the first study, which was quite flawed, and ignore the second.  Below I’ll discuss both studies.

Study #1: Niacin + Laropiprant Study (2014).   This study in my opinion was poorly designed and almost seems calculated to protect pharmaceutical interests.  Let me start with some facts about growing niacin sales:

“The use of niacin in the US and Canada is increasing, with investigators reporting that nearly 700,000 prescriptions per month were being written in the US at the end of 2009, an increase of 191% from 2002 [1]. In Canada, the use of niacin increased sevenfold, with nearly 14,000 prescriptions written at the end of 2009. In both the US and Canada, the increase in the use of niacin outpaced the use of statin therapy.” [1]

Notice the incredible number of prescriptions for niacin and notice that it could be perceived as quickly gaining traction on the statin market.  I am sure this did not go without notice, since statins are some of the most profitable pharmaceuticals to manufacture and sell.  In 2011 they totaled over $30 billion in sales!

So what would you expect to happen if a relatively inexpensive vitamin begin to outperform and chip into sales of one of the most lucrative pharmaceutical lines of business?  Well, if you are a bit jaded, you might expect that the following sequence of events would occur:

a) A study would be set up with the least effective, most commonly liver toxic form of high dose niacin. [3]

b) It would be coupled with a controversial and unsafe medication.

c) Non-ideal patients would be chosen for treatment, i.e. those that do not have very high LDL or triglycerides – the sweet spot for niacin. [5]

d) Niacin would be blamed for any issues even though two medications were involved.

Sounds far-fetched, right?  Well, this is exactly what happened!  So, in spite of the fact that slow-release niacin does not raise HDL as much and more often causes liver issues, this was the form chosen for the study.  Furthermore, they added a weird medication called laropiprant into the mix to reduce the flushing from niacin, but laropiprant has the opposite effect on protasglandins that niacin does, so the drugs may have been fighting each other in certain pathways.

In spite of this poor design, the study seems to solely attach niacin and states that it does the following:

–Increases the risk of diabetes by 32%

–“There were also highly significant excesses of other recognized adverse effects of niacin, including gastrointestinal, musculoskeletal, and skin-related serious adverse events.” [4]

–“The excess of gastrointestingal serious adverse events in the niacin-laropiprant group as compated with the placebo group (4.8% vs. 3.8%) included bleeding and peptic ulceration, as well as other problems in the the upper and lower gastrointestingal tracts (mostly dyspepsia and diarrhea, respectivey.” [4]

The bottom line is that this study received significant criticism, the drug was pulled from the market and, because two medications were involved simultaneously, no definitive conclusions could be drawn.  What was needed was a study with JUST niacin.  It turns out that there was just such a study a few year prior:

Study #2.  AIM-HIGH Study (2011 and 2014 Summary. It turns out that there was just the kind of study that we need just a few years prior to the NEJM to study #1.  In the case of this study, they had a cohort with just time-release niacin and also carefully kept track of adverse events. [7] Perfect!

So what did this study find?  Well, all you niacin-lovers out there would like to hear that niacin was a saint with almost no adverse events.  Unfortunately, that did not prove to be the case.  In fact, this better designed study found many of the same similar negative increases:

“There were significant between-group differences in the numbers of serious adverse events in the System Organ Class categories of gastrointestinal disorders (7.4% vs. 5.5%).”

–“…infections and infestations (8.1% vs. 5.8%).  Although the full list of serious adverse events suggests certain similarities with the data from HPS2-THRIVE, particularly regarding serious adverse infectious events…”

–“..the nonsignificant numerical excess in adverse bleeding events with niacin cannot be considered definitive.” [8]

If these sound familiar, it’s because they are almost identical to those found in #1.  Now, admittedly, statistical significance was not always achieved, but it is quite suspicious that increases were found in the exact same categories as the 2014 research.

Even worse, heart outcomes were just not there. They found NO improvement in cardiovascular outcomes from the niacin.  And this is odd, because look at the positive changes in lipids:

–HDL rose from 35 to 42 mg/dl

–Triglcyerides dropped from 164 to 122 mg/dl

–LDL-C dropped from 74 to 62 mg/dl

Does this mean that niacin is worthless and ineffective?  Let me give you several reasons why it would be hasty to jump to this conclusion:

a. Lipids Not That High.  In the above study, the patients were already on a statin and another cholesterol-lowering medication.  So their lipids had already been sigificantly lowered, which is obvious if you look at their starting point above.  Again, as Dr. Gould pointed out with study #1, this is not really niacin’s “sweet spot.”  Clearly, the incremental benefit of adding another medication on top of another is going to be less.  This is generally with high blood pressure, diabetes and other classes of medications as well.

b. Improving Lipids Helps.  Many, many studies have shown that improving lipids can improve cardiovascular mortality and events.

c. Triglcyerides Still High.  With heart disease, you must  improve ALL areas according to the work of the men I call The Plaque Regressing Doctors. If you’ll notice, the triglycerides of these participants is still quite high.  122 is simply not that good. My guess is that the niacin helped slow down plaque buildup but did not stop it completely, because their triglcyeride levels were still too beefy.  See my page on HDL, LDL and Triglyceride Targets to Reverse Arterial Plaque.

d, Niacin Meta-Analysis. There were recently a large meta-analysis done, which is a study of studies, that pooled together all the niacin research to date and concluded the following:

“Eleven eligible trials including 9,959 subjects were identified. Niacin use was associated with a significant reduction in the composite endpoints of any CVD event and major coronary heart disease event. No significant association was observed between niacin therapy and stroke incidence. The magnitude of on-treatment high-density lipoprotein cholesterol difference between treatment arms was not significantly associated with the magnitude of the effect of niacin on outcomes.” [9]

Basically, the conclusion was that a) niacin helps signficantly heart disease except for stroke and b) HDL appears to have nothing to do with it.

MY CONCLUSION: Niacin has some very impressive meta-analysis cardiovascular results and heart disease is the number killer of men.  That said, a case can be made that high dose niacin increases the risk of some rather serious side effects and adverse events.  In my case, I am going to continue to try solve my issues using more natural means.

1) Medscape, “Niacin Use Increased Nearly 200% Over Seven-Year Period,” Michael O’Riordan, June 10, 2013

2) https://www.telegraph.co.uk/news/health/news/8267876/Statins-the-drug-firms-goldmine.html

3) Heal Your Heart, by Dr. K. Lance Gould, p. 176-177.

4) N Engl J Med, 2014 Jul 17, 371(3):203-12, “Effects of extended-release niacin with laropiprant in high-risk patients”

5) https://www.miaware.org/positron-emission-tomogrophy/dr-k-lance-gould-weighs-in-on-nih-niaspan-study-cancellation

6) https://www.reuters.com/article/2014/11/10/us-merck-zetia-idUSKCN0IU26J20141110

7) N Engl J Med 2011, Dec 15 2011, The AIM-HIGH Investigators, “Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy”

8) N Engl J Med, 2014, 371:288-290, “Safety Profile of Extended-Release Niacin in the AIM-HIGH Trial”

9) https://www.peaktestosterone.com/forum/index.php?topic=5318.0

10) https://johnlamattina.wordpress.com/2011/11/21/does-niacin-still-have-a-role-in-cardioprotection/

11) https://www.athero.org/commentaries/comm547.pdf

12) Am J Cardiol. 2007 Mar 19;99(6A):22C-31C, “Safety considerations with niacin therapy”

13) https://www.jillcarnahan.com/2014/02/23/health-tips-for-anyone-with-a-mthfr-gene-mutation/

Hormone Replacement Therapy - Delivery Systems - Peak Testosterone

The previous couple of steps have helped you look at natural ways to get your testosterone back.  One step even threw out the possibility that you could restart your testosterone, i.e. that it needed a “reboot.”  But, much more often than not from what I have seen, these methods simply do not work.  For example, I tried everything under the sun in my pre-HRT days and nothing budged my testosterone.  However, I am almost positive that I have had low testosterone since puberty.

So, if you fall into that category, and you just cannot increase your testosterone by any other rmeans, then you really have just a few ways you can go:

3. HCG Monotherapy.  HCG is a Luteininzing Hormone mimic that will directly stimulate your testes to produce more testosterone.  Many men wishing to preserve fertility and keep “the boys” in working order use this option.  For reasons that are not completely understood, this option generally does not make men feel as good as they would through standard HRT (TRT) from what I have seen.  One of the reasons is that it seems to disproportionately raise estradiol levels.  However, even if men use Arimidex to lower estradiol, men using HRT Monotherapy still do not have the increases in libido, energy and mood that men on HRT typically get.  Nevertheless, it is a popular option as you can see on this  Peak Testosterone Forum Poll.  You can read more about on the page:  HCG Monotherapy.

4. Arimidex (or Aromatase Inhibitor) Monotherapy. This is rarely used and rarely successful from what I have seen, but some men take Armidex to boost their testosterone.  It has certain risks and rewards, For example, it is very convenient as Arimidex (anastrozole) is cheap and available. However, if your estradiol is low already, this could be risky (and potentially result in bone loss). In addition, Arimidex is known for interfering negatively with the clotting cascade.

5. Standard HRT (TRT). The most common solution to hypogonadism is exogenous testosterone, i.e. testosterone applied to the body.  HRT has been a miracle-worker for me and many other men on Peak Testosterone Forum. However, it is not always that way and some men even have negative reactions, side effects and so on.  I will discuss some of these issues in ensuing steps.  Here I wish to cover some of the basic delivery systems:

NOTE:  If you are having trouble with Androgel or Testim, you may want to consider a Compounding Pharmacy, which can often deliver the testosterone at a higher does and lower cost.

b) Injections (Cypionate and Enanthate). Testosterone cypionate and enanthate are two esters of testosterone that are commonly injected on a once every two or three week basis.  Traditionally, this is done intramuscularly (IM) but the new and very popular kid on the block is subQ (subcutaneous) injections.  SubQ is how I am currently doing my cypionate injections and I have had excellent results with this.

c) Scrotal Patches.  These are easy to use but tend to result in higher DHT levels than other delivery methods.  In addition, almost everyone that uses them gets some sort of skin irritation, rash, etc. and has to discontinue usage.

d) Longer Term Solutions. Some men do not want to mess with daily transdermals or even weekly injections due to concerns about travel, convenience, etc.  For these men, protocols that occur every 6 weeks to 3 months include Pellets or testosterone undecanoate.  The former are small “capsules” inserted just below the skin by a urologist and the latter a longer-lasting (but high volume) injection.

For more information about all of these HRT options, I have fairly detailed pages here on the basics, all of which should help in any discussions you have with your physician:  https://www.peaktestosterone.com/.

DHT: What Are Ideal Target Levels? - Peak Testosterone

I cover the benefits of DHT (dihydrotestosterone), such as increased libido and orgasm frequency, in my page on Testosterone and DHT. Many men with a low sex drive are searching for a root cause and often they need to look no farther than their DHT levels.  If your physician has never pulled your DHT levels, you can do it yourself here:  Inexpensive Testosterone Labs. (I have no affiliation with any of them.)

Once you have the number, then the question becomes “what do you do with it?”  Let’s look at how different experts choose target DHT levels.  As you’ll see, there is a considerable difference in opinion:

REFERENCES:

1)   https://ask.lef.org/7366%5C/Testosterone-Cream—too-high-dosage?Keywords=androgel%20bioidentical%20testosterone%252Breplacement

2) Neuro Endocrinol Lett, 2008 Apr, 29(2):201-4, “Dihydrotestosterone and testosterone throughout the life span of Czech men”

3) Clin Endocrinol (Oxf), 2012 Nov, 77(5):755-63, “Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: the healthy man study”

4.  https://www.peaktestosterone.com/forum/index.php?topic=5712.0

5) https://www.peaktestosterone.com/forum/index.php?topic=4095.0

1.  WRONG WAY TO DO IT: Typical lab ranges for DHT are 16-79 or 30-85 ng/dl.  Most physicians that pull your DHT will simply look look to see if you fall within this range to decide if your DHT levels are “okay” or not.  My experience on the Peak Testosterone Forum is that often men experience libido problems when one gets into the low 30’s (or below) ng/dl range.  In other words, just like with testosterone, the lower end of the range can be problematic for a significant percentage of men

2. Life Extension Foundation. LEF is an organization that has tried to go a step beyond standard Western medicine and actually provide more natural longevity and anti-aging strategies.  They are very research-based and their articles are generally excellent, although definitely pro-supplement in orientation.  One nice service that they provide is a lot of lab testing and their recommended levels for DHT are between 30 and 50 ng/dl for adult males. (You should call them and confirm of course.) [1] Their reasoning for targeting the lower half of the physiological DHT range I am sure is avoidance of common DHT-related issues that some men could experience.  DHT is the hormone most responsible for BPH (enlarged prostate) and male pattern baldness.

3. Site Sponsors. A couple of our site sponsors officially target the same 30 to 50 ng/dl, and these clinics have worked with hundreds of patients of course.  One grey area is transdermal testosterone:  some men feel great on testosterone products applied to the skin.  These can be compounded or brand products such as Androgel, Fortesta or Axiron.  They key is that these will often boost DHT well above 100 ng/dl, i.e. to supraphysiological levels.  So we have an interesting situation where the large pharaceutical backed products often boost guys to very high levels of DHT. The theory is that gels like these have a higher DHT conversion rate because of the extra alpha reductase in hair follicles. More concentrated products that are rubbed over a smaller surface area will not, according to the theory, have as high of a rate of conversion into DHT.   Side effects from this are suprisingly rare, but in my opinion, it’s always good to stay physiological.

4. INTERESTING THEORY:. Some anti-aging clinics believe that all hormones should be restored to youthful levels.  I call this a “replacement philosophy” and it a very popular theory out there that many men feel comfortable with. One argument for a replacement philosophy of DHT are a couple of studies that show that healthy men have no decrease in DHT through the normal aging process. For example, one study examined over 10,000 men and concluded that “the data show that after a peak of DHT:T in infancy and a subsequent decrease in puberty, the ratio of both androgens remains practically without change from approx. 20 years of age till old age.” [2] Yet another study looked at 325 men over 40 that reported themselves in good or excellent health and found the following:

“Serum T, DHT and E(2) displayed no decrease associated with age among men over 40 years of age who self-report very good or excellent health although obesity and ex-smoking status were associated with decreased serum androgens (T and DHT) but not E(2). These findings support the interpretation that the age-related decline in blood T accompanying non-specific symptoms in older men may be due to accumulating age-related co-morbidities rather than a symptomatic androgen deficiency state.” [3]

Assuming these studies are correct and the T/DHT ratio and the absolute level of DHT remain constant in healthy middle-aged and senior men, one appears to have Mother Nature on his side if he wants beefy DHT numbers.  Yet another argument for this standpoint is the fact that so few men on HRT have issues with an enlarged prostate.  When a man goes on testosterone therapy, his testosterone will ramp up (if the physician knew what he/she was doing) and DHT will go up correspondingly.  This causes a small but measureable increase in prostate volume normally.  I can say that, of all the men that have gone on HRT on Peak Testosterone Forum, not one of them has complained of BPH that I remember. (It does happen from time to time though, so “eyes wide open.”)

COMMENT: As you can see, there is tremendous variance in philosophy as far as treatment and safety when it comes to DHT.  How can you decide, then, what ideal target DHT levels are?  Unfortunately, there are no DHT-mortality studies and very minimal research on DHT and cardiovascular / arterial health.  Your crystal ball is probably just as polished as anyone else’s at this point, and that means, at least at this time, you are going to have to do your own research and hopefully find a knowledgeable physician to provide their best guess.

Pulling DHT is not as common on the forum, because it is a fairly expensive test – closer to $100 than not. (In the U.S. you can now pull total testosterone for less than $30 for example.) However, a few guys have pulled it and DHT can help diagnose low libido in many cases – it’s definitely worth looking at.   However, it is not perfect of course as libido is complicated. We had a man on HRT who have boosted his DHT above midrange and yet his libido really struggled. [5] He believed it was due to unmanaged estradiol and that is certainly a possibility.  High prolactin can also lower libido, but that will generally drive down testosterone and, therefore, DHT simultaneously.  And anything that negatively impact the brain and neurotransmitters can do the same from recreational drugs to pharmaceuticals to poor lifestyle choices, sleep disorders, nutritional deficiencies, etc.

That said, DHT is one of the stronger predictors of libido, especially when it is low as this man described:

“The trick, of course, is to find a “normal” doc who’ll prescribe anything unless you have extremely low T levels. My last few blood tests had me between 335-375 ng/dl, my libido was seriously diminished, and I was suffering noticeable mental fog and lack of concentration..” [4]

What was his DHT at the time?  It was 27 ng/dl within a lab range of 16-79, i.e. near the bottom.

High Blood Pressure - Peak Testosterone

So what’s a little high blood pressure (hypertension) among friends? Nothing if you don’t expect to have a sex life:  nearly 70% of men with high blood pressure have erectile dysfunction. [1]  This is particularly scary because it is estimated that nearly 25 percent of Americans have high blood pressure.  That means a heck of a lot of guys struggling with erectile dysfunction and other problems associated with high blood pressure, including stroke and some of the items I cover below.

Elevated blood pressure (hypertension) usually comes with a suite of symptoms called Metabolic Syndrome which, besides robbing you of all your bedroom glory and erectile strength, leads to heart disease and stroke:  having high blood pressure even slightly above youthful 120/80 values leads to greatly increased risk of heart disease. In fact, one 2006 study found that readings of 120-129/80-84 led to a 180% greater heart disease risk probability. [6] And, as I emphasize on this site, heart dysfunction means erectile dysfunction.

High blood pressure is also associated with “brain damage” and that is largely because it is a huge risk factor for strokes. Not all strokes are the kind that leave you drooling and incoherent:  your brain can suffer microstrokes that do month-by-month damage to your precious grey matter.  Microstrokes and microscopic brain damage are yet another reason you MUST lower your high blood pressure:  one large study of 999 men found that “cross-sectional measurements at age 70 showed that high 24-hour BP, nondipping, insulin resistance, and diabetes all were related to low cognitive function”. [10] Other researchers quantified this and found that for each 10 point rise in the last blood pressure number (diastolic), there was a 7% greater risk of cognitive decline. [24] In other words, high blood pressure destroys your ability to learn and remember.

REFERENCES:1) Intl Journ Impot Res, (19)296-302, 2007

2) Clin Nutr 2004;23(3):423-33

3) Nutrition Research, 2001, 21: 1251-1260

4) Jour Nutrition 137:84-87, 2007

5) Amer Journ Clin Nutr 2006; 83:780-787, 2006

6) Am Journ Med 2006(Feb);199(2):133-141

7) Magnesium Res,1989,2:229;PNAS,Oct 15 1984,81(20):6511-15

8) J of Andrology, May/June 2006,27(3)

9) J Nutr,Nov 2007,137(11):2405-2411

10) Hypertension,1998;31:780-786

11) Arch Intern Med,2008,168(7):713-720

12) NEJM,April 17, 1997,16(336):1117-1124

13) https://findarticles.com/p/articles/mi_hb4365/is_/ai_n29180324

14) British Med J, 2008 Jul,15(337):a258

15) Hypertension, 2005, 45:28

16) Biofactors, 2004,22[1-4]

17) European Heart Journal Advance Access published online on June 7, 2007; “The red wine hypothesis: from concepts to protective signalling molecules”

18) J of Clin Hypertension, May 9 2007, 9(4):249-255

19) J Nutr. 2005 Feb;135(2):212-7

20) Am J Cardiol, 2004 Apr 1, 93(7):933-5

21) Circulation, Submitted on Nov 27 2008, Accepted May 15 2009, “Glutamic Acid, the Main Dietary Amino Acid, and Blood Pressure. The INTERMAP Study (International Collaborative Study of Macronutrients, Micronutrients and Blood Pressure”

22) Hypertension, Published Online on Feb 4 2008, Andrew J. Webb, et. al., “Acute Blood Pressure Lowering, Vasoprotective, and Antiplatelet Properties of Dietary Nitrate via Bioconversion to Nitrite”

23) Sleep, Jun 1 2009, 32(6):760-766, “Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk”

24) Neurology, 2009, 73:589-595, “Association of higher diastolic blood pressure levels with cognitive impairment”

25) Amer J of Clin Nutr, March 2005, 81(3):611-614, “Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons”

26) Perez-Pozo S, et al “Excessive fructose intake raises blood pressure in humans” AHA BPRC 2009; Abstract P127

27) Webmd, “Daily Glass of OJ is Heart Smart”

28) Phytotherapy Research, Received: 13 November 2008; Revised: 3 March 2009; Accepted: 11 March 2009, “Hesperidin suppressed proliferations of both Human breast cancer and androgen-dependent prostate cancer cells”, Choong Jae Lee, et. al.

29) Biological Psychology, Feb 2006, 71(2):214-222, “Blood pressure reactivity to stress is better for people who recently had penile vaginal intercourse than for people who had other or no sexual activity”

30) BMC Cardiovascular Disorders,2008, 8:13, “Effect of garlic on blood pressure: a systematic review and meta-analysis”

31) Modesti PA, et al “Daily sessions of music can reduce 24-hour ambulatory blood pressure in mild hypertension” ASH Meeting 2008; Abstract 230.

32) Consumer Reports on Health, Oct 2009, p. 2

33) Prevention, Jan 2010, p. 98.

34) Intl J of Epidemiology, 24(6):1117-1123, 1995, “Dietary Calcium, Potassium, Magnesium and Blood Pressure in the Netherlands”

35) Journal of Hypertension, Jan 2009, 27(1):92-101, “Antihypertensive effect of French maritime pine bark extract (Flavangenol): possible involvement of endothelial nitric oxide-dependent vasorelaxation”

36) American Journal of Clinical Nutrition, Feb 2008, Vol. 87(2):323-331, “Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol”

37) The Lancet Oncology, Jul 2010, 11(7):627-636, “Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials”

38) Am J Clin Nutr, 2009, 90:493-498, “Whole grains and incident hypertension in men”

39) Curr Hypertens Rep, 2007 Dec, 9(6):520-8, “Stress reduction programs in patients with elevated blood pressure: a systematic review and meta-analysis”

40) https://en.wikipedia.org/wiki/Transcendental_Meditation

41) J. Nutr, First published December 16, 2009; “Hibiscus Sabdariffa L. Tea (Tisane) Lowers Blood Pressure in Prehypertensive and Mildly Hypertensive Adults”

42) Am J Hypertens, 2012, 25(6):640-643, “Watermelon extract supplementation reduces ankle blood pressure and carotid augmentation index in obese adults with prehypertension or hypertension”

43) Nutrition Research, Feb 2007, 27(2):119 123, “Cellular effects of garlic supplements and antioxidant vitamins in lowering marginally high blood pressure in humans: pilot study”

44) https://www.dailymail.co.uk/health/article-2110806/Zona-Plus-Can-squeezing-ball-help-cut-blood-pressure.html , “Can squeezing a computerised stress ball help cut your blood pressure?”, by PAT HAGAN

WARNING: High blood pressure medications have recently been implicated as cancer-causing. [37]  The specific class of drugs involved are the ARB’s (Angiotensin Receptor Blockers).  Talk with your doctor about possibly using some of the more natural approaches given below if applicable.

Fortunately, modern research has found many strategies to lower your  blood pressure back down to normal and thus decrease your risk of erectile dysfunction.  What is “normal” blood pressure?  120/80.  Those are the magic numbers. Do not settle for anything over that.  Keep working and working and working – with your doctor of course – at lowering your high blood pressure until you get it below 120/80.

Here are 35 Natural and Research-Backed Solutions to Lower Your Blood Pressure based on the lastest research, of course, in order to keep you out of the land of stroke, heart disease and erectile dysfunction.  Note that the items designated “HEAVY HITTER” lower blood pressure as much as most pharmaceutical blood pressure medications.

CAUTION:  Do NOT make any changes to your blood pressure medications without consulting first with your doctor.  And, if you have high blood pressure, stroke-related issues or heart disease, it is always a good idea to check with your doctor first.

1. HEAVY HITTER: DASH Diet .  This diet is a clinically proven lowerer of high blood pressure .  It is somewhat similar to the Ornish Diet and Mediterranean Diet that I write about in many links on this site in the sense that whole grains, fruits and vegetables are emphasized and saturated fats are avoided. But there are many key differences.  For example, the DASH Diet allows fish, non-fat dairy and nuts (including peanut butter). Furthermore, the DASH Diet does even allow some meat but you have to trim away the fat, buy lean cuts, etc.  Furthermore, there is a kind of ‘pyramid’ where a certain number of servings of different types of food is laid out.

Here is the standard daily eating pattern on this diet:  a) 8 servings of grains, b) 5 servings of vegetables, c) 5 servings of fruit, d) 2-3 servings of skim or low-fat milk, e) yogurt or cheese, f) 5 servings per week of nuts, seeds or beans, g) 1-2 servings of meat, poultry or fish and h) restrict sweets and fats.

But all the effort is well worth diet:  the DASH Diet is also fast at producing results:  in the clinical study it began working within 14 days. Average blood pressures in the original study were 131/85 and the DASH Diet reduced this by 5.5/3.0 (although bigger gains were achieved by those with higher than average pressures). [12] So the DASH Diet almost took the study participants back to normal pressure. Even greater results were achieved in a follow up study that limited sodium as well.

A recent study, which studied 88,000+ nurses found that stroke and heart attacks were significantly reduced as well.  Those whose diets most closely resembled DASH were 24 percent less likely to develop heart disease and 18 percent less likely to have a stroke than those women whose diets strayed most from DASH. [11] Other studies have shown that the DASH Diet lowers bad cholesterol and homocyteine, both strong risk factors for heart disease, as an added bonus.   (The Ornish Diet is still King at heart protection.  But the Ornish Diet is significantly harder to follow for the typical Westerner than the DASH Diet since it is low fat and does not allow meat of any kind.)

<pCAUTION: If you have a medical condition or are on any medications, please discuss any changes with your doctor first. Certain supplements, foods and even juices can alter absorption rates of certain medications for example. Play it safe.2. HEAVY HITTER: Vitamin C and Garlic. A 2013 study came out showing that the combination of Vitamin C (2 grams/day) and garlic (2.5 grams/day)  greatly lowered blood pressure in marginally high hypertensive patients, which means right on the border of 140/90. [43] Neither supplement by itself did much of anything, but, in combination, it took blood pressure down to below 120/80 and increased nitric oxide by three times! Now it would be nice if they did some followup study work, but these two supplements are very well tolerated and appear to be as powerful as any medication that I have read about.  (I would recommend also reading my links on Why Take Vitamin C and Increase Your Nitric Oxide with Vitamin C for some additional information.)

3) HEAVY HITTER: Citrulline. A couple of studies that use a combination of Citrulline + Arginine have shown very substantial decreases in blood pressure. One study gave obese adults with hypertension or prehypertension 6 grams daily of Citrulline with Arginine, which I believe would be 4 grams of Citrulline with 2 grams of Arginine. This led to ankle and brachial reductions in systolic blood pressure of 11.5 and 15.1 mm, respectively! [42]

4. HEAVY HITTER: Ornish Diet.  The Ornish Diet dramatically lowers blood pressure and also cleans out your arteries while it’s at it. In fact, it’s an understatement to say that the Ornish Diet lowers high blood pressure:  it drops it like a rock.  One study of diabetics (half with heart disease) found that their average blood pressure was a high 136/79 and fell to an average of 124/72 on the Ornish Diet.  This is a huge drop and put people with very serious medical condition(s) just a hair above normal! Similar results were found with ‘1,245 participants who had coronary heart disease (55%), diabetes, and/or at least three other risk factors (hypertension, hyperlipidemia, and obesity)’. [13]

5. Sex. That’s right – researchers found that penile-vaginal intercourse (PVI) improved stress reactivity, i.e. arterial blood pressure response to stress. [29]  And you thought research was dry and boring? Now it’s important to note that only PVI and not other sexual activity had this effect. I have already written to the department chair asking if they need volunteers for any follow-up study work.  Also, remember that sex also improves overall mortality and erectile dysfunction!

6. HEAVY HITTER: Dark Chocolate (Cacao). A little known fact is that dark chocolate lowers blood pressure almost as much as the much more well-known DASH Diet mentioned above.  A recent study found that average systolic blood pressure in healthy subjects went from 113.9 to 107.5, a very healthy drop indeed. [25] This is one of the secrets of the ultra heart healthy Kuna peoples. You can bet these folks have lower rates of impotence and erectile dysfunction to go along with it.

7. HEAVY HITTER: Quercetin. A 2007 study showed that supplementation with about 700 mg of quercetin lowed blood pressure by an average of 7 and 5.  [9]  Quercetin is commonly found in various fruits and vegetables. (This is large amount of quercetin.)

8. HEAVY HITTER: Pomegranate Juice .  Heart patients with significant artherosclerosis were given an ounce of pomegranate juice daily and blood pressure lowered on average by 20% .  [2]

9. HEAVY HITTER: Grape Juice. One study on Korean men with mild hypertension who took Grape Juice decreased their systolic blood pr9sure by 7.2 mm on average and their diastolic by 6.2 mm.  [16] This is a very significant decrease. Don’t go crazy with grape juice, however, as it is relatively high in fructose and high fructose consumption is increasingly associated with a host of health issues. CAUTION:  Red wine and Alcohol should, theoretically, lower blood pressure but, in fact, are associated with a small increase in blood pressure. [17] Alcohol is very cardioprotective overall, but if you are hyptertensive, this is definitely a factor to consider.

10. HEAVY HITTER: Juvenon.  This is a supplement that is basically a combination of Acetyl-L-Carnitine, the mitochondria booster, and ALA (Alpha Lipoic Acid), the powerful antioxidant. One study showed a nice reduction in blood pressure in those with Metabolic Syndrome (139 to 130) and hypertension (151 to 142). [18]

11. HEAVY HITTER: Music and Breathing. One study showed that “rhythmically homogenous” music combined with breathing exercises for a half hour a day reduced systolic and diastolic blood pressure in mildly hypertensive patient by 4 and 3, respectively. [31] Furthermore, the results persisted for one month. A variety of music was allowed, including classical, Celtic and Indian, but rhythmic consistency was required.

12. Nitrates in Plant Foods. Researchers have also been discovering that the nitrate content of many plants gets converted to nitrities by the saliva which then raises Nitric Oxide levels in the body and relaxes arteries.  (Yes, that will be good for erections.  One study showed that beetroot juice was particular powerful in this regard, but many other vegetables and grains have nitrates, especially green leafy vegetables. [22] See my link on Beetroot Juice for more details.

13. Pycnogenol. Pycnogenol lowered blood pressure in a randomized, double-blind, placebo-controlled study performed in mildly hypertensive patients. [3][35]  This is just one of the many reasons that Pycnogenol Helps with Erectile Dysfunction.

14. Orange Juice.  One 2009 study showed that the flavinoid hesperidin, found in citrus fruits, lowered blood pressure in adults. [27] The good news is that the amount of hesperidin in the study was the equivalent amount in one (500 ml) glass of orange juice.  Hesperidin also has anti-cancer qualities as well. [28]

15. Grains, Legumes and Beans. Researchers recently found out that the high glutamic acid content in plant products, such as grains in particular, led to a drop in blood pressure. [21]  Glutamic acid is the primary amino acid in plant protein.  Later research uncovered the fact that those who ate whole grains daily, over about 46 grams/day, were 19% less likely to develop hypertension. [38]  All of this may explain some of the powers of the Ornish and DASH Diets to lower blood pressure.

16. Excess Weight.  Lose the Excess Weight. Studies show that as weight increases so does blood pressure (and blood pressure is a huge risk factor for erectile dysfunction [8] and heart disease).  You cannot expect to lower your blood pressure with that spare tire strapped to the middle of your body!  And, not too suprisingly, those excess pounds are directly associated with erectile dysfunction and lowered testosterone as well.

17. Heme Iron. There are two types of iron:  iron from meat (heme) and iron from plants (non-heme).  Heme iron is much more readily absorbed and a recent study found that it is significantly correlated with high blood pressure. [14] This was a large study involving almost 5,000 men and women from Asia, the UK and the US.

18. Fructose.  Watch your fructose consumption.  Fructose is contained in corn syrup, fruits and table sugar and studies show that high blood pressure is significantly correlated with high uric acid levels and – you guessed it – fructose consumption leads to elevated uric levels. [15] One 2009 study found that men put on a high-fructose (200 g/day) diet raised their blood pressure by 6 mm and 3 mm, respectively.  In addition, putting them on a uric acid blocker almost eliminated the increase. [26] You don’t need to worry about the small amount of fructose in fruit:  200 g is a LOT of fructose.  But you should definitely limit sweets and cokes and anything with a substantial amount of sugar or corn syrup.

19. Exercise.  Exercise increases nitric oxide output, which relaxes the vessels and lowers blood pressure. Exercise also leads to lower body inflammation levels which lowers the plaque buildup in your arteries.  Exercise has also been shown to greatly improve erectile dysfunction.

20. Olive Oil.  One recent study showed that olive oil was associated with a 3% drop in systolic blood pressure. [4] (You probably have to have high polyphenol olive oil for this effect, however.)

21. Cutting Carbs.  One recent study found that replacing high glycemic carbs, such as white bread, pasta and sugars, with lean read meats decreased blood pressure by four points. [5] Note:  High levels of cheap carbs are associated with Metabolic Syndrome and insulin resistance, which is in turn associated with hypertension.

22. Magnesium, Calcium and Potassium.  Is sodium the only mineral that affects blood pressure?  Definitely not – researchers have found a trinity of other minerals that are probably more important.  Magnesium, calcium and potassium were found in one British journal, for example, to be associated with lower blood pressure. [7]  Of course, whole grains and veges are loaded with potassium and magnesium. Don’t go crazy with calcium as it’s associated with an increased risk of prostate cancer.

23. L-Arginine. Men with high cholesterol were given 12 g of Arginine per day, which is a lot in my opinion, but did achieve decreased blood pressure and significantly decreased homocysteine, a leading heart disease risk factor. [19] Another study gave 6 g/day of L-Arginine and also found a decrease in blood pressure and an increase in blood flow. [20] Read my link on Arginine. There is study with pycnogenol and Arginine that shows an improvement in erectile dysfunction as well. CAUTION: Do not take L-Arginine if you have had a heart attack recently and read all side effects on the above link as well as discussing with your doctor.

24. Salt Intake .  Be very careful of your salt intake. Time was when the prevailing wisdom was that salt only affected the blood pressure of “salt sensitive” individuals.  However, salt draws water into the arteries increasing the burden on the heart and often increasing blood pressure.  One study published in Sep. of 2009 showed a significant reduction in blood pressure for patients with existing hypertension by decreasing salt to 1, 150 mg per day. [32]

25. Vinegar.  Vinegar probably lowers blood pressure.  It also does a host of other semi-miraculous things as well.  Please read How Vinegar Lowers Blood Pressue and Keeps the Weight Off.

26. Nicotine and Alchohol.  1-2 drinks of alchohol per day is likely heart healthy: studies of light drinking show that it raises HDL (good cholesterol) and decreases cardiovascular risk.  However, the studies show that 3+ drinks per day of alchohol actually leads to increased blood pressure and that means potential erectile dysfunction.  And, as if you didn’t need another reason to quit smoking, nicotine actually constricts blood vessels which of course can lead to increased blood pressure.

27. Insomnia.  Insomnia is correlated with both heart disease and heart failure.  Researchers in one study have found one reason why:  it raises nighttime blood pressures which could be deadly. [23]

28. Eggs. Believe it or not, eggs may actually lower blood pressure.  See my link on Beef and Eggs for details.

29. Nostril Breathing. Did you know that the olfactory nerves connect to the hypothalamus and the hypothalamus helps regulate blood pressure?  Researchers tested a breathing technique involving alternating breathing through each nostril back and forth for about 7 minutes.  This led to a 1 mg drop in blood pressure.  This is a small drop but shows how little we understand the body.

30. Garlic. Supplemental garlic (600-900 mg/day of Kwai powder) lowers blood pressure very significantly.  A meta-analysis found a decrease of about 8 and 7 points in systolic and diastolic pressure for hypertensive patients and the researchers noted that the results are similar to standard high blood pressure medications. [30] Again, anything that lowers high blood pressure is likely to help and improve erectile dysfunction and impotence.

31. Mineral Water. I have covered elsewhere the many problems in tap water, and it may be no surprise that natural water confers some surprising health benefits. For example, Pelligrino – not the seltzers – has 56 mg of magnesium and 208 mg of calcium and in one study significantly lower blood pressure in individuals with mild hypertension. [33] CAUTION:  This may lower stomach acid a bit, which is critical for digesting certain nutrients and vitamins.

32. Berries. A 2008 study showed that moderate berry consumption resulted in decreased blood pressure levels (and increased HDL) in a group of middle subjects. [36]

33. Transcendental Meditation and Progressive Muscle Relaxation. Both of these techniques decreased blood pressure according to one recent meta-analysis. [39]  Forgetting about some of Transcendental Mediation’s strange spiritual connections may be difficult for some [40], but it was the most powerful stress reducing technique when examined just based on the physical evidence.

34. Hibiscus Tea. Hibiscus Tea is a favorite of mine.  It is much-loved in Mexico and known there as Jamaica. I live in the southwest and you can buy it in most of the supermarkets in the Mexican herbal section.  Just throw it in some boiling water for several minutes and pour it over ice (with maybe a half teaspoon of sugar) and – voila! – you’ve got an excellenet ice tea with some bite to it.  In fact, Hibiscus Tea is very popular in a variety of cultures around the world and is a common long-standing ingredient in many herbal tea preparations even here in stodgy, non-exotic America.  Researchers have found that Hibiscus tea has many many excellent properties iincluding ample Vitamin C and the lowering of cholesterol. Perhaps best of all, a 2009 study discovered that the equivalent of about 3 cups of hibiscus tea per day can significantly lower blood pressure. [41]  If you can’t find it locally for some reason, you can order it off of Amazon: Hibiscus Tea – Certified Organic – 24 Teabags.

35. Hand Grip Devices. Using a hand grip device for 10 minutes was recently shown to lower blood pressure several points. This is not a bad reduction for such a simple procedure. It may not produce the same results in those who are already exercising regularly. However, it may be way for someone working a desk job to get some downward motion in this blood pressure during the day? [44]

Zinc Deficiencies & Low Testosterone - Peak Testosterone

In fact, let’s look at one study that took four young men and gave them a zinc deficient diet.  Their testosterone dropped from a pre-study level of 1176 ng/dl to a zinc deficient level of 311 ng/dl in just 20 weeks. [1] This is a drop to almost one fourth of starting levels!  This seems to match well with the almost four times increase that the above man reportedly experienced from zinc supplementation.  However, one might be thinking that this is an artificially created scenario and my not work as well in real life.  Well, the researchers read our minds and examined a more practical “real life” scenario:

They took a group of “mildly zinc deficient” seniors and found that their average testosterone levels were very low:  244 ng/dl, which is hypogonadal by any lab standards that I know of.  So what happened when they gave them zinc?   Their testosterone almost doubled to 470 ng/dl. Notice that this did not magically give them youthful levels.  However, the key is that it did boost their testosterone back up to more normal levels for their age group.  Not bad for an inexpensive supplement, eh?

The takeaways from this study seem clear and are:

–Zinc deficiency can lead to very low testosterone levels.

–Correcting a zinc deficiency can lead to dramatic increases in testosterone.

–Correcting a zinc deficiency can restore testosterone to “normal” levels

NOTE: You can test for a zinc deficiency using what is called a “taste test.”  For example, check out the Designs for Health Zinc Challenge

There are other signs that zinc may improve your testosterone levels besides just a straight deficiency.  For example, one study took men with long term infertility and testosterone less than 480 ng/dl and put them on zinc.  Their testosterone, dihydrotestosterone (DHT) and sperm counts rose significantly. [3] Of course, it’s probably prudent to just get a zinc test done, but this study shows just how widespread zinc deficiencies may be and how other male-related symptoms may be a sign that one is low on zinc.

NOTE:  You may also be interested in my page on the The Pros and Cons of the Zinc Taste Test.

Why does zinc boost testosterone?  I have never been able to find a solid explanation for it.  Of course, zinc is known for inhibiting the aromatase enzyme, which will tend to lower estradiol and raise testosterone.  My HRT clinic, for example, will even give a man zinc as “Arimidex Light” just for that purpose.  But it’s aromatase-limiting powers are quite limited and so this would have a minimal impact on testosterone.  Adding to the mystery is that neither the enzyme that converts pregnenolone to progesterone, DHEA to androstenedione or androstenedione to testosterone actually contains zinc, so zinc’s testosterone-raising role is clearly secondary.  However, since zinc is actually in 100+ human enzymes, its role in human health is critical and it is, therefore, no surprise that it can so dramatically alter one’s testosterone.

CAUTION:  More is not better when it comes to zinc.  Zinc can be neurotoxic and competes with copper.  There is evidence that even small amounts of zinc supplements can lead to some rather nasty issues, something I show in my page on The Potential Dangers of Zinc Supplementation.

1) https://peaktestosterone.com/forum/index.php?topic=3369.0

2) Nutrition, 1996 May;12(5):344-8, “Zinc status and serum testosterone levels of healthy adults”

3) Systems Biology in Reproductive Medicine, 1981, 7(1):69-73, “Effect of Zinc Administration on Plasma Testosterone, Dihydrotestosterone, and Sperm Count”

4) Am J Clin Nutr, Jul 1992, 56(1):1 148-157, “Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men”

Painkillers are Sex Life Killers: Supplement Solutions .

I see it all the time: men who are otherwise health-conscious and otherwise living a natural lifestyle show up to the Peak Testosterone Forum obviously addicted to pain medications. I have no doubt that it probably started out innocently enough – perhaps pain in the knee or back or even recovery from surgery. But next thing they know, they are addicted to these medications and find that they can’t sleep or function without them. The opiates are notoriously addictive, both psychologically and physically, and also have the problem of resistance or tolerance. In other words, over time many men have to take a greater dosage just to find the same pain relief.

And what most men do not realize:  these drugs will almost always impact their sex life negatively.  Yes, a medication like hydrocodone (Vicodin) is just a fraction as powerful as something like morphine, but it can definitely lower sexual function.  And it is more often than not middle-aged men struggling with injured backs and worn out knees that start taking these kind of pain medications and they do not have the buffer in their erectile strength and libido to handle the negative effects of these drugs.

Opiates such as hydrocodone, oxycodone, Darvocet, Vicodin, etc. slowly chip away at both testosterone and libido.  One study of men on intraspinal opiods found GREATLY reduced testosterone levels and a number of men that could no longer even achieve an erection. [1] All men had some reduction in libido. I cover some of the more extreme cases in my link on Heroin and Erectile Dysfunction as well.

I do want to also mention that some men with pain issues pop NSAIDs (ibuprofen, Naproxen, Advil, Motrin, Aleve, etc.) and acetomeniphen (Tylenol) like candy not realizing that the former often affects sexual function and the latter has many potential negative impacts, a fact I cover in my link on The Dangers of Tylenol.  So, as you may have guessed, I am trying to point out that these pain relievers are very likely to greatly reduce your quality of life and possible your bedroom performance.  And I ask the question, “Why not consider more natural alternatives?”

Most men simply do not realize the abudnance of reserach that has gone into more natural pain management solutions.  Below I have summarized some of the many studies that show this:

CAUTION: Do not discontinue any medication without consulting your physician first.  And if you have any medical condition or are on any medications, check with your physician first.

1. Hypnotherapy. Hyponotherapy, as in the licensed, non-sensational kind, has achieved widespread acceptance in the U.K. and is growing in popularity in many countries including the U.S.  The reason is that research results have been excellent. One of the most interesting uses of hypnotherapy is in pain management and results can be astonishing: I knew one relative who needed a root canal and was suffering quite badly who was completely relieved of all pain for several days after just one hypnotherapy session.  This has not surprising considering that hypnotherapy has shown powerful pain releif in a wide variety of conditions including chronic, abdominal and non-cardiac chest pain. [2][3]

2. Progressive Muscle Relaxation.  Pain can usually be significantly reduced by stress and anxiety-reducing techniques.  One example of this is Progressive Muscle Relaxation, one of my favorite techniques, because it backed by a mountain of research and is easy to learn and do.  For more information, see my page on The Many Benefits of Progressive Muscle Relaxation. PMR, for short, has also been shown to help with osteoarthritis and insomnia, both common issues associated with pain management. [4]

3. Curcumin. Looking for a decent NSAID substitute with many less side effects? (NSAIDs are notoriously hard on the GI tract and can contribute to sexual dysfunction.) Curcumin is worth consideration and has dozens of studies and centuries of folk usage behind it. Curcumin is a component of turmeric, which is in turn an ingredient in yellow curries and mustards. Asians who eat curry seem to enjoy many of the anti-inflammatory benefits of consuming curry every day. However, curcumin is poorly absorbed in general and to get therapeutic benefits you probably need to consume it with piperine, a phytochemical in black pepper. Life Extension makes such a product for example: Life Extension Bio-curcumin Vegetarian Capsules. [5]

4.  Meditation.  One thing I ask men to consider is Secular (Non-Religious) Meditation for stress and cortisol management. Virtually every form of meditation has been shown to help manage pain as well. For example, mindfulness meditation was shown to substantially help men and women in chronic pain who could not be helped by traditional pain management techniques. [6] Lovingkindness meditation was shown to significantly lower pain in patients with chronic lower back pain and Transcendental Meditation also has a study behind it. [7][8]

5.  Vitamin D.  A vitamin D deficiency has been reported in many studies to be associated with chronic pain.  Some studies have shown nearly miraculous results with this ultracheap supplement.  For example, one study showed pain miraculously resolving and returning based on Vitamin D status and supplementation. [9] Yet another study in fibromyalgia patients showed very positive results as well. [10] However, the studies have certainly not been consistent.  Nevertheless, it is always smart to get your Vitamin D status checked – a big percentage of people are deficient – and this can even boost your testosterone a little.  Read this link on Vitamin D and Testosterone for more information. Resoving a Vitamin D Deficiency can help in a hundred different ways as well. In other words, it’s worth a try…

7. Boswella. This herb has been used for centuries in ayurvedic medicine for pain relief and, therfore, no one was surprised to find that it really works, especially for arthritis-related pain. [12] It works by downregulating various inflammatory cytokines such as TNF Alpha.  Unfortunately, it looks like it may downregulate nitric oxide as well. [13]

8.  Yoga. Your wife or girlfriend likely loves yoga.  If you have chronic lower back pain, you probably should too according to one study of Iyengar Yoga. [14] This type of yoga is a form of Hatha Yoga, but is designed to be very safe for the joints.

9.  Tai Chi. This ancient tradition, like Mindfulness Meditation, has multiple studies showing its benefits to various pain conditions, including arthritis and fibromyalgia. [15][16]

10.  White Willow Bark.  This is another herb used for, well, just about forever to relieve pain and inflammation.  One study showed it was quite effective on osteoarthritis. [17]

1)   Journal of Pain and Symptom Management, Feb 1994, 9(2):126-131, “Altered sexual function and decreased testosterone in patients receiving intraspinal opioids”

2) GASTROENTEROLOGY, 2007, 133:1430 –1436, “Hypnotherapy for Children With Functional Abdominal Pain or Irritable Bowel Syndrome: A Randomized Controlled Trial”

3) Gut, 2006, 55:1403-1408, “Neurogastroenterology Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy”

4) Pain Management Nursing, Sep 2004, 5(3):97–104, “A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis”

5) https://www.drweil.com/drw/u/QAA400915/Curcumin-or-Turmeric.html

6) General Hospital Psychiatry, Apr 1982, 4(1):33-47, “An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results”

7) J Holist Nurs September 2005 vol. 23 no. 3 287-304, “Loving-Kindness Meditation for Chronic Low Back Pain: Results From a Pilot Trial”

8) Psychosomatic Medicine, Apr 1 1981, 43(2):157-164, “The transcendental meditation technique and acute experimental pain”

9) JAMA, August 1991, 151(8), “Can Vitamin D Deficiency Produce an Unusual Pain Syndrome?”

10)

<p11) evidence-based=”” complementary=”” and=”” alternative=”” medicine,=”” 2004,=”” 1(3):251-257,=”” “bromelain=”” as=”” a=”” treatment=”” for=”” osteoarthritis:=”” review=”” of=”” clinical=”” studies”<=”” p=””>12) Phytomedicine, 2003, 10(1):3–7, Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – A randomized double blind placebo controlled trial”

13) International Immunopharmacology, Apr 2007, 7(40:473–482, “Pure compound from Boswellia serrata extract exhibits anti-inflammatory property in human PBMCs and mouse macrophages through inhibition of TNFα, IL-1β, NO and MAP kinases”

14) Pain, May 2005, 115(1-2):107–117, “Effect of Iyengar yoga therapy for chronic low back pain”

15) The Journal of Rheumatology, 30(9):2039-2044, “Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial”

16) N Engl J Med, 2010; 363:743-754, “A Randomized Trial of Tai Chi for Fibromyalgia”

17) Phytotherapy Research, Jun 2001, 15(4):344–350, “Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial†”

18) Phytotherapy Research, Jun 2001, 15(4):344–350, “Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial†”

Statins and Testosterone - Peak Testosterone

REFERENCES:

1) BMC Med, 2013 Feb 28, 11:57, “The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials”

2) Cancer Epidemiol Biomarkers Prev, August 2007, 16:1587, “Do Statins Affect Androgen Levels in Men? Results from the Boston Area Community Health Survey”

3) https://www.medscape.com/viewarticle/822730

4) U.S. San Diego News Center, July 01, 2015, By Scott LaFee, “Statins Linked to Lower Aggression in Men, but Higher in Women”

Here are some of the studies showing Statins Lower Testosterone But Probably Not By Much:

1. Meta-analysis.  One large meta-analysis looked at many studies and found that men with high cholesterol, on average, lost 0.66 nmol/l or about 20 points (in ng/dl) of testosterone.  Now this isn’t much of a drop, so the question is if it could cause issues when coupled with other effects of statins.

2. REBUTTAL: Not With Controls. In fairness to good doctors like Dr. Gould, who often use statins to regress arterial plaque, I want to mention that a 2007 study found that if you controlled for things like age, BMI, time of day (for the blood draw), etc. the drop was only 5.5%. [2] Of course, every molecule is precious, eh?  But let’s be honest and admit that one is very unlikely to notice a drop from, say, 500 ng/dl to 475.

3. Lowered Aggressiveness and Disrtubed Sleep. Now let’s go to what is probably the most relevant aspect of statin use:  their ability to sometimes product “low testosteorne symptoms.”  For example, one study found that men had lowered levesl of agressiveness on statins and speculated that it was from the lowered testosterone levels. [4] The authors explained that:

“For men, the picture was more complex. Three male participants who took statins (and no one on placebo) displayed very large increases in aggression. When these were included in analysis, there was no average effect. When these outliers were removed from the analysis, a decline in aggressive behavior for male statin users was significant.” [4]

Now, assuming that testosterone is actually lowered by very small amounts actually, this is a bit of stretch.  And the researchers in the same study explained that “changes in testosterone and in sleep problems on simvastatin each significantly predicted changes in aggression. A larger drop in testosterone on simvastatin was linked, on average, to a greater drop in aggression.

Thus sleep and other brain changes are probably the real culprit.  Notice that the researacher mentioned simvastatin specifically.  As I explain in my page on The Dangers and Risks of Statins, some of these medications are much more lipid soluble than others. And the significance of being lipid soluble is that they penetrate the blood brain barrier easily and can, apparently, have undesireable consequences.  Simvastatin (Zocor) is very lipid soluble.  Yeah, you didn’t read that in fine print, did you?

CONCLUSION: So what should you do?  Should you trust these studies and assume your testosterone may go down a little but not by much? My opinion is that you should measure your testosterone before and after any change and see for yourself. Studies deal with averages, and what if you are an outlier?  Here in the U.S., they are multiple labs where you can pull testosterone inexpensively without a direct doctor’s orders, so just do it:  Inexpensive Testosterone Labs.

NOTE:  Statins can have one positive effect:  improved erectile and endothelial function. One study note a quite significant improvement in erectile dysfunction from taking statins in older men, and this is undoubtedly due to higher cholesterol levels that plaque arterial blood flow to and within the penis. [3] However, I would argue that there is a much better and safer to lower cholesterol levels and improve erectile function for many men and that is through a well done, whole foods, good carb low fat diet.  Low fat diets will almost always drop your cholesterol very significantly and, if you do it right, can actually lower triglycerides.  See my page on The Benefits of a Low Fat Diet for more information.  Remember that statins go in and interfere with the enzyme that creates CoQ10.  Low fat diets do NOT.  Furthermore, one does not have to worry about crossing the blood-brain barrier with the whole foods that are emphasized in a low fat diet.

Testosterone Levels - Peak Testosterone

I cover the benefits of DHT (dihydrotestosterone), such as increased libido and orgasm frequency, in my page on Testosterone and DHT. Many men with a low sex drive are searching for a root cause and often they need to look no farther than their DHT levels.  If your physician has never pulled your DHT levels, you can do it yourself here:  Inexpensive Testosterone Labs. (I have no affiliation with any of them.)

Once you have the number, then the question becomes “what do you do with it?”  Let’s look at how different experts choose target DHT levels.  As you’ll see, there is a considerable difference in opinion:

REFERENCES:

1)   https://ask.lef.org/7366%5C/Testosterone-Cream—too-high-dosage?Keywords=androgel%20bioidentical%20testosterone%252Breplacement

2) Neuro Endocrinol Lett, 2008 Apr, 29(2):201-4, “Dihydrotestosterone and testosterone throughout the life span of Czech men”

3) Clin Endocrinol (Oxf), 2012 Nov, 77(5):755-63, “Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: the healthy man study”

4.  https://www.peaktestosterone.com/forum/index.php?topic=5712.0

5) https://www.peaktestosterone.com/forum/index.php?topic=4095.0

1.  WRONG WAY TO DO IT: Typical lab ranges for DHT are 16-79 or 30-85 ng/dl.  Most physicians that pull your DHT will simply look look to see if you fall within this range to decide if your DHT levels are “okay” or not.  My experience on the Peak Testosterone Forum is that often men experience libido problems when one gets into the low 30’s (or below) ng/dl range.  In other words, just like with testosterone, the lower end of the range can be problematic for a significant percentage of men

2. Life Extension Foundation. LEF is an organization that has tried to go a step beyond standard Western medicine and actually provide more natural longevity and anti-aging strategies.  They are very research-based and their articles are generally excellent, although definitely pro-supplement in orientation.  One nice service that they provide is a lot of lab testing and their recommended levels for DHT are between 30 and 50 ng/dl for adult males. (You should call them and confirm of course.) [1] Their reasoning for targeting the lower half of the physiological DHT range I am sure is avoidance of common DHT-related issues that some men could experience.  DHT is the hormone most responsible for BPH (enlarged prostate) and male pattern baldness.

3. Site Sponsors. A couple of our site sponsors officially target the same 30 to 50 ng/dl, and these clinics have worked with hundreds of patients of course.  One grey area is transdermal testosterone:  some men feel great on testosterone products applied to the skin.  These can be compounded or brand products such as Androgel, Fortesta or Axiron.  They key is that these will often boost DHT well above 100 ng/dl, i.e. to supraphysiological levels.  So we have an interesting situation where the large pharaceutical backed products often boost guys to very high levels of DHT. The theory is that gels like these have a higher DHT conversion rate because of the extra alpha reductase in hair follicles. More concentrated products that are rubbed over a smaller surface area will not, according to the theory, have as high of a rate of conversion into DHT.   Side effects from this are suprisingly rare, but in my opinion, it’s always good to stay physiological.

4. INTERESTING THEORY:. Some anti-aging clinics believe that all hormones should be restored to youthful levels.  I call this a “replacement philosophy” and it a very popular theory out there that many men feel comfortable with. One argument for a replacement philosophy of DHT are a couple of studies that show that healthy men have no decrease in DHT through the normal aging process. For example, one study examined over 10,000 men and concluded that “the data show that after a peak of DHT:T in infancy and a subsequent decrease in puberty, the ratio of both androgens remains practically without change from approx. 20 years of age till old age.” [2] Yet another study looked at 325 men over 40 that reported themselves in good or excellent health and found the following:

“Serum T, DHT and E(2) displayed no decrease associated with age among men over 40 years of age who self-report very good or excellent health although obesity and ex-smoking status were associated with decreased serum androgens (T and DHT) but not E(2). These findings support the interpretation that the age-related decline in blood T accompanying non-specific symptoms in older men may be due to accumulating age-related co-morbidities rather than a symptomatic androgen deficiency state.” [3]

Assuming these studies are correct and the T/DHT ratio and the absolute level of DHT remain constant in healthy middle-aged and senior men, one appears to have Mother Nature on his side if he wants beefy DHT numbers.  Yet another argument for this standpoint is the fact that so few men on HRT have issues with an enlarged prostate.  When a man goes on testosterone therapy, his testosterone will ramp up (if the physician knew what he/she was doing) and DHT will go up correspondingly.  This causes a small but measureable increase in prostate volume normally.  I can say that, of all the men that have gone on HRT on Peak Testosterone Forum, not one of them has complained of BPH that I remember. (It does happen from time to time though, so “eyes wide open.”)

COMMENT: As you can see, there is tremendous variance in philosophy as far as treatment and safety when it comes to DHT.  How can you decide, then, what ideal target DHT levels are?  Unfortunately, there are no DHT-mortality studies and very minimal research on DHT and cardiovascular / arterial health.  Your crystal ball is probably just as polished as anyone else’s at this point, and that means, at least at this time, you are going to have to do your own research and hopefully find a knowledgeable physician to provide their best guess.

Pulling DHT is not as common on the forum, because it is a fairly expensive test – closer to $100 than not. (In the U.S. you can now pull total testosterone for less than $30 for example.) However, a few guys have pulled it and DHT can help diagnose low libido in many cases – it’s definitely worth looking at.   However, it is not perfect of course as libido is complicated. We had a man on HRT who have boosted his DHT above midrange and yet his libido really struggled. [5] He believed it was due to unmanaged estradiol and that is certainly a possibility.  High prolactin can also lower libido, but that will generally drive down testosterone and, therefore, DHT simultaneously.  And anything that negatively impact the brain and neurotransmitters can do the same from recreational drugs to pharmaceuticals to poor lifestyle choices, sleep disorders, nutritional deficiencies, etc.

That said, DHT is one of the stronger predictors of libido, especially when it is low as this man described:

“The trick, of course, is to find a “normal” doc who’ll prescribe anything unless you have extremely low T levels. My last few blood tests had me between 335-375 ng/dl, my libido was seriously diminished, and I was suffering noticeable mental fog and lack of concentration..” [4]

What was his DHT at the time?  It was 27 ng/dl within a lab range of 16-79, i.e. near the bottom.

How I Do a Low Fat Diet - Peak Testosterone

I get asked every so often how I implement a low fat diet.  This isn’t something I really discuss often, because my diet is so spartan and countercultural.  Besides, there are many great low fat books out there with great recipes.  Cooking is deifnitely my forte and,I basically, I eat to minimize prep time.   I enjoy what I eat, but for me it’s much more chemistry than culinary. Notably missing from my standard diet are little things like a) cooking and b) foods that are socially acceptable.  The latter simply does not matter me to any more. For all these reasons, you may not find my diet very practical.  But for those not faint of heart, you can check out how I eat below and it may give you some ideas at least.

Let me mention some strong points of my diet that may not be readily apparent:

a) Low Fat Paleo. I consider my diet very Paleo  and would term it “Low Fat Paleo”.  I rarely consume wheat, for example, and the primary “grain” that I eat is quinoa, which is not really a true grain. I also eat fish (BPA-free, low mercury sardines) almost every day and rarely have dairy or soy.

b) Good Fats. One of the big problems that plant-based folks often have is horrendous omega-6 to omega-3 ratios. Mine is stellar and right around 1:1.

c) Just Pretty Low Fat. I do not go super low with the fat levels and am in the 15-20% range (as a percentage of total fat).  I believe this is important to displace some carbohydrates and increase nutrient absorption.  It is the recommendation in the Pritikin Edge as well.

d) 90% Plant. I believe that the sweet spot for diets is 90% Plant / 10% Animal.  The ultraelite supercultures (Hunza, Abkhasians, Tarahumara, Vilcabambans) eat roughly this way and they enjoy not only incredible longevity but a life without heart disease, cancer or autoimmune disorders.

SUCCESSES:  Here are some goals that I have achieved while consuming a low fat diet that I think are noteworthy:

a) Heart Scan of Zero. About a year ago, I had a heart scan and they found zero cardiac artery plaque.  That’s pretty good for a guy in low mid 50’s in a Western Culture.  This is good for erections and should greatly improve my chances of traditional heart disease, assuming I can maintain it.

b) A1C. My latest A1C was 5.2.  While not stellar, this is a pretty respectable number for a guy eating a solid amount of carbohydrates.

c) Hypertrophy. I am a skinny bastard, but I have 20+ more pounds of muscle than I did in college with almost exactly the same amount of body fat.

d) Excellent Triglycerides, LDL-C and apoB. For example, in 9/4/2014 I pulled the standard lipids and had cholesterol of 121, triglycerides of 98 and LDL of 76.  My apoB was 68 mg/dl, which is a very respectable number.  I’d like to get the triglycerides and apoB down about 10% more, but the point is that diet alone can get you very close to plaque regression levels.

CONCERNS:  Here are a few things that I need to work on:

a) Occasional Prehypertension. When I go to a doctor’s appointment, I will at time get a reading that is about 128/86.  This could be a side effect from TRT or from overwork.  I can only say, “Working on it.”

b) High PSA. I had a high PSA read and actually had to have a biopsy.  They found (in a biopsy) no cancer and inflammation, so so far so good.

RDA’s: Although not perfect, my RDA totals are very good.  I eat pumpkin seeds, which are high in zinc and magnesium, and consume nutritional yeast, which is high in the B vitamins, areas where plant-based men can come out a little low:

Yes, selenium is a little low, but I actually take it in supplement form to make sure I get enough. Iron is a little high, but I am consuming almost entirely non-heme, so I believe I will be okay there. Niacin is also a little low, but I haven’t worked on that yet. Note that sodium is not actually low, as I get ample amounts from my pumpkin seeds which have salt.

FOODS:  I guess I should also include the actual foods that I eat!  Here they are:

HOW I EAT – THE MECHANICS:  As I mentioned, my diet is designed around minimum prep time and fast but nutritious meals.  Basically, I do the following:

Note that for sauces I will use low fat ones that I find at Trader Joe’s.  This includes various salsas, salad dressings,  etc.  This adds some “spice” to eating the same thing virtually every meal.  I will sometimes substitute brown rice or millet in place of the quinoa.

MACRONUTRIENT LEVELS: I exercise about an hour a day and, therefore, need a good supply of carbs in my opinion.  My goal is a carb-to-protein ratio less than 2:1, which this diet achieves.  In addition, as mentioned above, I was targetting fat levels at 15-20% of total calories.  You’ll also notice that I consume a fair amount of protein for hypertrophy (muscle building) purposes:

Everyone is obsessed with saturated fat for reasons that escape me. I consume about 4 grams per day. Saturated fat servers no useful purpose and lowers nitric oxide levels. So I avoid it.

TOTAL CALORIES: All the above numbers are based on a diet of 2,000 calories.. However, I have some buffer, where I can eat some additional calories – around 300 – from fruit, etc.. Therefore, my actual calories levels are around 2,300 per day.  This is probably low for some of you men out there that are very athletic, doing endurance sports or just young with a high metabolism.

OTHER PAGES OF INTEREST:

My Heart Scan Results

A Review of the Pritikin Edge

HDL, LDL and Triglcyeride Targets to Regress Arterial Plaque

ApoB Levels to Regress Plaque

Why (Non-Wheat) Grains are Perfectly Paleo

Exercise: How It Powerfully Fights Arterial Plaque .

But what does this really prove?  Perhaps you can regress plaque without exercise, but why not turbocharge your plaque reversal? As I’ll show below, the arterial benefits of exercise are overwhelming.  It’s not something to put on the backburner while you’re cleaning up your diet:  it’s something to do right now to radically improve your cardiovascular health.

In fact, I believe that it will be much more difficult for the typical modern, urban dweller to control his atherosclerosis without exercise.  Yes, diet is #1, but in my opinion, it generally needs its partner, exercise, in order to reach the finish line for many reasons I will outline below And, as an added benefit, exercise will protect and boost your sex life in dozens of key ways, something I document in my page on Sex and Exercise in considerable detail.

So let’s go over the Eight Compelling Reasons that Exercise Can Help Regress Atheroslcerosis (Arterial Plaque) from the research:

NOTES: One study showed that intense exercise did not lead to increased nitric oxide levels, because it created a heavy oxidative (free radical) load.  Nor did mild exercise, because it just did not stimulate nitric oxide sufficiently.  However, moderate exercise had a powerful nitric oxide-boosting effect and thus may be the best way to boost NO levels post-exericse.  Again, see the page above for more information.  NOTE: My favorite form of exericse is weight lifiting.  However, I have to admit that it may not be the best exercise for arteries.  In fact, there is some evidence that a certain percentage of men experience “stunned”, hardened arteries post-exercise.  See my page on Weight Lifting and Your Arteries for more information.  This is why I always do some cardio after lifting weights.

2. Lowered Blood Presure. Exercise has a powerful, positive effect on blood pressure and just walking alone has been shown in several studies to decrease systolic blood pressure between 10 and about 13.5 mm. [1] This is as powerful as many medications.  High blood pressure is a huge risk factor for erectile dysfunction, stroke and atherosclerosis and so this is a no-brainer.  Also, in my page on Walking and Blood Pressure, I discuss a study that found that walking actually lowered blood pressure more than running. Again, this is probably because of the factor I mentioned above in #1, where moderate exercise trumps both mild and intense exercise when it comes to nitric oxide responsiveness.

By the way, high blood pressure probably is a sign of underlying conditions that cause atherosclerosis, particularly prediabetes / Metabolic Syndrome, and also causative of atherosclerosis.  Obviously, increased pressure on arterial walls can lead to slight increases in damage that accumulate over the months and years.

4. Reduced Oxidation of LDL. What is the most important LDL-related factor leading to atherosclerosis?  The research to date indicates that the sheer concentration of LDL particles in the blood is the most important factor.  However, another important factor is how much of that LDL is oxidized.  Studies show that exercise can reduce oxidized LDL in the 20 to 25% range. [2][3]

5. Increased eNOS Efficiency. Endothelial Nitric Oxide Synthase (eNOS) is the enzyme involved in your arterial nitric oxide production.  Exercise upgrades its “efficiency,” i.e. it will increase nitric oxide produced from this pathway. [4]

6. Decreased Inflammation. Many of you know that certain inflammatory markers, such as IL-6 and CRP, are predictive of atherosclerosis as well as many other chronic diseases.  Several studies have shown that exercise cna decrease levels of these and other inflammatory cytokines. [5] NOTE: One study showed that weight lifting did not lower these markers.

7. Stabilization of Plaques. A couple of animal studies show that long term exercise stabilizes plaque. It is “unstable” plaque that is so deadly. [6] It can rupture, ,which then forms a “clot” that can lead to a stroke or heart attack.

8. Improvements in Lipids. We all know the standard lipid test that includes HDL, LDL and triglycerdies.  These are still often on many annual physicals and you can pull these numbers here in the U.S. for around $20 to $25 at one of these inexpensive laboratories:  Testosterone Labs.

a) Triglyceride Reduction.  I discuss on my page How to Lower Your Triglycerides different exercising strategies that can lower baseline and post-meal triglycerides levels by about 20-25%. Exercise – and that includes weight lifting for you fellow gym rats out there – can do nice job on your triglycerides.

b) Raising HDL.  Endurance exercise (cardio) now has many studies showing it improves HDL between about 5 and 20%.  The study mentioned above describing how exercise reduces oxidized LDL also showed an increase in HDL of 15%. [2] Note that HIIT also improves HDL.

CONCLUSION:  As you can see, exercise is the perfect complement to any anti-plaque diet.. A notable example of this is Nathan Pritikin who had extensive cardiovascular disease in the first part of his life and reversed it with a low fat diet and exercise.  He ran from what I have read for an hour per day and died with perfect clear arteries.  The coroner certified that his arteries were plaque-free. His goal was imitate some of the healthiest and long-lived cultures on the planet, such as the famed Tarahumara.  The Tarahumara, who are probably the healthiest people on the planet:   I cover their diet in my page on The Diet of the Tarahumara.

1)  https://www.peaktestosterone.com/Walking_Blood_Pressure

2) Medicine and Science in Sports and Exercise, 1998, 30(10):1496-1501, “Reduced oxidized LDL levels after a 10-month exercise program.”

3) International Journal of Sports Medicine, 2005, 26(6):420-425, “Acute prolonged exercise reduces moderately oxidized LDL in healthy men”

4) Circulation, 2003, 107:3152-3158″Regular Physical Activity Improves Endothelial Function in Patients With Coronary Artery Disease by Increasing Phosphorylation of Endothelial Nitric Oxide Synthase”

5) Brain, Behavior, and Immunity, May 2006, 20(3):201 209, “Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of -blockers, BMI, and psychosocial factors in older adults”

6) Med Sci Sports Exerc, 2009 Dec, 41(12):2128-35, “Long-term exercise stabilizes atherosclerotic plaque in ApoE knockout mice”

IGF-1: How to Lower It - Peak Testosterone

I recently pulled my IGF-1 (6/2014) from Life Extension Foundation and found that my levels were 175 ng/ml, which was within the lab range of 61-200 ng/ml for my age. (Kudos to Life Extension Foundation and other similar organizations for providing preventative care testing that you’ll never get through regular doctors or health insurance!)  Now I lift weights and anyone into strength and/or trying to build muscle knows that IGF-1 is good for hypertrophy, i.e. building muscle.  So was I happy to be at the top of the range in IGF-1, right? My answer actually is just the opposite:  it concerned me a great deal to be that high in IGF-1.

My answer probably made some of you cringe, but I ask the question:  how many of you would want high insulin?  Well, you should, right?  After all, insulin is incredibly anabolic.  But, unfortunately, high insulin levels in your middle and senior years will get you killed and I’m 54, so I don’t want high insulin either.  In any event, this same kind of misguided logic applies to IGF-1:  while it is true IGF-1 builds muscle, it also accelerates cancer and causes you to lose your insulin/glucose control.

Now on this page, I am not going to go into why you want to lower IGF-1 if you’re over 40 – I will do that on a subsequent page – but let me give you a teaser:

Laron Syndrome. People with Laron Syndrome have a genetic abnormality where they are insensitive to HGH.(human growth hormone).  This dramatically lowers their IGF-1 levels and so they all die a painful and early death, right?  Wrong!  They actually become completely impervious to cancer and diabetes. [1] Yes, these people are superhuman, because it turns out that losing most of your IGF-1 is a fantasy.  Of course, it is probably better if it occurs post-puberty, because those with Laron Syndrome are very short. But imagine living in a world where you do not have to worry about dying a gruesome death from cancer.  Such is the world of Laron Syndrome individuals and there have many more health advantages as well:  it  also looks like lowering IGF-1 is stackin up to be one of the Holy Grails of anti-aging for example.

2. Switch to Plant Protein. Anything you can do to lower methionine levels will lower IGF-1 and, as I mentioned above, plant proteins have lower levels of methionine.  I just looked at my containers and my rice, hemp and yeast powders all have about 300 mg per serving.

This isn’t that big of a change for me, because I was a 95% plant guy anyway.  And so I am not sure how much good this will do me.  However, some of your reading this could probably significantly lower your IGF-1 with this strategy.  In my case, I was eating BPA-free sardines three times a week and whey protein on the animal side of the dietary world and that’s it.  (Whey protein should not be an issue, but, to play it safe, I cut it out too.)

Note that I still get quite a bit of methionine.  My rough back-of-the-envelope calculation for how much methionine I consume each day is about 3 grams.  Of course, that’s going to be about double what I would get if I implemented a low protein diet, so it’s no wonder my IGF-1 is on the high side of the range.

3.  Glycine. There is preliminary evidence that supplemental glycine can lower IGF-1 by acclerating the liver clearance of methionine.  A recent study on rats showed the same life span extensions by giving them extra glycine as researchers saw with methionine restriction. [2] Now the researchers gave these animals rather large doses of glycine, something I would not feel comfortable with.  But I can see myself taking a few grams of extra glycine each day to help tilt my glycine-to-methionine ratio even more favorably.  And all of this is good news, because glycine is readily available as a supplement.  Furthermore, a couple of studies show that taking 3 grams of glycine before bed improves sleep. [3]

There is another more “natural” way to do this as well:  increase my intake of plant protein powders with higher levels of glycine.  Rice, hemp and yeast have 400, 600 and 800 mg/serving per serving according to my containers.  (The total grams of protein per serving are 12, 15 and 13, respectively.)  So, obviously, if I emphasize hemp and yeast, I will boost my glycine consumption.  This is good, anyway, because rice is so often tainted with traces of arsenic.

NOTE:  I prefer Undenatured Proteins, but I can’t help but point out that Pea Protein has very low levels (200 mg) of methionine per serving. And, what is more remarkable, is that lysine is 800 mg for the same serving. This gives pea protein an unprecedented 4:1 ratio of glycine to methionine.  (One serving is 20 grams of total protein and pea protein will likely lower your blood pressure as well!

CAUTION: Always check with your doctor before taking any new supplement.  In addition, keep in mind that there are no studies showing risks from taking extra glycine.  Consider this my personal experiment.

4. Intermittent Fasting (Time-Restricted Feeding). IGF-1 is just what its name implies:  a growth factor.  However, your body has a complementary “system” or mode for recovery.  When your body interprets that it’s time for recuperation, it will actually lower IGF-1 and other growth factors in order to rebuild and heal itself.  And this is exactly what happens when you cut calories or restrict food.  The body goes into a state of conservation.

Now it’s well-known that intermittent fasting can lower IGF-1, but there are very few studies on the subject.  Because of this, many lay people are simply doing it on their own and tracking their IGF-1 and other health paremeters.  One of the fairly popular strategies is called 5:2 and involves eating normally five days followed by two days of 600 calories. There are many reports of IGF-1 dropping on this kind of protocol.

One of the techniques used in the animals studies is an 8 hour “feeding window,” after which no food is allowed.  This technique may lower IGF-1 levels as well.

Unfortunately, there is very little hard info out there and very little published research.  Therefore, one has to just try one of the intermittent fasting techniques and see what it does to one IGF-1 levels.  I plan on probably trying an 8 or 10 hour daily window method, because I cannot afford to lose much weight.  I can eat as much as I need to in those 8 or 10 hours hopefully and then “fast” for the 14 to 16 hours.  And I feel I need a method that may trick my body into lowering IGF-1 without weight loss.

6. Folate. Some study work shows that the higher your folate levels, the lower your IGF-1. [5] However, supplementing with folic acid is unwise in my opinion, because some research shows that it can increase cancer risk.  Admittedly, this is controversial, but folate is involved with DNA replication and repair and so potentially it could cause issues. But the bottom line is that you definitely want to make sure that your diet is adequate in folate and that you do not have any digestive issues that could interfere with absorption of nutrients.

7. Resveratrol. This high profile anti-aging supplement has some research showing that it can lower IGF-1 levels. [6] However, I shy away from it because of a recent animal study that showed that initially resveratrol lowered prostate cancer and then later increased it.  You can find the study in my page called A Prostate Cancer Cure?

CAUTION: Interestingly enough, a couple of the pro-inflammatory cytokines, such as IL-6, suppress IGF-1.  So you can have the curious where one has high inflammatory promoters and yet low IGF-1.  So who wins?  Well, recent study work has shown that higher IL-6 and lower IGF-1 is a risk factor for Metabolic Syndrome, or prediabets along with all the nasty health conditions it entails. One summary stated that “IGF-1 has anti-inflammatory effects and decreases expression of proinflammatory cytokines such as interleukin-6 (IL-6). There is also evidence in animal models that IL-6 decreases circulating IGF-1 levels.” [7]

REFERENCES:

1)  Sci Transl Med, Feb 16 2011, 3(70), “Growth Hormone Receptor Deficiency Is Associated with a Major Reduction in Pro-Aging Signaling, Cancer, and Diabetes in Humans”

2) The FASEB Journal, 2011m, 25:528.2, “Dietary glycine supplementation mimics lifespan extension by dietary methionine restriction in Fisher 344 rats”

3) Sleep and Biological Rhythms, Apr 2007, 5(2):126 131, April 2007″Glycine ingestion improves subjective sleep quality in human volunteers, correlating with polysomnographic changes”

4) Cancer Prev Res, May 2011, 4:702, “Effects of Tomato- and Soy-Rich Diets on the IGF-I Hormonal Network: A Crossover Study of Postmenopausal Women at High Risk for Breast Cancer”

5) Growth Horm IGF Res, 2013 Dec, 23(6):267-71, “Association between dietary folate intake and serum insulin-like growth factor-1 levels in healthy old women”

6) Nature, 16 November 2006, 444:337-342, “Resveratrol improves health and survival of mice on a high-calorie diet”

7) Diabetes Care, Sep 2008, 31(9):1886 1888, “Reciprocal Association of Plasma IGF-1 and Interleukin-6 Levels With Cardiometabolic Risk Factors in Nondiabetic Subjects”

I should also jump in and point out that this issue is personal for me:  I had a high PSA reading (6.3) late in 2013 and they pulled me off of HRT.  Yes, that was painful! They then performed a prostate biopsy and left me hanging for 10 days around Christmas waiting for the results – not fun.  The good news was that the biopsy revealed no cancer and showed inflammation, so that is probably the root cause of the high PSA.  But it is certainly possible I have some prostate cancer, and so I am doing everything in my power to protect myself and so should anyone reading this over the age of 40 in my opinion.  Well, actually, you should measure your IGF-1 and see if you are low already of course.  But I am on the high side and so want to lower it through natural means.

CAUTION:  If you are low or high in IGF-1, discuss with your doctor.  There can be medical reasons for being out of range.

Below are some of the Ways to Lower IGF-1 Naturally according to the research.  I have recently implemented some of these and will report back with successes and failures.  IGF-1 is not the cheapest lab in the world and so it’s not something I will be pulling every week though.

1. Decrease Protein.  Before I go on, let me say that I have NOT implemented this strategy yet and hope not to. However, I think you read this one, because the underlying principles are important, even though I believe I have discovered a way around it. The fact is, though, that many studies have shown that simply decreasing protein will lower IGF-1 and lower it significantly. So, if you’re not an athlete or trying to build muscle, then this is a no brainer in my opinion.  Simply drop your protein down to as low as you can do and meet the daily requirements and you should see your IGF-1 levels fall.  As an illustration of this, let me relate a story from the health world:

Those of you well-read in health matters will remember that Caloric Restriction (CR or CRON) has been in the forefront of anti-aging strategies for decades, which basically means eating less.  It increases maximum life span in many animal species and one of its keys is that it lowers IGF-1.  However, it did not work in a human study which was baffling to researchers.  However, they figured out the underlying issue:  in primates IGF-1 levels do not fall if you cut calories and still consume significant animal protein.  Later they found that IGF-1 levels fall significantly if you simply cut out animal protein.  (Dr. Greger has a great set of videos on the subject.)

So why do animal proteins uniquely raise IGF-1 levels?  The reason is that most animal proteins – whey is the exception – have a high amount of the sulfur-containing amino acid methionine.  Researchers have found in animal studies that they can extend maximum life span simply by restricting methionine for this reason, a further verifiction that IGF-1 is one of the roots of all aging.  For those of you buying plant protein powders, look at your container:  you’ll find that a serving has about 300 mg of methionine, a relatively low amount compared to meats and eggs for example.

Now I am trying with all my power to resist this option and have not implemented it.  I want to build muscle – aren’t we all chasing Dr. Life? – over the years and I’m not going to do it with a meager amount of protein.  So I am still consuming 1 gram per pound of body weight, which for me is around 160 grams.  I’ll explain my strategy for doing that below.

Vaginal Dryness and Prescription Medications - Peaktestosterone

Americans, and a lot of Western societies, like their drugs. Well, this is a tragic mistake in most cases as drugs generally cause more problems than they solve.  This is particular true in the bedroom and we have covered this topic in my page on Erectile Dysfunction and Drugs.

Unfortunately, this is not just an issue that plagues males only:  the sex life of females is often disturbed by pharmaceuticals as well.  In my link on Female Libido and Hormones, I discuss various drugs that can effect female libido negatively and here I want to discuss another frequent drug-induced issue for women:  vaginal dryness.

Vaginal dryness, like a fire in a concert hall, can destroy even your most magnificent performance. Even “mild” vaginal dryness can result in irritation and infections leading a woman to sour on the idea of diving under the covers.  Furthermore, it can create a vicious cycle, because the slowdown in sexual activity actually can contribute to increased vaginal dryness and, in addition, the stress and negative feelings often worsen a woman’s natural lubrication as well.

Let’s start with antihistamines.  Most guys don’t realize that the drying properties of antihistamines can make or even initiate prostatitis and, in still other cases, lower erectile strength as well.  Likewise, most woman do not realize the same holds true for the walls of the vagina.  These drugs can dry up much more than your sinuses!

Similarly, antidepressants, which often cause erectile issues in males, can also lead to lack of vaginal lubrication. Obviously, if you were fighting depression, it isn’t going to help you if your medication is sabotaging your sex life as well.  Tranquilizers and sedatives are also similar.  Finally, the same “sin” drugs that cause males erectile issues, such as narcotics, alcohol and nicotine (smoking), can also result in lack of lubrication for a woman as well.

Yes, this is just one more example as to how drugs can sabotage all your hard work in the bedroom.  The solution?  In most cases, you can solve the issue with a good lubricant.  See our article on the Best and Most Nutural Lubricants for Intercourse for more information.

How To Take Vitamin C - Peak Testosterone

How To Take Vitamin CThere are lots of men on The Peak Testosterone Forum that are megadosing Vitamin C, and I’m one of them for the reasons I outline here: https://www.peaktestosterone.com/why_take_vitamin_c That said, I cannot emphasize enough that, in general, megadosing on antioxidants is very unwise due to some rather horrifying issues uncovered in recent research: The Dangers of Megadosed Antioxidants.

But let’s say, like me, you’ve drunk the koolaid and believe that Vitamin C is the one antioxidant that we can and should be megadosing, then here are 3 Critical Ways to Take Vitamin C To Hopefully Keep From Hurting Yourself:

1.  Buffered on an Empty Stomach. I don’t believe anyone takes straight ascorbic acid any more, but just in case: they now have great buffered forms such as this:  Ester-C Vitamin C that are gentle on the stomach and very absorbable.  And, if you want the turbocharged version, consider liposomal Vitamin C.

Why is it so important to take on an empty stomach?  The reason is that Vitamin C can increase iron absorption.  This is potentially dangerous and could increase ferritin and body iron stores, something that has been linked (on the high end) to various types of chronic disease.  If you ask me, it’s better to play it safe and take it with no food in your stomach – and Ester-C should not upset your stomach.

2. 500 mg 2-3 Times Per Day.  In my opinion Vitamin C is best taken several times during the day. The reason for this is simply to make sure that plasma levels stay high as this can improve nitric oxide levels in your arteries and potentially collagen formation and artery protection.  The NO increase is not huge with Vitamin C alone but every little bit helps, eh?  It should also be noted that, if you combine Vitamin C and garlic, you can get a HUGE synergistic effect on nitric oxide, something I discuss in my page on Garlic and Erectile Dysfunction. In fact, this strategy boosts nitric oxide so much that I believe you have to be careful using it. (You don’t want to increase inducible nitric oxide in the process.)

By the way, you will still often read that, if you take more than 200 mg/day of Vitamin C, it does not significantly raise plasma levels and so it is a waste of time and money.  This was completely disproven by the research here: Liposomal Vitamin C, where the authors showed that Liposomal Vitamin C could greatly increase plasma levels beyond the 200 mg per day “saturation point” and, furthermore, that long time megadosers have plasma levels that are significantly higher due to tissue reabsorption. In the case of the latter, Vitamin C is stored in tissues and released later.

3. Never With Fat In Your Stomach.  If you do consume Vitamin C at or near meal time, then realize that there is a study out there showing that, if the contents of your stomach contains over 10% fat, then Vitamin C could increase nitrosamine formation.  What are nitrosamines?  Basically, these are carcinogenic chemicals that exist, for example, in certain types of processed meats.

REFERENCES:

1) https://www.longecity.org/forum/topic/50037-vitamin-c-saturation/

Check Out These Manly Drinks! - Peak Testosterone

Okay, I love the taste of beer as much as the next guy.  But let’s start with a simple fact that I cover in my link on Beer and Your Hormones: beer lowers testosterone and raises estrogen (estradiol).  Period. When I found that out, I started looking for some other beverages that were actually going to help me in the bedroom and improve my long term health as a male.

Let’s say it’s Friday night and I’m looking for a little amore. Wouldn’t I want to pull out a drink that is going to boost my nitric oxide levels and improve blood flow without negatively impacting my T and E2? That would be Viagra-in-a-bottle, would it not? Well, such drinks exist, but most men just do not know about them and so instead they pull out a hormone-hammering beer instead.

Below I am going to show you Five Blow Flow Boosting Beverages and, yes, you’ll thank me later:

1) Black Tea. Black tea has a great property: the more you drink, the more your blood pressure lowers according to the studies. [1] Yes, this means that the more you drink, the greater the blood flow, and more truly pumped you will be.  Now you don’t want to go crazy with black tea because of the tannins, which can reduce mineral absorption, and fluoride, which can be hard on the brain if too much is consumed.

2) Raw Unprocessed Cocoa.  Raw cocoa is one of the best drinks to turbocharge your sex life.  However, as with some other things, it tastes pretty nasty in its raw form. I cover this in my link on The Power of Raw Cocoa Powder. Many studies have shown the power of the flavonoids in raw cocal, but look at what just one researcher wrote:

1) J Hypertens, 2009 Apr, 27(4):774-81, “Black tea consumption dose-dependently improves flow-mediated dilation in healthy males”

2) Journal of Hypertension, Dec 2003, 21(12):2281-2286, “Flavanol-rich cocoa induces nitric-oxide-dependent vasodilation in healthy humans”

3) https://www.peaktestosterone.com/forum/index.php?topic=63.msg107#msg107

“Cocoa can contain extraordinary concentrations of flavanols, a flavonoid subclass shown to activate nitric oxide synthase in vitro…Four days of flavanol-rich cocoa induced consistent and striking peripheral vasodilation.”  [2]

NEWS FLASH AND WARNING:  Consumer Labs recently found that many of the raw and retail cocoa powders are very high in cadmium. This was extremely disappointing to me as I found that the cocoa I had been consuming in order to improve my health was high in this very toxic heavy metal. Until the industry cleans up its act, I am putting cocoa purchases on hold myself. Consumer Labs has a few cocoas they do recommend, so you may want to read their analysis.

Now this is what I call a manly drink. Vasodilation means, of course, that it opens up your arteries, allowing more blood flow.  And this will mean more blood flow everywhere, including your brain, muscles and even penis.  Hard to beat that, eh?

You do have to watch out for one thing though:  the standard cocoa powder that you buy in the stores is NOT “flavonol rich”.  The reason?  Consumer and food product companies do to cocoa what they do best:  they boil the crap out of it until it is unrecognizeable and loses all of its health properties.  They do this to improve the taste and it works and make you happy.

3) Beetroot Juice. Researchers are all over beets and the reason is simple:  they are probably the highest nitrate-containing food readily available.  Recently, researchers have discovered that beets boost nitric oxide, lower various cardiovascular risk parameters and improve athletic performance.  Many elite and Olympic athletes are now using beet formulations before competition.  And you can use beets before your big event for increased performance if you know what I mean.

What makes high nitrate foods so special?  It turns out that they bypass the normal arginine cycle that boosts nitric oxide in healthy males.  The problem is that most of us are not healthy males:  we have significant arteriosclerosis, making it difficult for our arteries to pump out precious nitric oxide.  This leaves many of us struggling to achieve even low levels of nitric oxide.  Beets and other high nitrate foods are a dream-come-true for us and I cover this in my link on A Review of Beet the Odds. See also my link on The Power of Beetroot Juice. Get your beets for a few days and you will very likely notice a nice improvement in hardness factor, refractory period and other erectile parameters.

4) Smoothies with Nitrates. I mention this separately, because it is not just beets that are high nitrate. Many other foods, such as spinach, lettuce and celery have substantial nitrate content as well. You may have dissed your wife’s salad, not realizing that it packed with nitric oxide boosting nitrates.  Many men on the Peak Testosterone Forum have commented on the remarkable ability that daily Smoothies have on their sexual and general health. Try to go organic if you can and make this a part of your daily routine.

5) Pomegranate Juice. This powerhouse lowers just about every heart disease risk factor that you can think of. But it’s not just long term cardiovascular issues that it protects you from: it has same day coverage as well, boosting nitric oxide and blood flow right away. This juice is so powerful that one study shows that it can clear out arterial plaque in some men. Imagine a drink that cleans out your artieries while you’re busy doing more important things, oh Weekend Warrior. Manly, yes, and you can read more about it in my link on https://www.peaktestosterone.com/pomegranate.

One forum member attributed getting his morning erections back primarily to drinking smoothies twice a day. [3] He said he got the equivalent of eight servings of fruits and vegetables by doing this. “About a month and a half ago I started drinking about a quart of green smoothie every day. About 1/3 to 1/2 fruit (berries, apple, banana, peaches – whatever), a little juice, and the rest greens (kale, romaine, spinach, chard, broccoli – whatever).” Not bad for just a few minutes of work, eh?

And, most importantly, give it your woman also!  It will pump up her nitric oxide, and, yes, her sexual health and general health is very dependent on nitric oxide just like you, something I discuss in my link on Female Libido and Viagra.

There are many other Manly Drinks (and foods) that can help you in a similar manner, but it is too lengthy to cover in one web page. I have place these in my book https://www.peaktestosterone.com/ for those interested. The important thing is to get started: put down the beer and pick up something that is really going to help you.

Coffee: Ten Reasons to Drink The Stuff - Peak Testosterone

I have good news for a lot of you out there:  coffee is not just good for you, it’s great for you.  In fact, it’s not too much of a stretch to call it a legitimate anti-aging tonic according to the latest research. Think that’s an exagerration?  Well, ready below and judge for yourself.

So, yes, there is such a thing as a healthy addiction.  Dark Chocolate  and green tea are other examples.  Marijuana, smoking and fast food are all addictions that will kill you, but coffee according to the latest research is a true friend.  And let’s face it:  it’s hard to find a healthy friendship that will last through the decades.

1.   All Cause and Cardiovascular Mortality. Coffee is one of those rare factors that can actually reduce your risk of dying.  The reason:  it is close to neutral or maybe slightly positive with regards to cancers deaths but significantly reduces cardiovascular death rates.  For example, a 2008 study followed over a 100,000 men and women for 18 years and found a clear dose dependent decrease in all cause (overall) and cardiovascular mortality. [1] Remember:  dose dependence is the gold standard of such studies and adds more weight to the evidence, because it meant that the more coffee that was consumed the less the risk of dying.  Previous studies had found the same thing by the way.  NOTE:  Decaf coffee showed the same results but to a lesser degree. [1]

2.  Cancer Reduction. The mortality studies mentioned above do not show significant overall cancer reduction among coffee drinkers.  However, coffee does appear to decrease the risk of certain specific types of cancer, including cancer of the colon, kidney and non-melanoma skin. [2]  Still other studies have shown that coffee offers signficant protection against prostate cancer, especially the most agressive kind. [3] And, interestingly enough, the same benefits were found for decaffeinated coffee, indicating the results came from coffee’s phytochemicals and not the caffeine itself.

REFERENCES:

1) Annals of Internal Medicine, June 17, 2008, 148(12):904-914, “The Relationship of Coffee Consumption with Mortality”

2) J Natl Cancer Inst, 1986 May, 76(5):823-31, “Coffee drinking, mortality, and cancer incidence: results from a Norwegian prospective study”

3) https://www.medicinenet.com/script/main/notfoundstatic.asp

4) The Lancet, 22 February 2003 , 361(9358):702 – 703, “Coffee consumption and risk of type 2 diabetes mellitus”

5) American Journal of Clinical Nutrition, October 2006, 84(4):682-693, “Coffee, diabetes, and weight control”

6) Journal Journal of Alzheimer’s Disease, 2009, 16(1), “Midlife Coffee and Tea Drinking and the Risk of Late-Life Dementia: A Population-Based CAIDE Study”

7) Am J Clin Nutr, 2009, 90(3):640-646, “Coffee drinking in middle age is not associated with cognitive performance in old age”

8) European Journal of Clinical Nutrition, 2007, 61:226 232, “Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study”

9) Neuropsychobiology, 1993, 27(4), “Investigation of the Effects of Coffee on Alertness and Performance during the Day and Night”

10) PSYCHOPHARMACOLOGY, 110(1-2):45-52, “Does caffeine intake enhance absolute levels of cognitive performance?”

11) Medicine & Science in Sports and Exercise, Fall 1978, 10(3), “Effects of caffeine ingestion on metabolism and exercise performance”

12) Br J Sports Med, 1992, 26:116-120, “Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running”

13) J Appl Physiol, Sep 1998, 85(3):883-889, “Metabolic and exercise endurance effects of coffee and caffeine ingestion”

14) Journal of Hypertension, Jun 1990, 8(5), “Association between habitual coffee consumption and blood pressure levels”

15) Annals of Neurology, Sep 2002, 52(3):276-284, “A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson’s disease”

16) JAMA, 2000, 283:2674-2679, “Association of Coffee and Caffeine Intake With the Risk of Parkinson Disease”

17) https://esciencenews.com/articles/2011/05/17/ coffee.may.reduce.risk.lethal.prostate.cancer.men

3) Diabetes. Another mystery of coffee consumption is the fact that it seems to, in the short term, negatively affect glucose metabolism and insulin sensitivity yet very significantly reduces the risk of diabetes according to multiple studies. In fact, those who drank seven or more cups per day had only one half the risk. [4]

4) Weight Loss and Weight Maintenance.  Coffee, both through caffeine and some of its consituent ingredient, has been shown to help keep those pounds off. [5]

5)  Dementia and Alzheimer’s Reduction. Several studies have shown that coffee reduces the risk of dementia and Alzheimer’s, unlike tea. [6]  3-5 cups/day confers optimal protection according to one study.  In fairness, one study did not find such a reduction. [7]  However, the reason is likely the dose as yet another study found that too much coffee resulted in a loss in cognitive gains. [8]  Again, right around 3 cups appears to be the sweet spot.

6)  Alertness and Mental Performance. It’s no secret that coffee boosts your mental sharpness, endurance and acuity.  The studies show alertness and mental performance are enhanced with coffee consumption. [9]  It may not turn you into Einstein, but it can give you a decided edge.  One study found a dose dependent response where the more coffee that was consumed, the better the cognitive performance. [10]  NOTE:  Decaf coffee did not have nearly the same benefit.

7)  Exercise and Athletic Performance. Coffee boosts lipolysis, the ability of your body to burn fats and rates of nerve impulse transmission. [11]  This means greater endurance and, therefore, performance in most exercise and athletic conditions. One study of middle distance runners showed that it improved overall race time, final stretch run speed and VO2. [12] What else is there, eh? By the way, coffee does this without exclusively relying on caffeine’s epeniphrine-boosting properties.  For example, one study showed that coffee actually dampened the effects of epinephrine. [13]

8) Reduced Blood Pressure. This one has researchers scratching their collective heads.  Some initial studies showed that coffee increased blood pressure and thus the risk of hypertension.  However, follow-up work showed clearly that heavy, “chronic” coffee drinkers actually had lower blood pressure. [14] The threshhold is about 5 cups/day and has the strongest correlation in males.

9) Parkinson’s Disease.  A 2002 meta-analysis shows “strong epidemiological evidence that smokers and coffee drinkers have a lower risk of Parkinson’s disease”.  [15] (This is just about the only disease where smoking is protective.)  The reduction in risk for 3 cups/day is in the range of 25-30%.  A previous study from a few years prior had arrived at the same conclusion. [16]

10) No Fluoride. This is just an apologetic argument to use with your tea-drinking friends.  Green tea is similar to coffee in the sense that it is a caffeinated beverage that strongly reduces the risk of cardiovascular disease, some cancers and all cause mortality.  However, green tea has a big disadvantage:  an abundance of flouride.  Flouride can be hard on the brain and your precious neurons.  Black tea has a lot of flouride and green tea double that.

11. Prostate Cancer.  One recent study found that heavy coffee drinkers, decaf or regular, had a 20% reduction in all kinds of prostate cancer and a 60% reduction in the most aggressive form of prostate cancer. [17]

NOTE:  Tell your woman about the wonders of coffee as well.  Most of the benefits above apply to her as well!

Kombucha: Healing UTI's, Arthritis and Other Health Issues.

One of our senior posters on the Peak Testosterone Forum, Seth, had a life changing experience taking Kombucha and sauerkraut. I’ve read enough of Seth’s posts to know he lives a healthy lifestyle overall, but he was almost cut down by antibiotics.  Of course, antibiotics save tons of lives – been there! – but they also cause a multitude of problems, especially in the gut where they clear out both good and bad bacteria.  Seth experienced a lot of these issues and this is Kombucha’s sweet spot:  gut health.

If you read about Kombucha much, you’ll see that reports abound of its ability to provide the following benefits:

Now, at first glance, the above benefits of Kombucha (and other fermented foods) might seem completely random and likely just the effect of chance. However, those of you who poke around the health world enough notice something immediately: these are all benefits of improved gut health. It’s hard to believe improving the health of your colon could make such a difference to your health, but study after study has shown this and this is one of the more active branches of current health research. The fact is that your interestine is actually a highly sophisticated, finely tuned organ on par with the heart or kidneys or any other organ of your tuning. It controls a multitude of metabolic and immune functions on top of providing you with most of your nutrients!

Of course, gut health is very dependent on your “intestingal bacteria,” i.e. the composition and number of the bacteria living down in that underworld.  Even if you are not experiencing any major issues, I highly recommend that you give my interview with Seth a read:  it’s just fascinating in my opinion just how many health benefits of Kombucha he experienced:

NOTE:  Many of you men have less love making nights, because your woman is plagued by UTI’s (Urininary Tract Infections).  Antibiotics have mixed success in treating these, so you may want to pay particular attention to what Seth wrote below about the subject.  (Do not make any change without discussing withyour doctor first.)

CAUTION:  A small percentage of men have rather serious gut (intestinal) issues and probiotics and fermented foods can cause overgrowth.  Consult with your doctor if appropriate.

Q1. You mentioned that you were on a lot of antibiotics and that these gave you UTIs and poor colon health? Can you give us a little history?

I have BPH which was causing urinary retention. Even with this the doctors were baffled at the amount and the veracity of the UTI’s. So I had to go through a whole host of exams including some very invasive ones. Turns out it was only urinary retention and not that much urine. Their only solution is antibiotics.

I believe any round of antibiotics will upset your balance of bacteria in your system. I found that after the first rounds of antibiotics I was getting severe heartburn. (I have never had heartburn in my life) and very watery bowel movements which also was a first for me.

Q2. Are you still on the antibiotics?

Currently no but, if I have a UTI, I have to go on them since I go into Urinary Sepsis easily and that could become fatal if left untreated. I haven’t been on antibiotics for 6 or 8 weeks I believe. That is the longest I have been antibiotic free in the last 3 years.

Q3. So you tried probiotics to help with these issues and what results did you achieve?

Yes. At first I tried the pill form with 50 billion active bacteria. These were ok. They slowed down the infections but only by a few weeks. Then I did some research online and I learned that many people were having success with fermented foods, especially Kombucha. I added Kombucha and Sauerkraut along with a multivitamin that contains probiotics. This has slowed down the bad bacteria up to this point that I go months without a UTI. I am hoping I can go at least 4-6 months without one. Two a year is manageable but zero would be the best.

Q4. Did you try any conventional therapies to help with the UTI’s and other antibiotic-related issues? If so, did these help at all?

Yes, I tried the “candida” diet which limits fruits and sugar. This didn’t work. I added back fruits but I don’t eat artificial sugar or sweets. I don’t believe fruits hurt UTI’s. In fact citrus fruits seem to help . I don’t eat dairy so I didn’t need to cut that out.

I also used D-mannose which works great if the bacteria is the E.coli bacteria. 90% of people get the E.coli in UTI. I am not that lucky. Sometimes it’s E.coli (twice in my experience) but other times it’s other bacteria. D-Mannose is ineffective against them.

Q5. You mentioned that fermented foods have really helped you. What fermented foods are you talking about? Can you give a little detail as to how much and how often you eat them?

I take a Fermented Kombucha by Botanica. I take 20 ml a day of this. This brand was recommended by a few people. I also eat a few cups of Sauerkraut a day. On top of this I use a Vitamin C multivitamin that also contains 2 billion CFU. These are called C-Punch by Trophic and it comes in individual pouches. I believe that fermented foods have helped me more than the pill forms.

Q6. How do you know if you are getting “the good stuff?” Are there brands/types, etc. that guys should watch out for?

That is a tough one. The brands I mentioned above seem to be high quality and were recommended to me. I would avoid any Kombucha “Sports” drinks and only buy a fermented pure kombucha from a reputable brand. Of course you can also make your own fermented stuff which isn’t that hard. I have never tried but I know people who have. Most fermented foods should be high quality since they are either fermented or not. It’s the fermentation process that creates the “good stuff”.

CAUTION: A few people have hurt themselves making Kombucha, so it’s probably better to buy your own from a reliable brand.Q7. What did these fermented foods do for your UTI and other symptoms?

They have slowed them down (maybe even stopped them – we’ll see about that). Also, due to the numerous antibiotics that were killing off my good bacteria I was suffering other issues. I suffered from heartburn and bad bowel movements. These occurred, for the first time in my life, after the battery of antibiotics I took. This has been cured with my regiment of probiotics. No more heartburn and good bowel movements.

Q8. How did you get the idea to try fermented foods to treat antibiotic side effects? Did you just stumble onto that?

Actually it was from the “women” online. Men rarely suffer UTI so the women know them better. I stumbled across a few boards where women discuss them and the same recommendations came about: D-Mannose, Uva Ursi (never tried it) and fermented foods. It wasn’t until I had an online chat with a moderator of a soon to be mother’s forum that turned me onto fermented foods. She told me to drop the pills and eat fermented foods especially kombucha. I was skeptical but it couldn’t hurt. I am glad I tried it. It has been a godsend for me not only with UTI but general health. The general consensus is that antibiotics kill both the good and bad bacteria so when you get off them there really is no “natural defense” to the bad bacteria so you end up in a cycle since bad bacteria grows faster than good bacteria. The fermented foods repopulate your stomach so nature can take over. I don’t have the science behind this, but I honestly believe this is what happens.

Q9. Have you read any explanation out there as to why fermented foods might be superior in many cases to probiotics? I know that Paleo theory is that our physiology is used to fermented foods. Is that the gyst of it?

I have no clue and have not read any science behind it. The research in this area is lacking as I have tried to see what is happening. I could only make an educated guess and agree that our physiology is geared towards fermented foods. It’s like taking Vitamin C in fruit form or pill form. Food is always better. Another theory that a lady (she was a naturopath I met online) stated to me about Kombucha is this:

Q10. Any other tips/comments out there for guys that have been on antibiotics, struggling with UTIs, etc.?

For anyone who takes antibiotics for any reason I would strongly suggest you take probiotics in the form of fermented foods. You need to balance your bacteria ASAP and want the good bacteria before the bad bacteria takes over. If you are a man and have UTI you need to find out the cause. It’s rare for men to get them but if you do I would suggest fermented foods ASAP, high doses of Vitamin C (it makes your urine acidic and bacteria doesn’t like that), a lot of water and a very clean diet. Cut out all sweets and sugar (not fruit ) as I have talked to many people who state that eating sweets and sugar laden foods speeds up a UTI infection. I also am very strict with my diet and about 80% of my diet is fruits and vegetables and the rest lean protein. This seems to agree with my body. So far it’s working so I won’t change it. Hopefully I never get a UTI but time will tell. Even if I get one I have at least slowed them down from constant UTI’s to some breathing room in between.

Psychogenic (Psychological) Erectile Dysfunction

Erections are actually quite complex and involve decent function from your cardiovascular, neurological and psychological systems. The psychogenic – the term the medical community prefers for “psychological” – aspect of an erection almost always plays some role in your hardness factor for several critical reasons:

1.  Nerves and Neurotransmitters. It’s no secret that erections are initiated by a nervous system response. Sexual stimulation fires up various neurotransmitters, such as epinephrine, acetylcholine, oxytocin and nitric oxide for starters.  These, in turn, fire up the ol’ neurons and you know the rest of the story.

Thus, any nerve-related issues, such as neuropathy, i.e. “nerve damage”, can be a partial contributor toerectile dysfunction [1].  Diabetics, who often have accelerated neuropathy, can struggle with this in particular. Researchers can even induce an erection in dogs simply by stimulating the perineal nerves directly. [2]

One of the beautiful things about PDE5 Inhibitors, such as Viagra and Cialis, is they actually do not work unless the patient is stimulated visually or by touch in a sexual manner.  This is because the nervous system must first be stimulated which in turn fires by the endothelial nitric oxide response that these drugs are famous for.  And that is a good thing, because otherwise you could get guys getting a spotaneous erection at almost any time of the day!

1) International Journal of Impotence Research, 2002, 14:433-439, “The neuropathy of erectile dysfunction”

2) International Journal of Impotence Research, March 1997, 9(1):11-16, “Perineal nerve stimulation: role in penile erection”

3) J Sex Med, 2007, 4:1117-1125, “Integrated Sildenafil and Cognitive-Behavior Sex Therapy for Psychogenic Erectile Dysfunction:  A Pilot Study”

4) Intl J of Impotence Res, 1998, 10:211-314, “Short term use of intracavernous vasoactive drugs in the treatment of persistent psychogenic erectile dysfunction”

5) Journal of Sex & Marital Therapy, 1975, 1(4), “The assessment of nocturnal REM erection in the differential diagnosis of sexual impotence”

6) ARCHIVES OF SEXUAL BEHAVIOR, 1987, 16(2):125-137, “Use of sexual history to differentiate organic from psychogenic impotence”

7) Int J Impot Res, 2007 Jan-Feb ,19(1):104-7, “Cabergoline treatment in men with psychogenic erectile dysfunction: a randomized, double-blind, placebo-controlled study”

2.  Failure. Generally,  erectile dysfunction for middle-aged and beyond guys is endothelial (artery-related) in nature.  In addition, low testosterone often exacerbates the condition. These underlying physical conditions often lead to a few performance failures, which can create tremendous anxiety for most guys (and often for their spouses and/or partners as well). This can bring the psychological (psychogenic) part of an erection to the forefront very quickly.

Tragically, all of this can be made worse by visiting the doctor. The doctor will often do nothing or imply it’s just a natural part of aging.  The patient is left to struggle alone.

Psychogenic Erectile Dysfunction – Diagnosis

So how do you know if you have psychogenic (pscychological) erectile dysfunction?  Well, the gyst of the diagnosis has to do with whether or not a man can achieve a normal erection under some circumstances but just not in the bedroom.  Here are a few of the things that they will look at:

1.  Morning Erections.  Odds are if you can achieve a firm morning erection that you’re physically functioning fine.  In fact, this has been used by diagnosticians for literally decades as an excellent tool. [5] In fact, one study noted that “the single best predictor was the presence or absence of early morning erections as reported by the patient.” [6]

2.  Rigiscan.  Doctors will sometime use the Rigiscan device, which essentially measures your “hardness factor”, i.e. the firmness of your erection.  Again, if you can get hard when you’re not under pressure, then you’ve likely got psychogenic erectile issues.

Psychogenic Erectile Dysfunction – Solutions

Solving psychogenic impotence can be difficult indeed.  Many guys, after repeated failures in the bedroom, dread another attempt and risking failure.  In addition, sex is about as personal of a subject as one can come up with and, for most males, is tied to their maleness and manhood.

Fortunately, there are reasonable solutions with solid success rates, which are discussed below.  One methodology that I won’t discuss is sex therapy with a sex therapist, which is the mainstay of such sexological leaders as Masters and Johnson.  This methodology has a reasonable success rate but most guys are just not going to do it.  (This methodology requires a sex therapist to be present during the meetings with or without your partner.  For many, this is just too uncomfortable and/or may not reconcile with one’s religious beliefs.

Other solutions include the following:

1.  PDE5 Inhibitors. Viagra alone produced a 66% success rate in getting men over their psychogenic erectile dysfunction. [3]  Of course, this is likely because erections come so easily and quickly with Viagra that there is less time for anxiety. However, sexual satisfaction was significantly increased with Cognitive-Behavorial Therapy, which include working with their partner to “identify positive aspects of themselves and their parter; review positive relationship experiences;  recall past, present and future ways to share and show love and affection and then prepare a surprise from the list”, etc.

2. Intracavernous Injections. In some men the performance anxiety and fear of failure is very high and PDE5 Inhibitors and Therapy just do not work.  In these cases physicians can actually give men a set of preloaded syringes for pre-bedroom use.  The men has to actually inject his own penis – it doesn’t hurt as much as you might think – that literally forces an erection.  Men involved in this sort of treatment have “no worries” as the medicine keeps him erect through almost any emotional state. Although it sounds very painful, only one fifth of the men in one study complained of pain and this was correctable in all cases. [4]

3. Dostinex (Cabergoline). This medication is used to treat men with high prolactin and/or prolactinoma and can, in those cases, boost testosterone and improve the refractory period.  Dostinex belongs to the class of medications called dopamine agonists and has a study behind it showing that it may also improve psychogenic E.D. [7]

The success rate for this strategy is very high.  For example, in one study of couples with “honeymoon impotence”, 93% of the couples achieved success and only a few needed long term use.  The 7% that were unsuccessful, by the way, was due to vaginismus, or vaginal pain.

DHEA: How to Increase It (Naturally and Otherwise) - Peak Testosterone

On this page, I will be talking about the standard DHEA dosages that I see out there. However, even discussing the subject makes some assumptions in my mind. First of all, I don’t think anyone should supplement that is not actually low in DHEA-S. Furthermore, I believe that this kind of “protocol” should be followed:

a) Talk to a doc or LEF, naturopath or Life Extension Foundation and find out if you have any contraindications.  (High PSA, arrhythmia, etc.)  Read my page on DHEA Dangers.

b) Get a DHEA-S blood draw and, if low, proceed to b.

c) Discuss with  a doc or LEF, naturopath or Life Extension Foundation an appropriate dosage.  Of course, I recommend reading below

c)  Find your target DHEA-S levels.  I have seen docs and the LEF generally target a range of 350-500 ug/dl approximately.

d) Re-measure after a few weeks and verify you have hit your target levels.

CAUTION:   My labs were 108 ug/dl, which is very low, and this is the sole reason that I tried it. Again, you do not want to even consider taking DHEA in my opinion unless you are low in DHEA-S and you do not want to go too high in DHEA-S after you begin taking DHEA either. Set a target with your physician or naturopath. From what I have seen, usually the upper mid range of DHEA-S is what is targeted and where men often feel best.

1. Ray Peat (~4 mg daily).  Ray Peat, a respected blogger with a Ph. D. in Biology wrote:

“Young people produce about 12 to 15 milligrams of DHEA per day, and that amount decreases by about 2 mg. per day for every decade after the age of 30. This is one of the reasons that young people eat more without getting fat, and tolerate cold weather better: DHEA, like the thyroid hormone, increases our heat production and ability to burn calories. At the age of 50, about 4 mg of DHEA per day will usually restore the level of DHEA in the blood to a youthful level. It is important to avoid taking more than needed, since some people (especially if they are deficient in progesterone, pregnenolone, or thyroid) can turn the excess into estrogen or testosterone, and large amounts of those sex hormones can disturb the function of the thymus gland and the liver.” [1]

His comment about 4 mg restoring youthful levels does not mesh with that of LEF, where around 25 mg is used to get men back to youthful levels.  Studies that I have seen also mention a higher dosage to get to youthful levels. As I always say:  measure yourself and see if you are hitting your target levels.  You can do that with these cheap Self-Testing Testosterone Labs.

2. Dr Shames (5-10 mg daily). Dr. Shames is one of the pioneering thyroid and adrenal fatigue physicians.  He writes in his book that it is a “potent medication” that should be limited in his opinion to 5-10 mg daily. [4]

CAUTION: I always recommend, when it comes to hormones, working with a knowledgeable physician, naturopath or organization such as Life Extenson Foundation.  Also, some countries do not allow over the counter purchases of DHEA.

3. LEF (15-50 mg daily). To find the dosage appropriate for me, I called Life Extension Foundation and they recommended 25 mg for a man on testosterone therapy like myself.  However, their page says that one may need between 15 and 50 mg in order to achieve target levels of DHEA-S.  What are these target levels?   According to their web site as of this writing, the stated goal for adult men is to keep DHEAS levels between 350 and 500 ug/dl. [2] This is what I call a “replacement philosophy,” where the goal is simply to restore a give hormone to youthful levels. The contrast to this is going “supraphysiological,” i.e. raising hormones past what is normal and natural.  This often leads to problems in my opinion whether you are talking about testosterone, estradiol, DHEA, melatonin, etc.

One of the moderators on the Peak Testosterone Forum provided an example of this when he took 25 mg of DHEA and yet it only boosted his levels of DHEA-S to ~220 ug/dl. []

4. IGF-1 (25 mg).  On my page DHEA and IGF-1, I make a case that 25 mg should probably be your upper limit on DHEA, in order to avoid raising your IGF-1 levels too much.  (Not everyone reacts the same to a given dosage, so the best thing is to measure your IGF-1 before and after using on of these Hormone Labs in my opinion.)

5. Well Known TRT Doctors (25 mg daily). Dr. Shippen is one of the early pioneers of testosterone therapy and seems to be well-respected by his patients.  (I have no affiliation.)  He wrote the TRT classic The Testosterone Syndrome years ago that was clearly ahead of its day. According to one of our senior posters on testosterone therapy, Dr. Shippen prescribed 25 mg of oral DHEA per day.  Dr. Shippen prefers this brand.  Like me, this man is on HRT (testosterone therapy) that includes a combination of testosterone cypionate and daily HCG.  Does this mean that Dr. Shippen always recommends 25 mg?  Of course not.  I am sure he tailors based on your preexisting DHEA-S levels, whether you are on TRT and a number of other factors, i.e. you’d have to set up an appointment to verify. [3]

In addition, you can read in my post on How DHEA and Pregnenalone Cured My Anxiety how Dr. Justin Saya put me on a similar dosage of 25 mg of DHEA per day (oral before bed). Again, you would have to call Dr. Saya and make an appt to find his dosage for you inidividually.

6.Diabetes and Prediabetes (25-50 mg daily). This is an involved subject as the studies are mixed.  In my opinion, the data overall suggests that  men struggling with blood sugar issues and high cholesterol can improve insulin sensitivity and normalize blood sugar levels with reasonable dosages of DHEA.  Of course, if you are diabetic in particular, it is critical to talk to your doctor first before making any changes.

7. Mood, Depression, Anxiety and Cognition (50 mg). Dosages in the successful studies for these conditions tend to be 50 mg from what I have seen.  For example, one study of middle-aged and senior men and women 40-70 years found that 50 mg “was associated with a remarkable increase in perceived physical and psychological well-being for both men (67%) and women (84%) .” [5]

REFERENCES:

1) https://raypeat.com/articles/articles/three-hormones.shtml

2) https://www.lef.org/Protocols/Metabolic-Health/Dhea-Restoration/Page-les

3) https://www.peaktestosterone.com/forum/index.php?topic=7610.0

4) Feeling Fat, Fuzzy or Frazzled, by Dr. Shames, p. 163

5) J Clin Endocrinol Metab, 1994 Jun, 78(6):1360-7, “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age”

6) https://www.peaktestosterone.com/forum/index.php?topic=7610.0

How to Prevent Prostate Cancer - Peak Testosterone

Every male needs to take an aggressive approach to protect himself from prostate cancer. If you’ve grown up in a Western society, then you have spent decades eating beef (especially) and other meats cooked at high temperatures.  That delicious black residue on your meat is filled with various cancer causing agents such as HCA’s (heterocyclic amines) that head straight for your prostate. (The typical fast food burger, that we literally live and die for, is loaded with the stuff.)Many aspects of the Western lifestyle increase risk for prostate cancer and current lifetime estimates are 16%. [36]  

Many of you have also consumed huge amounts of dairy – another huge risk factor for prostate cancer. Again, to protect yourself from prostate cancer, you have to realize that you have no time to waste:  the “seeds of destruction” have already been planted through significant free radical and DNA destruction inside the delicate tissue of your prostate. In addition, many of you are overweight, which puts a significant and potentially deadly estrogen load on your prostate.

NOTE:  You should also check out my page How to Lower Your PSA, which shows the latest research on how to lower your PSA, and my page that discusses the research on Does Testosterone Therapy (TRT) Cause Prostate Cancer?.

But the good news is that research has shown us that you can drastically lower your odds of prostate cancer through simple dietary and lifestyle measures. I’ve listed below some of the most critical foods that you can eat (or avoid in some cases) to very significantly protect yourself from prostate cancer.

1) Men s Health 9/05 p 74

2) Science,Jan 23 1998,279:563-66

3) JAMA, 2004,291:1578-86

4)  PNAS, June 17, 2008,105(24):8369-8374

5) Cancer Epidemiol Biomarkers Prev,2006,15(2):203-10

6) Cancer Research, Jun 1 2008,68:438

7) Journal Nutrition, 136:2813-2819, 2006

8) Am J Clin Nutr, 2007 Nov, 86(5):1420-5

9) Amer Jour Epidemiology, 163:989-996, 2006

10) J Nat Canc Inst,2007,99:1200-1209

11) Cancer Res 2007 Mar1,67(5):2239-46;J Biol Canc,2005 Mar 11,280(10):8756-64

12) Cancer Causes Control,2002 Dec,13(10):947-55

13) Clin Cancer Res,Jul 1 2006,12(13):4018-26

14) Proc Natl Acad Sci USA. 2005 Oct 11;102(41):14813-8

15) Cancer Epidemiol Biomarkers Prev,2007,16:63-69

16) Jour Clin Invest 117(7):1866-1875, Jul 2 2007

17) Amer Jour Clin Nutr 2007,85:523-9

18) Cancer, Epidemiology, Biomarkers Preview, v.6, 1997, p967-9

19) Prostate, v.27, 1995, p. 25-31

20) Journal of Clinical Endocrinology and Metabolism, v82, 1997, p571-5

21) Int l Journal of Andrology, v.25,2002, p119-125

22) Cancer Research v.59,1999, p4161-4; Amer Journal of Clinical Oncology v20,1997,p605-8;Journal of urology, v163, 2000,p824-7; Prostate v47, 2001, p52-8; Journal of the American medical Assoc, v276, 1996, p1904-6

23) Am J Clin Nutr. 2007 Feb;85(2):523-9

24) UUrology,2007,70:672-676

25) Amer J of Epidem,2008,167(1):71-77

26) PLoS ONE, 2008, 3(7):e2568

27) Cancer Epidemiology, Biomarkers & Prev, Nov 1, 2007, 16:2213, “Cholesterol-Lowering Drugs and Advanced Prostate Cancer Incidence in a Large U.S. Cohort”

28) Cancer Epidemiol Biomarkers Prev 2009, 18:2807-2813, “Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the Prostate Cancer Prevention Trial”

29) Cancer Epidemiol Biomarkers Prev 2009; 18:2814-2821, “Prediagnostic total and high-density lipoprotein cholesterol and risk of cancer”

Cancer Epidemiol Biomarkers Prev, 2009;18:2805-2806, 2807-2813, 2814-2821

31) Harvard Men’s Health Watch, June 2007

32) CA Cancer J Clin, 2004, 54:68,”TOMATOES BEAT LYCOPENE ALONE FOR PROSTATE CANCER PROTECTION”, https://caonline.amcancersoc.org/cgi/content/full/54/2/68

33) https://www.northwestern.edu/ newscenter/stories/2010/11/soy-prostate-cancer.html, Northwestern University Newscenter, Nov 8 2010, “Soy May Stop Prostate Cancer Spread: Experimental soy-based drug shows benefits in men with localized prostate cancer”

34) The Lancet, 1 January 2011, 377(9759):31-41,”Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials”

35) https://www.dailymail.co.uk/health/article-2359466/Taking-omega-3-fish-oil-supplements-increase-risk-aggressive-prostate-cancer-70.html

36) JAMA, 2011, 306(14):1549-1556, “Vitamin E and the Risk of Prostate Cancer The Selenium and Vitamin E Cancer Prevention Trial (SELECT)”

37) J Natl Cancer Inst, 2000 Dec 20, 92(24):2018-23, “Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer”

38) https://www.medicalnewstoday.com/articles/260338.php

Another huge question in the minds of many males is “will HRT (testosterone supplementation) put me at risk for prostate cancer”?  Several large, well done studies – see below – have showed this not to be the case.  Talk to your doctor, of course, but the evidence looks very positive for testosterone therapy.

Below are several studies that show normal testosterone levels and supplementation are actually healthy for the prostate:

You may have a concern if you have heard or read that sometimes doctors will treat certain prostate cancers by decreasing androgens, i.e. signficantly lowering testosterone.  The reason that this is done is that testosterone actually suppresses t-lymphocyte immune response.  So some doctors feel that your body can more aggressively attack the prostate cancer with testosterone out of the way. As a side note, this may be why females more frequently develop autoimmune diseases:  their immune response in some cases may be too strong due to a lack of testosterone.

Benign Prostate Hypertrophy (BPH)

One other worthy subject with regards to the prostate is protecting yourself against prostate enlargement, which leads to difficulty urinating and a host of other problems.. Current research shows that vegetables, in particular, protect against BPH. One recent study [23] showed that vegetables rich in lutein, beta-carotene and Vitamin C were particularly protective.  (Note:  Fruit consumption did NOT correlate with increased protection from BPH. Furthermore, getting these nutrients from supplements did not correlate well either.) But most protective are actually onions and garlic.  In one 2007 study onions decreased the risk of BPH by 60% and garlic by 30%. [24]  For more information, please read this link on Protecting Your Prostate from BPH.

Propecia (Post-Finasteride) Cures - Peak Testosterone

I took Propecia (finasteride) briefly for male pattern baldness and sometimes I wonder if it put the accelerator on issues I was already experiencing from low testosterone. (More on that below.) And I’m not alone as many men experience issues after this DHT-lowering medication. Experts estimate that between 5-20% of men that use Propecia will experience significant sexual side effects, including erectile dysfunction and lowered libido.  As I discuss in my page on Propecia and Depression, long term psychological side effects are probably much more prevalent due to finasteride’s negative effect on brain GABA levels. Common complaints of “Post-Finasteride Syndrome (PFS)” as it is termed includies things like brain fog, testicular/prostate pain, “lifeless” gonads (eunich-like) and low androgen hormone levels.

If you read about the experiences of those coming off of Propecia, it can be overwhelming and even discouraging.  As I document in my link on The Risks of Propecia, the effects can not only affect the gonads but also the brain and can easily become a life-changing event. One can quickly lose hope.  The good news is that I can say that I have seen a few things that have worked for those with PFS and I discuss those cases below:

1. Case #1. HRT (Testosterone Therapy). HRT does not always help victims of Propecia, but sometimes it works very well. From what I have read, PFS sufferers tend to have lower testosterone levels.  However, it is my belief that this is not because Propecia causes low testosterone but rather because low testosterone men are very vulnerable to the negative brain effects of Propecia.  The reason for that is simple:  low testosterone can cause depression (and anxiety) and I show the research evidence in my page on Testosterone and Depression. Many men on the Peak Testosterone Forum can attest to the fact that HRT has greatly helped them in this area.

So clearly the last thing a low testosterone man needs is Propecia, which will likely then lower his GABA levels significantly. GABA, along with serotonin, are the “relaxing / peace-and-harmony” neurotransmitters.  Low GABA levels are associated with – you guessed it – increased depression and anxiety.  Therefore, one would think that restoring testosterone levels in a PFS hypogonadal man would at least partially reverse these negative psychological symptoms.

3.  Case #3 (Weights, Running, Fish + Lifestyle). This was another young man who took it for 8 years starting at age 18! He was able to largely recover in just six months by doing the following:

The important point is that it appears that hormonal adjustments and lifestyle changes can greatly reverse the negative effects of PFS.  And, undboubtedly, it may take to heal as well.  There is simply no reason to despair and give up hope, and, as always, I want to warn against is “just giving up”.  Men can assume that they have done permanent damage, when, in fact, that does not have to be the case.  However, if you give up, and succumb to the stress and erectile dysfunction and then post-finasteride syndrome often likely heads into a downward spiral.

Notice also that what they did for a cure was really not that complex: a good, clean nutrient dense diet with weight lifting coupled with a few supplements that emphasize omega-3’s, a multivitamin and maca. Of course, I prefer what I call Low Fat Paleo, which should be much more arterial protective based on my personal experience. Regardless, the point is that these men got off of their standard Western Diet and took control of their health. Weight lifting for those, who do not know, has several studies showing that it can boost T, something I document in my link on Testosterone and Weight Lifting. Weight lifting can also help you burn calories for 24 hours afterward and is a proven nitric oxide booster. You do have to be a little careful about Lifting Weights and Your Arteries perhaps.

Some men resort to pharmaceutical solutions that target GABA, which can be lowered by Propecia.  This is not good, of course, because these can be addictive.  Of course, I encourage always trying to find a natural solution even if it takes a bit more time.  In the long run, it is a much safer path to travel upon.

This is, in fact, exactly what I believe happened to me.  On my page How I Believe Propecia Negatively Impacted My Health, I discuss how looking through my old records revealed that I started really having difficulties with my health immediately after about six months on Propecia (to supposedly halt hair loss).  It took years before I finally got on testosterone therapy, but, when I did, it was a life saver for me.  It was like night and day mentally and psychologically.  My depression was completely gone and anxiety was lowered about 50%.  My boss commented on the positive improvements and said, “I don’t know what it is, but you’re a lot easier to work with!”

2.  Case #2 (Lifestyle + Supplements).  This young man was able, over time, to almost double his testosterone to 430 ng/dl. Of course, 430 is still pretty low testosterone, but a big improvement nonetheless.  He was determined not to go on HRT as he wanted to preserve his fertility and, hopefully, rebuild his HPT function.  However, he felt much, much better and here is how he said he did it: [1]

Probiotics and Erectile Strength - Peak Testosterone

If someone came to you one day and said, “Let’s throw some bacteria into a pill and you’ll swallow it and then let’s watch your brain, liver, heart, erection and mood function miraculously improve!” – you’d tell him he was crazy, right?  Yet researchers have found that replenishing certain intestinal bacteria, or probiotics, does all of that and much, much more.

It kind of makes sense when you stop to think that “you are what you eat” and what you eat has to pass through your small intestine and all the bacterial inhabitants that live therein.  Colon health may not be glamorous, but with every passing month researchers find how it is one of the most important aspects of your personal well-being and fitness.

Let’s look at five counterintuitvie – one might almost say “weird” – ways that probiotics have been found to affect male health:

1) Gastroenterology, Aug 2011, 141(2):599-609, “The Intestinal Microbiota Affect Central Levels of Brain-Derived Neurotropic Factor and Behavior in Mice”

2) European Journal of Clinical Nutrition, 2007, 61:355 361, “Impact of consuming a milk drink containing a probiotic on mood and cognition”

3) Hepatology, Feb 2003, 37(2):343 350, “Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease”

4) Journal of Allergy and Clinical Immunology, Feb 2003, 111(2):389-395, “Effect of probiotic Lactobacillus strains in children with atopic dermatitis”

5) World J Gastroenterol, 2008 Apr 28; 14(16):2511 2516, “Anti-inflammatory activity of probiotic Bifidobacterium: Enhancement of IL-10 production in peripheral blood mononuclear cells from ulcerative colitis patients and inhibition of IL-8 secretion in HT-29 cells”

6) Alimentary Pharmacology & Therapeutics, Apr 2006, 23(8):1077 1086, April 2006, “Systematic review: are probiotics useful in controlling gastric colonization by Helicobacter pylori?”

7) Journal of Cardiovascular Disease and Research, 2010, 1(4):213-214, “Potential of probiotics in controlling cardiovascular diseases”

8) Infection and Immunity, Sep 2004, 72(9):5308-5314, “Live Lactobacillus reuteri Is Essential for the Inhibitory Effect on Tumor Necrosis Factor Alpha-Induced Interleukin-8 Expression”

1. Heart Disease (and Erections). Research is preliminary and somewhat speculative at this point, but it is very likely that probiotics can improve cardiovascular disease and erectile dysfunction in many men.  The reason?  One study explained that probiotics help the arteries in three key ways: a) increasing and improving t-cell response which relaxes our normally “overzealous” immune system, meaning less white blood cells will end up creating plaque along the endothelium, b) secretion of proprionic acid which signals the liver to produce less cholesterol and c) forcing the liver to use more cholesterol which, in turn, lowers plasma total cholesterol numbers. [7] All of this will be good for men struggling with erectile strength and ensuing studies will undoubtedly show their benefit.

NOTE:  Inflammation is incredibly important to both erectile strength and heart health. Please see my link on How to Lower Inflammation for more information.

2. Anxiety. An animal study found that administration of an antibiotic “cocktail,” which kills most intestinal flora, led to an increase in anxiety in the mice.  Upon examination, they found that the mice has an increase in BDNF, which is known to increase anxiety. [1] This may explain part of the reason why researchers have noticed that antibiotic use is often associated with stress reactions, depression and anxiety.

4.  Liver. Researchers discovered yet another bizarre connection with gut flora:  TNF-alpha.  You may recall that TNF-alpha is the bad boy inflammatory cytokine that is a root cause of many other chronic conditions that plague modern urban-dwelling men. Thus researchers have found (in an animal study) that better control of TNF-alpha led to big improvements in Non-Fatty Liver Disease. [3]  Some probiotics have beens shown to improve IL-10, an anti-inflammatory cytokine, and other parameters of inflammation as well.

NOTE:  This improvement in TNF-alpha is yet another reason that probiotics may help many men with erectile dysfunction. Please see my link on Juice and Inflammation for more information.

5. Immunity. Several studies have found that various probiotics help immune function. Researchers have found that it likely helps with childhood dermatitis [4], ulcerative colitis [5], H.Pylori/ulcers [6] and on and on. Researcher do not totally understand yet how probiotics works its wonders on the immune system, but it seems to be by positive affecting inflammation and the permeability of the intestine.

So what are probiotics good for?  It’s not too much of an exagerration to say “everything!”  Anything that boosts immunity, brain function and improves the body’s inflammatory response is a huge factor in personal health.

REFERENCES:

Pesticides and Testosterone - Peak Testosterone

1) Epidemiology,2006,17(1):61-68

2) Food Chem Toxicology, 2008, 46:270-279

3) 4) J Environmental Health, Jan 2009, 8:2″Mercury from chlor-alkali plants: measured concentrations in food product sugar”, Renee Dufault, et al;  Institute for Agriculture and Trade Policy, Jan 26 2009, “Much High Fructose Corn Syrup Contaminated with Mercury New Study Finds:  Brand Name Food Products Also Discovered to Contain Mercury”.

4) National Acad of Sciences, July 24 2009, “LIMITED DATA SUGGEST POSSIBLE ASSOCIATION BETWEEN AGENT ORANGE EXPOSURE AND ISCHEMIC HEART DISEASE AND PARKINSON’S DISEASE IN VIETNAM VETERANS”,

5) National Academy of Sciences, July 27 2007, , “Data Suggest a Possible Association Between Agent Orange Exposure and Hypertension, But the Evidence Is Limited”

6) https://www.nrdc.org/media/2009/090824.asp

7) Brian Halweil, Nov 2002, Worldwatch Institute on November 1, 2002, “Worldwatch Paper #163: Home Grown: The Case For Local Food In A Global Market”

8) Exp Neurol, Apr 2007, 204(2): 619 630, “Dieldrin exposure induces oxidative damage in the mouse nigrostriatal dopamine system”

9) Hayes WJ jr. and Laws ET jr. eds. (1991) Handbook of Pesticide Toxicology, Academic Press Inc., San Diego, 732-735, 741, 828, 832, 836-840

10) American Journal of Epidemiology, 2010, 171(4):455-464, “Pesticide Use and Thyroid Disease Among Women in the Agricultural Health Study”

Is organic food just for girly men? Actually, it might be just the opposite: recent studies are showing strong evidence that some pesticides may make a guy a little too light in the loafers. A recent issue of Epidemiology found a correlation between exposure to the pesticide chlorpyrifos and a decline in testosterone. [1] The researchers examined males undergoing fertility treatment and found “multiple linear regression models showed an inverse association between TCPY [a metabolite of chlorpyrifos] and testosterone concentration“.  Simply put, that means the more the chlorpyrifos, the less the testosterone.

The Tour De France is a little over 2,000 miles and your food typically has to travel about that on average to get to your local supermarket.  Your fruits, vegetables and grains travel an average of between 1,500 and 2,500 miles  and increasingly from foreign countries including China. [7]  This means – you guessed it – more pesticides and chemicals have to go on your food to get it to survive the typical megatrek to your plate.

What does that mean to all of you concentrating on your fitness and health?  It means that as you do the right thing and eat your fruits and green stuff, Old MacDonald is trying to shrink your nuts to the size of a fruit fly!  Am I exagerrating?  Well, a little bit.  But the study found that men with the most pesticide byproducts in their systems typically had 10% less testosterone than men with the least pesticide by products. That s quite a hit for just one pesticide, especially for those on the low testosterone side in the first place. I should also mention that previous research has found this pesticide widely present in the general population:  in other words, you’ll be extremely unlikely to escape ingesting it under normal circumstances.  (Before I go on, please, please read this section on Excitotoxins:  these have the potential to be much more deadly to your testosterone than even pesticides.)

The researchers also found that two additional pesticides, carbaryl and naphthalene, were also correlated with lower testosterone in subjects. Imagine what the other forty pesticides you re eating are doing to your precious testosterone. The concern over pesticides actually came over decades of observations as to what they (and other chemicals such as those used in plastics) are doing to the animal kingdom. Florida gators next to pesticide manufacturing plants have a drastically increased mortality and many of the adult males have ovaries instead of testes. Not good.

Atrazine is another example. In America 60 million pounds of this are sprayed on annually on sugar cane, corn and other crops where, of course, it washes into rivers, streams and various water supplies. Unfortunately, researchers found that it caused sexual abnormalities in frogs! In Europe it is banned but not in the good ol U.S. of A!  NOTE: The National Resources Defense Council just found Much Higher Levels of Atrazine than previously estimated by the EPA.[6]

Why do these chemicals cause so many problems? The trouble is that many of them are endocrine disruptors. Some of them, for example, mimic estrogen or testosterone and take over receptor sites. Others interfere with the chemical pathways responsible for formation or delivery of testosterone or estrogen. In the case of chlorpyrifos, researchers believe it effects luetinizing hormone, which signals production of testosterone in males.

I should mention that pesticides and herbicides don’t just do their damage by modifying hormone levels.  Pesticides and herbicides can do damage throughout the body without ever touching your hormones!  See this link on How Pesticides and Herbicides Can Lead to ADHD and Parkinson’s.

One example of this is dieldrin, a DDT alternative, which has proven to be more toxic to vertebrates than insects.  One study showed it increases oxidative stress, lowers dopamine levels and is likely a cause of Parkinson’s Disease. [8]  Furthermore, it has induced liver and hepatocellular cancers. [9]  Even worse, it is not biodegradable. It has been banned for decades yet still persists in our food supply like radioactive waste.  How could they use a non-biodegradable pesticide in our food supply?  Is it possible to be more irresponsible?

Previous data from the National Academy of Sciences has shown that Agent Orange and other herbicides do not just damage the brain but can induce hypertension, as shown by examination of Vietnam Vets with significant exposure. [5] Dioxins and other chemicals cause proteins to accumlate in and around the organs which can cause significant issues including lymphomas and cancers as well.  They stated that “the committee based its conclusion on the fact that AL amyloidosis shares many biological and pathological similarities with multiple myeloma and certain B-cell lymphomas, which have been found to be associated with exposure to herbicides”.  Nasty!

NOTE:  Dioxins are so deadly that they were used in 2005 to poison Victor Yushchenko, a well-known opposition Ukranian leader.

So how do you avoid these T-killing compounds?  If you want to shop at a regular supermarket, it will be tough. About the only thing that researchers can tell us at this point is which fruits and vegetables have the greatest incidence and total amount of pesticides.  Here’s a link that gives such a list: https://www.ewg.org/news/story.php?id=2076.

This EWG states that among the worst offenders, which they call the Dirty Dozen, are “apples, bell peppers, celery, cherries, imported grapes, nectarines, peaches, pears, potatoes, red raspberries, spinach and strawberries”.

The Latex Glove Award: Apples are particularly known for being the “most sprayed”. The problem is that apples are usually grafted and therefore not very pest resistant. Farmers spray more to compensate and that’s why organic is probably a good idea in this case.

The Latex Glove Runner Up: Probably the second most chemical-ridden item out of a farm is the potato.  Because they’re a root vegetable, they get treated with fungicides and then are sprayed with an herbicide to get rid of the “little string roots” that come out of potatoes.  After they are harvested, they get another dose making for one scary vegetable.

The least contaminated produce found was “asparagus, avocados, bananas, broccoli, cauliflower, corn, kiwi, mangoes, onions, papayas, pineapples and sweet peas”.

At least science has provided us with a way that you can try to avoid pesticides:  by limiting yourself to those on the least contaminated list.  Realistically, though, the only real way to avoid pesticdes is to buy organic.  Studies have shown that children who eat organic vegetables and fruit only dramatically lose pesticide residues in their body tissues and then regain them upon returning to regular produce.

Keep in mind that the knowledge about the effects of pesticides on humans is still in its infancy.  Making the task even more difficult is the fact that there are about 87,000 different chemicals currently in use making it impossible to test even a small percentage of the total. My opinion, though, is “better safe than sorry”.

News Flash #1: Pesticides and fungicides are increasingly being correlated with thyroid disease as well.  One 2009 study based in Nebraska found that women exposed to the most of organochlorine pesticides and fungicides were much (40%) more likely to develop hypothyroidism, which results often in weight gain, loss of libido and other serious medical conditions. [10]

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs.

News Flash #2:  Recent research has found that Triclocarban, a chemical that is widespread in our water supply and various home care products such as antibacterial soaps, can actually increase testosterone. But before you try to transform yourself into Barry Bonds by washing your hands twenty times a day, I only relayed this story to show that we are not researching the products we put onto and into our bodies nearly enough.  Who knows what else triclocarban does to you?  Messing with your testosterone may be just the beginning.

Mercury:  Although not really a pesticide, I want to mention that Methyl Mercury will definitely lower testosterone. [2] Sadly, one of nature’s most healthy foods, fish, is often contaminated with Mercury and so extreme care is warranted.  Most recommend fish only once or twice per week because of it. Researchers just announced that mercury contamination is extremely common in high fructose corn syrup:  50% of products tested by researchers were contaminated! [3] The issue apparently is that there are no standards for mercury residue in hydrochloric acid and hydrochloric acid is used to make high fructose corn syrup.

REFERENCES:

Venous Leakage - Peak Testosterone

“Venous leakage.”  Sounds nasty, doesn’t it?  Kind of like a hemorrhage or something, eh?  Well, most guys would probably rather have a little hemorrhaging than venous leakage, because it leads to weak and/or rapidly disappearing erections.

Venous leakage describes the condition where the blood escapes from the penis and thus a good erection cannot be achieved.  An erection begins when penile smooth muscle relaxes enabling blood to infill the corpus cavernosum, two cylindrical “caverns” of spongy tissue running within the penis. Stage two of the erection process occurs with this infilling of the corpus cavernosum.  The inflow of blood expands the spongy tissue, which begins to pinch off the emissary veins of the penis, decreasing outflow and – voila! – the erection begins to build.

NOTE: Venous leakage should not be confused with venous insufficiency, which is a condition in which the valves in the lower legs go out due to varicose veins, deep vein thrombosis, etc.  There is some evidence that grape seed extract can help with this condition. [4]

Venous leakage occurs when this second stage fails and bloods leaks out as fast as it infills. The “pinching off” of the outflow veins never occurs adequately and, basically, you’re sailing in a leaking boat. Again, though, it’s not really that the veins are leaking but rather that the veins are not receiving proper compression.

1) J Sex Med, 2005, 2:759–770, “The Physiological Role of Androgens in Penile Erection: Regulation of Corpus Cavernosum Structure and Function”

2) Endocrinology, Apr 1 1999, 140(4)1861-1868, “Effects of Castration and Androgen Replacement on Erectile Function in a Rabbit Model”

3) J Urol, 2004 Aug, 172(2):658-63, “Randomized study of testosterone gel as adjunctive therapy to sildena?l in hypogonadal men with erectile dysfunction who do not respond to sildena?l alone”

4) https://www.umm.edu/altmed/articles/grape-seed-000254.htm

5) Andrologia, 2006, 38:61–68, “Testosterone and erectile function in hypogonadal men unresponsive to tadala?l: results from an open-label uncontrolled study”

6) Braz. J. Morphol. Sci., 2008, 25(1-4):35-10, “Stereological study of extracellular matrix of penile body in felis domestica: experimental model applied to erectile dysfunction”

7) Journal of Andrology, Nov/Dec 2008, 29(6), “Testosterone Improves Erectile Function in Hypogonadal Patients with Venous Leakage”

8) J Urol, 2004 Aug, 172(2):658-63, “Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone”

9) Journal of Andrology, Nov/Dec 2008, 29(6), “Testosterone Improves Erectile Function in Hypogonadal Patients With Venous Leakage”]

The causes for venous leakage can be summarized to several basic underlying conditions: 1) smooth muscle insufficiency and 2) structural changes of the corpus cavernosum.  Now what condition can lead to both of these erection killers?  Low testosterone, a.k.a. hypogonadism.

That’s correct – low testosterone is a freight train ride to venous leakage and we’re going to look at why below.  Here’s the good news:  it doesn’t have to be a one-way train ride – you can get off the train.

1) Smooth Muscle Dysfunction. Researchers now know that testosterone both maintains smooth muscle and the nerves the fire them in the corpus cavernosum. [1][5] For example, researchers have noted that in castrated animals, the nerve fibers and myelin sheaths around them actually shrink and “wither”. And they have also noted that smooth muscle content in the corpus cavernosum decreased as well. [2] Yes, testosterone affects everything in a male!

The bottom line is that researchers have found that in a low testosterone environment, the inside of the penis literally atrophies and is replaced with inelastic, fibrous tissue.

For some of you that have discovered that you lived in a hypogonadal state for years without knowing it, this may be a scary prospect.  “Did it do permanent damage?” is the natural question to ask yourself. Below we discuss some study results that show about where venous leakage can occur.

However, before I write anything else, let me state that the good news is that the studies show that, if testosterone is restored, normal erectile function usually goes with it.  This means that the damage could not have been too severe from a long term low testosterone environment and indicates that a significant reversal is usually possible.

Venous Leakage and Testosterone

So what is the magic number at which internal penile damage begins to occur and venous leakage begins to rear its ugly head? In one study, researchers looked at men with venous leakage, all of whom had testosterone < 300 ng/dl (10.2 nmol/l). [7] Obviously, 300 ng/dl and less can be a problem area for many guys.

However, could we say, then, that 300 ng/dl is the threshold? Actually, for some men it is probably higher than that as indicated by one study where all participants had venous leakage and some men had testosterone up to 400 ng/dl. [8] In other words, it depends on the individual, but it is possible that some men will begin to experience damage to the penis at 400 ng/dl (13.6 nmol/l) with still others at 300 ng/dl or even 250.

Is there a solution? Several studies to date have shown that by restoring testosterone to more normal levels, a partial reversal is possible. Of course, just how much of a reversal can be achieved likely depends on many factors, including the number of hypogonadal years as well as various lifestyle factors. The good news is that a study of Russian, low T men with erectile dysfunction and venous leakage showed good results from testosterone therapy. In this study, almost all of these men were unresponsive to PDE5 Inhibitors such as Cialis, Levitra and Viagra and all of them had testosterone below 300 ng/dl (10.2 nmol/l). [9] In spite of their seemingly dire circumstances, about a third of the men were cured through just testosterone therapy alone. Another third were cured through a combination of testosterone and PDE5 Inhibitors. The means that a solid majority of the men were significantly healed of their venous leakage and achieved a substantial reversal with the help of HRT.

By the way, some of you who may not respond well to PDE5 Inhibitors, such as Viagra or Cialis, may find that restoring your testosterone via HRT restores your erections for the above reasons. One study looked at hypogonadal males who did not respond to Viagra and found a significant restoration of erectile function after HRT (Testosterone Therapy). [3] Very similar results were found in a study of Cialis non-responders as well. [5] In other words, sometimes the problem is nitric oxide and sometimes it is low testosterone (or both).

So the bottom line is that many of you need to either Increase Your Testosterone Naturally or discuss with your doctor Hormone Replacement Therapy if you want your erections back.  And, yes, Sex is Good For You.

High Fat : The Cortisol Connection - Peak Testosterone

I just had someone post on The Peak Testosterone Forum that he had recently quit a high fat diet.  And it’s no wonder:  high fat diets often do the OPPOSITE of what is expected and many men have men have no idea why.

First of all, what I am talking about when I say a “high fat meal,” I mean a meal where the fat calories are approximately 45-55% and above of the total calories and there are some carbs present.  Let’s take one of the typical ingredients in a low carb/high fat meal:  ground round.  Let’s say a man grabs some 90/10 ground beef.  The package says that it is 10% fat, but this is misleading, because 85 of its 182 calories are actually fat calories, which is right at 46%.  And, typically, other butters and oils are added to the meal on one form or another and the percent fat goes well over 50%. And, once you get near this 50% mark, things can get ugly really fast.

Don’t believe me?  Here are 7 Reasons You May Want to Rethink that High Fat Meal:

1. Testosterone (Free and Total).  One found a prolonged loss of testosterone (about 8 hours) after a high fat meal. [4] Furthermore, the study found the loss to be significant, 22% and 23%, in total and free testosterone, respectively.  Ouch! An earlier study found that it was likely that a high fat diet affected the testes as opposed to leutinizing hormone. [6]

2. Insulin Resistance. High fat meals have long been used by researchers to induce insulin resistance in laboratory animals! For example, one study wrote “chronic high-fat feeding in rats induces profound whole-body insulin resistance, mainly due to effects in oxidative skeletal muscle.” [2] Many men on higher fat diets assume that by lowering carbs, they are improving their MetS (prediabetes) or avoiding it.  However, this is not necessarily the case and in a signficant block of men the opposite will happen.

NOTE: The same study above also noted that “prior exercise, a single low-fat meal, or fasting all significantly increased insulin-stimulated glucose utilization.”  [2] In other words, exercise, fasting or a Low Fat Diet can all somewhat counteract a High Fat meal.  But one can’t help but ask the question, why do it in the first place?

1) J Am Coll Nutr, 2007 Apr;26(2):163-9, “Low carbohydrate, high fat diet increases C-reactive protein during weight loss”

2) Diabetes, Dec 1997, 46(12):2022-2028, “Diet-Induced Muscle Insulin Resistance in Rats Is Ameliorated by Acute Dietary Lipid Withdrawal or a Single Bout of Exercise: Parallel Relationship Between Insulin Stimulation of Glucose Uptake and Suppression of Long-Chain Fatty Acyl-CoA”

3) Lipids, 2008 Jan,43(1):65-77, Epub 2007 Nov 29, “Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation”

4) Metabolism: Clinical and Experimental, Nov 2001, 50(11):1351-1355, “Effects of a high-fat diet on postabsorptive and postprandial testosterone responses to a fat-rich meal”

5) Am J Clin Nutr, 2003 Jan, 77(1):139-43, “Effect of dietary antioxidants on postprandial endothelial dysfunction induced by a high-fat meal in healthy subjects”

6) Metabolism, 1990 Sep, 39(9):943-6, “Effects of a fat-containing meal on sex hormones in men”

7) The Journal of Clinical Endocrinology & Metabolism November 1, 2007 vol. 92 no. 11 4480-4484, “Dietary Macronutrient Content Alters Cortisol Metabolism Independently of Body Weight Changes in Obese Men”

8) Cell Metabolism, Aug 6 2009, 10(2):99-109, “Intestinal Cholecystokinin Controls Glucose Production through a Neuronal Network”, Grace W.C. Cheung, et. al.

9) Clinical Cardiology, May 2002, 25(5): 219-224, “Vitamin C preserves endothelial function in patients with coronary heart disease after a high-fat meal”

10) European Journal of Applied Physiology, Oct 2006, 98(3):256-262, “The effect of acute exercise on endothelial function following a high-fat meal”

11) Am J Clin Nutr, 2007 Nov, 86(5):1286-92, “A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation”

12) Arch Androl, 2000 May-Jun, 44(3):213-20, “Role of estrogens in human benign prostatic hyperplasia”

3. Endothelial Dysfunction. High fat meals actually increase endothelial dysfunction. Saturated fat, in particular, sludges the blood and lower nitric oxide levels.  Of course, if you’ve read much on this site, you realize that endothelial dysfunction is virtually synonymous with erectile dysfunction. [5] Now, admittedly, eating vegetables was found to partially overcome this in the study.  But, again, why risk it?  The high fat meal was found to reduce the ability of the arteries to expand and platelets were found to clump together more easily.

4. Blood Flow! High fat meals hammer endothelial function, as mentioned above, and correspondingly blood flow. Less nitric oxide, less expandable arteries and less fluid plasma all translate to decreased blood flow. And, yes, erections are all about blood flow, so this will not be good for your sex life. Knowledgeable researchers have known that this is a significant problem with high fat diets and have actually studied ways to try to cirdumvent the issues. For example, one study found that massive doses of Vitamin C helped heart patients retain their endothelial function post-meal. [9] Yet another study found that exercise can do the same in healthy adults who ate a high fat meal. [10] And, as I mention elsewhere on the site, walnuts have been found to partially do the same.

Doesn’t the fact that you have to so diligently protect yourself from the effects of a high fat diet tell you something?  How do you know you can exercise after a high fat meal?  It is much more safe to just not eat so much fat in my opinion!

5. CCK Resistance. Researcher discovered that that rats fed a high fat diet developed CCK resistance. [8] Cholecystokinin, or CCK, is the messenger to the brain which tells the liver to loeert blood sugar output.

6. BPH (Prostate Enlargement). As men age, they often struggle with an enlarged prostate and difficulty with urination.  What causes this?  Well, researchers have recently discovered that one of the key factors is insulin resistance and – you guessed it – a high fat diet is a risk factor because it induces insulin resistance.  These authors state that “a western diet, characterized by high fat consumption, predisposes men to BPH, while a diet rich in flavonoids and lignanes, containing phyto-estrogens, lowers this risk.” [12] Check out my link on https://www.peaktestosterone.com/ for more information.

7. Endotoxemia. Endotoxemia is a condition where harmful chemicals (antigens) released by bacteria in the gut raise inflammation levels in the body.  What causes endotoxemia?  Researchers found that a single high fat meal raised endotoxin levels by 50% and postulated that “low-grade endotoxemia may contribute to the postprandial inflammatory state and could represent a novel potential contributor to endothelial activation and the development of atherosclerosis.” [11] That’s right:  high fat could potentially harden your arteries, including the ones in your penis.

NOTE:  I am NOT attacking meat eating here, but rather a high fat diet based on modern, industrial meats that are nothing like wild game.  Almost all of the problems in this article vanish if one eats range fed meats.  I discuss many options in my page on https://www.peaktestosterone.com/.

Testosterone and Adrenals-testosterone affect everything in male

Can testosterone affect the kidneys? The answer is’yes’, since testosterone affects everything in a male. In fact, testosterone can affect the kidneys in several counterintuitive ways that most men on HRT (testosterone therapy) may not be aware of.  One is generally positive and the other generally negative.  And, unfortunately,  by negative I mean that in some cases testosterone replacement therapy could actually aggravate or harm the kidneys in certain sensitive men.

In addition, it is one reason many men probably do not want to go too high in their testosterone level if they are on HRT.  Consider this discussion below:

1. Erythropoieten. This kidney hormone is responsible for triggering your red blood cell production in the bone marrow and testosterone ramps both erythropoieten and red blood cell production upwards significantly. In fact, low testosterone men are quite often anemic because of it and men who go on HRT need to monitored to make sure their RBC count, hemocrit or hemoglobin does not go too high. This can have some serious consequences, which I discuss in my link on Ways to Lower Hemoglobin.

Does simply raising erythropoieten cause any issues with the kidneys?  Well, not directly.  However, there is evidence that in some men with hypertension, testosterone therapy can further raise their blood pressure.  And any increase in blood pressure can potentially, over time, injure the delicate vessels in the kidneys. When these blood vessels get injured, the kidneys struggle to do their job and eliminate wastes, etc.  This can lead to an increase in fluids.  Are you sensing a vicious cycle here?  Yes, as the fluids increase, blood pressure increases and so on.  This can be a big problem for diabetics and men with advanced kidney disease.

NOTE: One interesting fact about erythropoitin is that it is also called EPO, a name that may be more familiar to some of you.  Yes, that should bring the name Lance Armstrong to mind.  Lance Armstrong confessed to using EPO as a performance enhancing drug strictly for the purpose of raising his red blood cell counts for racing purposes.  Basically, he was doing a different and very dangerous kind of steroid.  Giving EPO to these racers leaves them vulnerable to dieing in their  sleep from the “sludging” of the blood that occurs.  It does turn them into superhumans however.

2.  Contraindicated for Advanced Kidney Disease.  There are some sources that recommend that testosterone therapy not be given to men with kidney disease, even if they are hypogonadal. [2] The reason for this is that testosterone could potentially aggravate or inflame the kidneys for these men according to their thinking.  Healthy men can hold this process in check without chronic injury, but these experts would not take chances in those who are vulnerable.

1)   https://www.globalpost.com/dispatches/globalpost-blogs/world-at-play/lance-armstrong-oprah-what-is-epo-blood-doping

2) https://www.drugs.com/pro/testosterone-cypionate.html

3) Kidney International, 2004, 65:1252 1261; “Testosterone promotes apoptotic damage in human renal tubular cells”

<4) AJP – Renal Physiol, Nov 1 2005, 289(5):F941-F948, “Testosterone supplementation in aging men and women: possible impact on cardiovascular-renal disease”5) Journal of Biological Chemistry, 279:52282-52292, “Testosterone Is Responsible for Enhanced Susceptibility of Males to Ischemic Renal Injury*”6) https://peaktestosterone.com/forum/index.php?topic=1607.msg15492#msg15492

7) The Journal of Urology, Jul 2006, 176(1):15 21, “Sex Differences and the Role of Sex Steroids in Renal Injury”

The primary reason is that testosterone appears to “promote apoptotic damage in human renal tubular cells.” [3] Several animal studies showed this effect and then researchers repeated the test in vitro. [3][5] Apoptosis basically refers to the “programmed cell death” that many kinds of cells have latent within them.  Testosterone basically accelerates this condition according to the above anyway.

Further study work has identified other key ways that testosterone may be questionable for those with kideny issues:

a) ” increase tubular sodium”

b) “water reabsorption”

c) “activate various vasoconstrictor systems in the kidney, such as the renin-angiotensin system and endothelin.”

d) ” increase oxidative stress.” [6]

Furthermore, I don’t believe we have had a single legitimate complaint of a kideny issue on the Peak Testosterone Forum  related to testosterone therapy. We had one man who thought he had an issue actually:

“Can the shot cause kidney issues?? Ever since I got the shot on Thursday in my right hip. My left kidney lower back has had a constant pain almost like I got a kidney stone.. 1st shot I had issues with my tongue feeling like it was to big for my mouth. Now this.. Any ideas??” [5]

However, it tunred out that he had a small kidney stone!

Bottom line:  get screened before and after for kidney function and discuss with your physician.  How do you check kidney function?  Well, this is a big subject of course, but here are some or all of the standard tests: GFR (Gromurular Filtration Rate) and creatinine clearance.

How to Lower Your PSA and Possibly Regress This Cancer.

Finding that your PSA has risen can be a sobering reminder of your mortality.  Most of us know that the PSA – used by urologists to detect and monitor prostate cancer – is a very imperfect test and can be thrown off by everyday occurrences such as sex, prostatitis and vigorous exercise.  Furthermore, many men with low PSA have been found to have existing prostate cancer. [1] And some men just seem to have high PSA’s for no apparent reason.

All of that said, the PSA inching up over a year or two can also indicate prostate cancer and so it needs to be taken dead seriously instead of just being brushed off.  Below I am going to suggest some radical steps – at least to some – to lower your PSA and, hopefully, offer protection from prostate cancer.  Before I do that, let me give you Five Reasons You Should Try to Lower Your PSA Asap:

1.  Death. If your PSA rises, you can ignore it and say to yourself, “Well, prostate cancer is usually slow to develop” and “I’ll bet it went up because I really worked out hard the day before.”  That is incredibly dangerous thinking and the reason is simple:  if you do have prostate cancer, it can eventually metastasize.  Once it spreads to the bones or another organ, life as you have known it is forever changed.  You will almost for sure be placed on androgen deprivation therapy – the polar opposite of HRT – and radiation and chemo may not be far beyond. Yes, it will shrink the tumor and perhaps save your life, but it is fraught with nasty side effects.

NEWS FLASH: I used a supplement and dietary strategy to lower my PSA from a high of 6.3 to 2.0. I tell the story in my page on How I Improved my PSA Score.

2.  HRT Continuance. There is another reason that many of you will want to protect yourself from a rising PSA:  you are on HRT and want to stay that way.  Many men getting testosterone do not stop to think about what happens if their PSA goes too high (> ~2.5) or rises too quickly in a year (> ~1 point in a rolling 12 months).  Most HRT clinics, PCP’s and endo’s will require you to get “urological clearance” if that happens and no urologist will likely clear you until you have either a) lowered your PSA or b) stabilized your PSA with a negative biopsy.  Either way you are going to likely be months or even a couple of years off of testosterone therapy while you try to correct the problem.  Bye bye muscle.  Hello classic low T symptoms.

Yes, you can pull out Morgentaler’s studies and try to preach to your urologist about how testosterone therapy will not increase prostate cancer risk.  But I can tell you that almost for sure they will not listen.

CAUTION:  Do NOT try anything on this page if you have a high PSA and/or past/existing prostate cancer without clearing it with your urologist.  These are strictly ideas that should be discussed with him or her.  Cancer is tricky and your doctor gets paid to be up-to-date on the latest research.

3.  Nowhere to Hide.  Prostate cancer is incredibly common.  A common stat is that 1 in 6 men will develop prostate cancer. Dr. Morgentaler has gathered evidence that low testosterone men are likely at increased risk for reasons that are poorly understood. [1] Furthermore, almost all of us have eaten a Western Diet most of our lives.  Fried meat – probably due to the HCA content – is a risk factor for developing prostate cancer along with overindulgence in dairy products, something I cover in my page on Prostate Cancer and Testosterone.

4. Reverse Prostate Cancer. Prostate cancer has been found to be in very high percentage of men, even men with low PSA values.  Dr. Morgentaler’s work shows that up to 15% of men may have latent prostate cancer. [1] Generally, this is not an immediate death sentence – there are nasty, fast moving prostate cancers – because prostate cancer generally develops slowly over years and even decades.  So, if you are one of those guys, why not arrest or even reverse that existing prostate cancer before it becomes a life-changing and/or life-ending issue?  The current solutions (in the U.S.) are ugly:  prostate removal, which is a major surgery that leaves you with E.D. and incontinence for several months (at a minimum), radiation, etc.

A high PSA or a rising PSA is nothing but trouble.  Again, this is why I think it’s important to consider some radical steps to stop or ideally reverse existing prostate cancer.  And for those of you without latent prostate cancer, why not take steps to prevent it from occurring in the first place considering that it is one of the most cancers in men?

Here are some ideas that can actually decrease your PSA:

1. Flaxseed. Many men are afraid of flaxseed, because it is high in phytoestrogens. However, it has been widely used as a food and recent research has provided substantial evidence that it not only can lower PSA but also greatly protect against the spread of prostate cancer.  One 2008 study showed a 50% reduction in cancer cell proliferation from flaxseed consumption, something I document in my page on Flaxseed and Prostate Cancer.

This same study showed that it was flaxseed that had the greatest superpowers against prostate cancer, even more so than a Low Fat Diet.  This is important, because a 2004 study showed that a Low Fat Diet coupled with flaxseed reduced PSA from 8.32 to 5.72.  Again, most of the effect was likely from the flaxseed as you can read on my page above.

2. IP6 (Phytic acid). Phytic acid gets a lot of bad press from the Paleo and Low Carb communities and the reason is that it is a compound present in most plant foods that binds tightly to (primarly) iron and zinc but also (secondarily) to calcium and magnesium. [2]  It is hard for your body to break out the minerals from phytic acid and so cultures that depend heavily on high phytic acid foods can end up with mineral deficiencies in the iron and zinc.  Of course, meat eaters love to point out that this is a big disadvantage of vegetarian and vegan diets and you can read many pages on the web about the importance of sprouting and fermenting your grains to avoid these deficienciues.

In my opinion, most of the concern about phytic acid is overblown.  Vegetarian and vegans, who generally consume a lot of phytic acid, have excellent health outcomes and some of the best documented mortality rates.  Furthermore, many of the underlying assumptions against phytic acid have been called into question lately.  First of all, some of the minerals  – notably zinc and iron – have been found to be neurotoxic if consumed in overly high levels.  Thus, phytic acid consumed in reasonable quantities may actually be brain protective as Dr. Neal Bernard points out.  (Elevated iron causes a host of other problems as well, including cardiovascular.)

Most importantly to us here, phytic acid (IP6) has also been found, at least in a couple of animal studies, to reduce prostate cancers.  Researchers believe that this may be the reason that fiber is considered protective against prostate cancer, since IP6 is present in plant fiber.

Researchers first accomplished many studies with IP6 and various prostate cancer tumor cell lines and later with grafted human prostate cells into mice. [3] Three studies have now been done on TRAMP mice, a breed of mice that are predisposed to prostate cancer and considered a good model for humans.  A 2012 study produced the most profound results and the study authors noted a “profound reduction in tumor size.” [5] In other words, IP6 actually shrunk prostate tumors in this mouse model!

What is the secret of IP6?  Researchers have found that it has many metabolic superpowers, but one of them probably lies in its ability to lower VEGF (Vascular Endothelial Growth Factor). [4] Many cancers occur in the endothelial cells of various organs.  Endothelial cells refer to the lining of the organ in question where there are fast growing cells that replace themselves fairly rapidly, i.e. have a high turnover. This higher cell creation can leave us vulnerable as we age to the creation of cancer cells.  VEGF is one of the body’s natural chemicals that governs this and, as we age, it is probably wise to put the brakes on VEGF for cancer protection, especially for those of those who have lived the typical Western lifestyle with all of its toxins and heavy oxidative load.  More on this below.

Of course, what is missing is a human trial such as has been done with the flaxseed.  However, researchers are already recommending that a large human study take place, since IP6 is without any known side effects. [6] I also have not been able to find any recommended dosing levels.  I can tell you that one of the most popular IP6 supplement manufacturers recommends 1.6 grams twice per day.

CAUTION:  The only downside that I know with IP6 is that one study shows that it slows down telomerase activity. [7]This is similar to green tea. Slowing down telomerase may not be good for anti-aging but does, in some cases, appear to be good for cancer protection.

3.  Soy and Tomatoes.  I have been cautious about soy, because, as I document in my link on Soy and Men, soy may have some brain-shrinking effects (in males) due to its high phytoestrogen effects. The rebuttal to this is that the Okinawans ate fairly high levels of soy and enjoyed incredible longevity and health.  And for prostate cancer protection, soy appears to be a powerful food-based protective agent, especially when combined with tomatoes.  (The lycopene in tomatoes is well-known for its prostate assisting abilities.)  Better yet, these cancer-fighting abilities have been verified in a couple of human studies.  The first was a study that looked at men with high PSA values and/or steadily increasing PSA values and thus likely had prostate cancer.  The combination of a soy isoflavone and lycopene supplement essentially stopped any growth in the PSA, indicating that cancer had been at least halted or stopped in its tracks. [8]

NOTE:  Soy, at reasonable dosages, does not appreciably lower testosterone as is often asserted per a number of studies.  Soy also boost nitric oxide.

A study published the following year (2008) found even more promising results in men that had active prostate cancer.  About a third of the men had actual reductions in PSA, indicating that the prostate cancer was actually being reversed. [9]  Thus, for men with active prostate cancer – and you could very easily be one of them without even knowing it as I discussed above – this could potentially be a life saver (and/or a sex life saver).

4.  A Vegan, Low Fat Diet (Ornish Style). The flaxseed study above as well as a genetic study by Dr. Dean Ornish showed that a Low Fat Diet can have powerful anti-prostate cancer effects.  The best evidence, though, was a follow-up study headed by Dr. Ornish that looked at men with early stage, diagnosed prostate cancer. He then put them on his standard Low Fat protocol with a few additional supplements:

Results were excellent.  The control group’s PSA rose by 6%, whereas those following the vegan, low fat diet had a decrease in PSA of 6%. [11] However, the primary change was that cultured prostate cancer cells taken from the men showed 8X less profileration than control.  In other words, the ability of the prostate cancer cells to proliferate and grow was greatly limited.  NOTE:  To read the whole study, check out this link.

REFERENCES:

1)  https://www.lef.org/magazine/mag2008/dec2008_Destroying-the-Myth-about-Testosterone-Replacement-Prostate-Cancer_01.htm

2) https://en.wikipedia.org/wiki/Phytic_acid

3) Anticancer Res, 2005 Jul-Aug, 25(4):2891-903, “Prostate cancer and inositol hexaphosphate: efficacy and mechanisms”

4) Clin Cancer Res, Jan 1 2004, 10:244, “In Vivo Suppression of Hormone-Refractory Prostate Cancer Growth by Inositol Hexaphosphate: Induction of Insulin-Like Growth Factor Binding Protein-3 and Inhibition of Vascular Endothelial Growth Factor”

5) Cancer Prev Res, Jan 2013, 6:40, “Inositol Hexaphosphate Inhibits Tumor Growth, Vascularity, and Metabolism in TRAMP Mice: A Multiparametric Magnetic Resonance Study”

6) Nutrition and Cancer, 2006, 55(20), “Protection Against Cancer by Dietary IP6 and Inositol”

7) Biochemical and Biophysical Research Communications, 3 Nov 2006, 349(4):1361–1367, “Inositol hexaphosphate represses telomerase activity and translocates TERT from the nucleus in mouse and human prostate cancer cells via the deactivation of Akt and PKCα”

8) Nutrition and Cancer, 2007, 59(1), “Lycopene and Soy Isoflavones in the Treatment of Prostate Cancer”

9) Nutrition and Cancer, 2008, 60(2), “A Combination of Tomato and Soy Products for Men With Recurring Prostate Cancer and Rising Prostate Specific Antigen”

10) The Journal of Urology, Sep 2005, 174(3):1065-1070, “INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER”

11) J of Urology, Sep 2005, 174:1065-1070, “INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER”

Natural Ways to Decrease PSA

The New PCA3 Test and Varicocele Tie to Cancer? - Peak Testosterone

I’m one of the few that on the Peak Testosterone Forum that still believe there is considerable value in the PSA test. Even so, I will freely admit that there is a lot to be desired with the PSA.  One of the issues is that it picks up on other conditions, such as the prostate growing in volume, increased inflammation, prostatis, etc.  So wouldn’t it be a great idea if they came up with a test that specifically targeted just prostate cancer? Well, that is exactly what the new PCA3 test does.  The test is not perfect, but it does give good additional information that I believe can help in the diagnosis and treatment of prostate issues.  (I have read that it is about 70% accurate.)

NEWS FLASH: There is now a significantly more accurate test out of the market called the 4Kscore.  I recently took this test and here is my story with it:  My 4kScore to Test for Aggressive Prostate Cancer. I urge you to read that page first.

I am particularly interested in this topic, because I myself had a high PSA and was kicked off of HRT. “Never again” is my motto now.  Urologists have not begun using this test, but a few naturopaths that specialize in men’s health issues have and below is my interview with one of them, Dr. Eric Yarnell.  You will be fascinated with the Doctor Horror Story that drove him to become a naturopath and a discussion as to how he has healed a few men of their low testosterone.  He also discusses a fascinating (and scary of course) research link between varicoceles and prostate cancer.  Most of the interview below, though, is a discussion of the PCA3 test and how he uses it in his practice.

CAUTION: Please do not alter your treatment plan or medications based on anything in this article without discussing it first the urological physician, naturopathic or allopathic, first.

Q. I think it’s great that you’re a naturopathic doctor. Can you let us know what drove you to take this route with your career?

A. My displeasure with the conventional medical system combined with my general interest in healthy eating (I became vegetarian as a teenager, though ultimately found that diet wasn’t the best for me) and helping people. I’ll give an example: I developed otitis media in college. I went to the emergency room as I was very dizzy and disoriented. I sat naked except for a hospital gown in a freezing cold room (to this day I have no idea why they wanted all my clothes off for an ear problem) for over 2 hours before I was seen by an intern who was super rushed and fairly disoriented himself. He did look in my ear and pronounced that I had an “ear infection.” When I expressed skepticism about his plan to give me antibiotics, he eventually brought in the senior doctor who seconded his opinion without looking in my ears. I was prescribed the antibiotics and sent on my way. I did not fill the prescription; I found a naturopathic doctor in Colorado Springs who instead gave me some herbs to take, explained that usually otitis media was due to allergies, and had me do hot compresses over my ear and to rest. She took her time, really listened to me, didn’t have me sit and freeze naked and exposed for 2 hours, and was just generally very pleasant. In a day I was feeling much better without drugs and really feeling encouraged that there were options.

Q. One thing that I know some men will be interested in: do you handle HRT in your current practice? If you want to say a bit about that, I know some men are always looking for good practitioners.

I have chosen not to prescribe testosterone in my practice. I am working hard to figure out why testosterone levels fall in some men and correct the underlying causes. In some cases where testosterone has been clearly indicated I have referred to colleagues who do prescribe it. I am concerned that we are headed down a similar path as what happened with estrogen in women: an uncritical treatment of the lab numbers instead of the person, a failure to ask why the process was happening, and a failure to then do something about the underlying causes. And we have the added difficulty that the “normal range” for testosterone is extremely wide and no one can really explain why or how one man with a serum total T of 300 feels completely fine when another with a serum total T of 400 feels awful with classic hypogonadism symptoms. And I’ve seen both situations!

Anyway, it seems clear to me we are in a new era of understanding men have hormonal changes, but they are complicated and I don’t believe they just happen out of nowhere. I believe obesity, sedentariness, poor diet, stress, environmental toxins, and probably many other factors play a role in causing this (based on my observation that very often I can get patients feeling better and their levels will go up if they are able to make major changes in their lifestyles).

Q. The PCA-3 test is a topic of great interest to me. As you know, I had a high PSA read (6.3) and I am still above my old baseline values of about 1.4. I had a biopsy and they found no cancer or precancer (PIN) and found inflammation. So, supposedly, I have no PC, but the bioposies are not perfect. Would I be a good candidate for the PCA-3 test and, if so, why?

A. In my opinion you would be a good candidate, though having more information about your case would be necessary to say for certain (including results of past prostate exams, urinalyses if any, and any other symptoms you might have in the area). One of the main problems with biopsy is sampling error: at some level the needles are stuck in randomly (ultrasound does try to identify the most likely areas of problem to target, but often doesn’t see any). PCA-3 is much better at overcoming this (but not perfect) as it is dealing with cells shedding from throughout the prostate. Anyhow, the test is also relevant because it is very safe (no needles, just a digital rectal exam/brief massage of the prostate required) and either of its results could really change the course of your case. If it were positive, I would strongly consider imaging the prostate with color Doppler ultrasound or endorectal MRI. If it were negative, I would be thinking much more about chronic prostatitis.

Q. Where you do you stand on the subject of testosterone and prostate cancer? Do you feel that well-managed HRT can fuel prostate cancer, etc.?

A. I am following closely the publications by Gat and Goren out of Israel and their studies on local vs. systemic testosterone and prostate cancer. This is my current working model (which is subject to change and isn’t perfect I’m sure, but does a better job than existing models of explaining what we see clinically):

Q. How accurate do you feel the test is both on the false positive and false negative side of the equation?

A. Very good on false negatives front, moderately good on the false positives front.

False negatives: so far I haven’t seen any of these and the test numbers look pretty good. We’ll need a lot more data to be really sure. But I suspect due to sampling error problems we will see false negatives. We may also see some due to mutational differences between prostate cancer strains that the test can’t identify (yet).

False positives: I have not seen this be thrown off by prostatitis or BPH which is a big step up over PSA. However, I have seen several positive tests where biopsy showed low-grade, minimal cancer (Gleason 3+3 in 1-2 cores only) or imaging (if the patient refused biopsy) showed only what seem to be very mild problems.

So like practically every test we have for prostate cancer, this test is still limited by its inability to distinguish aggressive from non-aggressive prostate cancer. This is huge because most prostate cancer is non-aggressive and doesn’t need to be treated with surgery, radiation, or drugs (the major exception would be for those patients who are so very anxious they can’t stand living with even this low-grade cancer in their body). All patients with prostate cancer have to be monitored lest they have early aggressive forms and we can catch them as they start to look more aggressive as early as possible.

Q. Is the PCA-3 test FDA-approved yet? If not, do you think it ever will be?

A. It is approved (well at least one testing kit for it by Gen-Probe is approved): https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm294907.htm

Q. What are the rough costs for the test itself? And are you seeing other naturopaths and/or traditional urologists making it a part of their regular practice?

A. I have seen some pretty crazy differences in prices between labs. I talked the current lab down to $432 (used to be several hundred dollars more). The lab they bought out used to charge $250.

I am not seeing urologists use it much at all. They seem to feel that it is biopsy or nothing. But I see it occasionally. And more naturopaths are definitely starting to use it, though I still get a lot of referrals. Part of the problem is, it doesn’t warrant keeping the kits around if you don’t do a lot of them, so most NDs are just not seeing enough patients with this problem to warrant it. I do, so it makes a lot of sense for me.

I also tend to see those patients who refuse a prostate biopsy no matter what, and conventional urologists get frustrated and angry and can’t work with these patients. Rather than writing them off as “kooks” or whatever, I have come up with other ways to help them the best I can. PCA-3 and imaging are part of this, as they avoid the needles but can still help us know pretty well (nothing is perfect) whether they have aggressive cancer that really needs conventional and natural medicine combined, or if they have low-grade cancer which just natural medicine can help, or no cancer at all.

Q. Do you think the PCA-3 should be used in conjunction with the PSA or in place of it or neither?

In conjunction, with careful education and preparation of the patient to understand what the tests can and cannot do, and how to interpret them. I also emphasize that if they are positive it means more testing is going to be necessary.

Q. Do you feel that the PCA-3 is as accurate as the standard 12-point biopsy? And, if so, could it ever replace the biopsy?

A. In terms of detecting prostate cancer in general, it gives the biopsy a run for its money. In terms of differentiating aggressive from non-aggressive cancer, biopsy is way, way better. So it is not really an issue of replacement, and I don’t think it ever will be. PCA-3 should be a tool to decide whether a patient should undergo a biopsy or more intensive imaging; if it is negative, then we can just wait and retest in a year or two.

Q. One of the things we really need to know is if one has aggressive prostate cancer. Does the PCA-3 test help with that at all?

A. Nope. See discussion above.

Q. Finally, can you tell us a little bit your practice and give men some contact information if they have further questions for you?

A. DrYarnell.com has all the information. I do a lot of things so I only practice one or two days a week depending on my teaching and writing schedules.

Cheers,

Eric Yarnell, ND

LH (Luteinizing Hormone Receptors) in Male Tissues.

REFERENCES:

1) Endocr Pathol, 2009 Winter, 20(4):256-61, “Case report: Adrenal LH/hCG receptor overexpression and gene amplification causing pregnancy-induced Cushing’s syndrome.

2) Oncol Rep, 2012 Jun, 27(6):1873-8, “Luteinizing hormone facilitates angiogenesis in ovarian epithelial tumor cells and metformin inhibits the effect through the mTOR signaling pathway”

3) Semin Reprod Med, 2001, 19(1):103-9, “Neural actions of luteinizing hormone and human chorionic gonadotropin”

4) Horm Behav. 2010 Nov;58(5):705-13, “Low luteinizing hormone enhances spatial memory and has protective effects on memory loss in rats”

5) J Alzheimers Dis, 2010;19(3):943-51, “Higher luteinizing hormone is associated with poor memory recall: the health in men study”

6) Hormones and Behavior (Impact Factor: 4.63), 61(4):479-86, “The role of testicular hormones and luteinizing hormone in spatial memory in adult male rats”

One of the questions that comes up on the Peak Testosterone Forum from time to time is whether or not LH (luteinizing hormone) levels and receptors are important in men, especially in those on TRT (testosterone replacement therapy). The reason this questions gets asked is that most men know that LH’s primary male function is to stimulate the testes to produce testosterone. So, if a man is on testosterone therapy, then he doesn’t need LH any more, right?

Unfortunately, the answer is not so simple and below I will show you Three Different Tissues in Men Where LH Likely Plays an Important Role. There is a lot more to this subject – for example, how it potentially argues for low dose HCG as a complementary therapy in TRT – and so I hope you will visit my pages The Benefits of HCG with TRT and My List of HCG Pages.

NOTE:  HCG is not LH.  Yes, it is a similar hormone and binds onto the luteinizing hormone receptor.  However, there are key differences.

1. Brain, Cognitive and Hippocampal Tissue.  There is some preliminary evidence that LH and the LHCGR play important roles in many key parts of the brain:

“Specific receptors for LH/hCG have been identified in the hippocampus, dentate gyrus, hypothalamus, cortex, brain stem, area postrema, cerebellum, choroid plexus, ependymal cells, glial cells, neural retina, pituitary gland, and neuron processes of the spinal cord.” [3]

The role of LH may be particularly important in the hippocampus, the center of memory and ground zero for almost everything that you do consciously as a human.  In fact, the hippocampus has the highest density of these receptors.  Does anyone really believe that these receptors are vestigal, i.e. no longer serve any purpose?

In my opinion, it stands to reason that having an almost undetectable LH level, which is what happens with a man on a solid TRT protocol, may not be a good idea.  Interestingly enough, what has been confirmed in men, women and animals is that high luteinizing hormone is hard on memory. [][][]

2. Adrenal (Cortisol Production). It turns out that the luteinizing hormone receptor (LHCGR) can actually play a role in Cushing’s Disease upon rare occasion.  Check out why below:

“Transient pregnancy-induced Cushing’s syndrome (CS) is extremely rare, with only several cases reported in the literature. Ectopic LH/hCG-receptors (LHCGR) in the adrenal gland have been suggested to be involved in the pathogenesis of this condition. We report the clinical, molecular, and genetic features of a patient with pregnancy-induced CS. A 29-year-old female patient developed CS during multiple pregnancies, leading to repeated miscarriage. Signs and symptoms of hypercortisolism resolved soon after delivery or abortion, only to recur in subsequent pregnancies. In the non-pregnant state, hCG stimulation testing resulted in elevated cortisol levels.” [1]

So clearly HCG and LH can increase cortisol through activity on the adrenal gland.  So, is the ultralow LH from TRT a possible risk factor for low cortisol in the longer term? Is this one of the reasons that some men on TRT sometimes report low cortisol.  I can tell you that I just pulled my morning cortisol and it was low, but clearly more studywork is needed.  But it is definitely in the realm of possibility that very low LH like I have could somewhat negatively impact the adrenals.

3. Vascular Effects (Angiogenesis via VEGF and EGF).  As I mentioned in my page on Some Potential Concerns of Too Much HCG, HCG is a powerful stimulant of angiogenesis. Now angiogenesis is a necessary part of life in order to revascularize tissues but can contribute to cancer if too high.  Here is just one of many examples in the medical journals:  “in conclusion, high levels of LH promote angiogenesis in ovarian cancer via the PI3K/AKT-mTOR pathway.” [2] So could super low LH lead to the other extreme?

NOTE: Tying into this is the research showing that LH/HCG may play a role in developing Down’s Syndrome, which is caused by an extra chromosome.

Retin-A: Is It Safe? - Peak Testosterone

Hopefully, you have read my link on Using Retin-A for wrinkle reduction and are now wondering just how safe is this product. After all, Retin-A (tretinoin) is the “gold standard” for topical reduction of wrinkles and also is a powerhouse in the treatment of acne as well.

Again, Retin-A is nothing more than a form of Vitamin A that irritates the skin and cause regrowth.  It literally forces your face to grow new, more “baby-like” skin.  (You do have to be careful not to overapply as tretinoin can increase irritation, inflammation and sun damage if used incorrectly.)

Because Retin-A is so widely used, there has been considerable research as to its safety.  Below is a summary of some of the most interesting points.

1. Hayflick Limit (Telomeres and Telomerase). One concern with tretinoin use is that it does cause your face to regenerate new skin.  As your skin cells recycle, some have been concerned that eventually the skin cells would reach the point where they no longer divide easily and become dysfunction, “old” cells.  In other words, does Retin-A possibly trade an improved look in one’s younger years for a worse look in your older years?

This is definitely a valid question as one of the theories of aging has to do with shortened telomeres.  (See my link on Telomerase and Aging for more details.)  Again, as the cell divides, it loses a little bit of genetic material off its ends (telomeres) and some tissues begin to have problems at that point.  However, this appears not to be an issue with Retin-A (although there has been definitive study to date). There are millions of Retin-A users and there has been no observed end-of-life accelerated aging. (Talk to your doc of course.)

One of the reasons for this may be that the Hayflick Limit does not seem to apply to skin cells (fibroblasts) that make collagen.  These powerhouses have shown a Hayflick Limit in a “test tube” but humans clearly have many more cell divisions than this laboratory limit. Both telomeres and telomerase appear to be preserved virtually indefinitely. [1]

2. Retinoic Acid.  Retinoic acid is the chemical name for Retinol, the close retinoid cousin of Retin-A, that is used in literally hundreds of skin care products for wrinkle reduction. Retinoic acid has been shown to extend the Hayflick Limit by 50% in the lab. [2] Again, fibroblasts do not seem to be governed by the Hayflick Limit in live human subjects, but it is comforting to note that retinoids seem to actually improve the situation.

3. Sun Damage. One protocol for those who use Retin-A is sun avoidance, because it can lead to increased risk for sun burn. Therefore, one concern is that perhaps it would accelerate photoaging and/or sun damage. A couple of studies have actually shown the exact opposite.  For example, one study on mice, who were photoaged with UV lamps, documented that those treated with retinoic acid had less damage than those that were untreated. [3]  Once again, tretinoin has been shown to actually heal.

REFERENCES:

1) Arch Gerontol Geriatr, 2002 May-Jun, 34(3):275-86, “Promise and problems in relating cellular senescence in vitro to aging in vivo”

2) https://www.smartskincare.com/aging/aging-mechanisms_cellular-clock.html

3) Connect Tissue Res, 1984, 12(2):139-50, “Topical retinoic acid enhances the repair of ultraviolet damaged dermal connective tissue”

Interview with Nitric Oxide Researcher Daniel Kim Shapiro

I recently asked researcher Daniel Kim-Shapiro a series of burning questions that I have had about nitric oxide, nitrite conversion and nitrosamines.  To my great delight he not only answered my questions but even responded with the following:

“I feel part of my job as a scientist is to communicate with people – so no problem with the questions.”

I can almost guarantee you that he is working 70+ hours a week, so it’s much appreciated.  Notice below that he even discusses a potential nitric oxide boosting technique that is in the works:

Q. Hello. I run a large men’s health web site and have a quick question for you if you have time. I just read a summary of your research as to how deoxygenated hemoglobin is the prime mover in converting nitrite to nitric oxide in the arteries. I have a bunch of men, including myself, consuming high nitrate foods to do just that and it works pretty well. In my case, I have to consume a lot of high nitrate foods to get an effect and I was wondering if you had any info as to why some men might have an impaired conversion process? I’m eating a half bag of arugula and probably a quarter bag of spinach (from Trader Joe’s), which seems like a lot to me! Any tips as to how to get more nitrate to nitrite to NO conversion?

A. Too much NO would lower your blood pressure below an acceptable value or give you a headache. Make sure those are not happening. One study by Andy Jones showed after you take a certain amount of dietary nitrate, there is no added physical benfit of taking more. About 500 mg nitrate should be enough according to that study.

Q. One last question that has really bothered me: I know that Vitamin C is known for nitrosamine formation. In fact, I believe it is added to foods for that reason, although you can correct me if I am wrong. Anyway, there is a study out there that has concerned me (Gut, 2007; 56:1678-1684, Published Online First: 4 September 2007, “Fat transforms ascorbic acid from inhibiting to promoting acid-catalysed N-nitrosation”) This study, if I understand it right, says that Vitamin C actually promotes nitroamines if you eat a substantial amount of fat in your meal. Now I eat low fat pretty much, but most of the guys on my site do not and so I am concerned about this for their sakes. Do you have any commentary on this issue by any chance?

A. I had not seen that paper and agree with your interpretation. I think vitamin C is generally protective but not consuming high fat is a good idea anyway.

Q. Thanks for the response. I love beets, but they do a number on my GI tract. But I’ll try it. I know that Vitamin C + garlic really boosted NO, but can I ask why the Vitamin C + beetroot juice? I assume on an empty stomach to avoid the increased iron absorption?

A. We think (and are actually currently testing) to see if vitmain C increases plasma nitrite in the blood when you take oral nitrate. Also, vitamin c decreases nitrosamine formation in the gut.

Mercury and Testosterone - Peak Testosterone

REFERENCES:

1) Food Chem Toxicology, 2008, 46:270-279

2) J Environmental Health, Jan 2009, 8:2″Mercury from chlor-alkali plants: measured concentrations in food product sugar”, Renee Dufault, et al;  Institute for Agriculture and Trade Policy, Jan 26 2009, “Much High Fructose Corn Syrup Contaminated with Mercury New Study Finds:  Brand Name Food Products Also Discovered to Contain Mercury”.

3) https://www.consumerlab.com/reviews/    Omega-3_Fatty_Acids_EPA_and_DHA_from_Fish_Marine_Oils/omega3/

4) Reproductive Toxicology, 1991, 5(3):205-209, “Ultrastructural demonstration of mercury in sertoli and leydig cells of the rat following methyl mercuric chloride or mercuric chloride treatment”

5) Reproductive Toxicology, Sep-Oct 1993, 7(5):469-475, “Autometallographic detection of mercury in testicular tissue of an infertile man exposed to mercury vapor”

6) Occup Environ Med, Aug 1994, 51(8):536 540, “Endocrine function in mercury exposed chloralkali workers”

7) Comptes Rendus de l’Academie Bulgare des Sciencesi, 53(12):91, “Mercury Vapour and Some Reproductive Parameters in Human”

8) https://www.cbsnews.com/stories/2005/03/01/health/main677206.shtml

9) https://www.ncbi.nlm.nih.gov/pubmed/15721537

10) https://forum.a1supplements.com/content.php?469-Is-Tuna-Shrinking-Your-Balls

11)

12) Toxicol Appl Pharmacol, 1997 May, 144(1):156-62, “Mercury in saliva and feces after removal of amalgam fillings”

13) J Dent Res, 1996 Jan, 75(1):594-8, “Long-term Use of Nicotine Chewing Gum and Mercury Exposure from Dental Amalgam Filling”

14) AJP – Regu Physiol, Oct 1 1991, 261(4):R1010-R1014, “Mercury from dental ‘silver’ tooth fillings impairs sheep kidney function”

Methyl mercury, a byproduct of the industrial age, has permeated our environment.  The planet is covered in coal-based power plants and these spew mercury into the atmosphere, which then settles over the entire planet.  Every mountain, valley, ocean and stream becomes polluted leading to a contaminated food supply for us.

Methylmercury accumulates in the testosterone-producing Leydig cells of the testes [4], the brain and pituitary. Several studies have shown workers occupationally exposed to mercury have lower testosterone levels. [6][7][1]

Keep in mind that it doesn’t take much to lower testosterone.  Mercury is both toxic and powerful. Denise Zuniga, the actress who accidently mercury poisoned herself from eating too many cans of tuna per day, only had tissue levels about twice that of a normal person. [10]  She has devoted an entire page on her site to the subject for those interested. [11]

Mercury can affect many of our body’s systems, including fertility [5] and thyroid [7] function as well. In other words, all of your hormones can be affected by this deadly toxin. And it’s important to mention that Mercury’s deadly affect on your neurons is a known IQ-lowerer.  Recent news attention has been given to mercury’s ability to lower the IQ of children in the womb. Experts estimate that about 8% of pregnant women have high enough levels to damage (slightly) the brain of their fetus. [8]

So how can you best preserve your testeosterone and other hormones from the ravages of this heavy metal?

NEWS FLASH: One of our Peak Testosterone Forum members documented a case study, using hair testing, where his Mom clearly was experiencing mercury overload from consuming 4-5 cans of tuna every week. See this page for the details: Hair Testing and Mercury.

1.  Fish. Do not consume fish more than once or twice per week. Most experts recommend fish only once or twice per week because of the methylmercury content. I cover this in greater detail in my link on Fish Safety. One story on this page is about a Discover article writer who found that his mercury levels went very high after consuming fish. The reason, he found out, was that he had a negative, but quite common genetic mutation that governs his glutathione levels.

2.  Corn syrup. Avoid corn syrup. Researchers just announced that mercury contamination is extremely common in high fructose corn syrup:  50% of products tested by researchers were contaminated! [2] The issue apparently is that there are no standards for mercury residue in hydrochloric acid and hydrochloric acid is used to make high fructose corn syrup. NOTE:  You should be safe consuming Fish Oil as a recent Consumer Lab Study looked at over 50 fish oil brands and found all were mercury-free. [3] (Fyi: PCBs and lead were also in check.)

3.  Glutathione.  Boost your body’s glutathione levels.  Glutathione is your natural detoxification chemical.  I have dedicated a whole page, How to Naturally Boost Your Glutathione Levels, to the subject.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

4.  Coriander, Parsley and Cilantro. These three herbs and spices are known for binding easily to mercury and some experts feel these can aid in detoxing the body from mercury, lead and other heavy metals. [9]

5.  Watch Those Mercury Fillings. Removing mercury fillings dramatically reduces plasma mercury levels according to a couple of studies. [12] Should you remove them.  Talk to your doctor and dentist about that one.  However, mercury loading looks like a potential issue, especially for those who chew gum or grind their teeth. [13] One animal study showed that 12 fillings could actually impair kidney function short term. [14] What if you have 2 or 3 fillings leaching out mercury over decades?  That is a difficult question, but it may have to do with your genetics:  see #1.

6.  Undenatured Whey. The standard wheys in most stores are loaded with nasty excitotoxins and, just as important, do not boost your glutathione levels as real whey does. I cover this in more detail in my link on Undenatured Whey, which is a powerful glutathione booster.

Probiotics and Erectile Strength - Peak Testosterone

If someone came to you one day and said, “Let’s throw some bacteria into a pill and you’ll swallow it and then let’s watch your brain, liver, heart, erection and mood function miraculously improve!” – you’d tell him he was crazy, right?  Yet researchers have found that replenishing certain intestinal bacteria, or probiotics, does all of that and much, much more.

It kind of makes sense when you stop to think that “you are what you eat” and what you eat has to pass through your small intestine and all the bacterial inhabitants that live therein.  Colon health may not be glamorous, but with every passing month researchers find how it is one of the most important aspects of your personal well-being and fitness.

Let’s look at five counterintuitvie – one might almost say “weird” – ways that probiotics have been found to affect male health:

1) Gastroenterology, Aug 2011, 141(2):599-609, “The Intestinal Microbiota Affect Central Levels of Brain-Derived Neurotropic Factor and Behavior in Mice”

2) European Journal of Clinical Nutrition, 2007, 61:355 361, “Impact of consuming a milk drink containing a probiotic on mood and cognition”

3) Hepatology, Feb 2003, 37(2):343 350, “Probiotics and antibodies to TNF inhibit inflammatory activity and improve nonalcoholic fatty liver disease”

4) Journal of Allergy and Clinical Immunology, Feb 2003, 111(2):389-395, “Effect of probiotic Lactobacillus strains in children with atopic dermatitis”

5) World J Gastroenterol, 2008 Apr 28; 14(16):2511 2516, “Anti-inflammatory activity of probiotic Bifidobacterium: Enhancement of IL-10 production in peripheral blood mononuclear cells from ulcerative colitis patients and inhibition of IL-8 secretion in HT-29 cells”

6) Alimentary Pharmacology & Therapeutics, Apr 2006, 23(8):1077 1086, April 2006, “Systematic review: are probiotics useful in controlling gastric colonization by Helicobacter pylori?”

7) Journal of Cardiovascular Disease and Research, 2010, 1(4):213-214, “Potential of probiotics in controlling cardiovascular diseases”

8) Infection and Immunity, Sep 2004, 72(9):5308-5314, “Live Lactobacillus reuteri Is Essential for the Inhibitory Effect on Tumor Necrosis Factor Alpha-Induced Interleukin-8 Expression”

1. Heart Disease (and Erections). Research is preliminary and somewhat speculative at this point, but it is very likely that probiotics can improve cardiovascular disease and erectile dysfunction in many men.  The reason?  One study explained that probiotics help the arteries in three key ways: a) increasing and improving t-cell response which relaxes our normally “overzealous” immune system, meaning less white blood cells will end up creating plaque along the endothelium, b) secretion of proprionic acid which signals the liver to produce less cholesterol and c) forcing the liver to use more cholesterol which, in turn, lowers plasma total cholesterol numbers. [7] All of this will be good for men struggling with erectile strength and ensuing studies will undoubtedly show their benefit.

NOTE:  Inflammation is incredibly important to both erectile strength and heart health. Please see my link on How to Lower Inflammation for more information.

2. Anxiety. An animal study found that administration of an antibiotic “cocktail,” which kills most intestinal flora, led to an increase in anxiety in the mice.  Upon examination, they found that the mice has an increase in BDNF, which is known to increase anxiety. [1] This may explain part of the reason why researchers have noticed that antibiotic use is often associated with stress reactions, depression and anxiety.

4.  Liver. Researchers discovered yet another bizarre connection with gut flora:  TNF-alpha.  You may recall that TNF-alpha is the bad boy inflammatory cytokine that is a root cause of many other chronic conditions that plague modern urban-dwelling men. Thus researchers have found (in an animal study) that better control of TNF-alpha led to big improvements in Non-Fatty Liver Disease. [3]  Some probiotics have beens shown to improve IL-10, an anti-inflammatory cytokine, and other parameters of inflammation as well.

NOTE:  This improvement in TNF-alpha is yet another reason that probiotics may help many men with erectile dysfunction. Please see my link on Juice and Inflammation for more information.

5. Immunity. Several studies have found that various probiotics help immune function. Researchers have found that it likely helps with childhood dermatitis [4], ulcerative colitis [5], H.Pylori/ulcers [6] and on and on. Researcher do not totally understand yet how probiotics works its wonders on the immune system, but it seems to be by positive affecting inflammation and the permeability of the intestine.

So what are probiotics good for?  It’s not too much of an exagerration to say “everything!”  Anything that boosts immunity, brain function and improves the body’s inflammatory response is a huge factor in personal health.

Carbs Per Day - Peak Testosterone

Are you carbophobic?  Many men are now, because there is so much anti-carb sentiment out there in the (American) health blogging world.  This is tragic for many reasons.  Below I will show you why the great majority of men not only needs carbs but an abundant supply for several simple reasons:

a) For intense exericse

b) For optimal muscle growth

c) For maximum colon health

Let’s start with the first item – exercise.  I believe most men recognize that exercise is foundational to a healthy lifestyle and, for those doubters, remember that exericse is one of the best ways to naturally boost nitric oxide.  For a dozen other great reasons, see my page on  Exercise and Sexual Health. And I believe that the research clearly shows that, in all but the most rudimentary of exercise programs, carbohydrates are essential.  NASM (National Academy of Sports Medicine) does an excellent job in my opinion of summarizing the evidence for this:

“The amount of carbohydrate in the diet can affect performance.  High-carbohydrate diets increase the use of glycogen as fuel, where as a high-fat diet increase the use of fat as fuel.  However, a high fat diet results in lower glycogen synthesis.  This is of particular concern if the individual is consuming a reduced-energy diet.  For the endurance athlete, a carbohydrate-rich diet will build glycogen stores and aid in performance and recovery.  Although some studies show an increase in  performance associated with the consumption of a high-fat diet, these improvements are seen in exercise at a reliatvely low intensity (less than 70% of VO2max).  As the intensity of exercise increases, performance of high-intensity exericse will ultimately be impaired.” [1]

Basically, lower intensity exercise such as slower jogging and walking can be handled with a fat-based diet.  However, most exercise programs are based on periods of higher intensity.  How many of us are ultramarathoners after all?  Most men want to lift weights, power lift, increase our speed on a bike and running, do an aggressive HIIT routine, etc.  All of this requires higher intensity levels and those higher intensity levels demand ample carbohydrates.  In fact, not have those carbohydrates could contribute to overtraining.

NASM goes on to recommend between 2.7 and 4.5 grams of carbohydrate per pound of bodyweight. That’s actually a lot of carbs and. for me, a 167 pound guy would mean between 451 and 751 grams of carbs per day.  As I’ll show below, I don’t feel that I need quite this many carbs, because I don’t really consider myself an “endurance athlete.” I am serious about my exericse programs and try to exercise an hour and get in 13,000-14,000 steps per day.  So, even though I am not really an “athlete,” I still need a good supply of carbohydates.  In particular, I lift weights quite intensely and do either HIIT or cardio (treadmill running).  I cannot imagine trying to do those without carbohydrates!

REFERENCES:

1)  NASM Essential of Personal Fitness Training, Fourth Ed. Revised, Jones & Bartlett Learning, p. 480

2) https://www.jissn.com/content/9/1/54 , Journal of the International Society of Sports Nutrition , Vol. 9, “Protein timing and its effects on muscular hypertrophy and strength in individuals engaged in weight-training”

You also have to have those carbs to really build muscle.  Yes, you can put on some muscle with lower carb diets, but most of you into bodybuilding know that insulin is often considered just as anabolic as testosterone.  In fact, that’s the purpose of those post workout drinks that men consume after lifting:  they are trying to spike their insulin levels to drive the amino acids they have consumed into muscle cells.  Of course, I don’t advocate spiking your blood sugar and insulin, but some carbs will help with that process.  The Journal of the International Society of Sports Nutrition points out the scientific principle behind this strategy:

“A combination of a fast-acting carbohydrate source such as maltodextrin or glucose should be consumed with the protein source, as leucine cannot modulate protein synthesis as effectively without the presence of insulin and studies using protein sources with a carbohydrate source tended to increase LBM more than did a protein source alone. Such a supplement would be ideal for increasing muscle protein synthesis, resulting in increased muscle hypertrophy and strength.” [2]

Thus, the protocol after a weights, power lifting, kettleballs, etc. is to consume protein and carbs within about 20 minutes.  There are still other exercise-related reasons to consume carbs:  a) if you workout goes over 90 minutes, b) a post-meal drink for endurance athletes to maximize glycogen synthesis and stores and c) glycogen loading.  You just can only go so far with an exercise program that does not include carbohydrates and, in my opinion, every man needs to be serious exercise.

NOTE:  You also desperately need the fiber and resistant starch that comes with complex carbohydrate foods for proper colon/intestinal health.

GOOD CARBS AND BAD:  Yes, refined carbs are bad – no one disputes that.  Complex carbs are the core staple of virtually superculture on the planet.   Just as there are good fats that you should emphasize and bad fats that you should demphasize, there are good carbs and bad carbs.  Good carbs are complex carbohydrates with various forms of fiber.  These are be nutrient-packed and loaded phytonutrients.  They also are generally replete with nitric oxide-boosting compounds that will help men in a hundred different ways, which is the subject of my book The Peak Erectile Strength Diet.  

One of the keys is to consume low glycemic carbs.  Dr. Barnard has show that you can reverse adult onset diabetes with lots of carbs and a low fat diet as long as they are low glycemic.  (See my page on Low Fat Diets and Diabetes.)  Beans, legumes and fruit tend to be lower glycemic for example.  NOTE:  Wheat, even whole wheat,  is NOT lower glycemic and neither is white or basmati rice.  Deemphasize these foods.

NOTE:  No, too many carbs do NOT make you fat contrary to what so many health bloggers claim.  Too many calories make you fat!

Why Not Go High with Carbohydrates?

While it is critical to consume an ample amount of complex carbohydrates, it is also critical to not go too high.  Below are just a few reasons:

1. Elevated Triglycerides and Lowered HDL. If you consume too many carbs, you could find that your triglycerides climb up and your HDL falls.  This is a sign of insulin resistance setting in and could accelerate the buildup of plaque in your arteries. See my page on HDL, LDL and Triglycerides Levels for Plaque Regression.

2. Go Pattern B with Your Lipids. If you consume too many carbs, you could find that your LDL becomes smaller and your LDL particle count goes up.  The particle count (LDL-P or apoB) is probably the single most important number to maintain and control arterial plaque.  See my page on LDL-P Particle Count Levels for more information.

3. Raise Post-Prandial Blood Glucose Levels. Probably the best test for insulin resistance is post-meal blood glucose levels.  As prediabetes sets in – and this is incredibly common in modern cultures – your post-meal blood glucose will begin to spike.  This can hammer the beta cells in your pancreas and send a man into adult onset diabetes. See my page How to Test for Insulin Resistance for information on how to perform this basic best..

Every man is different as to how many carbs he can consume and it requires testing and monitoring, something that should become part of your health and fitness lifestyle if it is not already.

5 Steps To Choosting Your Carbs Per Day

So how do you actually choose your carbohydrate levels?  I am going to assume you know about how many calories you want per day.  If you don’t, I will do a post soon on how to estimate your base calories.  For now, I will just assume that it is 2,200, but you can adjust accordingly.

1.  STEP 1. Choose a Superculture (For Fat Levels). You must start by deciding a few all-important macronutrient percentages that you want in your diet, such as the level of fat.  There are basically 3 options:

a) Low Fat. The ultra elite supercultures that have no cancer or heart disease AND incredible longevity all eat low or lower fat diets.  The Tarahumara are probably the lowest fat of these cultures with fat calories in the 10-15% range of total calories. You can read more about them in my page on  The Tarahumara Diet. (They are also famed ultramarathoners.) I prefer this kind of diet to maximize nitric oxide and blood flow. In addition, the most elite supercultrues fall in the range and you can read about others in my review of the book Healthy at 100.

b) Mediterranean or Pukapuka Diet Fat Levels. This would be fat levels in the 30-35% range.  The Mediterranean Diet has had good health outcomes overall and the Pukapuka have nearly perfect heart health.  You can read about them here if interested:   The Pro-Testosterone Diet of the Tokeluau and Pukapuka.

c) Tokeluau or Paleo Diet Fat Levels.  In my opinion, the highest level that one would want to consider is 35%.  However, there is another Pacific Island group that eats fat in the 50% range and discussed in the link above.  Many of you are consuming what I call “classic Paleo Diets” and my be more comfortable at this level.

2. STEP 2.  Choose a Level of Protein. Most guys trying to put on muscle or significant exercise will go higher on their protein levels.  I am going to assume below that this is the case, simply because almost every guy on the Peak Testosterone Forum seems to be in this category. If you don’t care much about protein, adjust accordingly.  By the way, contrary to the bodybuilding magazines, you don’t need a g/lb of body weight.  The actual ACSM guidelines for strength athletes is 1.2 – 1.7 g/kg, which works out to about 0.55 – 0.77 g/lb.  So, for example, I am 167 pounds and lifting weight regularly but am not a competitive bodybuilder obviously.  I need about .65 g/lb, which works out to about 108 grams of protein per day, which would be about 20% of my calories.  This is the number I will use below.

3.  STEP 3.  Calculate Your Carbohydrates Per Day Based on the Above. Those of you familiar with macronutrient calculations can do this on your own, but for those unfamiliar, I have included three sample sets of numbers based on the which fat level is chosen and assuming total calories of 2,200 and that 20% of those calories are protein:

Notice that the carbs per day is between 165 grams per day and 358 grams per day, depending on how much fat you include in your diet.

4.  STEP 4.  Calculate Your Carbohydrates Per Meal. This gives you a rough gauge as to how many carbs will be consumed with each meal.  I eat around 6 meals per day and so basically I need 358/6 = ~ 60 grams of complex carbohydrates per meal.  This is not something rigid and, after a day or two, you can quickly learn how much carbohydrate to add to your meal without getting out a laboratory scale for measurement.

Lose Weight to Decrease Estradiol - Peak Testosterone

Are you overweight? If so, realize that you can very significantly lower your estradiol through weight loss (and boost testosterone while you are at it):

In my page Testosterone and Weight Loss, I discuss how men can profoundly increase their testosterone – sometimes double or even triple it – through weight loss if they have ~ 75+ pounds to lose. And considering that one third of the U.S. population is obese and another third is overweight, many men fall into this category or darn close. Of course, the tragedy is that few men understand what a powerful and positive impact weight loss can have on their hormone levels.

Below are a couple of studies from the research showing this effect:

1. Study: Healthy Versus Thin Controls.  Lets start with a study of obese men versus thin healthy controls.  The researchers found that “serum estrone (E,) and 17 -estradiol (E2) were noted to be 2-fold elevated in a group of morbidly obese men.” [1] There are actually three primary estrogens in men and the most powerful of the three is estradiol.  The same study also found that the obese men had average testosterone of 348 ng/dl versus the 519 ng/dl of normal men, which is about a 33% reduction in testosterone.  Furthermore, some of you may recognize that 348 number:  it is the exact threshold at which LabCorp defines hypogonadism in adult males.  Basically, these men, by putting on all those extra pounds, drove themselves into a hypogonadal state.

The tragedy is that very few doctors will explain just what all those extra pounds do to a guy and will just give the man Cialis if testosterone is high enough or put him on HRT (TRT or testosterone therapy) if it is low enough.

2. Study: Effect of Weight Loss on Estradiol, T and T/E2. A more recent study took moderately obese men and had them lose about 60 pounds of weight.  Most obese men have significantly more to lose than just 60 pounds, but this shows a nice snapshot of the change that can occur.  Look at what happened to their hormones levels:

—Testosterone increased 34% from 400 to 536 ng/dl

—Estradiol dropped 22% from 36 to 28 pg/ml

—The testosterone-to-estradiol ratio increased by 72% from 11.1 to 19.1.

The authors basically noted that weight loss restored these men to normal hormone levels:

“In conclusion, increased circulating estrogens and reduced androgen binding were found in moderately obese men, which were completely corrected with weight loss..”

Of course, I would guess many of them could have lost a bit more weight and improved things even furthermore.

Some of you may be thinking, “22% is not that great.  Why not just take Arimidex?”  First of all, I have seen even greater drops on the Peak Testosterone Forum. In fact, the way that I would word it is that, if you drop your body fat percentage down to around 15% – yes, what you were (hopefully) in high school or college – your estradiol levels will fall right back to youthful levels.  In other words, skewed estradiol levels are not so much a function of aging but just the weight gain that occurs so often with those in Western societies.

But even if you “only” got a 22% drop in estradiol, remember that you would boost your testosterone-to-estradiol ratio by 72% according to the above study, which is very likely to make you feel a lot better.  Plus, you’ll like feel much, much better for many other reasons as well.  I outline those in my page on 20+  Reasons to Lose That Extra Body Fat.  Here is just a partial list:

Also, my favorite way to lose weight is with the approach of Clarence Bass. Clarence was a Muscle and Fitness columnist for almost two decades and has done well in Over 40 Mr. USA competitions as well.  He is most famous for maintaining low body fat percentages (2-6%) year around, decade after decade.  What I like about his approach is that he emphasizes losing weight slowly, never being hungry, using a bioimpedance scale and a program comprised of the following:

a) weights and cardio

b) a primarily plant-based diet with some meat

And the other thing about Clarence is that he has proven his program works well into his senior years.  He is still has a great physique, energy and respiratory fitness in his late 70’s!  If you are interested, see my pages  Clarence Bass: Challenge Yourself, Clarence Bass, Senior Bodybuilding and Clarence Bass: Ripped for more information.

REFERENCES:

1) J Clin Endocrinol Metab. 1979 Apr, 48(4):633f , “Increased Estrogen Production in Obese Men”

2) The Journal of Clinical Endocrinology & Metabolism, Published Online: July 01, 2013, 53(4), “The Effect of Weight Loss on Reproductive Hormones in Obese Men”

Citrulline Benefits - Peak Testosterone

Probably the prime benefit of Citrulline supplementation is showing itself to be increasing erectile strength and hardness factor. In fact, in my forum some of the recent comments from men with erectile dysfunction have been strongly positive. One man with apparently rather severe erectile dysfunction commented that he had an erection of sufficient quality for penetration, something that clearly had been missing for him for a long time. [1] In fact, he mentioned that he had tried other supplement combinations without any success, so L-Citrulline appeared to have the most horsepower for him.

L-Citrulline is somewhat of a newcomer to the erectile supplement market. Researchers have for years concentrated on L-Arginine to raise nitric oxide and results had stalled. Arginine had had lackluster results and in one study even appeared to be dangerous for some men with advanced heart disease – see my link on The Pros and Cons of Arginine for more information.

However, just when “all hope seemed lost”, L-Citrulline showed up as the real superstar in recent latest. What is interesting is that L-Citrulline is a precursor of L-Arginine. So one would not expect it to really do any better or worse than Arginine supplementation, right? Actually, the opposite turned out to be case. Taking L-Arginine directly has issues, which we will discuss below, that make it less than ideal. Arginine had to be taken in overly high dosages (5 grams +) to have an effect. For example, one study found that about a third of men, probably those with endothelial dysfunction as we will discuss below, had significantly improved erections with 5 grams of L-Arginine daily. [3]

Unfortunately, 5 grams approaches the daily amount given (9 grams/day) in the above-mentioned study of Arginine where six men died. Of course, Arginine can be used successfully when at much lower doses (1.5 grams/day) when combined with other supplements such as Pycnogenol. But all of this goes to show that L-Arginine has definite issues when used by itself.

1) https://www.peaktestosterone.com/forum/index.php?topic=89.0

2) Urology, Jan 2011, 77(1):119-22, “Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction”

3) BJU Int, 1999 Feb, 83(3):269-73, “Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double blind, randomized, placebo-controlled study”

4) Journal of Chromatography A, Jun 2005, 1078(1-2):196-200, “Determination of citrulline in rind”

5) Nutrition, Mar 2007, 23(3):261 266, “Watermelon consumption increases plasma arginine concentrations in adults”

6) PNAS, Sep 20 2005, 102(38):13681-13686, “L-citrulline and L-arginine supplementation retards the progression of high-cholesterol-diet-induced atherosclerosis in rabbits”

7) Br J Clin Pharma, 2008, 65:51-59, “Pharmacokinetic and pharmacodynamic properties of oral L-citrulline and L-arginine: impact on nitric oxide metabolism”

8) https://peaktestosterone.com/forum/index.php?topic=3419.0

One of the big issues with ingesting L-Arginine directly is that it is metabolized in the liver by arginase. And in men with heart disease, arginase is upregulated or more active. This means that more Arginine is converted to the amino acid ornithine, which, as mentioned previously, can potentially lead to herpes outbreaks and other issues.

L-Citrulline, on the other hand, seems to produce equal or better results at much lower dosages. For example, one 2011 study found that a mere 1.5 grams of Citrulline increased the hardness factor of a significant number of men. [2] One of the reasons that so much less is required is that Citrulline supplements completely bypass the liver and the whole arginase conversion process. One study put Arginine head-to-head with Citrulline and showed that Citrulline was the clear winner. [7]

One beautiful thing is that you can easily get this dose through food, namely in watermelon. One study found that an average dosage of watermelon, although the content can be quite variable, was 1.9 mg of Citrulline per gram of weight. [3] This may not sound like a lot but you have to realize that a cup of watermelon is about 154 grams or 290 mg of Citrulline. I don t know about you, but I can easily down a few cups, and voila! you ve just consumed a clinical dose, making watermelon a true super erection food.

What I have used is Citrulline in powder form from Source Naturals: Source Naturals L-Citrulline Powder, 100g. This works very well for me and seems to be the most powerful erectile dysfunction supplement for me.  The powder, at least in my opinion, actually tastes half way decent and is probably the cheapest option.  I have taken between 1-3 grams/day in 3 divided dosages and all of them seem to help.  Talk to your doc first of course.

And it is no wonder that Citrulline works so well for me :  it is now thought of as an excellent solution for men with endothelial dysfunction. The reason? It actually acts as an alternative source for arginine – rather than the typical endothelial pathway – and thus provide an excellent way to increase your baseline nitric oxide levels even if you arterial issues. In addition, you lose some of your nitric oxide just from aging, so this is a way to compensate.

Remember:  even Viagra and Cialis really do not “create” nitric oxide but rather work on the enzyme that breaks it down. Viagra and Cialis simply allow nitric oxide to stay in your system longer, because it is broken down less quickly.

However, this is one of the reasons that Viagra, Cialis and Levitra do not work for many men with endothelial dysfunction. In these men, the lining of their arteries and blood vessels is so damaged that they do not put out enough nitric oxide for these PDE5 Inhibitors to act upon. L-Citrulline can substantially help such men by actually providing more substrate for these medications to act upon.

CAUTION: Always check with your physician before trying any new supplement with another medication. Example: One forum poster said that Citrulline gave him a migraine (since any vasodilator can do that). [8]

Or, better yet in my opinion, L-Citrulline can act as a source of nitric oxide for other more natural NOS (the “nitric oxide enzyme”) solutions such as Ginseng, Pycnogenol, exercise and food. This, by the way, is one of strategies behind the nitric oxide boosting supplement that has recently been all over the web called Neo-40. It is an interesting combination of L-Citrulline and Hawthorn Berry Extract that does just this. One of the foremost nitric oxide researchers in the world, Nathan Bryan, helped design it and so we know we are onto something here.  A couple of the guys on the Peak Testosterone Forum  have taken it with decent results.

Citrulline also has excellent potential for improving general arterial health, which always benefits erectile function as well. How does it do it? By slowing down the progression of arteriosclerosis. That s right, an animal study showed that by increasing nitric oxide and blood flow and reducing superoxide (a potent free radical) gene expression, it could actually greatly help in the batlle against hardening of the arteries. [6]

The short term benefits are hard to argue with. As I mentioned, one poster on a forum thread said that L-Citrulline restored his morning erections. And yet another poster stated “I have only been on the Citrulline for 2 days and it appears to be marvellous stuff- practically the equivalent of having an explosion in my pants!”

DOSAGE:   The highest dosage that I have seen in a study is 3 grams per day.  However, I would recommend trying a lower dosage, 1-2 grams to start out with . Keep in mind that even a few cups of watermelon will likely help. There are also many excellent sources of L-Arginine in food, which tend to have a nice balance of both Arginine and Lysine (important for herpes control). For example, an egg white has almost equal levels of Arginine and Lysine (200 mg). Rice protein, on the other hand, has about a 3 to 1 ratio of Arginine to Lysine.

How to Clear Your Arteries of Plaque (Penile Atherosclerosis)

I personally believe that most of you can actually clear out ALL of your plaque or at least make significant improvements.  The will lead to nice gains in blood flow and nitric oxide in the process.

So how do you do this?  No, the correct answer is not by taking massive doses of statins (in my opinion)! There are actually studies showing that statins can reverse plaque in some cases.  However, they personally make me uncomfortable for reasons I outline in my article on The Potential Dangers of Statins. But, if you have existing cardiovascular illness, you and your physician have to decide what is best for your situation of course.

In the meantime, I want to outline Six Natural Ways to Clear Out Your Arteries.  Most of these strategies come from the men that I call the Plaque Reversers – clinicians that have built up a substantial practice and reputation for actually reversing plaque with many patients.  All of them have written extensively about their experiences and are apostles for heart health. The significant of their work cannot be overestimated in my opinion, because plaque is the #1 killer of men (in modern societies).  In addition, unchecked atherosclerosis can lead to:

2.  Hardening of the arteries

3.  Increasing blood pressure, a risk factor for erectile dysfunction, stroke and many other medical conditions.

4.  Great risk of a heart attack, triggered by “pieces” of plaque breaking off (coupled with coagulation)

5.  Surgeries, stints, angioplasties and countless office visits and drugs.

6.  Angina (heart pain)

Let’s look at some of the natural and semi-natural strategies out there:

1.  Dr. Gould (Heal Your Heart).  Few men have heard of Dr. K. Lance Gould, but he has written a must-read book that I discuss in my Review of Heal Your Heart. If you need motivation to get started on an anti-plaque journey, this is probably the best book to do so, because it is just packed with data.  Dr. Gould includes studies showing how our meals create plaque, the age at which plaque begins to form and the consequences of what happens as the plaque begins to grow and take on a life of its own.  Of course, he also carefully carves out his methodology for reversing plaque:

The advantages that I see with his diet is that he allows men to have some low fat meat and dairy, which would make a low fat diet much more palatable for the typical man that has grown up in a modern lifestyle.  The disadvantage is his use of statins, which many men feel uncomfortable with, for many of his heart patients, i.e. those with significant existing arterial plaque.  In addition, I personally feel uncomfortable with too much dairy as this can potentially increase prostate  and other cancer risk.

2.  Weight Loss. One of the best to regress plaque is to just lose weight according to one study.  This study showed that it didn’t matter how the participants ate:  as long as the lost weight, their atherosclerosis receded equally.  I cover this very interesting study on this page: Arterial Plaque and Weight Loss .  Most men reading this are probably 20-50 pounds overweight.  If they gradually lose that weight over a couple of years, it is very likely that they can achieve several years of plaque regression and get their arteries back. This is very important for erectile strength and, well, survival. (I have a lot of additional information on the subject here:  My Weight Loss Pages, Testosterone and Weight Loss and A Study Showing That Reducing Calories Too Much Can GREATLY Lower T Levels.

3. Prevent and Reverse Heart Disease (Dr. Esselstyn). Some of you health veterans may remember that the first researrcher to really prove that you could regress plaque was Dr. Dean Ornish.  Dr. Ornish emphasized an almost entirely plant-based diet but did allow some non-fat dairy.  He also insisted on some exercise, stress management, etc.  A physician with a similar protocol was Dr. Caldwell Esselstyn, who is now very well-known for his work at the Cleveland Clinic.  As I discuss in my Review of Prevent and Reverse Heart Disease, Dr. Esselstyn’s program is probably the most simple and striaghtforward of all the Plaque Reversers.  He basically asks men to follow a strict whole foods, low fat vegan diet and does not like dairy, nutrs/seeds or meat (including fish).  Furthermore, he does not emphasize supplements and basically wants all men to target low LDL-C levels.

His philosophy is that if you get your LDL-C low enough, below about 80, then a whole foods vegan diet will take care of all the other issues, such as lowering inflammation, that are required for plaque reversal. And, if he can’t get that LDL low enough through diet, then he will sometimes give a man a low dose statin.

Also, I want to mention, because there is so much misinformation out there from the Low Carb and Paleo crowds, that all carbs are not bad.  Just as there are “good” fats and “bad” fats, there are good carbs and bad carbs.  Vegetables, fruit, legumes and beans are all excellent low glycemic choices.  In my opinion, whole grains – like quinoa (which isn’t a grain actually), brown rice (which boosts nitric oxide) and non-GMO whole corn – can be used in moderation.

The other key thing to remember is that low fat carbs do something beautiful:  they clear out lipids from liver cells. I cannot emphasize how important this is.  This is one of the reasons that cultures that eat a lot of lower fat carbs are so healthy and long-lived:  their liver cells are drained of lipids.  The root cause of insulin resistance is extra fat getting packed into the liver cells.  This is why low fat diets, if done correctly, can actually reverse diabetes.  Dr. Bernard proved this in a landmark study, which I discuss in page on How to Reverse Diabetes with a Low Fat Diet.

By the way, it is tragic that a Low Fat Diet is called “low fat”, because it is really not low in fat at all.  The typical person on a Low Fat Diet will consume between 20-40 grams of fat per day and 5-10 grams of saturated fat which is plenty.  Even “dry” foods like whole grains, legumes and beans will supply a significant amount of saturated fat, more than enough to trigger ample production of cholesterol for the body’s needs.  (I believe you should avoid wheat however, because it is GMO’d and spikes blood sugar levels.)

My personal take on Dr. Esselstyn’s program is that it will definitely work for about 80% of men reading this.  However, I do have concerns that some men in maintenance mode, i.e. neither gaining or losing weight, could have their LDL Particle Counts go too high.  The reason I say that is that Dr. Davis and Dr. Gould have observed that some men on low fat diets actually increase LDL particle counts and small particle LDL, which usually leads to an increase in plaque.  Furthermore, studies show that signficant numbers of men with low LDL, even lower than Esselstyn advocates can end up with atheroslcerosis and heart disease.  This is going to mostly be men who are insulin resistant, i.e. prediabetic. If you don’t know what I mean by that, please read this all-important page on Understanding LDL-P Particle Count Levels to Reverse Plaque.

So the bottom line is that Dr. Esselstyn’s program is an excellent one, but I would pull your LDL Particle Count about a month into your program and just double check that you are handling the increased carbohydrates properly.  An additional test is your triglyceride levels.  If those go too high – say above 100 – then you may need to figure out a way to ramp down the carbs.

4.  Dr. Davis (Track Your Plaque).  Dr. William Davis is probably the most popular and well-known of the Plaque Reversers.  He resonates with many in the Paleo community in particular, because he advocates eating only small amounts of carbs, rails against wheat and most grains and allows a significant amount of fat.  Originally, he preached against to saturated fat, but I heard from a member on the Peak Testosterone Forum that he now actually encourages saturated fat. Saturated fat can slow down blood flow, so that’s not my favorite idea, but many guys do not feel that that is an issue for them.

Here are some of the key aspects of his program as outlined in his book Track Your Plaque:

His book, Track Your Plaque, is a must-read for every English-speaking male on planet earth over the age of 20 and you can read about here: A Review of Track Your Plaque by Dr. William Davis. This is not my favorite way to try to regress plaque as I feel uncomfortable with decades of high dose niacin. However, Dr. Davis makes a strong case that it is generally safe if under the care of a knowledgeable physician. Even if you don’t accept that premise, the book is an absolutely invaluable source of information.

5. My Attempt (Pritikin-like, Tarahumara-like Program). Now I am not a clinician or researcher, so keep that in mind:  I am a sample of one.  However, I can tell you that I had a Calcium Score of zero at age 53, something I discuss in my article My Heart Scan Results. My personal opinion is that I very likely had some plaque a few year earlier, based on all the issues with erectile dysfunction that I was having.  And I believe that going on a low fat diet about five or six years ago reversed that (along with HRT of course).  I also know that I sure felt better. However, I cannot prove that I reversed plaque, because at the time I did not know enough to get an IMT or Heart Scan. I have, apparently, kept the plaque off tho, no small task in a Western culture at my age, so I am proud of that achievement.

In addition, I have always been intrigued with the story of Nathan Pritikin, who definitely had significant plaque and heart disease and died with perfectly clean arteries per a coroner’s report. My personal program is to try to take what I consider to be the best of the above three Plaque Reverers and essentially follow a Pritikin-type program.  Here is my summary of what Nathan Pritikin did for example:

Now notice the beautfy of Nathan Pritikin’s Program. The low fat diet will dramatically lower his LDL levels and the exercise will dramatically lower his triglyceride levels and increase HDL. All of this would have greatly lowered his LDL Particle Count as well, so no wonder he died with no plaque!  And this kind of lifestyle – a low fat diet plus exercise is what is consumed by the most long-lived, ultra heart healthy cultures around the globe. The supreme example of this is something I have written up in my page on The Diet of the Tarahumara.

CAUTION: There are a few unusual markers that can trip up any diet.  Again, read the book Track Your Plaque above to make sure you don’t accidently miss one of these.

And here is how I am implementing the above:

How can a Low Fat Diet clear out arteries? The research shows that it does it by hitting almost every major pathway that leads to arteriosclerosis:

a)  Lowered Cholesterol. A Low Fat Diet brings saturated fat consumption down to more natural levels and this, in turn, almost immediately drops LDL into the range where there is little to no heart disease.  (Actually, it is possible to have a heart attack with low LDL, but it is much less common.)  CAUTION:  Some men have low LDL for reasons that can be detrimental to their health potentially, such as certain genetic conditions, GI / digestive disorders, cancer, addictions, etc.

b)  Increase LDL Particle Size. Many of the experts consider the baddest of the bad boys are the very small LDL particles.  LDL, as many men now know, is the “bad cholesterol” of the lipid world.  However, it is really the small particles that do the most damage according to one school of thought. Well, one study showed that a Low Fat Diet increased LDL particle size. [1] Now, if you do a low fat diet wrong, this will not be the case, so play it safe and avoid wheat and all refined carbs.  And test to make sure that you are doing what you think you are doing.

c)  Decreased Oxidation.. Again, small, bad cholesterol particles need to be oxidizied in order to do their damage to arterial walls.  The above study showed very significant decreases in oxidation levels as well from a Low Fat Diet. [1]

d)  Decreased Blood Pressure.  Hypertension is a plague in modern society and high blood pressure damages arteries, capillaries and surrounding tissues throughout the body, especially as the years and decades go by.  A Low Fat Diet has been shown to decrease blood pressure levels significantly in a number of studies and I document this in my link on How to Lower Your Blood Pressure. (See #2.)

e) Diabetes Reversal and Blood Sugar Control. Again, Dr. Neil Bernard, outline how easily a Low Fat Diet can actually reverse diabetes. He shows how it can lower glycated hemoglobin (A1C) levels and normalize blood sugar. This also helps heal and restore your arteries (and about a 100 other tissues.)  CAUTION:  The key point here is to make sure that you eat low glycemic Low Fat foods, i.e. not cheating with sugars and a bunch of wheat, corn starch and other refined carbs.  In my opinion, a solid amount of daily exercise and activity is also crucial to make sure you do not go insulin resistant.

Right now low fat diets are the ugly stepchild in the health blogosphere, but the fact is that low fat diets have done very well in the research and you can check out this link for more details: The Many Benefits of a Low Fat (Ornish) Diet.  I do tweak a Low Fat Diet, though, to include more protein for building muscle and a few other things.

6. Pomegranate Juice. It is hard to believe but just a little pomegranate juice could actually clear out arterial plaque, but this is exactly what one study showed. [2] The group of pateints in this study had advanced arteriosclerosis.  However, almost anyone reading this article wondering how to clear their arteries is likely in that category or close. And in those with more normal narrowing of the arteries, other research showed that pomegrante likely slowed arterial plaque buildup even if it didn’t actually clear it the arteries.[3] Keep in mind, though, that this is just one study and the methodologies of the Plaque Regressers is much more well-developed.

In fact, pomegranate juice is a wonder worker for your arteries in many ways:  it lowers blood pressure, boosts nitric oxide, protects against oxidized LDL and lower cholesterol levels.  In short, it does everything you could possibly want a foood or supplement to do to protect your cardiovascular system.  (Talk to your physician if you’re on any medications as it can alter absorption rates of other medications.) For more information, see my links on The Power of Pomegranate Juice and The Benefits of  Pomegranate Extract.

Personally, I would not rely on just pomegranate juice to clear out plaque, but I believe it can be an additional tool in your arsenal.

7. Gum Disease. One small study showed that by reversing gum disease patients actually reversed arteriosclerosis.  This may seem implausible at first, but researchers have noted that “infections” of the mouth raise inflammation levels throughout the body and correlate to heart disease. [7] Again, keep in mind that this is one study and the fact that it was small and on patients with some periodontal disease. Read my links on How to Control Inflammation and Inflammation and Erectile Dysfunction for some related information.

Again, I would not rely on just correcting your dental hygene to reverse atherosclerosis, but this is interesting information nontheless and emphasizes the importance of controlling inflammation.

CONCLUSION: Get started!  Here are the basic steps:

a) Start by find out your personal plaque levels through an IMT (carotid ultrasound) for $70 as of this writing with Lifeline or a Heart Scan (usually around $99) at a local heart institute. A Heart Scan does involve some radiation, although it is relatively low level. You do not need a doctor’s orders here in the U.S. for either procedure in almost all states.  (There are a few Control Freak States that do not allow you to do any personal medical testing without a doctor’s orders.  These states decide who is a doctor and what is best for your personal health.)

b) I urge you tread Track Your Plaque and Heal Your Heart – mentioned in the links above – to understand how to monitor plaque, how rapidly it progresses and how it can lead to angina, stroke and heart attack.

c) Learn how to monitor your lipids and inflammation.  This is an involved subject.  I have good (imho) summaries here of HDL, LDL and Triglcyeride Levels and the all-important LDL-P Particle Count. But reading the books in b is critical: these should be on your nightstand and you should read and study them like a bible.

d) Of course, pick a diet and exercise program. Davis, Gould, Esselstyn, Pritikin – pick one of them and get started. The benefits are huge and, by the way, will pay off in the bedroom as you clear out penile plaque, boost blood flow and increase nitric oxide.

1)   Arteriosclerosis, Thrombosis, and Vascular Biology. 1996, 16:201-207, “Effects of Diet and Exercise on Qualitative and Quantitative Measures of LDL and Its Susceptibility to Oxidation”

2) Clin Nutr. 2004 Jun;23(3):423-33, “Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation”

3) The American Journal of Cardiology, Oct2009, 104(7):936-942, “Effects of Consumption of Pomegranate Juice on Carotid Intima Media Thickness in Men and Women at Moderate Risk for Coronary Heart Disease”

4) Neurology, Oct 1 1977, 27(10):905, “Cerebral blood flow, oxygen utilization, and blood volume in dementia”

5) Journal of the American Geriatrics Society, Oct 2007, 55(10):1613 1617, October 2007, “Assessment of Endothelial Function in Alzheimer’s Disease: Is Alzheimer’s Disease a Vascular Disease?”

6) https://www.davisregional.com/health-education/1,2513

7) FASEB J, 2009 Apr, 23(4):1196-204. “Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima-media thickness.

8) https://nutritionfacts.org/video/cholesterol-and-lower-back-pain/

Female Libido: Pain - Peak Testosterone

Have you noticed your woman disinterested from any or all advances to make love? Assuming you’ve ruled out BO, halitosis and various psychoses, then maybe you need to dig a little deeper for the cause. You may not be a bad lover or a loser after all. In fact, there could be another reason: pain  (Remember:  Sex is Incredibly Physically Important for Males.)

That’s right – it is VERY common – and we’ll cover some of the common issues below – for women to experience pain during intercourse.  “But she would tell me if there was a problem like that!”  Not necessarily, Casanova. First of all, it may not be bothering her all the time and, secondly, she knows this is an emotional topic for us guys.  Let’s face it:  if she told you, you would probably think she was really saying, “Not tonight, dear, I’ve got a headache”, right?

Regardless, there are probably a hundred reasons – women are pretty complex if you haven’t noticed – that she might not tell you and pain is suprisingly common, so you should be aware.  Remember that probably not even a horn dog like you would want to have sex if it felt like you were getting catheterized, so be patient with her.

So what causes pain for females?  Unfortunately, many things.  For us guys, about the only thing that causes us pain during intercouse is if we fall off the chair or the overhead mirrors land on our forehead.  And you’d be unlikely to complain anyway unless you had a spear through your thigh, eh?

That said, it pays to be aware of some of the common things that can cause pain for females:

1. Yeast Infection.  A full-blown yeast infection will make intercourse about as pleasurable as 120 grit sand paper on your scrotum.  Sometimes women have a less pervasive infection that causes them discomfort.  Over the counter medications can generally help with this.

2.  Dryness.  This one can be caused by many factors from hormones to lack of foreplay on your part, you Eager Beaver.  One important thing to keep in mind is that a number of common medications can increase or cause vaginal dryness, a topic that I cover in my links on Vaginal Dryness and Drugs and the Best and Most Nutural Lubricants for Intercourse.

3. UTI’s.  Urinary tract infections make everything hurt “down under” for her.  Of course, the solution is a antibiotic, although cranberry juice should also help.

4.  STD’s.  Herpes is a prime example and can cause considerable discomfort during outbreaks.  Look for the “pimples” and get her to go to the doc if necessary.  Chlamydia can trigger Pelvic Inflammatory Disease (PID) which will take the fun out all sex until she gets proper medication.

5.  Vulvodynia.  This is very common and basically refers to “pain of the vulva”, the vulva being that worshipped little mound above a woman’s vagina.  This is generally handled by docs who specialize and have experience with this condition.

6. Cervix Issues.  A lot of women have a uterus that can get in harm’s way during intercourse.  How would you feel if every thrust thumped your bladder or kidney, big fella?  There’s no pill for this as it is generally caused by the genetic positioning of the uterus in her abdomen.  The only solution is to try different positions, you lucky dog!

7.  Endometriosis.  Does your woman have very painful periods and frequent pelvic pain?  It could be endometriosis, a common condition where uterine tissues actually disperse into neighboring parts of her body.  One side effect can be painful sex.

It is important that you deal with the pain as soon as possible for many reasons.  Of course, you want to find the underlying medical issue and, in addition, it is possible that she can develop a very common condition called vaginismus.  Vaginismus occurs when a woman experiences an involuntary tightening of the PC muscles, the ones engaged during Kegel Exercises, making intercourse painfully difficult or even impossible.  Researchers have noted that this condition can occur seemingly without cause (idiopathic), but can occur after rape, anxiety and painful sexual encounters.

There are many, many other things that can cause under-the-sheet discomfort for females, but this is a good starting overview.  Again, this is another difference between guys and gals:  we have few such problems that take us out of commission. So we need to be sympathetic, ask questions and get her to a good doctor if there is a problem.  Once you remove the pain, you should get your old tigress back…

Testopel: An Interview with a Reader - Peak Testosterone

It is important to note that this reader has had a very positive testosterone therapy experience and, of course, that is not universal:  there can be side effects. Nevertheless, I think many guys will find his comments and perspective helpful.

So why did you and your doctor choose testosterone pellets instead of some other standard methods of HRT such as gels or injections?

I was first placed on Testim which I read had better absorption rates than Androgel. I applied it faithfully each morning after my shower but my body didn t absorb the testosterone. My total testosterone levels after two months on Testim came back at 325 ng/dl. My urologist started me on ten pellets last December. He has since increased me to twelve pellets. There is very little doubt about testosterone absorption when placed on pellets.

You were hypogonadal, right? Can you describe which of your symptoms the pellets helped? And how long did it take before you started noticing a change?

Last summer I initially saw a urologist for prostatitis. He also checked my total testosterone levels which came back at 307 ng/dl. Was told that level was normal and placed on Cipro to cure the prostatitis. Subsequent measurements prior to getting the pellets were always in the ballpark of 325 ng/dl.

Depending on what levels the doctors use as a cut off which varies, I guess I am hypogonadal or considered to have lower testosterone levels.

About two weeks after my first pellet insertion I noticed I was waking up with fuller erections and was thinking about sex in the middle of the day (like I used to do). Sexual relations just naturally resumed with my wife as I now had it on my mind and I would wake up in the middle of the night or morning needing to have sex. It wasn t a disruptive urge, but an urge that for several months had basically vanished from my life. There are no guidelines out there that really tell one what is normal for a guy at fifty years old.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

What sensations do you feel during the procedure?

I was nervous before the first insertion in anticipation of the unknown, but in retrospect it really is a piece of cake. I felt a slight sensation when my doc initially injects anesthesia in my buttocks, but after that there is absolutely no pain or discomfort.

How long did the prep work and procedure itself take in your case?

The prep work and procedure are done at my urologist s office and take no longer than ten minutes every three to four months.

Were you able to go back to work after the procedure? What is the downtime?

There is no downtime. I went back to work and resumed all normal activities immediately after. You can t go in a hot tub or sit in a bath for the first three days after the insertion. For me this isn t an issue.

So did you have any complications? What about bruising or bleeding?

There is minimal bleeding and steri-strips are used which are kept on the insertion site for the first week. For me, the day after the procedure was key as the anesthetic effects are gone there was minimal discomfort for a few days but never anything that I d consider painful. Believe me that would have been my first and last time for me had it been painful. There is bruising at the site for the first two weeks about the size of your clenched fist. It s on your buttocks and since there is minimal discomfort, for me it s not an issue.

I know you re a fan of the pellets. Can you explain why? Would you recommend them for most other guys?

Pellets work for me because you essentially forget that you have them for a three to four month span. That is tremendous. I didn t miss applying the gel on a daily basis or having it stick to my shirts or hearing my wife tell me that she didn t like the smell. I was also afraid of transferring the gel to my family so the shirt was always kept on and my hands were always washed thoroughly after each application. For me the daily application of the gel was a reminder that I have an issue. With the pellets you really do forget that you have an issue.

The best reason for me is that I feel like a man again. I m having sex between three and four times a week vs. one or two times a month. I m waking up with strong erections each morning even mornings after having sex the night before. My marriage has spice in it again and my wife and I are much happier.

I would definitely recommend pellets to other guys out there.

So do the implants get removed at a later time? How in the world does the doc find them?

The pellets are totally absorbed by your body so there is no need to remove them. You can feel them slightly with your fingers after they are inserted but you really have to be looking for them to find and feel them.

Have you had one of the implants work its way to the surface?

The pellets have never surfaced or come out. The insertion site has never become infected.

Can I ask if the pellets were covered by insurance? Or was only the office visit?

For me, the in-office procedure and the pellets are covered by my insurance carrier.

So I assume you ll continue with testosterone pellets?

Absolutely!

Any last words for the guys out there?

We all try to do what we think works best for us. For me, I performed my own due diligence and research on all forms of testosterone therapy along with their benefits and risks and became knowledgeable as possible so that I could best understand each treatment option. There is plenty of information out there. You just need to expend the time and energy to gather the information and assess your options.

Also, I went through a few doctors before I found my current doc. It s a matter of being comfortable with your doctor based on his/her credentials and how they treat me as a person. The docs do this sort of thing all of the time, but it was new to me and I needed a doc who truly cared about my needs and understood my issues, etc. For me this is very important.

Most important if you truly believe that you have a testosterone issue or any issue for that matter never give up your quest to help yourself. It may take you a bit of time to find what works best for you but with patience and perseverance you will get there.

Cortisol and Protein - Peak Testosterone

Most guys are suprised there are very negative aspects of animal protein.  How could this be when you have so many diets such as Atkins, South Beach, Low Carb and so on that are based on an abundance of meat and dairy?  Furthermore, haven’t humans been eating meat since the dawn of antiquity?

I can only tell you this:  animal protein has some very positive AND some very negative qualities. It is almost always a mistake to ignore or hide the research and such is the case with animal protein.  I eat between a half dozen and a dozen egg whites every day, but I know there are potential issues there.

Consider these problems with animal protein that the research has uncovered:

1.  Lower Testosterone. There are a couple of studies that show higher protein levels mean lower testosterone.  For example, one study of seven healthy men found that those with higher protein levels had 26% lower testosterone levels. [1]  The key according to this study was the protein to carbohydrate ratio.  (Fat and calories were held constant.)  For more information, read my link on Testosterone and Diet.

REFERENCES:

1) Life Sci, 1987 May 4, 40(18):1761-8, “Diet-hormone interactions: protein/carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man”

2) Am J Clin Nutr, 2003, 78:584S-592, “Bone mineral content of North Alaskan Eskimos”

3) Acta Medica Scandinavica, Jan/Dec 1983, 214(2):99 101, “Serum Calcium in Greenland Eskimos”

4) J Gerontol A Biol Sci Med Sci, 2010, “Protein Intake, Weight Loss, and Bone Mineral Density in Postmenopausal Women”

5) J Amer Dietetic Assoc, 2007, 107:1404-1408

6) American Journal of Clinical Nutrition, Sep 2005, 82(3):%53-558, “A high-protein diet increases postprandial but not fasting plasma total homocysteine concentrations: a dietary controlled, crossover trial in healthy volunteers”

7) N Engl J Med 2004; 350:1093-1103, “Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men”

8) Angiology, 2000 Oct, 51(10):817-26, “The effect of high-protein diets on coronary blood flow”

2. Cortisol. This same study found that high protein meant higher cortisol as well. [1]  Of course, this is a very undesireable situation – lower testosterone and higher cortisol – since lower testosterone is assiated with diabetes and heart disease and higher cortisol with neuron damage, muscle loss, visceral fat deposition (“beer gut”) and many other nasty anti-male qualities.  Read my link on Cortisol and Stress for more details.

3.  Bone Loss. There is some evidence that higher protein diets can lead to bone thinning and eventually osteoporosis (in some cases).  For example, in many of the supercultures that eat little dairy and almost no meat, osteoporosis is much less common.  According to conventional medical wisdom, these third world cultures should be rife with osteoporosis and hip fractures due to low calcium levels, but, in fact, the opposite is true.  Furthermore, several studies on the Eskimos have shown that they have accelerated bone loss and one of the key features of their diet is high animal protein. [2] One reason that experts speculate may be behind this phenomenon is that protein adds a tiny acidic load on the blood stream and the body, to compensate, pulls calcium from the bones to neutralize it. However, in fairness, the Eskimos have a low calcium diet and so that could play a role as well. [3]  NOTE: This has also been shown to be an issue for post-menopausal women, so you might want to tell your woman if it applies. [4]  Interestingly enough, significant bone loss was experienced for women consuming high levels of beef, chicken and vegetarian protein.

4.  IGF-1.  Many studies have shown that casein, the primary milk protein, increases IGF-1 and inflammation.  This is something I discuss in more detail in my link on The Pros and Cons of IGF-1, but suffice it to say this likely increases your risk of cancer and other problems.

5.  Homocysteine. Protein has been shown in several studes to raise homocysteine levels, a significant risk factor for heart disease.  For example, one study of healthy pre-middle-aged males found that a higher protein diet (21% of calories) lead to elevated homocysteine levels when compared to a lower protein diet. [6] There is some evidence that exercise can lower homocysteine levels, but clearly this is a potential risk.

6.  Decreased Immunity. Amino acids have powerful effects on the body, including our immune systems. One surprising property of protein, that most bodybuilders and athletes do not realize, is that the research shows that in many cases it can negatively effect our ability to fend off infections, parasites and autoimmune disorders. This is a big subject, which I cover in my link on Protein and Immunity.

7.  Gout and Urate Kidney Stones. Increased uric acid levels are an outgrowth of eating purine-rich foods such as red meat and sea food. One 12-year study of men found a 50% increase in gout from eating these high-protein foods. [7] High protein diets are also associated with an increased risk of the less common urate kidney stones.  However, high uric levels may increase formation of the much more common oxalate kidney stones.  Both gout and kidney stones are very painful conditions. Keep in mind that the erection-killing Metabolic Syndrome and insulin resistance are also associated strongly with elevated uric acid levels putting many modern, urban dwellers at risk for these issues.

8. Increased Systemic Inflammation. Researchers found that a high protein diet increased the inflammatory markers of “fibrinogen, Lp (a), and C-RP increased by an average of 14%, 106%, and 61% respectively.” [8] And we all know that elevated inflammation is the root of all evil, a root cause of heart disease, erectile dysfunction, autoimmune disease and cancer.

9. Lower DHT. DHT is important to libido and other functions of male health, so it is of some concern that researchers found that increasing the protein/carbohydrate ratio lowered DHT levels.  For more information, see my page on How To Increase DHT Naturally.

MYTH:  Higher protein diets have not been shown to affect kidney function. [5]

So why do I consume a lot of animal protein in the form of egg whites? Well, egg whites have no Saturated Fat, so I avoid all the problems associated with saturated fat consumption.  (See my page on The Potential Dangers of Saturated Fat for more information. Furthermore, egg whites are part of the Ornish Diet, which has a strong research track record.  (Well, maybe not as many as I consume!)

Finally, I lift weights and megadose on Vitamin C. These two things can potentially – and I emphasize potentially – protect me from 1-3 above.  Lifting weight has been shown in several studies to raise baseline testosterone and, of course, any weight bearing exercise is strongly protective of bone tissue.  Finally, megadosing on Vitamin C has been shown to lower cortisol and so I am counting on this to compensate.

Massage: The Quickest Way to Woman's Heart - Peak Testosterone

We already discussed at length how your woman’s body is literally wired for touch. This makes females generally incredibly responsive to massage and so I am going to give Massage 101 for those unfamiliar with the sport.

Maybe you were an insensitve jerk today?  Maybe even for the last decade?  Well, trust me.  Fifteen good minutes of massage will cover a multitude of sins as they say.  You can take the VIP elevator from the doghouse to the penthouse in a matter of minutes.  So don’t ignore this!  Embrace it and prove how your woman likes massage (or even light scratching or tickling) if you don’t know already.

Remember, guys:  massage, gentle rubbing or tickling will likely send her into ecstasy.  Who knows?  Maybe she’ll return the favor later?

Hopefully, you’ve already experimented with some of this, but let me give you a few of the ABC’s for those new to this sport:

1) The most basic form of massage is round, circular motions using the palms of the hands and fingertips.  Pressure is generally firm but not severe.  When you’re done, you’ll be able to pour her under the nearest door…

2) In many women you can induce a huge relaxation response using just one toe or fingertip.  Simple grab one finger (or toe), start at the base and slowly squeeze and massage upward until you reach the top of the fingernail.  Finish by pressing against the flat part of the nail and the other side of the finger.  I know it sounds weird, but trust me – it’ll produce a mini-orgasm in many women.

3) Hold the hand (or foot) and massage the palm gently but firmly.  She’ll be jelly in less than 30 seconds.

4) Massage the entire body using massage oils.  You will score huge points if you have and use fragrant massage oil and it serves a practical purpose making the massage much easier and deeper.  Trusty K-Y makes great massage oils that you can buy in places like WalMart and Target (in the U.S. at least).

5) I highly recommend a little gentle hair pulling.  Simply run your fingers through her hair – her hair must be dry and your hands must not have massage oil on them! – and then give a little tug at the end.  Do this all over her scalp and watch her eyes roll into the back of her head.

6) After massaging I recommend some light and gentle “tickling”.  No, I don’t mean to make her laugh!   I mean the kind of tickling that is pleasurable on the most sensitive areas of the body. Every woman is different, of course, but the neck, the lower back (right near the buttocks) and even the shins are often packed with nerve endings.  After loosening up her muscles, her skin will be completely ready for the gentle touch of your fingertips.

7) Consider using a vibrator for part of the massage. The gold standard for this is the Hitachi Magic Wand, since it can be so easily used for – ahem! – other things as well. It has a strong, powerful vibration that is the equivalent to the roar of a Harley for us males.

Finally, guys, I’m going to say this for the sake of a few of you overanxious types:  don’t go straight for the vagina and breasts. After you massage her for ten minutes, you’ll be ready to explode.  But trust me – almost every square inch on a woman is errogenous but you’ll be throwing cold water on all your hard work if you jump to the end too early.  Take it easy and enjoy yourself. You’ll know if the timing is right, so relax and enjoy the whole experience.  Remember – oxytocin!

Did you know that you can raise and lower your testosterone based on the foods you eat? And did you know that boosting testosterone through diet in the wrong way can lead to erectile dysfunction? Read about the High Testosterone Diet to find out how to improve both your testosterone AND your sex life.

REFERENCES:

1) Johnson, Steven. “Emotions and the Brain: Love”. Discover Magazine. May 1, 2003

2) Biol Psychiatry,2003 Dec 15,54(12):1389-98

Sleep and Erection Strength - Peak Testosterone

And, yes, calcified arteries are just what they sound like:  hardened, inflexible arteries that induce heart disease and erectile dysfunction. As we discuss below, sleep and impotence are intimately related: hardened arteries will be BAD for an erection since you want nice, flexible, expandable arteries that allow blood to flow into your penis.

Another big risk factor for erectile dysfunction is inflammation.  A 2008 UCLA study found that disturbing just a few hours of participants normal sleep led to significantly increased inflammation levels throughout the body. [15]  One 2009 study showed that a key marker of inflammation (TNF-alpha) was increased by too little sleep as well. [25] (By the way, some markers of  inflammation, specifically C-Reactive protein and IL-6, were increased by too much sleep, so moderation is in order here.)

REFERENCES:

13) J Psychiatr Res, Jan 2005, 39(1):93-9

15) Biological Psychiatry, 2008, 64:538-540

19) JAMA, 2008, 300(24):2859-2866

24) Women’s Health, Jun 2009, p. 28.

26) Sleep, Jun 1 2009, 32(6):760-766, “Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk”

40) Sleep, 2010, 33: 75-79, “Restless legs syndrome and erectile dysfunction”

41) NEUROLOGY, 2008;70:35-42, “Association of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study”

Few guys realize how intimately an erection is tied to sleep.  Lack of sleep is tied to many conditions that can effect erections including heart disease.  For example, the last thing that you want are clogged, hardened penile arteries and that is actually what low levels of sleep will do for you. What researchers actually recently discovered is that the arteries of people getting low sleep levels (less than five hours) actually become significantly more calcified. [19]  The rule of thumb is that you get a 33% increased risk of developing calcified arteries for each hour of sleep that you lose. Further verifying this is the fact that those getting the most sleep, greater than 7 hours, had a much lower incidence of calcification. [24] Further verifying this is the fact that those getting the most sleep, greater than 7 hours, had a much lower incidence of calcification.

The primary point though is that lack of sleep can be deadly to your erections due to increased inflammation, which is linked to heart disease, Alzheimers, autoimmune disorders and on and on.  Almost every nasty disease known to plague modern industrailized societies is rapidly accelerated by  inflammation. No wonder lack of sleep is associated with so many disorders and even some types of cancer!  NOTE: If you have trouble falling asleep, then read this link for helpful ideas.

Finally, lack of sleep is also correlated with lower testosterone and testosterone is critical for male libido and the androgen receptors on the pelvic/penile muscles that contract and trap blood in the penis.  I cover this extensively in my link on Sleep and Testosterone.

So are their any studies showing that lack of or poor sleep actually leads to a less hard erection and decreased erectile strength?  Research has shown that those with apnea have greatly decreased testosterone, libido and erectile function and it’s all from inadequate sleep. And don’t just get the idea that it’s severe sleeping disorders such as apnea that effect erectile function:  researchers have found that even “shortened REM latency” and “reduced theta power”, i.e. poor sleep quality, are associated with erectile dysfunction as well. [13]  Restless Leg Syndrome, another sleeping disorder, has also been linked with both erectile dysfunction [40] and heart disease [41].

When you stop and think about it, it is rather remarkable how many different pathways that reduced sleep can lead to a poor quality erection.  Low testosterone, high blood pressure, increased inflammation and arterial calcification – how could get it any uglier? Well, it can if you consider that lack of sleep makes you feel too tired to do much of anything above or under the sheets.  And that is bad for your long term health.

Clomid and Erectile Dysfunction - Peak Testosterone

4. High Estradiol. One point of confusion with Clomid is that some men believe it is an aromatase inhbitior, i.e. that it decreases estradiol.  However, Clomid is actually in a completely different class of medications, a SERM, and does NOT act to inhibit aromatase.  Thus, if a man gets a boost in his total testosterone from Clomid, his estradiol will also increase through a process called aromatization in his fat tissue.  So, as T goes up, so will E2 (estradiol).  And, in some men, especially those with extra body fat, estradiol can actually go too high.  In this case plasma estradiol levels may actually be causing issues.  See my Summary Page on Estrogen and Estadiol for additional details.

Because many men are now trying Clomid, one comment that I see come up on the Peak Testosterone Forum from time to time is that Clomid seems to have either a) created erectile dysfunction or b) not improved erectile strength even though total testosterone has significanly increased.  Below are just some of the Reasons that Clomid my Actually Worsen your Erections:

1. Estrogenic Zuclomipene Isomer. Clomid is actually composed of two medications, or isomers in this case, and one of those isomers (zuclomiphene) is significantly more estrogenic in its actions.  For women this is not as much of an issue, but for us men, it can cause major issues, including moodiness, lowered libido, depression, etc.  Furthermore, the zuclomiphene isomer has a much longer half life and, therefore, for some men seems to dominate the effects of the other isomer (enclomiphene).

This is critical to understand, because the lowered libido can cause erectile dysfunction in and of itself.  It has happened a number of times on the Peak Testosterone Forum where men have said that their testosterone has been boosted to 800 ng/dl or more and yet they have no sexual desire. This can create anxiety, boredom, etc. for a man and possibly lead to psychogenic erectile dysfunction.  Standard testosterone therapy is generally, though certainly not always, quite the opposite and increases libido in a dose dependent manner.  You can read more about here:  Testosterone and Libido. Again, Clomid can powerfully activate estrogen receptors in the male brain, and this can cause signficant issues for some men.

2. Clomid Failure or Fade. Some men take Clomid and assume that their low testosterone will increase to high levels.  However, this is certainly not always the case.  Their testosterone may be sitting in the 200-300 ng/dl range and after taking Clomid, their testosterone may only move up to 400 or 450. If a man has outflow issues – see my page on Venous Leakage for more information – then this may not be enough to solve his problems.  In addition, he may not be getting the boost in libido and decrease in insulin levels that he needs to really increase his erectile strength and endothelial function.

I should also mention that Clomid can sometimes “fade” in efficacy.  Men will start out as high responders with relatively high testosterone levels, only to find that their testosterone begins to fall as the months go by.  I have never read a good explanation as to why this happens, but a number of men have reported it.

3.  An Overly High Dose. Many doctors do not know that there is a low dose option that works very well with many men with a typical protocol being 12.5 mg MWF.  Men who are high responders, and a lot of young guys are in particular, will go quite high with this lower dose.  Unfortunately, many physicians start their male patients on dosages of 50 mg per day!  This is much more likely to increase the side effects of Clomid (visual disturbances, headaches, decreased mood, etc.) and lowered libido.  So a man may be able to improve his erectile strength simply by going to a much more reasonable dose.

Drugs and Medication for Lower Testosterone - Peak Testosterone

Yes, almost all  recreational drugs (and alcohol) can lower testosterone, which is something I cover in the following links:

—Alcohol and Testosterone

—Beer and Testosterone

—Cocaine, Heroin and Testosterone

—Ecstasty (MDMA) and Testosterone

—Marijuana and Testosterone.

Painkillers lower testosterone as well.  Of course, there are legitimate uses for painkillers, but there are also tons of men addicted to them as well and hammering their hormones while they are at it.

Intuitively, I think that many men realize that these supposed “feel good” drugs are hard on our hormones, so the above is probably no surprise.  However, what I often find on The Peak Testosterone Forum, is that many guys do not realize that legitimate, FDA-approved pharmaceuticals can also significantly lower testosterone as well.  Why in the world would the FDA approve a drug that lowered testosterone without a warning label, right?  Well, it just doesn’t work that way.  There a MANY drugs out there that lower testosterone and, making matters worse, most doctors do not know about it.

In modern, urbanized societies, it is very common for men over 40 to be on more than one medication and, of course, this just increase one’s odds even more.  Here are the 13 Major Classes of Drugs that can Decrease Baseline Testosterone Levels (and there are undoubtedly more):

CAUTION: Do NOT discontinue any medication without discussing it first with your doctor.  In many cases, dosage can be reduced or an alternative medication found, but this should be discussed with your physician first.

Testosterone and DrugsSTEP 6C.  Examine any medications, recreational drugs or alcohol for potential testosterone-lowering qualities.

1.  Antipsychotics. These are especially hard on testosterone through a variety of pathways but are notorious for raising prolactin levels.  Of course, prolactin fights testosterone and libido and if it goes too high will lead to sexual dysfunction in many ways. For more information, see my link on Testosterone and the Antipsychotics.

2.  Opiate Paikillers (Percocet, Vicodin, Morphine, etc.). These all will tend to lower testosterone via inhibition of LH (Luteinizing Hormone), the molecule released by the pituitary to signal the testes to increase testosterone production.  One review noted that “a large majority of men consuming sustained-action opioids have symptomatic androgen deficiency which apparently responds to replacement therapy. Opioid-induced androgen deficiency is frequently overlooked.” [4]

3.  Antifungal (Clotrimazole, Nizoral and Ketoconazole). Even something as simple as trying to get rid of a fungal infection can lower testosterone levels appreciably. [9] We have had a number of complaints on our forum about clortrimazole, especially when applied directly to the scrotum or penis.  Look at what these posters wrote:

“The doctors claimed that I would not need to get circumcised and that I could use this cream as long as I needed to. I was never warned about any possible side-effects. At about the one year mark of daily clotrimazole use, I began applying the clotrimazole cream to my scrotum and the surrounding areas as I began to get jock itch. About a year and 8 months into this, I began to lose lean weight for unknown reasons. I noticed that I had lost about 24 lbs of lean weight with basically zero change in diet or exercise routine (or lack thereof). I also noticed that my strength had also decreased quite a bit. Doors that were once light became heavy and my 112 lb girlfriend seemed to be harder to pickup. I chalked all of this up to stress from a new job and aging (I was 26 at the time – too young for any of this stuff to start happening). I asked doctors what was happening and they had no answers…At about the 2.4 years mark, I started doing research on the relationship between testosterone and clotrimazole. The first journal article I found indicated that clotrimazole is a potent inhibitor of the P450 cytochrome enzyme. P450, as I’m sure you all know, is an enzyme directly involved in testosterone metabolism.” [15]

“I just wanted to post saying the same thing about clotrimazole cream. I used it for only a few weeks back in July last year for jock itch, but it was applied near the scrotum. After using the cream for a few weeks I noticed my scrotum had shrunk in size! My testicles don’t hang low anymore (about half as low as they used to), even in a hot shower they just do not hang low anymore, even 7/8 months later! For me I have no doubt it was caused by the cream, it was such an obvious change after 2 weeks of use! 🙁 but fortunately I didn’t get any other side effects. Its a shame the anti androgenic side effects are so potent because it did clear up the fungal infection a treat. I’ve had some sort of weird non itchy fungal infection on the head of my penis for years now, but I’m scared to treat it with anymore antifungal creams because the clotrimazole cream permanently shrunk my scrotum! I wish I never used the stuff!” [15]

I don’t see a lot of reports like this out on the web, but there is some scary research on the subject.  Check this out the title of this journal article: “Clotrimazole is a selective and potent inhibitor of rat cytochrome P450 3A subfamily-related testosterone metabolism.” [16]

4.  Arrhythmias (Amiodarone). This drug for heart arrhythmia has high iodine content and can interfere with thyroid function, which, in turn, could lower testosterone. [1]

5.  Lithium.  Of course, lithium can be a life saver for someone with bipolar disorder.  [2]  However, this can interfere with the thyroid and lead to hypothyroidism, which in turn can interfere with testosterone production. [1]

6.  Diabetic (Sulfonylurea). These drugs sometimes used to treat type II diabetes can result in hypothyroidism and, therefore, potentially, a drop in testosterone. [2]

7.  Oxycodone (Oxycontin). This pain medication tends to raise prolactin and in some men may lower testosterone. [3] It also can have a side effect of very significantly lowering testosterone in some sensitive men as well.

8.  Dopamine Antagonists (Chlorpromazine, Compazine, etc.).  Anything that interferes with dopamine levels can easily diminish T levels.  These psychotropics are no exceptions.

NOTE:  I cover some of the famous “anti-aphrodisiac”, libido-reducing medications at the bottom of my link on Male Libido Supplements.

9.  Antihypertensives (Beta Blockers). Several studies have shown that beta blockers, a very common class of medications for high blood pressure can lower testosterone. For example one study found that atenolol, metoprolol, pindolol and propranolol all led to decreased testosterone levels.  Propranolol was found the above study to be the worst. [5][7]

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

10.  Valium (Diazepam). One theme you may have noticed:  almost any medication that affects the brain and/or brain function significantly tends to lower testosterone. Valium, the famous tranquilizer, is no exception and appears to tranquilize the testes as well. [6]

CAUTION:  There are a wide variety of toxins, pesticides, endocrine disruptors, xenoestrogens, excitotoxins and other chemicals that can be considered “drugs” even though they are not pharmaceuticals.  I give significant coverage to these on my site at this link on Nasty Chemicals That Can Lower Testosterone.

11. Anticonvulsants. These drugs commonly used to treat epilepsy lead to an interesting phenomenon: an increase in total testosterone but a decrease in free testosterone. [8] This situation arises from an increase in SHBG. So who wins?  The increased total T or the decreased free?  Unfortunately, in the above study, the loss of free testosterone correlated well with decreased sexual activity levels.

12.  Tagamet (Cimetidine). Strange as it may seem, this H2 Agonist Blocker for stomach issues actually directly lowers testosterone production. [10] In fact, one animal study labelled it as an antiandrogen. [11] Can’t be any more clear that that, eh?

13.  Antidepressants (SSRI’s).  SSRI’s are notorious for lowering libido and leading to sexual dysfunction in both men and women.  Depression itself is notorious for lowering testosterone, something I discuss in my link on Depression and Testosterone, likely due to its increase in cortisol levels as a stressor.  This makes it difficult to tease out if SSRI’s actually lower testosterone, since it is a side effect of the very illness these medications are trying to treat.  And, indeed, one study actually found that SSRI’s may increase T levels in men. [12]

However, more recent research showed very much the opposite.  Some studies have shown that most SSRI’s significantly affect liver enzymes and thus some postulate that they slow down the time to clear estrogen (estradiol), i.e. allow for estradiol to build up. [13] One report noticed a wide variety of SSRI’s that resulted in lower free T levels as well. [14]

But the most damning evidence came from studies on Prozac, which shows that, particularly in those who use it longer term, that testosterone levels do tend to drop.  See my page on Testosterone and Prozac for more information.

REFERENCES:

1) https://www.umm.edu/patiented/articles/ what_causes_hypothyroidism_000038_2.htm

2) https://health.nytimes.com/health/guides/disease/drug-induced-hypothyroidism/overview.html

3) Journal of Pain and Symptom Management, Feb 1994, 9(2):126 131, “Altered sexual function and decreased testosterone in patients receiving intraspinal opioids”

4) Current Opinion in Endocrinology & Diabetes, Jun 2006, 13(3):262-266, “Opioid-induced androgen deficiency”

5) https://www.jpathology.com/Issues/Previous%20Articles/9(3).html

6) Systems Biology in Reproductive Medicine, 1979, 3(1):31-35, “Effect of diazepam on serum testosterone and the ventral prostate gland in male rats”

7) Arch Sex Behav, 1988 Jun, 17(3):241-55, “Beta-blocker effects on sexual function in normal males”

8) J Neurol Neurosurg Psychiatry, 1983, 46:824-826, “Sex hormones, sexual activity and plasma anticonvulsant levels in male epileptics”

9) Eur J Clin Pharmacol, 1985, 29(4):489-93, “Effect of a single administration of ketoconazole on total and physiologically free plasma testosterone and 17 beta-oestradiol levels in healthy male volunteers”

10) Arch Intern Med. 1985;145(5):920-922, “Cimetidine Blocks Testosterone Synthesis”

11) Gastroenterology, 1979, 76(3):504-508, “Cimetidine is an antiandrogen in the rat”

12) Journal of psychosomatic research, 03/2012, 72(3):205-13, “Salivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort study”

13) European Neuropsychopharmacology, Apr 2006, 16(3):178 186, “The effect of tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and newer antidepressant drugs on the activity and level of rat CYP3A”

14) https://www.mental-health-today.com/rx/testos.htm

15) https://www.peaktestosterone.com/forum/index.php?topic=2931.0

16) Drug Metab Dispos, 2001 Jun, 29(6):837-42, “Clotrimazole is a selective and potent inhibitor of rat cytochrome P450 3A subfamily-related testosterone metabolism”

Aromatase Inhibitor Arimidex: The Problems - Peak Testosterone

Arimidex (anastrozole) is an aromatase inhibitor that now has widespread adoption by both women and men.  Arimidex was originally developed to help in the battle against breast cancer but was heavily used by male steroid users and, shortly after, fertility and sports medicine physicians.  These off label usages have been steadily growing, especially among the steroid community, whose supraphysiological testosterone levels often require the brakes be put on their heavy aromatization and all its ensuing side effects such as gynocomastia, mood changes, loss of libido and erectile dysfunction.

There are also a couple of additional usage relating to testosterone levels that have caused its usage among men to acclerate even further:

1) Pseudo-HRT. Arimidex can boost testosterone and the testosterone-to-estradiol ratio very significantly.  This can make it a viable short term solution for many men with low testosterone since it preserves fertility and can solve some estrogen-related problems.  An even bigger driver is the fact that at least half the male population is overweight or obese.  In my link on Testosterone and Arimidex, I cover how one study in senior men showed an average testosterone increase of 62% and a boost in the testosterone-to-estrogen ratio of 112%!  Not bad for just popping a pill, eh?

REFERENCES:

1)   Experimental Gerontology, Jun-Jul 2009, 44(6-7):398-405, “Immoderate inhibition of estrogen by anastrozole enhances the severity of experimental polyarthritis”

2) Breast Cancer, 2006;13(3):284-8, “Joint symptoms: a practical problem of anastrozole”

3) The Journal of Urology, Feb 2002, 167(2 Part 1):624 629, “AROMATASE INHIBITORS FOR MALE INFERTILITY”

4) https://news.wustl.edu/news/Pages/6902

5) https://www.peaktestosterone.com/forum/index.php?topic=765.0

5) Arthritis Rheum, 2004 Jan, 50(1):72-7, “Vitamin D intake is inversely associated with rheumatoid arthritis: Results from the Iowa Women’s Health Study”

6) https://www.peaktestosterone.com/forum/index.php?topic=7787.0

2) Estradiol Dampening on HRT. Men with low (hypogonadal) testosterone levels can end up with overly low estrogen levels such that they actually begin to experience bone loss and, eventually, osteopenia.  (Quite a few men will even go to full-fledged osteoporosis.)  However, the opposite situation is actually occurring  with some men going on the new testosterone therapies where testosterone is pushed well above 800 ng/dl, i.e. weekly injections or pellets.  In these cases, many men who are (generally but not always) carrying extra weight will find that their estradiol shoots way up at the same time.  So you may have a man with testosterone of a 1000 and estradiol of 100 that nullifies the effect of the raised testosterone.  E2 levels this high will usually put the brakes on erectile strength, libido and are a risk factor for many nasty conditions.

The solution?  Many practitioners are now relying on Arimidex to handle the elevated estradiol issue, so it is becoming increasingly common for men to be on high dose testosterone and low dose Armidex to lower one’s bloated estradiol levels.  And, from what I have seen, the physician does not think of Armidex as a short term solution while he insists on weight loss with his or her male patient.  Instead, Armidex is considered part of a package HRT solution.

As always, I am very concerned about packaging Arimidex as a long term, “natural” solution.  Arimidex is a pharmaceutical and it has many potential long term problems associated with it.  Here are a few of the sobering health issues that you should discuss with your doctor before you consider this as a rest-of-my-life option:

1. Negative Alterations of Inflammatory Cytokines.  One study showed that “anastrozole induced the increased levels of proinflammatory cytokines, IFN-gamma, IL-12, and the decreased levels of IL-4, IL-10 secretion. We further found that anastrozole suppressed the differentiation of naive T cells to Treg cells, and it blocked the balance of IgG2a/IgG1 in peripheral blood.” [1] This is potentially ugly as I would argue that Inflammation is Enemy Number One.  The last thing most guys need to accelerate systemic inflammation by even a small amount.

2. Joint and Arthritis Risk. One very common risk of Arimidex treatment is joint pain and/or arthritis. The study above concluded that “anastrozole potently promote the progression of arthritis.” One study on women showed that Arimidex users had a higher than expected number of complaints about joint issues. [2]  (Just because this was on women does not mean it does not apply to men. Many men complain of joint issues while on Arimidex.) Now I should mention that most of the study work has been done on women who are on Arimidex for breast cancer treatment.  Their estrogen is brought down very low.  Men who have moderate estradiol adjustment into youthful E2 levels are obviously a different animal altogether. In other words, men on low dose Arimidex will probably not have this concern, unless their doctor does not monitor and unwittingly pushes his patient’s estradiol too low.  I have see this happen on The Peak Testosterone Forum.

3. Liver Toxicity. Arimidex is mildly liver toxic in some individuals. For example, one study of men found that liver enzymes were raised in about 7% of men. [3] Now, admittedly, this is generally not a major issue, but liver function is extremely critical.  See my links on https://www.peaktestosterone.com/ and The Liver and Inflammation for examples. Again, is this going to be good over decades??  NOTE:  This is probably not an issue for men on low dose Armidex.

NOTE:  In my link on Arimidex and HRT, I discuss a number of other important reasons that men on HRT may want to limit their Arimidex usage as well. You may also want to check out my link Natural Estrogen Blockers if you want, under your doc’s supervision of course, to go to a more supplement or lifestyle-based approach.

4. Possible Clotting Issues. Arimidex can interfere with the clotting cascade. See my page on The Risks of Testosterone for more information. It is possible that men with certain clotting or cardiovascular risk factors could get themselves in trouble.

5. Vitamin D Depletion. Some researchers speculate that Arimidex depletes Vitamin D as they have found that patients with muscle and joint pains on Arimidex have lower than expected levels of Vitamin D, although this is not proven yet.  Practitioners have also noted that taking extra Vitamin D helps with a variety of side effects and one study in women even verified this. [4]  One Forum poster on Arimidex was put on high dose Vitamin D and my guess is that this is the reason. [5] Extra Vitamin D has also been known to help with rheumatoid arthritis. [6] NOTE:  This is not an issue for men on low dose Armidex who also have their 25-hydroxy levels monitored.

6. Estradiol Crash. Some men on the forum have reported that even small amounts of Arimidex have crashed their estradiol levels.  These men seem sensitive to even very small dosages and often have to go to compounded Arimidex.  However, we also had one troubling story on the Peak Testosterone Forum, where a man took Arimidex as part of an HRT (TRT) protocol and found his estradiol had tanked to below 5 pg/ml in two separate blood draws.  Furthermore, both blood draws showed his total testosterone to be above 850 ng/dl, so it was definitely not due to a lack in testosterone.  Something about the Arimidex seemed to completely shut him down. [6]

CONCLUSION: As you can see, generally the side effects of Arimidex are usually negligible assuming one is taking relatively small dosages.  However, there are several nagging concerns that, hopefully, will one day be addressed.  My opinion:  if you are going on testosterone therapy, get those abs back!  Yes, you can try Armidex short term.  But do what it takes to lower your body fat percentage to where you can  see a nice line down those abs:  this usually will dramatically lower your aromatiziation and, therefore, estradiol levels even on high dosages of testosterone therapy.  I have seen estradiol greatly reduced in men who have gotten their weight way down.

CAUTION:  Natural aromatase inhibitors are few and far between at this point.  I do not recommend chrysin, because it can affect the thyroid, nor too much zinc, as it can lead to copper depletion potentially

Orgasm: Why Every Man Should be an Orgasmatarian! - Peak Testosterone

I consider myself an Orgasmatarian. Simply put, that is eating in order to maximize one’s ability to achieve an erection and orgasm. Furthermore, I eat this way not, mind you, out of simple hedonism, but rather because of the solid research that stands behind such a way of living. Yes, indeed, in the same way that the eye is the window of the soul, the penis is the window of a man’s general health.  In fact, researchers have found that erectile dysfunction is a decent predictor of future heart disease.

The reason for this is simple:  erectile dysfunction is generally caused in large part by endothelial dysfunction, meaning that the lining of the arteries has become damaged.  And damaged arteries mean less flexibility, responsiveness and nitric oxide.  Most of the risk factors for endothelial dysfunction and damaged arteries have same risk factors as cardiovascular disease, dementia and cancer:  Elevated Inflammation, High Blood Pressure and Metabolic Syndrome just for starters.

One study even showed that a man has, on average, five years after the inception of his erectile dysfunction before he has a cardiovacular event of some sort.  See my link The Dangers of Erectile Dysfunction for more details.  The bottom line is that you likely just have a few years to straighten yourself and your penis.

If this is an issue for you, my sympathies are with you.  The tragic irony is that Western culture has twisted everything and made it very difficult for a man to maintain and preserve his erections and testosterone.  Steak and fries are a “man’s meal”.  But are they?  A consistent diet of steak and fries will leave most men with fried arteries, blood vessels and capillaries.

At some point, if it’s not too late, you have to try to Go Natural.  I changed my diet to clean, whole foods instead of processed, packaged foods. I increased my exercise.  I started sleeping more.  All of these things are what our bodies are naturally used to.

Sleep, exercise, diet (and weight loss for some of you) – these are big engines that can give you your life back. You don’t have to limp around like all the guys around you.  There is simply no reason not to get your health back.  Remember:  the body can generally heal itself if you feed it the right nutrients and get rid of all the toxic garbage.  But you have to give it a rest.

NOTE:  Remember that plant-based nutrition has INCREDIBLE advantages for erections and testosterone.  This is countercultural right now, but read this link on The Benefits for Men of Plant-Based Nutrition.

So become an Orgasmatarian.  Go natural.  All I know is that since I become an Orgasmatarian, I’ve never regretted a day…

And beer is supposed to be the ultimate “manly drink”.  Well, there’s nothing wrong with a beer or two – it won’t kill you.  I love tequila myself as much as the next guy.  But why is any drink that lowers testosterone and raises estrogen manly in any way? (See my link on Beer and Testosterone for the research behind this.) I’ll take Pomegranate Juice any day as a real manly drink:  it will boost nitric oxide, lower inflammation, lower blood pressure and possibly clean out your penile arteries.  (Pomegranate juice can interact with some medications.) It may even Boost Testosterone a little.

Propecia: Did It Take Out My Health? - Peak Testosterone

Let me tell what is a bad idea – a VERY bad idea:  giving a low testosterone man Propecia.  I think that I am living proof of that and I’ll explain why below.  In fact, I’ll start by saying that one thing that has always puzzled me about my health past is why I had such a sudden onset of nasty symptoms.  I am reasonably sure that I have always been low testosterone based on the fact that I do not ever remember having morning erections and I suffered from dysthymia my entire adult life.  Adding weight to my theory is the fact that both of these symptoms almost instantly disappeared when I went on testosterone cypionate.

One thing that has puzzled me, though, is why I had a sudden onset of nasty symptoms when I was probably always low T?   If I had truly been low testosterone for decades, why all of a sudden did a wave of erectile dysfunction, low libido, fatigue, achiness, mental fog and high anxiety hit me like a storm suddenly?

To try to find the answer to that I got hold of my old medical records – that wasn’t easy by the way – and found the first onset of these symptoms.  I believe that it started in 2001, because I found that a GI exam for celiac disease then.  Basically, I was feeling terrible and had many different theories at the time as to the cause.  (I knew next to nothing about testosterone at the time.) I had read about celiac disease, and thought, “I’ve got to be celiac!”.  My physician did not know what to do with me, and so he sent me to a GI doctor who scoped me and found that I was not celiac.

So, assuming this all started in 2001, then the burning question in my mind is what happened in 2000 that might have precipitated all these problems in 2001?  The answer may lie in the fact that I had prescriptions for Propecia in August 2000, September 2000 and February of 2001.  I was concerned with hair loss and do remember taking it for a period of time.

At the time, no one really knew of the long term side effects of Propecia.  In fact, even some of the basic pharmacological properties were not known:  it wasn’t until the late 90’s that information came out that it was a suicide inhibitor, something I discuss in my page on Propecia: An Irreversible 5-Alpha-Reductase Inhibitor.  The bottom line is that neither myself nor my doctor would have thought of my issues stemming from Propecia at the time.

NOTE:  Propecia was approved in 1992 and it was not until 2012 that the FDA required labelling changes. [6]

So why do I think Propecia caused my health issues?  Well, I would argue that common sense dictates that Propecia issues thrown on top of existing low testosterone would often be a nasty combination and would very likely lead to the exact symptoms that I was having.  Assuming I was low testosterone, then my depression likely stemmed from that and I was likely in a “weakened” psychological state.  (I was diagnosed as hypogonadal about 5 years after this.)  I’m not trying to be dramatic here, but low testosterone is hard on neurotransmitter as you can read about in my page on Testosterone and the Brain.  Now, if you throw in Propecia, which greatly lowers my 5-alpha-reductase enzymes and the ensuing fall in my (likely) already low DHT levels, it is no wonder that I struggled.  Propecia also lowers allopregnenalone, which decreases GABA levels.  Common symptoms of a GABA deficiency include increased anxiety, depression, difficulty staying asleep and pain. These all definitedly applied to how I felt at the time, and so, while I cannot prove it, I did seem to fit the profile for post-finasteride syndrome and a GABA deficiency.  I also had the very common sexual side effects.

Again, the reason that I highlight this is that I do not think anyone should take Propecia, but, in particular, low or lower testosterone men should be particularly wary. (One could make a case that it is necessary for BPH (enlarged), but there are other alternatives that one discuss with one’s doctor.)  A Low T Guy simply has no buffer to handle decreased hormones and neurotransmitters.

I also am discussing this, because it is quite common on The Peak Testosterone Forum for men to comment that their health went down rapidly in just a few months. Basically, the men in this category feel like they were sucker punched and never knew what hit them. One minute they had a strong libido and high erectile strength and energy.  And a few months later, everything is virtually the opposite – a total struggle. Of course, there can be many reasons for this from gut issues to toxins to the onset of autoimmune disorders, etc. However, I suspect that one of the more common causes of a downward spiral in male health is “post-finasteride syndrome (PFS).

So, if you feel you have issues that stemmed from your use of Propecia (finasteride), then I would recommend that you begin pulling  your basic hormone levels (testosterone, dht, estradiol, prolactin, thyroid, etc.) and find a doctor that can help you get treated and feeling better.  Some PFS men feel better going on TRT (testosterone therapy) for example.  I discuss some other ideas here as well:  Propecia Cures. As you’ll see on that page, men have used a blend of diet, exericse and supplement – sometimes hormones as well – to recover successfully from it.

REFERENCES:

1)  https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm299754.htm

Cortisol and Marijuana - Peak Testosterone

Marijuana and low testosterone:  the two go hand in hand.  Yes, marijuana is a “herb”.  Yes, marijuana is a “natural plant”.  However, none of that is going to change the fact that marijuana is a one way ticket to low testosterone, erectile dysfunction and fertility problems. The political debate regarding marijuana may be interesting, but the research shows it to be debilitating and potentially deadly long term.

Marijuana assaults your precious hormones in almost every negative way possible, especially testosterone. One study after another has shown that cannabis lowers testosterone.  For example one research team found that “a reanalysis of existing data established that testosterone levels are depressed both after smoking one marijuana cigarette and after intravenous infusion of delta-9-tetrahydrocannabinol, a pharmacologically active component of marijuana”. [1] The same study concluded that it would take at least 24 hours for testosterone levels to normalize after marijuana use. (NOTE:  It’s not just the smoke – an IV will do it.)

Another study found that not only was testosterone decreased after short term marijuana use, but leutenizing and follicle stimulating hormone were lowered as well. [2]  And just to add to the endocrinological misery, the arch-villain and stress hormone cortisol was raised as well in this same study.  There are also studies in animals and humans that strongly indicate that marijuana blunts growth hormone response as well.

But that’s where the good news ends:  animal studies show that marijuana use shrinks the testes. [5]  So, if you’re not happy with lowered testosterone, infertility and elevated cortisol, you can sit around enjoying the fact that you’ve got a little more air flow through your boxers.  (You may also be interested in my pages on Other Common Causes of Low Testosterone and How to Increase Your Testosterone Naturally for more information.)

You should also know that there are many reports that chronic marijuana use leads to gynecomastia, i.e. “bitch tits” or “male boobs” due to its abundant amounts of phytoestrogens. One journal writer pointed out that “given the effects of marijuana on the HPG axis in males and the possibility that noncannabinoid components of marijuana smoke have affinity to the estrogen receptor, an association with gynecomastia is plausible but has not been convincingly demonstrated”. [4]  Remember that estrogen fights against testeosterone in the body as well.

Marijuana has also recently been flagged as particularly dangerous for young people because it decreases seratonin and increases norepineprine. While these are not sex hormones like testosterone, these can alter mood negatively and, through prolonged use, may permanently alter anxiety levels and reaction to stress. [7] Again, the researchers are suggesting this may have long term, possibly lifetime anxiety and mood repercussions.  I would also add that any increase in stress will also likely lower testosterone as well.

So we ask the question, “Could someone please explain again why anyone in their right mind would smoke marijuana?”  The only thing we can think of is the extra hydrogen cyanide.  That’s right –  marijuana tobaco is much higher in hydrogen cyanide – probably five times higher – than cigarette tobacco.  Maybe that partially explains why habitual pot smoking is so hard on the lungs and why cannabis use has also now been linked to the most aggressive form of testicular cancer.

I am sure most of you have the good sense to stay away from the wacky weed and have heard every excuse in the book from its adherents.  I have heard one guy claim it helps him stay cut because it suppresses appetite, not realizing that it is whacking his precious muscle-building testosterone behind the scenes.  To those sorts of arguments, one can only give them a look that relays the idea that sticking burning leaves in your mouth and inhaling is never going to be a smart idea!  (Other toxic items that we consume include Excitotoxins, Pesticides and Additives Such as BPA.)

Not to make the bad news even worse, but there is also considerable reported evidence of erectile dysfunction among chronic marijuana users. This is undoubtedly partially due to the lowered testosterone.  However, the other reason was discovered by one study that showed marijauna effected Nitric Oxide and summarized by saying, “We conclude that early endothelial damage may be induced by chronic cannabis use (and endocannabinoid system activation”. [3] In other words, the happy weed may not make you so happy long term:  it may take your sex life with it.

The tragedy with marijuana is that many cultures and youth are embracing marijuana as more “natural”, but this is far from being the case.  One recent study found that marijuana induces just as much cell toxicity and DNA damage as cigarette smoke. [6] The researchers were very clear that marijuana displayed just as much cancer causing power as the cigarette smoke: “In addition, when corrected for total particulate matter yield, little difference was observed in the mutagenic activity of samples smoked under the extreme vs the standard regime for both tobacco and marijuana condensates”.

I went through the “Make Love Not War” era and pot was front and center stage.  Of course, the irony is that there’s a lot of guys walking around now not able to “make love”, not realizing that the lowered testosterone and decreased nitric oxide of long term marijuana use during that time is behind it all.

NOTE: Researchers have recently found that the THC in marijuana actually effects sperm negatively and literally makes them high.  The sperm get “wired” and then literally burn out making it hard for them to achieve their ultimate destination.  This may yet another reason why marijuana is tied to reports of infertility (along with the decreased testosterone, LH and FSH of course).

NEW FLASH: Marijuana does not just after your gonads – studies have also shown that it attacks the brain. Researchers have also found that heavy marijuana users have 7% and 12% smaller amygdala and hippocampuses, respectively. [8] They also have a higher incidence of “starter level” psychotic symptoms.

NEW FLASH #2: Researchers may have found one of the reasons that marijuana lowers testosterone: it decreases dopamine over time. [9] If you’ve ever noticed that your heavy potsmoking friends lacked a little motivation, now you know

REFERENCES:

1) J Theor Biol, 1983 Oct 21, 104(4):685-692, “Effects of marijuana on testosterone in male subjects”

2) Pharmacol Biochem Behav, 1986 Jun, 24(6):1749-54, “Acute effects of smoking marijuana on hormones, subjective effects and performance in male human subjects”

3) Intl J of Impotence Research, 2008, 20(6):566-573, “Early endothelial dysfunction as a marker of vasculogenic erectile dysfunction in young habitual cannabis users”

4) Endocrine Effects of Marijuana, Todd T. Brown, MD, and Adrian S. Dobs, MD, MHS

5) Eur J Pharmacol,1974, 26:111-114; Endokrinologie, 1977, 69:299-305

6) Chem. Res. Toxicol., Article Publication Date (Web): July 17, 2009, “The Genotoxicity of Mainstream and Sidestream Marijuana and Tobacco Smoke Condensates”, Rebecca M. Maertens, et. al.

7) Neurobiology of Disease, Dec 2009,” Chronic exposure to cannabinoids during adolescence but not during adulthood impairs emotional behaviour and monoaminergic neurotransmission”

8) https://www.physorg.com/news131644196.html

9) https://www.medicaldaily.com/articles/17065/20130702/long-term-marijuana-use-alters-brains-reward.htm

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Coconut Oil and Erections - Peak Testosterone

A  reader write in with the following comments about coconut oil:

“Or coconut oil, that is being sold now as a panacea. Many say that coconut oil actually causes fat loss and is good for your heart and is a superior source of quick energy!!! It has something to do with the fact that coconut oil has medium chain fatty acids as opposed to long chain found in butter etc. I would love to write a letter to McDougal or someone like that and ask about coconut oil and these claims.”

This gentleman was exactly right:  coconut oil is being touted as a panacea.  One of its biggest advocates is Dr. Mercola who just happens to make a killing on every bottle he sells on his web site. Another group that loves coconut oil is the Paleo Diet advocates, because it’s high in saturated fat and, therefore, must be a testosterone-boosting, miracle-working superfood, right?

1)  Journal of the American College of Cardiology, Aug 2006, 48(4):715-720, “Consumption of Saturated Fat Impairs the Anti-Inflammatory Properties of High-Density Lipoproteins and Endothelial Function”

2) Arteriosclerosis, Thrombosis, and Vascular Biology, 2005; 25: 1274-1279, “Flow-Mediated Dilatation Is Impaired by a High Saturated Fat Diet but Not by a High-Carbohydrate Diet”

3) Journal of the American College of Cardiology, 2006; 48(4): 715-720, “Consumption of Saturated Fat Impairs the Anti-Inflammatory Properties of High-Density Lipoproteins and Endothelial Function”

4) https://jn.nutrition.org/content/117/6/1011.full.pdf

5) https://www.drweil.com/

Have you ever noticed how almost all Paleo guys are always either 1) under 40 or 2) heavy exercisers? There is a reason for that and it is  blood flow (and, therefore, erections).

Many studies have shown that saturated fat slows down blood flow in humans. [1] One study even did a comparison between a nasty high saturated fat meal and a nasty high glycemic, low fat, high carb meal. Guess what they found? Blood flow was better after the high glycemic, low fat, high carb meal! [2] Both meals were bad, but the high saturated fat meal did even worse.

Again, the only way to compensate for the negative effects of saturated fat is to 1) either be young or 2) exercise like a wild man.

The answer was clearly shown in the famous “cake and shake” study – which used pristine, organic, virgin coconut oil – where researchers clearly found that flow-mediated dilation decreased by 32% after coconut oil consumption and only 17% after safflower oil (3 hours post-meal). [3] Once again, researchers found that saturated fat impairs blood flow, but the Paleo crowd just refused to accept it.

Their weird arguments are all over the internet and so you can read those if you want.  But all I have to say is this:  there is no conspiracy here.  Maximum erections require maximum blood flow, so if you want to eat saturated fat, then consider doing the following:

1) Take fish oil or consume fish as research has shown this will partially overcome the negative effects of saturated fat.

2) Exercise frequently (a couple times per day)

3) Consider eating a few walnuts as this also has been shown to partially overcome the blood flow issue of saturated fat. I cover this elsewhere on my site.

Even then, though, I don’t really recommend deliberately trying to increase your saturated fat consumption.  Animal studies show that coconut oil by itself will push cholesterol (and possibly triglyceride) levels much higher than compared to fish oil. [4] Dr. Weil gives a very balanced response for those interested. [5] Please read these links on The Potential Dangers of Saturated Fat  and The Potential Dangers of the Atkins/Paleolithic/Low Carb Diet for more information.

Leave the coconut oil and saturated fat for the young guys. After twenty years (unless they are extremely careful), they’ll end up with clogged arteries just like the rest of the West and will have to start researching the Ornish Diet to try to clear out all that arterial plaque and improve blood flow for erections.

Cheapest Testosterone Tests for Men - Peak Testosterone

It is no secret that doctors do not test as much as they should.  The primary reason is simple:  insurance premiums and partner physician agreements.  The bottom line is that they have to keep their costs in line and, of course, this isn’t all bad or our insurance premiums would be sky high.  The downside is that doctors often leave out valuable lower-probability tests.  In this case, it is up to the consumer to do his own testing if it is going to be done.

For the record: I have no relationship with any of these labs and I am not officially recommending any of them. You must do your own due diligence as a consumer. I can tell you that these labs have been used successfully by at least one of our senior members. Prices are not controlled by me and are strictly as reported as of 11/17/2013. You can read a little more about some of these in my link on Testosterone Labs.

NOTE: None of these labs do the actual testing. They actually contract out the actual work to LabCorp, which is the largest lab here in the U.S.

LEF (membership req’d $5 per month)

WalkInLab, LabsMD, HealthOneLabsHealthOneLabs (Uses LabCorp)

WalkInLab (Uses LabCorp)

Ginseng: Erection Builder - Peak Testosterone

Can the ancient herb Ginseng improve erectile dysfunction?  Yes, Ginseng can potentially improve your sex life and erections in many ways.  Ginseng is best known in herbal lore as an “adaptogen”, meaning that it helps overcome stress and stress-induced reactions.  Of course, it is also known as an energy booster and is added to a host of “energy drinks”.

However, Ginseng’s benefits in these are debatable at best with a number of studies showing contradictory results.  But there is one place where Ginseng does have some have some strong initial evidence:  improving erectile dysfunction.  It turns out that Korean Ginseng does boost nitric oxide output and, if you guessed that that means improvements in erectile dysfunction, you’d be right.  Several studies have shown Ginseng to improve erectile dysfunction.

For example, one well done 2002 double-blind, placebo-controlled, crossover study done in Korea looked at 45 men with moderate to severe erectile dysfunction. It took only 8 weeks for improvement in the scores on erectile performance, sexual satisfaction and other key measure for those men using Ginseng. [1] A similar study five years later on 60 men with erectile dysfunction found significant improvement in just 12 weeks in the areas of “rigidity, penetration and maintenance of erection” when patients were treated with three times daily routines of 1000 mg of Ginseng. [2]

Ginseng likely does this through several pathways with the most direct being stimulation of nitric oxide production. [6] Of course, nitric oxide is the magic chemical that relaxes your penile arteries and allows blood to flow in. Any increase in nitric oxide will likely improve erectile dysfunction and put a smile on your and your partner’s face.

1) J Urol 2002; 168:2070-3

2) Asian J Androl, 2007;9(2):241-4, “Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction”

3) Int J Impot Res,Sep 1995,7(3):181-6, “Clinical efficacy of Korean red ginseng for erectile dysfunction”

4) Urology. 2005 Mar, 65(3):611-5, “Free radical-scavenging activity of Korean red ginseng for erectile dysfunction in non-insulin-dependent diabetes mellitus rats”

5) Menopause, 2002 Mar-Apr, 9(2):145-50, “Estrogenic activity of herbs commonly used as remedies for menopausal symptoms”

6) Br J Pharmacol, 134:1159 1165, “Ginsenosides Rb1 and Re decrease cardiac contraction in adult rat ventricular myocytes: role of nitric oxide”

7) J Strength Cond Res, 2002 May;16(2):179-83, “Effects of ginseng ingestion on growth hormone, testosterone, cortisol, and insulin-like growth factor 1 responses to acute resistance exercise.

8)  Systems Biology in Reproductive Medicine, 1982, 8(4):261-263, “Effect of Panax Ginseng on Testosterone Level and Prostate in Male Rats”

9)  Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility.”

10) Asian Journal of Andrology, Mar 2007, 9(2):241 244, “Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction”

What are the odds that Ginseng can improve your erectile dysfunction?  One older study showed that 60% of men were satisfied with sex and firm erections with Ginseng as opposed to 30% without. [3] This is almost two thirds of the participants that were helped by Gingeng! The study authors summarized by saying that “in the group receiving ginseng, changes in early detumescence and erectile parameters such as penile rigidity and girth, libido and patient satisfactions were significantly higher than that of other groups”.  In other words, improvements were so strong that the actual thickness of the erect penis and the “hardness factor” were actually improved.  What else could you ask for, eh?

The story gets even better, though, in one animal study of diabetic rats.  Normally, diabetic rats have significantly depleted levels of key antioxidants, such as glutathione, that protect the lining of the arteries within the penis and therefore have significantly more erectile dysfunction.  However, the diabetic rats given Korean Ginseng had not only greatly improved antioxidant levels but also had no loss of erectile function. [4]  Of course, this was an animal study, but it probably means that Ginseng not only helps with erectile dysfunction in the short term but in the long term as well.  And notice that this study shows that it increases libido – woo hoo! – as well. (See my link on Aphrodisiacs for legitimate libido boosters to help with erectile dysfunction.)

Another way that Ginseng may in some case improve erectile dysfunction is through stress mediation.  Stress can hammer mood, confidence and even testosterone in some cases.  However, the studies are certainly not conclusive in this area and Ginseng probably has either a selective or subdued stress-reducing role.

Does Ginseng increase testosterone? Ginseng can help with cAMP levels, which, according to one study, boosted hormone, LH and DHT levels in men with low sperm counts. [9]  However, one study show that testosterone (and growth hormone) levels are not significantly raised by Ginseng, thus eliminating the possibility that Ginseng helps with erectile dysfunction through a hormonal route. [7]  I have never read of any bodybuilder, for example, using Ginseng to boost testosterone.

So the bottom line, as I document in my link on Super Sexual Herbs, is that Ginseng will very likely give most guys a nice boost in nitric oxide and libido and perhaps a small boost in testosterone as well.

Some Ginseng supplement manufacturers are sloppy and thus Ginseng has a reputation for having contaminants, including lead and various pesticides.  Thus, buying only the best brands is definitely wise.  For example, Consumer Labs failed 45% of tested products in a recent review for either having insufficient ginsenosides or being contaminated. However, a number of brands passed Consumer Labs’ analysis with flying colors.  Probably the best was  Solgar – Korean Ginseng Root Extract, 60 veggie caps which was not only contaminant-free but also had abundant ginsenoside content.

CAUTION:  Ginseng does have a few drug interactions (blood thinners, etc.) so check with your doctor first as always.

Semen Volume: Causes of Low Semen Volume - Peak Testosterone

Some men with low testosterone and/or erectile dysfunction notice that their semen volume greatly decreases, sometimes, it would seem, to almost nothing.  Any decrease in function is a little scary for us men and we can’t help but wonder what is going on.  Look at what this poster wrote:

“One of the things I noticed that occurred along with me ED is that i stopped “shooting” ejaculate. Now it just drips out. Additionally, the volume of ejaculation is much less (about 50-75% less). Did anyone else experience the same thing along with weak erections?” [1]

Of course, the answer to his question is ‘yes’ as it is quite common for men to notice this.  One of the things you have to evaluate is how much of a decrease in semen volume has occurred for reasons we will discuss below:

2. Aging. One study found that semen volume decreases by about half just from normal aging from age 35 to about age 55. The researchers found that “a peak semen volume of 3.51 +/- 1.76 ml(-1) was observed at age >or=30 to <35 years and a lowest volume of 2.21 +/- 1.23 ml(-1) was observed at age >or=55 years (P<0.05).” In other words, (P<0.05).” In other words, (P<0.05).” In other words, a man can expect a drop of about 38% at least from his early 30’s to his early senior years.

2. Retrograde Ejaculation. If a man notices a more pronounced loss of volume, it may be due to a condition called retrograde ejaculation. Basically, the sperm comes up from the testes into the prostate where it is mixed with the semen. It should then, during “the Big O”, get pushed through the urethra and out the opening of the penis. However, this requires that muscles on the neck of the bladder to close off tightly in order to keep the semen and sperm mixture from being shunted into the bladder.

In many men this “closing off” process does not happen, usually due to improper nerve function or even damage. (This is somewhat similar to a condition where a man loses his erection quickly called Venous Leakage.) This difficulty in sealing the bladder off is not usually a big issue for a man unless he is concerned about fertility. If you have retrograde ejaculation and you want to have kids, then you need to talk to your urologist or fertility specialist as a few treatments have been explored and some have reasonable success rates, which I discuss below.:

3. Diabetes. One of the primary symptoms of diabetes is neuropathy, or nerve damage. And one of the less well-known consequences of this type of nerve damage can be retrograde ejacaulation.  The reason is that the nerves on the neck of bladder that are involved in retrograde ejaculation can be affected.

4. ;Medications. Certain medications, especially SSRI’s and blood pressure medications can lead to retrograde ejaculation as well. Be sure to talk with your physician if this is an issue.

Solutions: Low Semen Volume

So are their any natural ways to increase semen volume? Certainly! I list these below:

1. Increase by Natural Methods. It is possible in many cases to increase your semen volume through lifestyle changes and/or supplements. For details, see my link on Natural Ways to Increase Semen Volume.

2) HCG. HCG has become a mainstay for men receiving testosterone therapy in many HRT and fertility clinics. It also reportedly increases semen volume as well in many men.

However, if you have retrograde ejaculation, these solutions are unlikely to help much. What good does it to increase semen volumen if almost all of it gets shunted down into the bladder? Those with retrograde ejaculation have to look at other options.

I do have to say, though, that semen volume is probably not terribly important unless you are interesting in having children. Retrograde ejaculation can negatively impact fertility and so, if this is your case, discuss possible solutions and aid with a urologist or fertility physician that specializes in these areas.

Some of the studies and research summaries out there show some very novel solutions: [2][3]

3) Imimaprine

4) Pseudoephedreine

5) a and b combined (61% success rate with diabetic patients)

6) Improving Nerve Function. Anything that aids or cures neuropathy will like help a significant percentage of men.  For ideas, see my page on Natural Neuropathy Remedies.

Anything that helps with neuropathy is likely to help as well and I discuss some of the more natural solutions in my link on Neuropathy Remedies for those interested in more information.

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=2518.0

2) Asian J Androl, 2012 Jan, 14(1):61-8, “Male sexual dysfunction and infertility associated with neurological disorders”

3) J Sex Med, 2008 Jan, 5(1):194-8, “Medical treatment of retrograde ejaculation in diabetic patients: a hope for spontaneous pregnancy”

DHEA: Low Levels Could Be Deadly - Peak Testosterone

The great majority of physicians do not believe that there is such a thing as low DHEA. They argue that DHEA levels dramatically decrease with age, something I illustrate on my page DHEA Levels in Men by Age.and that a fall in DHEA is just a “part of life.”  An additional argument is given that DHEA is precursor to many downstream hormones, including testosterone, estradiol, DHT, and that this is probably it’s primary role.

However, I will show below that DHEA is doing much more than just acting as a building block.  In spite of these seemingly powerful arguments against DHEA Replacement Therapy, I want to give you the counterarguments to the above.  Here are 4 Powerful Reasons You Don’t Want Low DHEA:

1.  Increased Risk of Heart Disease.  Low DHEA values have been linked to an increased risk of heart disease in us men.. [2] This will almost always mean increased arterial plaque.  Now the question always arises as to whether or not low DHEA values actually contributed to heart disease or were just an “innocent bystander,” i.e. a third party witness.  The reason that this is very unlikely is that DHEA stimulates nitric oxide and even has a receptor in endothelial (arterial lining) tissue, something I discuss in page on the The Benefits of DHEA.  In other words, low levels of DHEA will likely lead to decreased blood flow, which is almost always associated with increasing levels of atherosclerosis.  And, as your arteries build up plaque, this creates a vicious cycle of less nitric oxide, less blood flow and so on.  Many other thins that lower nitric oxide, such as homocysteine and PPI’s, are associated with accelerated cardiovascular disease.

2. Lowered Immunity.  It is widely recognized that cortisol lowers immunity and DHEA boosts it. [3] Several studies to date have verified this in various forms.  I find it difficult to imagine how low DHEA, which will help immune function, can possibly be a bad thing, especially in middle-aged and senior adults, whose immune system is already on the decline anyway to aging.

3. Increased Insulin Resistance. Animal studies had clearly shown that DHEA levels were tied to insulin sensitivity.  In other words, as DHEA levels fall with aging, insulin resistance will tend to go up.  This was verified in a recent study on seniors that found that administering DHEA decreased the insulin resistance of senior men (and women).[6] Again, this is very reminiscent of what testosterone does for us.

4. Increased Mortality. If you put all these together, one can see just why DHEA should be part of most men’s anti-aging protocols, with powerful evidence being provided by the fact that lower DHEA-S levels are associated with an increased risk of dying:

“In men, most available evidence suggests an association with cardiovascular (CV) mortality rather than cancer mortality. Further, there are biologically plausible mechanisms for an effect of DHEA/-S on the development of CV disease.” [4]

Again, how can one argue that low levels of this key hormone are a natural and protective part of aging in light of the fact that low levels can lead to an eariler death?!

CONCLUSION: DHEA has an unusual history because about 20 years ago, it was touted as miracle anti-aging supplement and was literally thought to be a fountain of youth.  However, then a couple of large followup studies put it against the ropes and suddenly DHEA found itself almost completely out of favor.  It was seen for the most part as a harmless waste of money.  However, now everything has come full circle and the last six years has seen just one study after another documenting the positive effects of DHEA supplementation and the very serious consequences of having low levels.

One recent reviewer made a nice summary by saying that “DHEA modulates endothelial function, reduces inflammation, improves insulin sensitivity, blood flow, cellular immunity, body composition, bone metabolism, sexual function, and physical strength in frailty and provides neuroprotection, improves cognitive function, and memory enhancement. DHEA possesses pleiotropic effects and reduced levels of DHEA and DHEA-S may be associated with a host of pathologies; .” [5]  Yes, these words should remind you of the consequences the research laid out for standard hypogonadism (low testosterone).

REFERENCES:

3) Aging Cell,4(6):319 324, December 2005, “Raised cortisol:DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity”

4) J Steroid Biochem Mol Biol, 2015 Jan, 145:248-53, “DHEA and mortality: what is the nature of the association?”

5) J of Sexual Medicine, Nov 2011, 8(11):2960 2982, “Dehydroepiandrosterone (DHEA) A Precursor Steroid or an Active Hormone in Human Physiology (CME)

Vegans Highest Total Testosterone; Vegetarians and Meat.

REFERENCES:

1) British Journal of Cancer, 2000, 83(1):95-97, Hormones and diet: low insulin-like growth factor-1 but normal bioavailable androgens in vegan men

The corollary to this formula is that vegetarians (and vegans especially) must have lower testosterone levels than their carnivore counterparts. This kind of thinking permeates most popular health blogs and forums out there, especially on Paleo Diet and bodybuilding sites. In addition, almost every major men’s health magazine, at least here in the U.S., have recipes and recommendations with meat front and center stage.  The message that guys get is clear:  if you want to be healthy and hormonal – you must eat meat.

The reasoning behind such thinking is fairly straightforward and goes something like this:

1.  Meat is full of saturated fat and the research shows that saturated fat is pro-testosterone.

2.  Vegetarian and vegan diets are higher fiber which also has been linked to low testosterone.

3.  Bodybuilding, a sport obviously highly dependent on testosterone, is completely dominated by carnivores.

I myself have discussed some these issues at length in my links on The Two F’s: Fat and Fiber and Testosterone and Diet.

So what do the studies show?  Well, first of all, saturated fat is definitely pro-testosterone and it is true that higher fiber diets have some linkage to lower testosterone. I myself have discussed some these issues at length in my links on The Two F’s: Fat and Fiber and Testosterone and Diet.

CAUTION: Saturated fat slows down blood flow, something always less than desireable for sexually active males, and can destroys arterial health under most circumstances: read my link on The Potential Dangers of Saturated Fat for more details.

However, what I also bring up, and this is generally ignored by the bodybuilding and Paleo communities, is that vegetarian diets tend to have ample pro-testosterone monounsaturated fats. Even more importantly, vegetarian (and vegan) diets are also high in certain phytochemicals, which have some evidence for increasing testosterone, as I document in my link on Antioxidants and Testosterone. Whole grains, fruits, vegetables, beans, legumes, nuts, seeds are the bulk of what most vegetarians eat and they are all packed with antioxidants, anti-inflammatories and other constituents that will protect and in some cases even stimulate those all-important Leydig cells.

So who is the winner?  Well, to date there has only been one study that directly examined this question.  The researchers were primarily interested in comparing IGF-1 levels in vegans, vegetarians and meat-eaters, but also monitored a variety of other androgen-related hormones, including testosterone, as well. What they found was that vegetarians and vegans had average testosterone 6% and 16% higher than the carnivores, respectively. This, by the way, was after adjusting for important variables such as age and smoking status.[1]

The one variable that the researchers did not adjust for was BMI (body mass index) and when they did that, the vegetarians and meat-eaters had virtually equal testosterone and vegans were higher than everyone by about 6%.  Again, this flies in the face of almost everything you read on the web:  supposedly vegans and vegetarians do everything backwards and are loading up on toxic grains, fiber and all the things that will their slam manliness. In fact, though, the truth is that their testosterone levels are perfectly health and may even be higher on average than carnivores.  Either way, there is no evidence that vegetarians are suffering from a lack of androgens.

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And this really is common sense.  Vegetarian diets have been studies extensively and there have been no signs that vegetarians have low testosterone whatsoever.  Furthermore, vegetarian (or very close) diets have been adopted by hundreds of millions of people around the globe and there are simply no signs of mass symptoms of low testosterone in these populations. In fact, one could actually argue quite the opposite:  cultures and societies that eat low quanitites of meat are known for their active sex lives later in life.  (See my book, the https://www.peaktestosterone.com/, for other reasons that many plant foods boost erectile strength.)

It should also be noted that those in the study were in early middle age, which means that had lived long enough to accumulate damage to the Leydig cells, the hypothalamus and other key tissues that control and govern testosterone.  Therefore, it is possible that younger meat-eating males may have slightly higher testosterone but build up damage from some of the pro-inflammatory or other aspects of a meat-based diet.  We just don’t know the answer to those kind of questions yet.

One very revealing aspect of the above study was that vegetarians and vegans both had very robust levels of SHBG, again significantly higher than the meat-eaters.  SHBG, Sex Hormone-Binding Globulin, is the protein tthat does just what its name implies:  it chemically bonds to most of the testosterone in your body.  Now that sounds bad, but researchers have noted that generally as SHBG increases so does total testosterone.

The Okinawans are another example that plant-based diets outperform meat-based diets in the long run.  The traditional Okinawans were actually not strict vegetarians, as they did eat some pork and fish.  However, the great bulk of their diet was always vegetarian and they ate relatively little fat, including saturated fat. Interestingly enough, they also consumed significant soy, which has fairly high levels of various phytoestrogens.

Yet, as I document in my link on https://www.peaktestosterone.com/, the average 70-year-old Okinawan has testosterone of 439 ng/dl, a very respectable number, and a direct contrast to the 346 ng/dl average level of the typical 70-year old American. [62] Just as remarkable is the fact that the typical Okinawan 100-year old has testosterone of 298, which is above the level considered hypogonadal. By any standards, Okinawans have delayed andropause by a couple of decades and are a further sign that the carnivore lifestyle is anything but superior when it comes to preserving and protecting one’s testosterone levels..

What about the fact that bodybuilding is dominated by the carnivore lifestyle?  Bill Pearl says that after going vegetarian, he had the same amount of muscle that he did when he won his Mr. Universe titles.  Kenneth Williams, a vegan bodybuilder, placed third in the 2004 Natural Olympia bodybuilding competition.  And, of course, Mike Mahler is long time vegetarian and strength coach extraordinaire. The fact is that, if you desire, one can easily build a massive physique while on a vegetarian or vegan diet.

Blood-Brain Barrier and Excitotoxins - Peaktestosterone

As you may have read in my link on Testosterone and Excitoxins, the standard argument for allowing excitotoxins, such as MSG and aspartame, in our food is because they cannot easily penetrate the blood-brain barrier.  (Of course, I have pointed out that this still leaves the hypothalamus unprotected!)  However, this argument is proving to be weaker with every month that passes by.

The problem is that the blood-brain barrier is much more porous than previously imagined. Yes, under normal circumstances the blood-brain barrier is a veritable fortress and actually thwarts the efforts of researchers to get cancer treating drugs into the brain for example.  However, circumstances are not always normal, in our modern lifestyles especially, and can leave us potentially vulnerable to excitoxin damage.

Remember: only minute amounts of excitotoxins can render huge neurological damage, causing neurons to “overexcite”, miswire and even self-destruct.  Many guys do not realize that excitotoxins are actually neurotransmitters, so common sense would tell you that you don’t want to flood the brain with these chemicals.

We know from animal studies the nasty things that excitotoxins do and, again, every month or two a new study comes out showing more about short term issues, such as Excitotoxin Syndrome, and longer term issues such as kidney decline.  Of course, what I’m doing is trying to warn guys to avoid excitotoxins at all costs because the blood-brain barrier ain’t what it used to be.

There are other reasons as well:  the blood-brain barrier (BBB) also blocks out almost all cancer cells, viruses and bacteria.  This is why there are few cancers and diseases of the brain.  In addition, MS and Alzheimer’s may have a BBB component.  The bottom line is that you need this barrier fully intact and working.

Here are several key items that can increase the permeability or porousness of your blood-brain barrier:

1) PDE5 Inhibitors.  Mick Jaggar would have undoubtedly called these Father’s Little Helpers and they include Viagra, Levitra and Cialis. One interesting discovery about these Rock Stars of the pharmaceutical world is that increase the permeability of the blood-brain barrier.  Of course, researchers are quite excited about the fact that they can potentially use PDE5 inhibitors to push brain cancer-killing drugs through the blood-brain barrier. One recent study did just that in mice using Levitra in order to push the anti-cancer drug Herceptin through the blood-brain barrier.[1] Caution is definitely in order here, because if guys on Levitra, Viagra and Cialis are allowing even very minute amounts of excitotoxins into their cranial neurons, it could wreak havoc.

2) Electrosmog.  This is a subject that I covered in my link How Dirty Electricity Can Alter the Blood-Brain Barrier and, like PDE5 inhibitors, can increase permeability.  Cell phones, computers and many other devices emit a certain kind of electrical “signal” or “noise” that could be allowing minute amounts of toxins into their brain.

3) Inflammation. Researchers have long known that inflammation can open, at least partially, the blood brain barrier.  In fact, scientists have suspected that this could partially explain how MS [] and Alzheimer’s progress, [3] as both require damaging proteins to cross the BBB (Blood-Brain Barrier).

4) Aging. Several studies have shown how aging thins the delicate endothelial capillaries of the blood-brain barrier, potentially leaving some of us vulnerable. [4][5] Mini-strokes are another potential problem.  Mini-strokes are imperceptible strokes that can, among other things, compromise the blood-brain barrier and are much more common as we age.

REFERENCES:

1) PLoS ONE 5(4): e10108, Received: February 23, 2010; Accepted: March 18, 2010; Published: April 19, 2010, “Phosphodiesterase Type 5 Inhibitors Increase Herceptin Transport and Treatment Efficacy in Mouse Metastatic Brain Tumor Models”

2) Brain, 1990, 113(5):1477-1489, “BREAKDOWN OF THE BLOOD-BRAIN BARRIER PRECEDES SYMPTOMS AND OTHER MRI SIGNS OF NEW LESIONS IN MULTIPLE SCLEROSIS”

3) Neurobiol Aging, 2007 Jul, 28(7):977-86. Epub 2006 Jun 16, “Microvascular injury and blood-brain barrier leakage in Alzheimer’s disease”

4) J Gerontol, 1979, 34(5):642-650, “Thinning of capillary walls and declining of numbers of endothelial mitochondria in the cerebral cortex of the aging primate, macaca nemestrina”.

5) Advances in Neurology, Vol. 30, 1981, “Blood-Brain Barrier, Againg, Brain Blood Flow and Sleep”.

Testosterone and Heart Disease and Your Arteries .

Of course, the significance of this is that heart disease is the #1 killer of men in modern, Western societies, and nothing else really comes close. It is no exaggeration to call it an epidemic and statins are a weak and I believe sometimes dangerous attempt to correct the problem, something I discuss here: The Dangers of Statins. I believe that right under our noses is an additional tool, testosterone replacement therapy, to fight cardiovascular disease in the solid majority of men with low or lowish testosterone levels.

Why do I say the “solid majority?”  Why not all men?  Well, there are likely exceptions, such as men with clotting disorders, certain men with hypertension or arrhythmias and men with high red blood cell counts, hematocrit or hemoglobin.  Men should be screened before going on TRT and, of course, any issues discussed with a knowledgeable physician. But on this page I will present the evidence, and there is a lot of it, that, generally speaking for most guys, boosting low testosterone will be a big help in the fight against heart disease.

NOTE:  The #1 way is to  Regressing Atherosclerosis.  If your diet and lifestyle is putting plaque in your arteries, then testosterone is not going to save you.

Here are just some of the benefits to the cardiovascular system associated with improved testosterone levels:

2. High Blood Pressure. Testosterone therapy can also lower blood pressure in men.  The change is usually not huge, but it is significant nonetheless.  The reason is that testosterone actually affects nitric oxide – yes the stuff that makes your erections possible.  I document all this in my link on Testosterone and Blood Pressure . By the way, one of the Peak Testosterone Forum members saw a huge drop in blood pressure from going on HRT.   He went from about 120/80 to  87/67! [5]

3.  Weight Maintenance. Study after study has shown that HRT will help hypogonadal men gain muscle and maintain or even lose weight. For example, one study even showed an increase in fat free mass, essentially muscle, and a decrease in fat mass in men with low normal testosterone. [6] Of course, testosterone will not keep you from overeating, but it is definitely another tool in your arsenal against the slow and steady weight gain that plagues men in modern societies. And, yes, those extra pounds are a risk factor for cardiovascular disease.

5.  Decreased Anxiety and Improved Depression. Anxiety and depression are both stressors and can increase cortisol and cause a host of direct and indirect cardiovascular-related issues. Testosterone can often help greatly with both of these and is a proven mood booster, something I talk about in my link on Testosterone and Depression . Psychologists are starting to admit the interrelationship of hormones and depression and perhaps one day getting your testosterone and estradiol checked will be a part of any psychological evaluation. On the Peak Testosterone Forum I have had a couple of low T men completely turned around from depression by going on HRT. Of course, it doesn’t always work that way as depression is a complex, multi-faceted condition. But having low testosterone is likely only going to make the condition worse and be very hard on one’s cardiovascular system.

6. Diabetes. It is no secret that type II, adult onset diabetes is an epidemic in the U.S. And it is no secret that, once a man gets diabetes, his chances of cardiovascular disease sky rocket. One study showed that men with diabetes tripled their chance of another heart attack if they had already had one. And, if they had not yet had a heart attack, they increased their risk six fold! [8] Testosterone therapy can be a HUGE boost in men with low or lowish testosterone in this area. As I mention in my link on Testosterone and Diabetes, I have spoken with one large HRT clinic where ALL of their men got off of insulin by going on testosterone cypionate injections to youthful levels. This is an incredible stat and, hopefully, more credence will be paid to it over the next decade by the medical community.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

7. Insulin and Inflammation. Probably the two biggest root cause killers of men are what I call The Two I’s: insulin and inflammation. As insulin levels and resistance increase, tissues begin aging and a host of nasty metabolic conditions set in, especially in the arteries. Testosterone therapy dramatically decreases both insulin and inflammation levels, something I document in my links on Testosterone and Inflammation and Testosterone and Insulin Resistance.

8. Visceral Fat. Visceral fat is the stomach fat that plagues so many men and is linked to Metabolic Syndrome and heart disease.  In one study of hypogonadal diabetic men, testosterone therapy decreased visceral fat. [3] This will very likely be the case for many of you because diabetes and prediabetes account for a huge block of modern societies.

9. Atherosclerosis. There is now in vitro evidence that testosterone (and estradiol, DHT and DHEA) can inactivate white blood cell activity in the arterial walls, which is so critical in the plaque formation process, and thus help a man prevent atherosclerosis. I cover this in my page on Testosterone, Arterial Plaque and Atherosclerosis.

All of the above are big risks for heart disease and so it would be tragedy to ignore all this research when heart disease is the #1 killer of us guys.  However, a big question remained in the eyes of researchers:  could testosterone therapy (for men with hypogonadism)  improve heart disease outcomes.  We all know of research that should have been positive but turned out to be the opposite. Would HRT fall into this category?

The good news is that testosterone therapy has done very well in the studies so far and has actually improved outcomes in a variety of studies.  Here are a few examples:

1.  Moderate Heart Failure. One study looked at men with moderate heart failure. It found significantly improvement from Androderm therapy even though not all the men were hypogonadal to begin with. [1]

2. Angina.  Heart patients with angina often suffer tremendously with chest pain.  One study gave men with stable, chronic angina low dose testosterone in the form of a patch. [2] The study, which was double blind and placebo-controlled, improved pain scores.  And, as expected, in men with lower bioavailable testosterone, the pain scores were improved even more dramatically.

3. Myocardial Ischemia. One (admittedly small) double blind, crossover study showed that testosterone helped heart patients’ myocardial ischemia, or insufficient blood flow to an organ or tissue. In this case, the researchers were concerned with proper blood flow to the heart muscle, which can limit tissue damage before and after a heart attack. [7]

What is remarkable about the above studies, if you stop and think about it, is that no lifestyle modifications were usually required of the participants. In general, cardiovascular disease is a disease of a Western lifestyle, and so it is rather surprising that testosterone can help so much just on its own. Imagine if testosterone therapy is combined with proper diet, exercise and general good, clean livin’? So, if your testosterone is low, talk to your doctor about the pros and cons of HRT. I have many links on the subject including ones on HRT, Pellets, Compounding and so on.

I also highly recommend that one read these two pages for other very important research on the subject:  Testosterone Therapy and the Recent VERY Postive Research and Profound Lowering of Cholesterol in Men through HRT.

NOTE: Erectile dysfunction often goes hand-in-hand with cardiovascular disease as well.  Your erections, just like your heart and arteries, are dependent on soft, expandable vascular tissues and ample nitric oxide that is not overly aged, injured and covered with plaque.  It will be no surprise, then, to learn that testosterone very often improves erectile strength as well, nor that hypogonadism is often a root cause of erectile dysfunction.  For more information, see my link on Testosterone and Erectile Dysfunction.

1)   European Heart Journal, 27(1):57-64, “Testosterone therapy in men with moderate severity heart failure: a double-blind randomized placebo controlled trial”

2) Circulation, 2000, 102: 1906-1911, “Low-Dose Transdermal Testosterone Therapy Improves Angina Threshold in Men With Chronic Stable Angina”

3) Eur J Endocrinol June 1, 2006 154 899-906, “Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes”

4) J Endocrinol, Sep 1, 2003, 178:373-380, “Testosterone as a protective factor against atherosclerosis–immunomodulation and influence upon plaque development and stability”

5) https://peaktestosterone.com/forum/index.php?topic=1077.msg9810#msg9810

6) The Journal of Clinical Endocrinology & Metabolism, Jan 1 2008, 93(1):139-146, “Testosterone Therapy Prevents Gain in Visceral Adipose Tissue and Loss of Skeletal Muscle in Nonobese Aging Men”

7) The American Journal of Cardiology, 1999, 83(3):437-9, A9, “Effect of acute testosterone on myocardial ischemia in men with coronary artery disease”

8) N Engl J Med, 1998; 339:229-234, “Mortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial Infarction”

Growth Hormone and Sleep - Peak Testosterone

Most guys know that growth hormone burns fat and increases lean muscle mass.  However, not as many know growth hormone is very dependent on sleep. Growth hormone is one of your truest friends:  it directly and positively effects the brain and “mental agility” as one set of researchers put it. [6] Really Human Growth Hormone’s capabilites goes beyond this and it is now recognized as directly improving learning and memory. [7] Yes, you can rebuild your brain even in middle age and beyond if you let your body squeeze out this precious hormone while you’re snoozing. (For other ways way to churn out Growth Hormone, read this link on How to Boost Growth Hormone Naturally and  Interval Training.)

And, just as with testosterone, sleep deprivation leads to no normal nocturnal Growth Hormone surge. Zip. Nada. It’s this simple:  if you deny yourself sleep, you get a drastically blunted Growth Hormone response.  One set of researchers summarized that “the nocturnal Growth Hormone surge is largely sleep-dependent.” [8] That’s pretty clear language for scientific researchers:  if you want Growth Hormone rebuilding your body and mind, you must have lengthy, quality sleep.

You might be saying, “Well, that only applies to those fools who engage in total sleep deprivation”.  Au contraire!  One study found, as is the case with testosterone, an almost linear relationship between Growth Hormone and slow-wave sleep. [9] This kind of deep sleep becomes progressively more difficult as we age:  sometimes we just plain have to work at it. The linearity that the researchers discovered means on a practical level that the more you sleep, the more Growth Hormone you ll have and the more sleep you lose, the less Growth Hormone you ll have, all other things being equal.

Optimizing Growth Hormone is often a concern of many dads who want their child to be as tall as possible, since Growth Hormone governs height for those of us with kids.  Of course, height is mostly a function of heredity, but I tell them that the safest way to optimize Growth Hormone is through sleep.  There is no study that I know that correlates height and sleep, but it is likely somewhat of a factor in the growth and development of your kids.

By the way, did I mention that Growth Hormone even stimulates additional testosterone production?  Growth Hormone creates a cascade of increasing IGF-1, FSH (Follicle Stimulating Hormone), LH (Leutinizing Hormone), which ultimately leads to increases in testosterone (and estrogen but proportionally of course).  The increases may not be huge but every little bit helps!

So the bottom line is that optimization and maximization of your growth hormone output requires you to just be disciplined and put your head down on that pillow.

NOTE:  For more information , see my links on sleep, see my pages on Sleep and Testosterone, Rebuild Your Brain Through Sleep, Sleep and Strong Erections and Natural Sleep Aids.

REFERENCES:

6) Rev Endocr Metab Disord,Dec 2006,7(4):225-35

7) Cardiovasc Res,Apr 2002,54(1):25-35

8) J Psychiatry Neurosci,July 1991,16(2):96 102

Cortisol and Cialis - Peak Testosterone

Viagra / Cialis / Levitra. These big three blockbuster drugs are only available by prescription and therefore are not supplements. But I wanted to cover them, because they’re as close to a “miracle pill” for anyone struggling with testosterone, libido or erectile difficulties. Viagra is good for four hours and Levitra for six. Cialis, on the other hand, in this category is king: it’s potency lasts for 36 hours. This makes it ideal as it really gets the penis back in shape by increasing early morning erection count, confidence and sexual activity for extended periods of time.

So do you want the good news or the bad news first?  I’ll start with the good news.  Viagra has been found, for example, to help with treatment of high blood pressure in the lungs, cardiovascular performance at high altitudes and may also prevent blood clots, a major cause of heart attacks and strokes. [1]  And Viagra’s long-lasting brother, Cialis, has been found to help men with BPH (Enlarged Prostate). [2]

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

So there is actually a lot of good medical news coming out about these drugs and the reason is probably simply the fact that you need Nitric Oxide and all of these drugs help Nitric Oxide to stay in your system longer.  Nitric Oxide does many things to help your body fight heart diseasse (and cancer) and so it should not be overly surprising that in aging males, a little more Nitric Oxide may actually be helpful in the same way that Testosterone Supplementation (HRT) actually helps restore youth to many older guys.

However, I would still recommend caution with these three drugs, becuase of their side effect profile – see below – and because, in general, it is better to solve the root of your erectile difficulties, which is almost always poor heart and endothelial function. Erectile dysfunction can also be related to low testosterone, another condition that you should see a doctor for.

NOTE:  Please read my link on Recreational Use of Viagra and Other PDE5 Inhibitors for additional information.

I recommend that these drugs be used primarily as a bridge to help you get your penile tissue back in shape after months of few morning erections. Furthermore, keep in mind that there are Supplements that are very effective as well for short term solutions.

There’s another reason that I emphasize using these short term if at all possible:  you want to coax your body to actually produce more Nitric Oxide on its own because this is a sign of endothelial health.  The endothelium is the thin lining of your veins and arteries and one of the signs of an injured, out-of-shape endothelium is decreased Nitric Oxide production.  Please, please, please read this link How To Fix Erectile Dysfunction Long Term to find out how to get your endothelium to start pumping out more Nitric Oxide naturally.

By the way, it is also possible that some of the men afflicated were taking too large of a dose. Some men overtake testosterone derivatives, i.e. steroids, quite frequently.  Would it be surprising that some men take too much Viagra during “desperate” situations?  But arguing against that is the fact that all three of these drugs had patients experiencing oxotocity, hearing problems during clinical trials while they were presumably testing dosing and other aspects of bringing this public. Again, talk to your doctor and do your homework.

Also, back in 2000, it looked as if there would be a promising new class of drugs coming out both more potent and with fewer side effects. So far these have not been tested on humans, but the animal studies are looking very good. I have not been able to find if the clinical trial process is making good progress on these drugs or not.

One interesting side note is that researchers have found that Viagra is about 80 X more potent at inhibiting PDE5, the enzyme that indirectly affects Nitric Oxide production, than the primary ingredient in Horny Goat Weed Icariin. However, there are many less side effects with Icariin and Horny Goat Weed, making it an excellent alternative to Viagra depending on the severity of one’s erectile dysfunction.  Researchers are currently taking Icariin and modifying it slightly to see if they can come up with a “new Viagra” with decreased side effects.  Read below for a discussion of the many side effects associated with these drugs:

NOTE: One recent study showed an increase in testosterone post-exercise in healthy male subjects taking Cialis. [7] So are these PDE5 inhibitors a good idea before exercise?  Unfortunately, the study also showed that Cialis increased cortisol more than normal and, of course, cortisol is definitely not something we want to boost under normal circumstances.  In addition, below I list a number of side effects from Cialis (and Viagra and Levitra as well) that would make using Cialis as a testosterone booster even more questionable.

CAUTIONS AND SIDE EFFECTS:

Now for the bad news or, better worded, cautions:  it is important to note that the FDA is now requiring a warning label on all three of these drugs because there have been 29 cases (at the date of writing this) of sudden hearing loss.  The problem is that there are related PDE5 receptors involved in hearing that these drugs activate. (Viagra has also been implicated in making sleep apnea worse.)  However, the number of men affected by this is small considering the very large number, about 30 million, using these drugs. In fact, Lilly spokeswoman Keri McGrath said a recent Lilly review found about 1.1 incidents of sudden hearing loss per million Cialis patients, which she said was lower than the incident rate in the general population. Nearly 12 million men have been prescribed the drug, the company said. Note: I have also read that Cialis has less of this crossover effect than Viagra. But, again, discuss all this with your doctor if you feel you need to go this route.

The underlying problem with these drugs is that they affect other phosphodiesterases in the body, including the ones that effect hearing, sight and heart function.  For example, Viagra can inhibit the PDE6 inhibitor, affecting the rod and cone photoreceptors in your eyes to a certain extent. One study came out and said there could even be potential damage to the optic nerve. [4] But subsequent studies found no such association. [5]

Another major issue with these drugs are dangerous arrythmias and palpitations.  The problem is that they increase, for reasons not fully understood, the sympathetic nervous system.  One study showed that noradrenaline was significantly increased after taking Viagra, for example, in healthy young men. [6] These fight-or-flight chemicals can be dangerous to the heart as they increase the likelihood of irregular heartbeat (and potentially stroke).

No, the doctor won’t tell you that when he gives you a prescription!  These drugs can cause problems with heart issues and medications so you’ve got to discuss that with your doctor if that is your situation.  Remember:  there are a number of possible side effects from drug combinations with Viagra for example.  You can also potentially get facial flushing, stomach upset and/or heartburn and headaches.

And the most potentially dangerous side effect involves nitroglycerin.  Nitroglycerin, a drug prescribed for heart pain, can result in shock if taken at the same time as Viagra. And, because drugs such as Viagra are worked on by the same liver enzyme, it could raise or lower levels of many other drugs such as ketoconazole and entacapone.

There has been concern that these PDE5 inhibitors should not be prescribed to patients with heart disease or that they could possibly lead to heart attacks.  However, several studies have shown Viagra to be safe in both cases [3], but of course you should also discuss this with your doctor.

REFERENCES:

1) Proceedings Nat Acad of Sciences USA, 1008, 105:13650-13655

2) J of Urology, 2008, 180:1030-1033

3) BMJ, 2001, 322(7287): 651–652; Archives of Int Med, 2004, 164(5): 514–520

4) Br J Ophthalmol, 2006, 90:154-57, “Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction”

5) J of Sexual Med, 3(1):12-27, Published Online 5 Jan 2006, “Ocular Safety in Patients Using Sildenafil Citrate Therapy for Erectile Dysfunction”

6) https://seniorhealth.about.com/library/weekly/aa010701a.htm

7) The Journal of Clinical Endocrinology & Metabolism, 2008, 93(9):3510-3514, “The Type 5 Phosphodiesterase Inhibitor Tadalafil Influences Salivary Cortisol, Testosterone, and Dehydroepiandrosterone Sulphate Responses to Maximal Exercise in Healthy Men”

Vitamin C: a Cheap Nitric Oxide Booster - Peak Testosterone

I am always looking for ways to naturally boost my nitric oxide levels and one of the best ways is probably one the cheapest also: Vitamin C. Vitamin C is the only supplement that I megadose and the reason is that I pretty well buy into what is called “Pauling Theory”, which points out that we are one of the very few mammals that does not manufacture its own Vitamin C. To date, there are huge benefits to Vitamin C and, in my opinion, very few downsides under rather special circumstances.

But let’s go to every guy’s favorite subjects:  boosting blood flow, increasing nitric oxide, lowering blood pressure and improving erectile strength.  Vitamin C does all of these.  It can also lower cortisol and decrease inflammation, something I discuss in my link Why Take Vitamin C? On this page, though, I want to focus on Vitamin C’s NO-boosting powers and here are just a few of the studies that show, directly or indirectly, that Vitamin C can raise nitric oxide:

1. Dose Dependent NO Increases. Dose dependency is what every researcher hopes to find, because it shows that the more you give of something, the greater the effect, which shows a more clear relationship. And this is exactly the case with Vitamin C and nitric oxide. One set of researchers stated it like this: “ascorbic acid [vitamin C] has been shown to stimulate endothelial nitric oxide (NO) synthesis in a time- and concentration-dependent fashion.” [1]

This same study even found how Vitamin C works to raise nitric oxide levels:  it protects (from oxidation) a cofactor eNOS called tetrahydrobiopterin.  A cofactor is “a substance that acts with another substance to bring about certain effects – especially a coenzyme.” So, assuming you have the baseline nitric oxide in the first place, which you can likely boost with either citrulline or nitrates (in food), then Vitamin C should raise nitric oxide levels for you.

1)  The Journal of Biological Chemistry, Jan 5 2001, 276:40-47, “L-Ascorbic Acid Potentiates Endothelial Nitric Oxide Synthesis via a Chemical Stabilization of Tetrahydrobiopterin”

2) Circulation, 1999, 99:3234-3240, “Long-Term Ascorbic Acid Administration Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease”

3) Free Radic Biol Med, 2000 May 1, 28(9):1421-9, “How does ascorbic acid prevent endothelial dysfunction?”

4) Gut, 1989, 30:436-442, “Vitamin C in the human stomach: relation to gastric pH, gastroduodenal disease, and possible sources”

5) Circulation, 1999, 99:3234-3240, “Long-Term Ascorbic Acid Administration Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease”

6) The Journal of Biological Chemistry, Mar 19 1999, 274:8254-8260, “L-Ascorbic Acid Potentiates Nitric Oxide Synthesis in Endothelial Cells”

2. Reduction of Nitrite to Nitric Oxide.  One thing that I talk about in my Interview with Dr. Nathan Bryan is how nitrate in food is converted to nitrite by bacteria in the mouth and later to nitric oxide in the gut. Vitamin C is a similar miracle worker and converts nitrites to nitric oxide. One set of study authors noted that “”Vitamin C is an effective scavenger of nitrite, reducing it to nitric oxide and preventing nitrosamine formation in vitro and in vivo.”[4] Thus the protection of tetrahydrobiopterin is not the only way that Vitamin C can increase a man’s baseline nitric oxide levels. (There is a study out there that says, in the presence of significant fat in the stomach, nitrosamine formation is actually increased.  See my caution below.)

3. Restoration of Endothelial Function in Heart Disease Patients. Heart disease patients with arteriosclerosis are plagued with “endothelial dysfunction”, which means that the lining of their arteries cannot pump out the sorely needed nitric oxide for lowering blood pressure/increasing blood flow/getting an erection.  (The lining of the arteries is called the endothelium.)  However, Vitamin C therapy has been found to help restore endothelial dysfunction in these cases, which is remarkable considering the severity of the situation. And what is more remarkable is that this occurred at the relatively small dosage of 500 mg/day. [5] If Vitamin C can help arteries and improve blood flow in heart disease patients, it can likely do it for you too!

DOSAGE and FORM: I am currently taking 3 doses of 500 mg split throughout the day.  I take the “Ester-C” form, which is calcium ascorbate with a small amount of some other herbs and extracts thrown in to increase absorption. Ester-C is a trademark or brand name However, you can also buy calcium ascorbate from other supplement manufacturers, but it will not have the exact name Ester-C.  Of course, you can also take Vitamin C as ascorbic acid, but I have tried this and it gives me heartburn.  This is why most people take the buffered forms.

NITRIC OXIDE TESTING: What is the best way to test your baseline nitric oxide levels? That is actually a fairly involved question, but there are new nitric oxide test strips available from Neogenis that can indirectly do the trick for you in the privacy of your own home. What they actually measure is nitrite on the tongue and you can read the technical details in this link on At Home Nitric Oxide Evaluation Test Strips to find out more. Keep in mind that Dr. Bryan, the inventor of these test strips, recommends that baseline readings be taken first thing in the morning before any activity, eating, brushing of the teeth or mouthwash, etc.

CAUTION:  Vitamin C should probably be taken on an empty stomach by most people, because it can increase iron absorption.  Most men do not need increased hermatocrit/hemoglobin and/or iron stores (ferritin), due to red meat consumption and other factors.   Elevated iron levels have been implicated in heart disease and various brain conditions.  (Iron literally “rusts” the body.)  There is also a study out there that shows, if you have over 10% fat in your stomach, Vitamin C can actually increase nitrosamine formation. (This is a controversial finding however.)

Female Libido: Looks - Peak Testosterone

All us guys have marveled at some gorgeous females walking with the most pathetic looking of guys. But, in spite of such anomalies, I can assure you of something: females do care about looks. If fact, let me put it another way: females are sexually stimulated by looks.

David Buss, one of the leading researchers in the field, recently did a huge survey of 37 cultures. He found that on a scale of 0.0 to 3.0, looks were only 0.5 less important for women than men. And we all know how important this is for us guys. This is universal, by the way: women in the USA, Germany and Mainland China ranked looks as 2.1, 1.8 and 2.2, respectively for example. [1] Looks are important to women and you can ignore it at your own peril.

In fact, many guys would be shocked to find out what women look at when shown erotic imagery.  One study showed that men concentrated on the face of the females in the images but females concentrated on the men’s genitalia! [2] So, while you’re politely looking at her face, she is checking out your body and your packaging!  I’m sure that surprised more than one of the researchers.  Yes, your body matters to the female in your life.

I can hear all the objections now. Women only care about money and females are not visually stimulated . Well, sorry, but the research says the opposite. Yes, money is important to females many studies bear that out.  (And it’s not important to us guys?!?) And, perhaps one can aruge that women are not as visually stimulated as males. Nevertheless, they are visually stimulated to a high degree and this is another key to the female libido.

This is further verified by the huge numbers of women on the net looking at porn.  Nielsen – and these guys know their demographics – say that one third of all adult web site visitors are women. [3]  And Hustler has stated that a little over half of all their adult sales come from women. [3]

Did you know that you can raise and lower your testosterone based on the foods you eat? And did you know that boosting testosterone through diet in the wrong way can lead to erectile dysfunction? Read about the High Testosterone Diet to find out how to improve both your testosterone AND your sex life.

The truth is that many of us guys like to think that looks don t matter to women, because we want to let ourselves go. We like to think that no matter how overweight, wrinkled, out of shape and flabby we are that it really doesn t matter. And then when the woman in our life isn’t interested in sex, we like to invoke the next big excuse, Women just don t have a libido.

The real truth is that most women have a good libido and if her interest isn t there, you may be partially or even mostly to blame. If she s less interested in sex these days, could it maybe be that paunch, the flat butt, the man boobs or the deep facial wrinkles?? Of course, it could!

Yes, she probably tells you that you re a hunk if you ve got a big gut for example, but we both know women are notoriously polite. You will be surprised at what a difference it makes and the comments you will get from her as you drop that gut, get some abs and muscle and take care of your skin.

And that s one of the messages of Peak Testosterone: you don t have to resign yourself to physical deterioration. You don t have to be overweight, look like Yoda or or walk around half dead. So please read my links on How to Lose Weight, on Improving Your Skin and Building Muscle Mass and increase her libido by making yourself look like you did back in high school or college.

Seriously, my body is better than it was in college: I ve got more muscle and more strength by almost any measure. Yes, I ve got a few more wrinkles, my skin has a few more sags and I definitely have less hair. But I still look dang good, thank you, for a guy just shy of a half century. You can easily do the same thing. In fact, it will probably be even easier for you, because I m a Skinny Bastard body type.

And, please, don t give me the objection: Well, my wife is forty pounds overweight! Why should I worry about her libido? Trust me the great majority of women will be highly motivated if you are highly motivated.

NEWS FLASH: My theories were recently verified by a study that had women rating men for attractiveness.  However, unbeknownst to the women, the men’s body fat levels were measured before the experiment.  Other studies have suggested that females are primarily attracted to “masculine”, “testosterone-related” features such as a strong jawline.  The researchers found that what was significantly more important to the women was the man’s thinness. [4]  In other words, women are much more attracted to those abs than any other feature. Yes, get working!

Start taking off the pounds and adding the muscle and you will be surprised how she comes around. You don t need to say much of anything. Let your actions speak. And she almost for sure will come around just be patient.

So it s time to drink from the Fountain of Youth. It’s time to get harder, leaner, stronger.  Read around on this site and you ll see the latest research of everything from Libido to Cosmetic Surgery find out how to get back on track and enjoy yourself while you re at it

REFERENCES:

1) Acta Psychologica Sinica, 2007, 39(3):502-512

2) The Neuroscientist, 2005, 11(4):288-293

3) https://www.cnn.com/2009/LIVING/personal/07/24/o.women.watching.porn/

4) https://www.huffingtonpost.com/2012/ 11/28/what-women-want-in-a-man_n_2206231.html

The Relaxation Response: Cortisol Killer and Manliness Build - PT

So what is the #1 thing a man can do to improve his sex life, general health and cognition.  Well, there are many top candidates:  exercise, a whole foods diet (Low Fat, Mediterranean, etc.), sleep, sexual intercourse and possibly losing weight if one is overweight or obese.  But there is another top contender and the great majority of men not only do not practice it but are not even aware that it exists.

Of course, what I am talking about is implementing the Relaxation Response into your daily lifestyle. Most men – and I admit myself included until recently – do not want to hear about relaxation.  It’s boring, a waste of time and on and on.  But medical researchers, when they use the term Relaxation Response, are not referring to a nice vacation in Maui, a good round of gold or even “relaxing” in front of the television.  Researchers are referring to a very profound physical and measurable clinical response that occurs when you do certain activities.  And, usually, these activities include various forms of meditation, Progressive Muscle Relaxation, autogenic training and a few other similar practices.

NOTE:  Pursuing the Relaxation Response through meditation or Progressive Muscle Relaxation need have NOTHING to do with religious practice. I personally practice what is called “secular mediation” as much as possible, which has absolutely no spiritual connotations.  No offense to anyone who does incorporate the spiritual into their meditation, but my point is simply that everyone should meditate, do PMR, autogenic training, etc.

These effects are stunning to say the least and include short term changes including a drop in blood pressure, a decrease in stress hormones and so on.  However, as we’ll document below, these changes are much more far-reaching than simple reversal of the “fight or flight response”.

So what is the formula for achiving a Relaxation Response.  Well,  the easiest is probably Progressive Muscle Relaxation, which simply involves tensing and relaxing the muscles in a quiet environment. It has a vast clinical and research track record proving its worth and utility.  However, one study points out that any technique that follows these four simple points will produce the Relaxation Response:

The authors also noted that “sitting quietly with the eyes either open or closed failed to produce the same changes.”  So, yes, you can keep it simple – just not too simple.  But, again, there are many other techniques, especially meditation, that will produce a Relaxation Response.  (And there are even many types of meditation.)

Below I will present evidence that getting the Relaxation Response to work for you is one of the biggest things that you can do and is the b>missing ingredientnbsp; Don’t believe me?  Check out these reasons to get busy Relaxin’!

1. Blood Pressure.  The Relaxation Response can have a profound effect on blood pressure, especially in hypertensive patients.  In fact, average responses can be about as much as some standard blood pressure medications.  For example, one study on patients with high blood pressure who were already on medications lowered average blood pressure from 146 and 92 mm to 135 and 87 mm, respectively. [1] This is an impressive drop for patients who had already been corrected via pharmaceuticals. Admittedly, this was an older study but a number of follow-up studies have verified similar results and I include one of those in my page on Progressive Muscle Relaxation.

Of course, high blood pressure is a leading risk factor for erectile dysfunction, stroke and men with high blood pressure have been found very often to have low testosterone as well. (Low testosterone probably tends to cause hypertension rather than the other way around though.)  See my link on High Blood Pressure and Erectile Dysfunction for more information.

2.  Nitric Oxide. Meditation undoubtedly lowers blood pressure by several mechanisms, including the diminishing of a variety of stress hormones. However, there is another property of meditation that should be of interest to men everywhere:  it increases nitric oxide according to a study on Zen meditation. [22] Of course, nitric oxide is the key molecule involved in initiating erections (and dilating arteries) and it is remarkable that both movement (exercise) and sitting quietly with focused attention (meditation) can both increase NO.

3. Anti-Aging and Telomerase. If you meditate for just one reason, do it to to slow down aging.  Sound too good to be true?  Well, one the core theories of aging centers around the shortening of your chromosomes, i.e. tlomeres through the action or inaction of the telomerase enzyme.  Meditation was found in a 2011 study to actually increase telomerase activity which will protect your chromosomes. [8] Many things that increase stress have been found to shorten telomeres and thus likely accelerate aging, so this was no major surprise to researchers.  See my link on Telomeres and Telomerase for more information.

3. Brain Size (Density). Don’t you wish there was a supplement that would increase the size of your brain? Well, why not meditate instead?  There is strong evidence that meditators increase the size (density of neurons) in many key parts of their brain. It is not wonder since meditation a) decrease cortisol which is very hard on the brain and b) increases blood flow to many importants of the brain owing to the requirement for concentration and focus.

What areas of the brain are affected positively by meditation?  Well, there have been a number of studies on this.  One of them summarize by saying that meditation affected the “dorsolateral prefrontal and parietal cortices, hippocampus / parahippocampus, temporal lobe, pregenual anterior cingulate cortex, striatum, and pre- and post-central gyri.” [21] Notice the hippocampus in that list, which is the seat of one’s memory and is one of the parts of the brain attacked by Alzheimers and dementia.

4. Risk of Dying (Mortality). There are indications that meditation can, for many people at least, increase your life span by decreasing your risk of dying.  For example, one study of seniors with hypertension found significantly decreased mortality rates. [25]  Study authors noted “a 23% decrease in the primary outcome of all-cause mortality…, a 30% decrease in the rate of cardiovascular mortality and a 49% decrease in the rate of mortality due to cancer.”  Not bad for 15-20 minutes of work per day, eh?

5.  Cortisol Reduction. As I have pointed out in a number of places on this site, Meditation and PMR are famed for decreasing cortisol.  Of course, high cortisol lowers testosterone, decreases muscle mass and injures the brain.  For more information, see this link on Stress Management.

6.  Intelligence. This one is hard to prove, but a couple of studies have shown that meditation may actually increase general intelligence – that’s how good it is for the brain. [4]

7. DHEA. Meditation should increase testosterone, because of its cortisol-lowering actions but there is no hard evidence of that. However, one hormone that does seem to be affect positively by meditation is DHEA. Practitioners of TM were found to have increased levels of DHEA [7] and, although study results have been somewhat inconclusive, it is safe to say that DHEA helps some men at least with libido, memory and energy levels.

8.  Work Performance. One very easy relaxation technique is simple to say the word “one” whenever you exhale and “passively disregard other thoughts.”  One study found a significant increase in work performance based on things like energy, concentration, problem-handling, etc. [6]

9. Neurotic Behavior, Panic Disorder, OCD (Obsessive Compulsive Disorder) and Anxiety. Progressive Muscle Relaxation has a solid research and clinical track record with all of these stress-related disorders.  See my link on The Miracle of PMR for details.  And considering how well PMR does with neurotic behavior, this study of Transcental Meditation on African American adults is interesting:  researchers found that there was less neurotic behavior resulting from TM than PMR. [20]

10. Depression.  One very common theme on the Peak Testosterone Forum is depression. Of course, sometimes depression results from low testosterone. However, sometimes depression can lead can cause men many issues, including loss of libido and erectile strength. (See my link on Depression and Erectile Dysfunction for some basic information.)  I list many Depression Cures and Helps, but one that will be a big help for certain subpopulations of men:  Progressive Muscle Relaxation. This form of The Relaxation Response has been shown in studies on men recovering for cardiovascular disease and cancer to help improve depression. [26][27] NOTE:  Mindfulness meditation was shown in one meta-analysis to not be significantly helpful with depression. [28]

11. Immunity (Colds and Flus). Yes, it looks like the Relaxation Response can even help prevent the common cold according to one study on college students. [16] A recent study on children looks like this may be the case for meditation as well. [17] Mindfulness meditation is associated with increased Natural Killer Cell activity as well. [18] Meditation has also been found to increase antibody response to the flu, which should translate to increased protection. [19]

12. Insomnia.  Many studies have shown that the Relaxation Response can help in many cases with insomnia.  PMR has done particularly well. [12][13][14] but meditation also has studies as well. [15] For other research-backed information, see this link on Practical Sleep Aids.

13.  Norepinephrine (noradrenaline). This stress hormone actually puts the brakes on erections. [3] One study found that a standard Relaxation Response produced reduced stress in a way that is typical of decreased noradrenaline. [3] However, one smaller, older study found that noradrenaline increased post-meditation. [10]

14. Headache. Studies have shown that meditation can be a powerful tool in the treatment of headache relief.  One study noted good results with cluster and migraine sufferers for example. [11]

15. Arthritis. A very common and debilitating condition is arthritis and research has shown that the Relaxation Response can help with this condition.  For example, one study using PMR and guided imagery showed that they significantly improved both mobility and pain in female patients. [23]  This study was on those with osteoarthritis but meditation has been shown to help with rheumatoid arthritis as well. [24]

REFERENCES:

1) S03(7852):289–291, “DECREASED BLOOD-PRESSURE IN PHARMACOLOGICALLY TREATED HYPERTENSIVE PATIENTS WHO REGULARLY ELICITED THE RELAXATIONRESPONSE”

2) https://www.peaktestosterone.com/Progressive_Muscle_Relaxation

3) Science, 8 Jan 1982, 215(4329):190-192, “Reduced sympathetic nervous system responsivity associated with the relaxation response”

4) Personality and Individual Differences, 1991, 12(10):1105–1116, “Transcendental meditation and improved performance on intelligence-related measures: A longitudinal study”

5)

6) AJHP, Oct 1977, 67(10): “Daily Relaxation Response Breaks In a Working Population: 1. Effects on Self-reported Measures of Health, Performance, and Well-being”

7) Biological Psychiatry, Feb 1 1997, 41(3):311-318, “Dehydroepiandrosterone (DHEA) treatment of depression”

8) Psychoneuroendocrinology, June 2011, 36(5):664–681, “Intensive meditation training, immune cell telomerase activity, and psychological mediators”

9) Psychosomatic Medicine, Jul/Aug 2003, 65(4):564-570, “Alterations in Brain and Immune Function Produced by Mindfulness Meditation”

10) JOURNAL OF NEURAL TRANSMISSION, 1979, 44(1-2):117-135, “Sympathetic activity and transcendental meditation”

11) Headache: The Journal of Head and Face Pain, Apr 1974, 14(1):49–52, “The Usefulness of the Relaxation Response in the Therapy of Headache”

12) APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK, 1976, 1(3):253-271, “Biofeedback and progressive relaxation treatment of sleep-onset insomnia: A controlled, all-night investigation”

13) Journal of Behavior Therapy and Experimental Psychiatry, Sep 1983, 14(3):251-256, “Treatment of insomnia in cancer patients using muscle relaxation training”

14) Journal of Abnormal Psychology, Jun 1974, 83(3):253-260, “A comparison of progressive relaxation and autogenic training as treatments for insomnia”

15) Behavior Therapy, May 1976, 7(3):359–365, “Meditation training as a treatment for insomnia”

16) Journal of Psychosomatic Research, Dec 2001, 51(6):721-728, “The effects of stress management on symptoms of upperrespiratory tract infection, secretory immunoglobulin A, and mood in young adults”

17) Ann Fam Med, Jul/Aug 2012, 10(4):337-346, “Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial”

18) J Altern Complement Med, 2010 May, 16(5):531-8, “Enhanced psychosocial well-being following participation in a mindfulness-based stress reduction program is associated with increased natural killer cell activity”

19) Psychosomatic Medicine, Jul/Aug 2003, 65(4):564-570, “Alterations in Brain and Immune Function Produced by Mindfulness Meditation”

20) Intl Journal of Neuroscience, 1989, 46(1-2):77-86, “The Effects of the Transcendental Mediation Technique and Progressive Muscle Relaxation on Eeg Coherence, Stress Reactivity, and Mental Health in Black Adults”

21) Neuroreport, 15 May 2000, 11(7):1581-1585, “Functional brain mapping of the relaxation response and meditation”

22) Progress in Neuro-Psychopharmacology22) Progress in Neuro-Psychopharmacology and Biological Psychiatry, Feb 2005, 29(2):327–331, “Effect of Zen Meditation on serum nitric oxide activity and lipid peroxidation”

23) Pain Management Nursing, Sep 2004, 5(3):97–104, “A pilot study of the effectiveness of guided imagery with progressivemusclerelaxation to reduce chronic pain and mobility difficulties of osteoarthritis”

24) Arthritis & Rheumatism, Sep 1990, 3(3):127-131, “Pain management in the older adult with rheumatoid arthritis or osteoarthritis”

25) The American Journal of Cardiology, 1 May 2005, 95(9):1060-1064, “Long-Term Effects of Stress Reduction on Mortality in Persons ≥55 Years of Age With Systemic Hypertension”

6) JCO, June 1991, 9(6):1004-1011, “A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms”

27) Psychother Psychosom 2008;77:119-125, “Effects of Progressive Muscle Relaxation Training on Anxiety and Depression in Patients Enrolled in an Outpatient Pulmonary Rehabilitation Program”

28) The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, Apr 2007, 52(4):260-266, “Does mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research”

Charts of the Standard Testosterone Delivery Systems

REFERENCES:

1) FORTESTA- testosterone gel, metered; Endo Pharmaceuticals Inc., HIGHLIGHTS OF PRESCRIBING INFORMATION; These highlights do not include all the information needed to use FORTESTA safely and effectively. See full prescribing information for FORTESTA; FORTESTA (testosterone) Gel for topical use CIII, Initial U.S. Approval: 1953

2) ANDROGEL Product Monograph, Date of Revision: January 28, 2015 ; Control No. 178980

3) Journal of Andrology, 33(5), Sep/Oct 2012, “Pharmacokinetic Evaluation and Dosing of Subcutaneous Testosterone Pellets”, https://onlinelibrary.wiley.com/doi/10.2164/jandrol.111.016295/pdf

4) Endocrine J, 2006, 53(3):305-310, “Hormone Profiles after Intrasmuscular Injection of Testosterone Enanthate in Patients with Hypogonadism”, https://www.jstage.jst.go.jp/article/endocrj/53/3/53_3_305/_pdf

Maybe you are a newbie and have no idea what I am talking about.  If so, I can only tell you that, as time goes on, you may not feel as good as you believe you could or perhaps experience a side effect of your protocol.  That’s when you’ll want to understand a bit more about how the testosterone you are using behaves, and the charts below will help you get a general idea.

Please keep in mind that testosterone levels are affected by many factors and these charts are just dealing in averages.  Here are just a couple of examples:

–If you are on topicals, the amount of testosterone that you absorb through your skin is quite variable.  Some men go on Androgel, for example, and their testosterone rockets up to 900 ng/dl.  Other man will get almost no change whatsoever and may be below 400 ng/dl.  And, when it comes to testosterone injections, low and high SHBG can significantly affect the half life of the ester you are dealing with.

–Low SHBG men tend to have a much lower half life and often struggle getting “dialed in” with TRT.

Fortesta Chart

This big name pharmaceutical topical (transdermal) is typically applied to the inner thighs. It has not been terribly popular on the forum but it is a good example of just how a topical acts: [1]

Of course, this chart of Fortesta could not be more different than that of undecanoate – see below – peaking at just 4 hours post-application and then rapidly tapering off afterwards. By 10 hours after the application, you are pretty much hypogonadal again. Please note that this (from what I can tell) is showing testosterone levels is someone just starting on Fortesta.  See the Androgel chart below for what happens when you have been on a topical for about 2-3 weeks.  (It takes 2 – maybe 3 weeks for steady state testosterone levels to be achieved on a cream or gel.)

Here is a sample chart resulting from the typical dosage of 750 mg (3 ml):

As you can see, you peak after about one week and after just four weeks you have dropped down to 500 ng/dl. Below this level, many men will not do that well – been there!  (I did a round of pelletes before I went on testosteorne cypionate.)

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

Androgel Chart

Of course, the mother of all topicals is Androgel. (That’s actually not true as compounded topical testosterones have been around for just about forever.) Below is an Androgel chart that you will see is similar in characteristics to Fortesta (as expected). [2] However, notice that we got a testosterone peak about 2 hours after application. Now this chart shows something much more useful that the Fortesta chart in my opinion. In this case, they are showing testosterone levels 30 days into using Androgel. Of course, in that case one has reached a steady state, stable testosterone level, which is why the baseline testosterone levels above are so much higher. For example, the average testosterone of the men prior to Andrgel was around 300 ng/dl and steady state levels are in the upper 500’s and upper 700’s with 5 and 10 milligrams of Androgel, respectively.

Testotserone Pellets Chart

Testosterone pellets are placed under the skin via an in-office urological procedure. I discuss the pros and cons on these pages: Testosterone Pellet Information and Interview About Testosterone Pellets. Pellets essentially ramp your testosterone right up and then you slowly fade over the ensuing months.  Check out these charts: [3]

Testosterone and Arimidex - Peak Testosterone

STEP 8:  If you are high estradiol, consider pharmaceutical solutions to high estradiol (with your physician of course):

What if I told you there was a relatively inexpensive pill that any low testosterone man could take that would likely double his bioavailable testosterone and increase his total testosterone by around two thirds?  One study looked at men over 60 years old found an increase in testosterone of 62% and a decrease in estradiol, the “bad estrogen”, of 24% for a net improvement in the testosterone-to-estradiol ratio of 115%. [3] It took their total testosterone levels up from an average of 330 to 535 ng/dl.

Another study on infertile men with a T/E ratio less than 10 and total testosterone under 200 ng/dl found even more impressive results:  total testosterone was increased by an average of 95%. [4] (Another similar drug (Femara or letrozole) produced spectacular results and other studies have shown that Teslac (testolactone) also does very well) [5]

Personally, I don’t think this kind of Arimidex Monotherapy is a good idea for several reasons:

1. Less Sexual Improvements. Some study work indicates that Arimidex Monotherapy does not improve libido and sexual function significantly, even though testosterone and estradiol levels are improved.  [8]

2. The Current State of Testing. One quandary that physicians and their patients are facing right now is coming up with a target range for estradiol levels.  The big labs are now emphasizing LC-MS/MS estradiol tests for men, which makes sense, because LC-MS/MS is the best practical technology to read the low levels of estradiol that a male has.  However, the results for the LC-MS/MS appear to be a little lower than the old assays, due to decreased cross reactivity with other molecules, making the old target ranges from previous study work probably invalid.

3. Risk of Osteopenia / Osteoporosis.  Some physicians do not properly monitor or use the wrong estradiol test.  This could lead to a man ending up with bone loss.

4. Possible Risk of Clotting.  Some experts believe that Arimidex, even low dose, could increase of clotting in some men.

Now what is curious is that Arimidex (anastazole) actually works by binding to the infamous aromatase enzyme that converts your testosterone into estrogen.  Thus it effectively inhibits or blocks this conversion.  So one might expect estrdiol (E2) to be affected more proportionately than testosterone, but notice that it was T that was affected more than E in the above study.  (For other ways to affect your proportion of T to E, see my Natural Ways to Improve Your Testosterone-to-Estrogen Ratio link.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=295.msg2616#msg2616

2) https://www.peaktestosterone.com/forum/index.php?topic=433.msg4718#msg4718

3) Clin Endocrinology, 2009, vol. 70(1)”116-123, “Effects of aromatase inhibition in hypogonadal older men : a randomized, double-blind, placebo-controlled trial”

4) https://hrt-rx.com/2012/06/05/ arimidex-vs-femara-for-increasing-testosterone-in-men-hrt/

5) Fertility and Sterility, Jul 2012, 98(1):48-51, “Changes in hormonal profile and seminal parameters with use of aromatase inhibitors in management of infertile men with low testosterone to estradiol ratios”

6) Molecular and Cellular Endocrinology, 16 May 2006, 250(1-2):2-7, “Hormonal approaches to male contraception: Approaching reality”

7) The Journal of Urology, Feb 2002, 167(1):624-629, “AROMATASE INHIBITORS FOR MALE INFERTILITY”

8) J Sex Med, 2012 Jun, 9(6):1681-96, “Estrogens in Men: Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency”

9) J Urol, 2013 Feb, 189(2):647-50, “Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy”

Some of the more forward thinking doctors are now prescribing Arimidex in conjunction with HCG.  HCG, of course, stimulates the testes to produce testosterone and is used primarily to avoid testicular shrinkage, but it can also cause estradiol problems downstream.  One of the more famous “internet hormone doctors” is Dr. Eugene Shippen and one of our Peak Testosterone posters went to him.  Dr. Shippen’s overall protocol for this man, whose testosterone was 296 ng/dl, was as follows:

“He sent back a letter and a prescription for Clomid. (for 7 day stimulation test) My results showed I had Secondary Hypogonadism. My T had risen to 541, My E2=47, and DHEA was below the bottom of normal and D3 was low. On May 30th I went to Pa. to meet with him, he spent over 2 hours going over all my test results and did a physical that included a prostate check. He order[ed] the following meds: HGC, Arimidex, and 25mg DHEA oral supplement. I must have a followup blood test in 3 weeks for T, E2, and DHEA-S. Then in 6 weeks a full blood workup for Endocrine testing. He wants me to take D3 4000mg daily and drink Pomergranate juice plus Vit. C 1000mg.” [1]

Of course, in this case Arimidex was used in conjunction with HCG, but it is also often used by itself. Look at what one of the men on the Peak Testosterone Forum experienced:

“Having said that, Arimidex has done wonders for me in the 2 months i’ve been taking it, and my E2 was only 48 after a few months on hcg. the doc prescribed me 0.5mg ED, which is higher than what most people I read about on msg boards take. I tried that at first, felt nothing for about 10 days, then all of a sudden I started waking up with the biggest erections I had experienced in many years. and libido came back and now I think about sex all the time. just the hcg alone wasnt doing it for me even though it did raise my T levels. i have now cut back to 0.5mg EOD, which is still higher than most people seem to take, but it seems to be working for me. I read a comment on another more steroid oriented forum where a guy was saying to calibrate the Arimidex dosage based on morning wood, because if it gets too low you wont have it, but if it’s just right it will be huge and powerful.” [2]

NOTE:  Arimidex is not the only way to clinically lower estradiol.  There are other aromatase inhibitors, such as letrozole (Femara), for example.  There are also irreversible aromatase inhibitors.  See my page Suicide Inhibitors for some background information.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

Arimidex also has a big advantage for younger men wanting to possibly have kids: it does a much job at preserving fertility than traditional testosterone therapy.  Classic HRT (Hormone Replacement Therapy) will generally significantly decrease fertility, making childbearing difficult to impossible.  In fact, the new 6-week testosterone therapy injectable, Nebido, is actually being used as a quasi-contraceptive by some men.  And there is considerable research going on to find the best way to use HRT to achive a reliable male contraceptive. One research summary even wrote that “current hormonal combinations completely suppress spermatogenesis without severe side-effects in 80 90% of men, with significant suppression in the remainder of individuals. Recent trials with newer, long-acting forms of testosterone combined with progestogens have yielded promising results and may soon result in the marketing of a safe, reversible and effective hormonal contraceptive for men..” [6]

The aromatase inhibitors (AI’s) can sometimes bypass that concern.  (Confirm with your doctor, of course.)  In fact, Arimidex will actually improve some fertility parameters.  One recent study looked at Arimidex and found that, besides delivering a nice boost in testosterone, FSH was largely unchanged and sperm density was increased by 78%. [4][5] For these reasons, fertility doctors will sometimes use Arimidex to treat male fertility issues.  For example, you might be started on Clomid for a few months and, if your testosterone is too high, Arimidex (anastrozole) may be prescribed in combination.  Or some men are started with both immediately and then monitored.  Again, I’m not a big fan of Arimidex due to the above four concerns, but some physicians do make use of it.

These types of fertility treatments for men are much more common than generally realized:  male fertility is probably impacting up to a fourth of all troubled pregnancies. Fertility doctors also tend to be much more cutting edge when it comes to boosting testosterone than many traditional doctors, such as urologists, endocrinologists and primary care physicians. Why? Fertility specialists have been treating men for over a decade with alternative treatments and are interested in preserving libido, which requires good testosterone levels, along with boosting sperm parameters. Thus, they have on average built up a lot more experience than most other specialities.

However, I should point out that some physicians are now using low dose HCG in conjunction with testosterone therapy in order to maintain fertility.  For those interested, see a fertility specialist familiar with Dr. Lipschultz’s work.  [9]

Arimidex and Testosterone Therapy

Arimidex (anastrozole) is also quite commonly used in men who are on testosterone therapy (HRT or TRT).  The reason is that 80% of a man’s estradiol comes from the conversion of testosterone into estradiol in the fat tissue through the aromatase enzyme.  The more weight that a man has gained, the higher the estradiol levels that he will have on average.  Furthermore, some TRT providers push men to very beefy levels of testosterone, say 1000-1200 ng/dl, which may be above the man’s natural set points.

When I first started cypionate injections at an HRT clinic, they put me on low Arimidex just a couple of months later. This really surprised me, because I really did not want to have to “medicate my TRT.”  The argued that the dose was very low compared to, say, a cancer patient, and it has no real side effects when done properly, i.e. estradiol is not sent overly low.

So for a few months I took .5 mg twice a week.  I then pushed them to let me lower it to .25 mg twice per week.  Both of these doses are pretty common for men on testosterone, and I see it quite often on the Peak Testosterone Forum. But I did everything in my power to get off of Arimidex and used a threefold approach to actually accomplish the task:

This allowed me to get off of Arimidex completely.  My testosterone levels are still very solid and in the 700-800 ng/dl range.  And in my opinion almost every guy on TRT should endeavor to do the same, because this will generally be more physiological, or natural.  Plus, the cautions and risks cited above for Arimidex Monotherapy also apply here as well.

Of course, Arimidex is often used by steroid users to decrease over-aromatization from driving their testosterone into supraphysiological zones, i.e. way above normal, which in turn leads to elevated estradiol.  They aslo use it post-cycle period when they are desperately trying to get their testosterone jumpstarted – sometimes unsucccessfully I might add. As strange and annoying as this is, steroid users and fertility doctors were some of the early pioneers of Armidex usage.

CAUTIONS: However, Arimidex is not something that should be used unless it is under a doctor’s supervision, primarily because estradiol, the E2 estrogen, needs to be monitored.  One of the problem’s with Arimidex is that one can easily push estrogen levels too low.  In the short term this can lead to joint pain.  Scientists are not sure why, but, when estrogen gets too low on Armidex, the joints can begin to be very painful.

Even more dangerous, though, would be long term damage fromm overly low estrogen levels.  Low E2 will eventually lead to bone mass loss, i.e. osteopenia and ultimately osteoporosis.  See my link on Why Men Need Estrogen for more details.

Arimidex can also negatively effect libido.  The thinking is that if estradiol gets driven too low that sex drive goes with it.  Again, estrogen in males has a fairly tight therapeutic range with too much or little decreasing sexual desire. (It can also send libido thorugh the roof!)

Increase Your Nitric Oxide Naturally - Peak Testosterone

STEP 2. Most men simply do not realize the massive difference that boosting your nitric oxide levels can make. You just feel better.  You exercise better.  You think more clearly.  Your blood pressure lowers.  And, perhaps best of all, your erectile strength increases. Of course, increased nitric oxide is the house upon which Viagra was built.

Of course, the huge problems that most men over the age of 40 have in the West is the lining of their arteries are now covered with atherosclerosis and scar tissue.  And I’ll just state the obvious: if your arteries go downhill and arterial plaque lowers your nitric oxide levels, you feel worse. That should come as no surprise. Many men with erectile dysfunction, libido, mental fog and fatigue do not realize how much those would be improved simply by increasing their nitic oxide levels.

Many men try to improve these kind of symptoms with HRT.  But HRT is not a miracle cure for atherosclerosis and low nitric oxide levels.  That must be worked on separately and there is no substitute for beefy NO levels.  Dr. Nathan Bryan has pointed out that many middle-aged men have less than half their youthful nitric oxide levels. Ouch!

And just because you are young, don’t think that you are immune. A number of studies have shown young men in their 20’s and 30’s with very significant artherosclerosis. Sure, you’re gonna be better off than most guys in their 60’s, but that may not be saying much!

So why not just take a PDE5 Inhibitor and call it a day? Although PDE5 Inhibitors (Cialis, Viagra and Levitra) have had considerable success at raising nitric oxide levels, they are fraught with side effects.  Tinnitus, hearing loss, visual disturbances, headaches and my personal favorite:  stomach upset and nausea.  These medications also can lead to what I call Viagra Resistance and Cialis Dependency. In addition, they do not work that well in men with a lot of arterial plaque.  Clearly, there has to be a better way!

This is where more natural solutions can step in and, in most cases, provide excellent results with many less side effects and issues.  I go into more detail in my book, The Peak Erectile Strength Diet, but below I give a nice summary of 10+ Ways to Increase Your Nitric Oxide Naturally:

CAUTION: Always check with your doctor before taking any new supplements or even fruit juices if you are on any medications or have any medical conditions.

1. Nitrates (in Foods). There are a number of foods that have high nitrate content, including carrots, lettuce, spinach and, of course, beets. I give substantial coverage to this in my links on Nitric Oxide Replacement Therapy, An Easy NO Boost Through Food, Beet the Odds and Beetroot Juice, but the beautiful thing about nitrates is that they give a man an alternate pathway to raise his NO levels even if he has significant atherosclerosis.  The way it works is this:  nitrates in one’s food are converted to nitrites by the bacteria on your tongue (assuming you haven’t killed it all off with mouthwash), which then are converted to nitric oxide in your gut.

NOTE:  An even better source of nitrates is arugula – thanks Dr. Greger – and several guys on the Forum including myself swear by the stuff.

2.  Citrulline. Citrulline is one of the more recent erectile supplement superstars.  Of course, it’s been around awhile, but it suddenly dawned on everyone that this was a nice way to boost arginine levels without The Potential Side Effects of Arginine. Basically, what I have read is that taking Citrulline bypasses the normal metabolic pathways and, again,  allows men with significant atherosclerosis to gain some of their nitric oxide back by bypassing the normal arterial pathway.  Quite a few men on The Peak Testosterone Forum swear by Citrulline and take 1.5-3 g/day. (Always talk to your doctor first.)

The research has really backed this up by the way: one study on senior men showed that taking 5 grams daily improved the stiffness of their arteries.  Nice!  These were healthy senior men, and this study also showed that arterial stiffness was improved independent of blood pressure. [3] Yet another study in the following year verified these promising results directly in erectile dysfunction patients by showing that half of study participants increased their hardness factor significantly by taking only 1.5 grams/day of L-Citrulline daily. [4] Again, these were senior men (average age 57 years) and, it should be noted, that their frequency of intercourse increased as well. What else could you ask for, eh?

3. Pomegranate Juice. Pomegranate Juice is the new heavy weight juice when it comes to improving your bedroom prowess.  And part of the reason is that it is a darn good nitric oxide booster.  It also lowers blood pressure, improves your cholesterol and, at least in some patients, clears out plaque!  For more information, see my link on The Many Benefits of Pomegranate Juice. CAUTION: Pomegranate juice can interact negatively with some medications, including Viagra (and perhaps other PDE5 Inhibitors).

CAUTION:  Erectile supplements should be combined very carefully and with the lowest dosage possible, because they can interact negatively with certain medications and medical conditions, and could potentially cause priapism, an erection that does not go away and can damage the penis permanently.  See my link on Common Causes of Priapism for more information on the latter. If you ever have an erection that will not go away after an hour or two, go to the E.R. immediately. Example: There have been several cases of pomegranate juice combined with Viagra leading to priapism.

4. Avoid High Fat Meals. Here is a quote from the lead author of a study on walnuts and olive oil: “The inner lining of the arteries produces a substance called nitric oxide that is needed to keep the arteries flexible,” Dr. Ros said. “When we eat high-fat meals, the fat molecules temporarily disrupt the production of nitric oxide, preventing the arteries from increasing blood flow in response to physical activity.” [3] The authors go on to explain that the higher fat in the meals creates an inflammatory response that walnuts (and not olive oil) can overcome.  Walnuts have both arginine, ALA and various antioxidants in them that actually helps overcome this arterial stiffness that follows a higher fat meal.

Low carbers may wonder if this applies to them.  Actually Low Carb does fairly well, according to a couple of studies I have seen, as long as you are losing weight.  However, the minute that you are on maintenance, i.e. no longer losing weight, you lose blood flow, vasoreactivity and, therefore, nitric oxide according to one study. [4] The moral of the story is that over the long haul you want to avoid high fat meals.  I outline many other issues in my link on The Dangers of a High Fat Meal, which includes a discussion of lowering testosterone.

5. Vitamin C.  Many men do not realize that Vitamin C can relax arteries by a different mechanism:  it protects your precious nitric oxide from being destroyed by free radicals. [3] Further evidence of Vitamin C’s powers in this regard are it’s ability to lower blood pressure and reduce arterial stiffness. (CAUTION: One study showed that Vitamin C actually constricted arteries.  However, this is when combined with another powerful antioxidant, so it is uncertain how applicable it is to practical situations.  See my link on Antioxidants and the Heart for more information.

6. CoQ10. If you are hypertensive, have diabetes (and probably prediabetes), CoQ10 is a proven improver of blood flow and lowerer of blood pressure. For example, one meta-analysis of hypertension studies came to the incredible conclusion that “coenzyme Q10 has the potential in hypertensive patients to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without significant side effects.” [6] The effect is so strong that scientists believe CoQ10 must be working on nitric oxide to help preserve it from oxidative stress.  Or it may act on eNOS. Either way it can have an excellent effect for many men struggling with E.D.  Typical dosages in the studies are in the 100 – 200 mg/day range.

7. Moderate Exercise.  Brisk walking, which basically just means over 3.0 mph, is a great way to boost your baseline nitric oxide levels.  Of course, exercise increases NO for a couple of hours afterward very significantly, but the practical application is that your overall nitric oxide levels can increase as well as long as you do it daily for around 30+ minutes.  See my link on The Benefits of Brisk Walking for the research. (It unstiffens arteries and lowers blood pressure also!) And, of course, other forms of exercise can help as well. I just mention brisk walking, because it is so well studied and avoids overtraining, a big issue for many men (including myself from time to time).

8. Ginseng. One supplement that has a successful erectile dysfunction study under its belt is Korean Ginseng.  This herb has been used for centuries for many medical conditions, and scientists have found one of its secrets:  it does a nice job of increasing nitric oxide.  I cover this in detail in my link on Erectile Dysfunction and Ginseng. NOTE: Ginseng can thin the blood a bit, so always talk to your doctor if you are on any medications.

9. Pycnogenol. Pycnogenol, which is a standardized extract of French maritime pine bark, is another supplement with a successful erectile dysfunction study. It works by increasing the activity of eNOS, the enzyme that Viagra and Cialis act upon. [13] For more information, see my page on Pycnogenol and Erectile Dysfunction.

10. Saturated Fat.  One of the big controversies on health blogs and even among experts centers around how much saturated fat really contributes to heart disease.  But here is one thing that most of the men arguing on both side of the discussion do not realize:  saturated fat very often lowers nitric oxide. One study summarized this issue by saying that “because diets with a high saturated fat content induce high plasma fatty acid levels, endothelial nitric oxide production is often impaired due to a reduction in nitric oxide synthase 3 phosphorylation.” [7]

This is one of the primary reasons that a high fat meal, as mentioned above, also usually lowers nitric oxide levels. Remember: you don’t need saturated fat to boost your body’s cholesterol levels, because your body makes its own just fine without you sucking down modern oils and butters and corn-fed cows and pigs. Also, virtually every primal culture on planet earth, regardless as to how much meat they consumed, had total cholesterol below 150 and they are much, much healthier than us.

TIP: A lot of people like the taste of olive oil and it’s part of Mediterranean cuisine. However, olive oil will actually reduce nitric oxide in many cases and canola oil will not. Furthermore, canola oil is much better regarding inflammation than olive oil. [12]

11. Raw Cocoa or Dark Chocolate.  The flavonoids in dark chocolate or raw cocoa can significantly raise nitric oxide levels.  For example, one study gave 44 hypertensive seniors just 30 grams of dark chocolate – a fraction of the typical chocolate bar – and found that it significantly lowered their blood pressure. [8]

As I point out in my link on The Kuna People, they have incredibly low rates of hypertension and they are regular consumers of raw cocoa. This is the surest way to make sure that you get your flavonol content as processing can reduce flavonols. By the way, the Kuna have average blood pressure readings of 110/70 and very little increase with age! [10] For more information, see my page on Raw Cocoa Powder.

NOTE: Hopefully, you’re noticing a pattern here:  many, many plant foods increase nitric oxide and animals are either neutral or lower nitric oxide, depending on their saturated fat content.  This is why the DASH Diet, a clinically proven way to eating to lower blood pressure in hypertensive patients, is almost entirely plant-based.

12. Quercetin. This phytochemical is found in many plants, particularly citrus fruits, onions, apples, parsley, wine and tea.  It works to boost nitric oxide by decreasing a peptide called endothelin-1.  Endothelin-1 is a very strong vasoconstrictor and is actually released by the cells in your endothelium and quercetin controls this effect. [10]

13. Icariin (Horny Goat Weed).  Horny Goat Weed has also been used for centuries to help erectile dysfunction and the primary component with it has been found to contain a natural PDE5 inhibitor called Icariin.  There are now extracts of Icariin in the 40+% range, which is usually desirable because Icariin is much less powerful gram-for-gram than the pharmaceutical Viagra.  (I have read 50 times less so.)

Again, there are many other fruits, fruit juices, drinks and vegetables that I cover in my book that will help you increase nitric oxide levels. But, again, the key is to eat a well-rounded plant-based diet packed with a variety of fruits and fruit juices. [9] Yes, you can eat some meat.  However, if you are a bit older and your endothelium is damaged, you will find that you do much better following some of the tips above.

TIP:  Did you know that just one cup of raisins can lower blood pressure (and slash TNF alpha levels)?  Anything with grapes – even many wines – can do the same thing.

REMEMBER:  Being overweight, being sedentary and smoking hammer your endothelium.  All the food and supplements in the world cannot overcome these.

REFERENCES:

1) Int J Cardiol, 2010 Nov 8, “Short-term effects of l-citrulline supplementation on arterial stiffness in middle-aged men”

2) Urology, 2011 Jan, 77(1):119-22, “Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction”

3) https://www.sciencedaily.com/releases/2006/10/061010022750.htm, “Eating Walnuts With High-Fat Meals Helps To Protect Arteries Against Short-Term Damage”

4) Circulation, 2007; 116:II_819, “Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss”

5) Journal of Biological Chemistry, 274, 8254-8260, “L-Ascorbic Acid Potentiates Nitric Oxide Synthesis in Endothelial Cells”

6) Journal of Human Hypertension, 2007, 21:297 306, “Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials”

7) Curr Opin Clin Nutr Metab Care, 2010 Jan, 13(1):97-104., “Regulation of nitric oxide production in health and disease”

8) JAMA, 2007 Jul 4, 298(1), “Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide: A Randomized Controlled Trial”

9) Lipids Health Disease, 2008, 7(14), “Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines”

10) Int J Med Sci, 4(1):253-258, “Does Flavanol Intake Influence Mortality from Nitric Oxide-Dependent Processes? Ischemic Heart Disease, Stroke, Diabetes Mellitus, and Cancer in Panama”

11) International Journal of Clinical Pharmacology and Therapeutics, 2002, 40(4):158-168, “A review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology”

12) https://www.pritikin.com/your-health/health-benefits/reverse-heart-disease/331-sex-nitric-oxide-and-your-heart.html

Zinc and DHT (Dihyrdotestosterone) - Peak Testosterone

In my link on Zinc and Testosterone, I cover the controversial and often contradictory results relating zinc to testosterone. I don’t think that anyone has any doubts that a zinc deficiency is going to be helpful to testosterone levels, but the studies just aren’t there showing zinc as a testosterone booster. What about zinc and DHT (dihydrotestosterone)? Of course, DHT is the “other androgen” and is involved in many “male” function including libido. Does taking zinc raise DHT even though it has lackluster results with resepect to T?

One study on infertile men indicates that that may be the case. [1] In this (small) study, they split the men up into two groups:  a lower T group with total testosterone < 480 ng/dl and a higher T group with testosterone > 480 ng/dl.  What they found was interesting:

1.  Testosterone, sperm count and DHT were increased by zinc in the under 480 ng/dl cohort.

2.  Testosterone and sperm count were not increased but DHT was increased by zinc in the over 480 ng/dl cohort.

Of course, what is noticeable is that in both groups zinc increased DHT.  Keep in mind, though, that this is just one small study on specific subpopulation. Also, isn’t it interesting that the lower testosterone group increased in testosterone.  Perhaps this explains some of the discrepancies we have seen in the testosterone-zinc studies?

Unfortunately, the situation is probably a bit more complicated than just that.  One study indicates that the amount of zinc is very critical.  At lower levels, 5-alpha-reductase activity is increased, which means that more testosterone would be converted to DHT and at higher levels the opposite was true. [2] Yet another study showed that, if you went high enough with zinc, it completely shut down 5-alpha-reductase activity.

Also, keep in mind that, if your DHT is low, creatine has been shown to increase DHT in one study.  You can read about this in my link on the Potential Risks of Creatine. Finally, remember that raising your DHT if you already have solid levels could potentially lead to side effects such as hair loss.  Again, testing and monitoring is always a great idea when using supplements.  Read my link on Zinc Dangers for important cautions with regard to zinc use:  more is NOT always better with zinc.

REFERENCES:

1) Systems Biology in Reproductive Medicine, 1981, 7(1):69-73, “Effect of Zinc Administration on Plasma Testosterone, Dihydrotestosterone, and Sperm Count”

2) J Steroid Biochem, 1984 Feb,20(2):651-5, “The effect of zinc on the 5 alpha-reduction of testosterone by the hyperplastic human prostate gland”

3) Br J Dermatol, 1988 Nov, 119(5):627-32, “Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid”

Low Carb Diets and Heart Disease - Peak Testosterone

Low Carb Diets are incredibly popular right now.  They’re a fast way to lose weight – mostly because of the shedding of water during the initial glycogen depletion – and attractive to the typical man used to a high fat Western Diet.  Given a choice between cutting back on meat or fruit and whole grains, most (American) guys will toss out the fruit and whole grains.

But what do these diets do to the heart and arteries?  That’s the all-important question, because cardiovascular disease is the #1 killer of men and will likely remain so for years to come.  The answer to that question is not as simple as one might expect.  For example, according to traditional thinking, low fat diets tend to regress plaque and higher fat diets the opposite, righf?  Again, the answer is not as simple as we might like.  One study, in particular, has demonstrated that fat levels are likely irrelevant in reducing atheroclerosis if significant weight loss is involved.

This study looked 322 middle-aged and early senior aged participants with BMI greater than 27.  They were then randomized into three different diets that included low carb, Mediterranean and low fat.  In other word, the authors wished to cover a wide spectrum of fat and carb levels in the diet. [1]

Secondly, this is under weight loss conditions.  The real test of a diet is when it is consumed for a decade or two and I discuss the evidence that a low fat diet, if done correctly, has the best research behind it in my page called The Evidence for Long Term Arterial Plaque Reduction Using Low Fat Diets.

Nevertheless, it appears from this study that a lower carb diet, as long as you are losing weight, can do a nice job of reversing your plaque and thus should be good for arterial health.

CAUTION:  Not all men do well on a low carb diet, due to gut issues, decreased arterial blood flow and lowered nitric oxide and elevated stress hormones, much of which I cover in this page on Low Carb Diets and Inflammation. My impression from running the forum is that the older the man, the less he can withstand some of the negative effects of a low carb diet, and lately I have had a number of middle-aged and beyond men on the retreat from higher fat and lower carb dietary regimens. Chris Kresser has a number of tactful articles that describe how he sees a significant percentage of men that do well on a low carb diet for a few months, but then have to stop.

Okay, so a low carb diet can reduce plaque if you are losing weight.  But what if you are not losing weight? Well, a number of things should give any low carber pause and reason to reflect.  Let me give you just a few examples:

1. Very High LDL and LDL Particle Counts. Many of you probably know who Jimmy Moore is:  he is one of the leaders of probably the biggest low carb site.  He posted his lipid numbers recently and please check them out:

“So, what were the results? Here were my numbers:

Of course, these are very high numbers. Not all low carb dieters have numbers this high, so I’m not quite sure what is going on here.

But I have seen it many times on the forum:  men on classic Paleo and low carb have medium high or high LDL and LDL particle counts, but low triglycerides.  Basically, they are hoping that their low triglycerides will protect them their high LDL.  In fact, Jimmy Moore says this in so many words.  Essentially he argues that his small LDL particle size will protect him from atherosclerosis.

In my opinion, that is risky.  There is substantial evidence that even larger LDL particles can cause plaque, something I cover in my page on Beware of Large Particle LDL. Of course, for his sake and many other Low Carb folks, I hope that it works out that way. However, I can only say that all the plaque regressors that I know of, require low LDL as well as good triglyceride and HDL numbers. And one of them, Dr. Davis, even dislikes low fat diets.  See my page on HDL, LDL and Triglyceride Requirements to Regress Plaque. Plus, when you stop losing weight, low carb dieters will probably add in some additional carbs and then this is where it gets dangerous in my opinion – more on that below.

2. During Maintenance Mode. What if you are not losing weight?  Well, an animal study shows a low carb dieting accelerating arterial plaque when the animals put on weight. The animals on the low carb diet developed 15% more plaque as they gained weight.  The lead researcher actually stopped his own low carb diet:

“Lead researcher Anthony Rosenzweig said the findings were so concerning to him that he decided to come off the low-carb diet he was following.” [3]

3. Middle-Aged And Senior Men. Young guys can withstand just about anything, but, as you age, you struggle to handle the increased stress of things like a low carb diet. (And this is no exagerration – low carb diets work by increasing stress hormones.) Based on a recent animal study, low carb diets look like they may be a bad idea for many men who are middle or senior aged: the researchers found that older animals experienced actual heart alterations and damage:  “these metabolic disturbances were responsible for cardiovascular damages only in adult mice, with decreased aortic distensibility and left ventricle dysfunction.” [4] The ventricles are the all-important lower chambers of the heart that receive and pump blood.

So, in older animal, low carb diets can negatively alter the heart itself. What about in other circumstances? Recent research has shown that elevated ketones can induce arrhymias that, in some men, could be very serious, something you can read about in my page on Low Carb Diets and Arrhythmias. Yet another recent study showed that a low carb diet may actually leave your heart vulnerable to stressors such as a heart attack.  For example, an animal study showed that obese animals experienced the following:

The head of this study was quoted as saying: “If I had heart disease or I was predisposed to having a heart attack, I would think carefully before starting this type of diet.” Now the author of the study was careful to say that his study does not show that low carb diets cause a heart attack, but we already showed you above that in maintence mode, low carb diets may accelerate plaque, so the sword may cut both ways for some men.  In other words, if you are not losing weight or are older per the above research, then you may be vulnerable to both getting a heart attack and worse outcomes afterward (if you survive). Cardiovascular disease is the #1 killer of men and I cannot see any reason to tilt the pendulum in the wrong direction.

The reasons for these poor outcomes after a heart attack are probably multiple and include the fact that ketogenic diets may increase free radical damage or that there is insufficient glucose for recovery. This is the same issue that higher intensity athletes have trying to make it with a ketogenic diet:  they lose performance.  So be careful…

REFERENCES:

1) Circulation, “Dietary Intervention to Reverse Carotid Atherosclerosis”

2) Jimmy Moore, “LipoScience’s NMR LipoProfile Test: A Revolutionary, More Accurate Lipid Profile Particle Size Screening”

3) https://news.bbc.co.uk/2/hi/health/8218780.stm

4) Am J Physiol Heart Circ Physiol, 2014 Sep 1, 307(5):H649-57, “High-protein-low-carbohydrate diet: deleterious metabolic and cardiovascular effects depend on age”

5) https://garytaubes.com/2011/04/before-sugar-were-talking-about-cholesterol/

Of course, if you’ve poked around the site much, you know I am a follower of Drs. Gould and Esselstyn who use a low fat diet as their starting point for plaque maintenance and reversal.  So the results of this study took me by surprise:  they found that ALL the diets regressed plaque according to a volumetric ultrasound technique.  The two that showed the most plaqure regression were the “low fat” and low carb diets, but low carb was actually the winner of the two.

NOTE:  The authors found that the most important predictor of plaque loss was the drop in systolic blood pressure.  Again, this is yet more proof how important control of blood pressure is.  See my page on High Blood Pressure and Erectile Dysfunction for natural ways to significant lower your blood pressure. Also, one other important side note is that this was a fairly diseased population:  26% of them where on anti-hypertensive and 20% on statins for example.  Someone with less plaque and a less plaque-building lifestyle will probably experience less regression.

Low Carb Diets: Potential Arterial Damage When You Are Not Losing WeightLow Carb Diets and Heart Attacks

Beef and Eggs - Peak Testosterone

Beef and eggs.  Can you find two more hated foods?  I doubt it.  The nutritional media establishment has loved to hate these two foods for so long now that people have become scared to even touch them much less eat them.  We hear over and over messages like “if the saturated fat and cholesterol don’t kill you, then the salmonella or e. coli will.”

How much truth is there in all of this? Unfortunately, there’s no quick, pat answer. Beef and Eggs are actually like a of relatives: a little heaven, a little hell and a whole lot of contradiction.

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Let’s start with the egg. Eggs are famous, or infamous perhaps, for their cholesterol content.  One egg yolk, after all, has about 200-250 mg of cholesterol.  (Egg whites, in contrast, have almost none.)  One would think that all this cholesterol would dramatically raise cholesterol levels, right?  As it turns out, the cholesterol is one egg yolk does not bump up your cholesterol as much as you might think.

This was re-re-verified in one recent study where researchs fed subjects three eggs for three weeks.  Their cholesterol and LDL went through the roof, right?  No! Both increased only a marginal amount. The reason?  Your body manufacturers the lion’s share of its cholesterol:  diet is a minor contributor.

Researchers also recently found that eggs do something strange and marvelous:  they substantially raise HDL (at least in overweight men on a calorie restricted diet). [11]  This study found that neither bad cholesterol nor triglycerides, the bad cholesterols, were increased significantly at all, while HDL, the good cholesterol, was increased by almost 50%!  In other words, there is a good chance, although this has not been studies either way, that a whole egg a day is actually heart healthy.

That said, we should remember that the healthiest cultures on planet earth almost all have cholesterol around 150 and eggs yolks will raise your cholesterol somewhat, so you don’t want to go crazy.

And one interesting discovery  certain peptides in eggs seem to act as powerful ACE inhibitors and should lower blood pressure. [7]  This has yet to be verified in a live study however.

However, there is one big reason I don’t consume egg yolks:  arachidonic acid (AA).  Especially if you don’t get enough omega-3’s, arachidonic acid increases Inflammation throughout the body. Of course, inflammation is a cause of heart disease, cancer, erectile dysfunction, Alzheimers, arthritis and on and on.  So this is not good, because one egg yolk has around 390 mg of AA, which is a high amount for a food source. [12]

So, while it’s true that egg yolks don’t raise cholesterol that much, the small boost in cholesterol coupled with the big boost in inflammation may be the kiss of death for your arteries.  One recent study recently found that consuming egg yolks raised carotid artery thickness, a measure of arterial plaque buildup (arteriosclerosis), as much as smoking! [13] In other words, eating egg yolks may very well be as bad for you as smoking. (Some would argue that if you get plenty of omega-3’s, you may be okay. I can’t thik of a good reason to take the chance.)

Some would argue that eggs are a fantastic source of choline and lutein, two very important nutrients in food.  However, the lutein content in eggs is relatively low and, of course, one can easily get choline in supplement form.

CAUTION:  Eggs are known for all too frequently carrying salmonella leading the FDA to action that included more stringent rules in mid 2009 for egg laying facilities, storage and transportation.  The FDA instituted these rules based on their estimates that over 140,000 people per year were infected from salmonella. [8] Cook your eggs all the way through and cooked eggs or egg dishes should be reheated to at least 165 degrees Fahrenheit or 74 degrees Celcius. [9]

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

Beef should be a favorite of testosterone lovers everywhere, right? It has many testosterone boosting qualities: ample zinc and a good saturated to polyunsaturate fat ratio for starters. Besides all that, beef is incredibly rich in B12, iron, selenium, phosphorous and riboflavin. It’s also one of the meats lowest in inflammatory messengers.  One 2007 Australian study veryified this by measuring C-reactive protein (and free radical damage) from replacing carbohydrate with lean, red meat. They concluded “our results suggest that partial replacement of dietary carbohydrate with protein from lean red meat does not elevate oxidative stress or inflammation”. [10]

Beef is also the core staple of the Masai tribe, one of the most heart-healthy cultures on planet earth. So beef has a lot of things going for it.

So then why the bad press? Well, there are four fundamental allegations:

We’ll have to tackle each of these separately starting with the hormone allegation. Yes, hormones are implanted in commercial North American beef. (You will have to research your own country if you’re from elsewhere around the globe.) There are six approved steroids, three synthetic and three “natural”. All six are essentially testosterone or estrogen.

Sounds scary, right? Well, it would be except that the levels of hormones that make it into a serving of beef is miniscule. There is a much greater quantity of estrogen in eggs and cabbage, for example, than in beef. Furthermore, the amount of estrogen in 6 oz. of beef, 3.8 ng, is dwarfed by the total amount of estrogen the tyical male (human) will produce in a day, 100,000 ng. So the hormone argument is  weak in my opinion.

However, the carcinogen argument is not so easily explained away. This argument stems from the fact that beef, when grilled at high temperatures, produces carcinogens such as heterocyclic amines (HCA’s) and benzopyrene. For example, Prevention magazine (3/06, p. 67) reported that one study showed that those who ate the most HCA’s and benzopyrene had a 2.4 times increase in their level of pancreatic cancer risk. Other studies have also shown red meat and/or HCA’s strongly associated with increased prostate cancer.

Animal studies have shown additional problems: HCA’s mutate prostate DNA in rodents for example. And researchers have also noted that HCA’s cause DNA mutation in the colon. So beware:  the longer (or hotter) that you cook beef, the more HCA’s and other carcinogens that you get.

So it’s obvious that HCA’s lead to prostate cancer, right? Well, yes and no. In fairness, some studies have shown the opposite, that is that HCA’s do NOT lead to prostate cancer. However, the general consensus among the nutritional community is considerable caution when the discussion of beef cooked at high temperatures.

I should also mention that one recent study showed that many common marinades will very significantly lower the amount of HCA’s (between 57 and 88 percent) produced when the beef was grilled at high temperatures. [4]  The most successful marinades were composed of spices from the mint family such as basil, thyme, mint, rosemary, savory, sage, oregano and marjoram. These herbs are all rich in three key antioxidant compounds – carnosic acid, carnosol and rosmarinic acid – that appear to be behind the inhibition of heterocyclic amines on the surface of the meat.  Of course, it should be noted, that this still left a significant amount of HCA’s on the meat.  Even an 88 percent reduction could leave someone with an unnecessarily high exposure to prostate and pancreatic cancers over a decade or two of eating cooked up marinaded meats.

The omega-6 and omega-3 argument is even more problematic.  Virtually all of today’s beef is not range fed but rather grain fed.  Grains are high in omega-6’s which leads to fatty tissue marbled with omega-6’s in our beef supply.  (Range fed animals, which feed off natural grasses, will have a much more healthy quantity of omega-3’s in their tissues.) What is the concern here?  Well, researchers at Wake Forest found that prostate cancer (in mice) was higher than normal with an omega-6 diet and lower than normal with an omega-3 based diet.  In other words, omega-6’s appear to promote prostate cancer and omega-3’s inhibit prostate cancer. [5]

Finally, modern cows are often sedentary and bred and fed to be extremely “fatty”.  Modern livestock is generally ridiculously high in fat content. For example, muscle tissue on a buffalo is about 3% fat.  But a modern, domesticated cow has been bred to be between 25-35% fat. Similarly, a wild pig is 1-3% fat, while a domestic pig is an astronomical 38-46% fat.

Unfortunately, the extremely fatty tissues of modern beef are going to be loaded with saturated fat.  Saturated fat will do a nice job of raising your testosterone, but unfortunately it’s brutal on the arteries.  It literally creates a temporarly hardening or stiffening of the arteries.  This is the opposite of what you want for good erections.  Good erections come from veins and vessels that can expand easily and let blood flow into the penis.  That’s also critical for protection against heart attacks and high blood pressure as well.

The bottom line is that saturated fat is associated with decreased endothelial function. After a large saturated fat meal, endothelial function can be decreased by as much as half. This is NOT what the typical middle aged guy needs in his life. I discuss the whole saturated fat issue in more detail here.

So, if you bake a lean, range-fed piece of beef that was cooked slowly, then you might be in good shape. It would tend to be low in saturated fat, high in omega-3’s and would probably even yield a small testosterone boost.  But how many men are going to do that?!

So, unfortunately, what should be one of nature’s healthiest and most testosterone-boosting foods has been morphed by modern livestock businesses into a food that places us steak-loving males at risk for prostate cancer and endothelial dysfunction.  For this reason, my recommendation is to eat beef sparingly.  Remember:  most of you reading this need to actually clean out your arteries, something the Ornish Diet will do.  The last thing you need is a bunch of saturated sludging around.  In fact, if you have any Erectile Dysfunction, try going without saturated fat for a couple of weeks:  you will probably see improvement from just that alone.

REFERENCES:

1) J of Nutr,2004,134:1887-1893

2) J of Nutr,2006,136:2568-2573

3) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 81, 92, 94, 95.

4) J of Food Science, Aug 2008, (73)6,T100-T105(1)

5) Journ Clin Invest, 117(7):1866-1875, Jul 2 2007

6) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 92.

7) J Agric Food Chem, 2009, 57(2):471–477, “Angiotensin I Converting Enzyme Inhibitory Peptides from Simulated in Vitro Gastrointestinal Digestion of Cooked Eggs”

8) https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm170640.htm

9) Consumer Reports on Health, Oct 2009, p. 3.

10) Journal Nutrition 137:363-367, 2007

EggsBeef

Horny Goat Weed: Viagra-Like Supplement - Peak Testosterone

Horny Goat Weed  –  quite a name for a supplement, eh? How are you going to explain that to the wife and kids? Well, I’ll leave that up to you, but you might want to use the scientific name of epimedium.  The important thing to realize that Horny Goat Weed is well worth your consideration, especially for those of you struggling with erectile dysfunction.

Why? Horny Goat Weed (HGW) does everything a guy could want.  First of all, it really does make you “horny” at least in rats and has increased their sexual response in anumber of studies. [8]  One study of healthy rats found that a constituent of this supplement, icariin, actually boosted testosterone levels. [7]  Most Horny Goat Weed supplement manufacturers do an extract of icariin along with the plant itself.

That’s just the beginning of the good news when it comes to Horny Goat Weed and erectile dysfunction:  it also increases your precious Nitric Oxide. In fact, that same compound, icariin, actually blocks PDE5 (and PDE4 which is used by the body for various inflammatory responses). [4] You may recognize PDE5 is the same phosphodiesterase chemical that Viagra and Cialis act on in order to increase Nitric Oxide. One recent study examined various herbal or herbally derived products including Horny Goat Weed, Icariin and Tribulis Terristris for PDE5 inhibitory properties and found that only the Horny Goat Weed and Icariin were able to inhibit PDE5. [6] In other words, Horny Goat Weed increases Nitric Oxide by the same mechanisms as Viagra:  slowing down PDE’s Nitric Oxide consuming capacities  This isn’t just theoretical:  several studies have shown that this supplemetn actually increased both cGMP and Nitric Oxide. [5][1][9]

REFERENCES:

1) Intl Journal of Impotence Research, July/August 2006, 18:335-342,”Epimedium brevicornum Maxim extract relaxes rabbit corpus cavernosum through multitargets on nitric oxide/cyclic guanosine monophosphate signaling pathwayEpimedium brevicornum Maxim extract relaxes rabbit corpus cavernosum”

2) Urology, Mar 2006, 67(3):631-635, “Effect of Epimedium brevicornum Maxim extract on elicitation of penile erection in the rat”

3) Acta Pharmacol Sin, Mar 2006, 27(3):311-20

4) Asian J Androl, Mar 2003, 5(1):15-8

5) Vascul Pharmacol, Jul 2007, 47(1):18 24

6) J Natural Products, 2008 Sep;71(9):1513-7. Epub 2008 Sep 9, “Potent Inhibition of Human Phosphodiesterase-5 by Icariin Derivatives”

7) Asian Journal of Andrology, 2006, 8:601 605, “The testosterone mimetic properties of icariin”

8) Journal of Ethnopharmacology, Dec 2007, 114(3):412-416, “Effect of lipid-based suspension of Epimedium koreanum Nakai extract on sexual behavior in rats”

NOTE:  Icariin has many other excellent properties.  See this link on the The Power of Icariin for more details.

This same study showed a relaxation of smooth muscle tissues, allowing increased blood flow into the penile chambers. [1]  Obviously, this is a supplement formula for a better erection.  A second study showed that administration of Horny Goat Weed was “erectile producing” in rats. [2] Finally, a very interesting study on embrionic cells in the lab found that it “inducible effects of icariin were partly related to increase in the expression of cardiac developmental-dependent genes, and elevation of the cAMP/cGMP ratio in ES cells, as well as upregulation of endogenous NO generation”. Translated that means:  Horny Goat Weed actually turns on genes that increase Nitric Oxide output for you steadily all the time 24 X 7. [3] What a contrast when compared with the erectile drugs that last for between 4 and 36 hours, eh?

Also, it is worth noting that some supplement manufacturers put Maca and Horny Goat Weed together in the same capsule taking advantage of their complementary effects on male physiology.  Horny Goat Weed directly boosts Nitric Oxide and libido.  Maca, through a different pathway, boosts semen volume and libido.

Inflammation and the Liver: Married at the Hip - PeakTestosterone

Non-alcoholic fatty liver disease (NAFLD) is nothing short of an epidemic in the U.S. and other modern, industrialized countries. If you read my link on Insulin Resistance and the Liver, you’ll see that NAFLD is very tied to insulin resistance and Metabolic Syndrome, so it is no wonder. Again, it is not unreasonable to assume about half of the men reading this page have NAFLD and that this is a very serious threat to not only their sex life but their life in general.  The moral of the story:  you can’t ignore your liver!

Yes, the liver is important and, as you probably remember from your high school biology, is that the liver performs many critical functions:  detoxification, processing medications, building proteins – the list could go on and on. And here is why you absolutely MUST take fatty liver disease very seriously:

1)   Postgrad Med J, 2006, 82:315-322 “Treatment of non-alcoholic fatty liver disease”

2) World J Gastroenterol, 2006 Dec 28, 12(48):7826-31, “Insulin sensitizers in treatment of nonalcoholic fatty liver disease: Systematic review.

3) World J Gastroenterol, 2007 March 14, 13(10):1579-1584, Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease”

4) HEPATOLOGY, 2010, 52(5), “Evolution of Inflammation in Nonalcoholic Fatty Liver Disease: The Multiple Parallel Hits Hypothesis”

5) J Clin Invest. 2003, 112(1):91–100, “The fat-derived hormone adiponectin alleviates alcoholic and nonalcoholic fatty liver diseases in mice”

6) The Journal of Clinical Endocrinology & Metabolism, Jun 1 2005, 90(6):3498-3504, “Plasma Adiponectin in Nonalcoholic Fatty Liver Is Related to Hepatic Insulin Resistance and Hepatic Fat Content, Not to Liver Disease Severity”

7) J Mol Med (Berl), 2002 Nov, 80(11):696-702, “Adiponectin: a link between excess adiposity and associated comorbidities?”

8) Ann Med, 2005, 37(5):347-56, “Fat in the liver and insulin resistance”

9) Cancer Cell, 17 Feb 2010, 17(2):115-117, “Obesity, Inflammatory Signaling, and Hepatocellular Carcinoma—An Enlarging Link”

10) Gastroenterology, Jul 2005, 129(1):113–121, “The Natural History of Nonalcoholic FattyLiver Disease: A Population-Based Cohort Study”

1. NASH.  Non-alcoholic steatohepatitis (NASH) is the ugly end point for some men who develop NAFLD.  All men with NAFLD have steatosis, which simply means fatty acids accumulating in the liver cells.  However, in some men this turns very ugly and you end up with steatohepatitis, or a form of liver disease that mimics classic hepatitis.  NASH is basically a condition that includes an inflamed liver with classic cirrhosis that is often debilitating and in some cases life-threatening. [10] Scientists have noted that there is little difference between the damaged liver that results from non-alcoholic fatty liver disease versus alcoholic fatty liver disease – it’s all bad news.

2.  Cardiovascular Risk Factors. NAFLD has become one of the many new risk factors for heart disease.  In other words, if you develop this type of liver disease, you are at increased risk for cardiovascular events and even death.  So one should treat NAFLD as erectile dysfunction, which also is a new predictor of impending heart problems.

3.  Type II Diabetes.  A fatty liver also increases your risk for type 2 diabetes. (The two conditions are highly interrelated.)

NAFLD appears to be such a powerful predictor that one recent study out of Japan found that it even foretold heart disease strongly than Metabolic Syndrome. Furthermore, it was found to be an independent risk factor for cardiovascular disease independent of all others.[3]  Researchers have noted that it is no wonder since “the liver, once fatty, overproduces most of the known cardiovascular risk factors such as very low density lipoprotein (VLDL), glucose, C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), fibrinogen and coagulation factors.” [8]

All of that said, what makes this type of liver disease so problematic is that it appears benign to the men diagnosed with it. In fact, many men have it and do not even know it. NAFLD is definitely not an immediate death warrant and the great majority of men with this type of liver disease – 90% and above – do not even have symptoms. It is somewhat like most prostate cancers:  it exists for years often before it rears its ugly head.

When one overconsumes calories or has an increased oxidative (free radical) load due to being overweight, the liver begins to accumulate these to protect itself from toxic triglyceride byproducts.  Evidence is mounting in animal studies that endotoxins, which result from out-of-whack intestinal bacteria and dysfunctional TLRs (toll-like receptors), which result from being overweight, increase systemic inflammation and lead to NAFLD. [4]  Several studies have also shown that adiponectin, a key inflammatory cytokine, regulates liver fat. [5][6] As you put on weight, your body lowers adiponectin levels and your liver fat increases – it’s that simple.  Furthermore, adiponectin is strongly (and inversely) correlated to body fat. [7]  And our old archenemies TNF alpha and IL-6 also have been found in animal studies to directly cause liver inflammation, which can accelerate the nasty liver-destroying cirrhosis called NASH mentioned above. [9]

The bottom line is that almost every major inflammatory cytokine involved in disease and cancer plays an active role in the initiation and progression of non-alcoholic fatty liver disease as well.  And these cytokines all become misaligned through growing body fat.  That has lead researchers to observe that your fat (adipose) tissue literally attacks your liver.  Your liver is ground zero when it comes to the battle for your health.

When you put on enough weight, you are literally pitting one organ against the other and creating a sort of internal war on yourself:  the fat tissue makes war on the liver, which in turn assails both the heart and penis.

So what will your physician do if you are diagnosed with non-alcoholic fatty liver disease?  You and your physician need to agree on a course of action andt there are several common elements in current treatment. [1]

1. Treat any underlying diabetes, insulin resistance or Metabolic Syndrome.  This can involve pharmeutical solutions in some cases.  Metformin and thiazolidinediones, insulin sensitizing drugs, have been popular in studies and done quite well. [2]

2. Improve insulin sensitivity by encouraging exercise and weight loss.

NOTE: A higher fat diet will also actually induce insulin resistance and so care must be taken. Although consuming a diet higher than about 40% fat is probably not that common, care should be taken.

3. Protect the liver through antioxidants and other supplements and agents.

Obviously, this is not where you want to be in the sense that you want to stay off of pharmaceuticals if at all possible. Phamaceuticals always have side effects and long term unintended consequences.  It is always better to let the body heal itself if one can and go about things naturally.

Here are some ideas to keep your liver fat free:

1. Insulin Resistance.  Read my link on Insulin Resistance and the Liver and battle the underlying insulin resistance at the same time that you battle the underlying inflammation.

2. Dietary Fat. Be very careful with dietary fat levels.  Remember that high fat diets are used in laboratory animals to induce insulin resistance and high fat diets will often increase inflammation as well.  Fat is also very calorically dense and can lead to weight gain, leading to a viscious cycle of increasing inflammation and insulin resistance. (By the way, this is yet another reason that many of the Atkins, Paleo and Low Carb diets can get you into trouble quickly. They seem like a good idea but can be very hard on the heart and liver.)

3. Weight Loss and a Low Fat Diet.  A whole foods Low Fat Diet can decrease control and even decrease liver fat content.  One study noted that “liver fat content can be decreased by weight loss and by a low as compared to a high fat diet.” [8]

4.  Fructose.  Watch your fructose!  It is known for both increasing insulin resistance and inflammation.  Read my links on

5.  Anti-inflammation. Yes, a little inflammation is a good things for figthing infections and basic immunity.  However, the vast majority of us in modern societies have the opposite problem:  an overactive inflammatory response.  Read this link on How to Control Inflammation for many ideas on how to get out of the inflammation rat race.

STUDY: Loss of Morning Erections Likely Due to Arterial Plaque.

One of the things that I constantly point out is that erections have everything to do with arterial plaque (atherosclerosis).  There are many lines of evidence for this, something I discuss in my page on Erectile Dysfunction and Arterial Plaque. Further evidence of this was shown in a study I just came across that used Cialis (tadalafil) to show some remarkable things about daytime erections, morning erections, nitric oxide and the role of atherosclerosis in each. The study involved was from 2005 and they took middle-aged and senior men with erectile dysfunction and compared them to younger men with psychogenic (psychological) erectile dysfunction for comparison purposes.

Why did they use men psychogenic erectile dysfunction as the control group?  The reason is that this group had nothing physically, if you will, with their ability to get an erection.  In other words, the plumbing was just fine at least, and one sign of this is the fact that men with psychogenic erectile dysfunction usually still have reasonable morning erections.  This is not necessarily the case generally with middle-aged and older men, who generally have a cardiovascular / arterial origin for their E.D.  The study authors decided to study a different aspect of this phenomenon and hypothesized that the loss of nighttime erections was primarily due to arterial plaque.

All men in the study were given 20 mg of Cialis, which is a huge dose, every other day.  Let’s look at some of the significant findings of this study and the conclusions that one might come to based on the results: [1]

1. No Arterial Plaque = Restoration of Morning Erections. The authors actually used a penile “cuff” if you will to monitor morning erections as the patients were sleeping.  What they found was that Cialis restored morning erections only in the men with no arterial plaque. Of course, the reason for this is that you “can’t squeeze blood out of a turnip.”  Basically, nitric oxide triggers (downstream) cGMP which relaxes the artery, including those feeding the penis and within the penis.  Cialis protects the degradation of this process and thus preserves this relaxing effect.  However, if there is not enough nitric oxide to go around, then there is nothing to preserve:  Cialis cannot do its job.  (I cover this in my page on Viagra Failure.)

2. No Arterial Plaque = Improvement in Daytime Erections.  The authors also gave a standard quesitonnaire to monitor improvement in erectile dysfunction, which of course has to do with the ability to have an erection during the waking hours. You can read about it on this page if you are interested:  IIEF Scores and Erectile Dysfunction.  What they found was that only the men with no arterial plaque had a significant improvement in their IIEF scores.

1)  European Urology, Aug 2005, 48(2):326 332, “Resumption of Spontaneous Erections in Selected Patients Affected by Erectile Dysfunction and Various Degrees of Carotid Wall Alteration: Role of Tadalafil”

3. Morning Erections Were Correlated with the Amount of Arterial Plaque. The authors stated that “NPTRM [nocturnal erectile strength] and P-CDU [doppler score] parameters were inversely related to different degrees of carotid wall alteration .” In other words, the more the plaque, the worse the nighttime erections.  Yes, plaque lowers your ability to produce nitric oxide, even with huge doses of Cialis!

CONCLUSION:  Why is arterial plaque so hard on the arteries and your ability to get an erection?  Caldwell Esselstyn, one of the Doctors Reversing Arterial Plaque, illustrates this nicely.  He points out that young, healthy men have 6-8 tennis courts of endothelial cells lining their arteries pumping out nitric oxide.  However, the typical senior man, due to the Western lifestyle, will have 1-2 tennis courts of endothelial cells.  This occurs because the Western lifestyle is so hard on the lining of the arteries that it literally destroys the endothelial tissue.  Of course, part of this process is the buildup of atherosclerotic plaques that are a root cause in  heart attacks, angina and stroke.

Step 2 is to beging regressing any plaque if you have any.  I have many pages discussing some of the important information surrounding this here:  Summary Page of Arterial Plaque Regression. You may want to start out with my page on How to Clear Your Arteries.

Brain and Mindfulness Meditation - Peak Testosterone

This site emphasizes natural health practices that can supercharge a man’s life (and sex life). Of course, exercise and a clean, whole foods diet are probably the top two items that come to mind. But right behind those should be Secular Meditation in its various forms. (I would also throw Progressive Muscle Relaxation into the mix as well due to its profound benefits.) Meditation may not seem manly, but, when you look at the benefits, it is hard to beat and I will prove that below when we examine Mindfulness Meditation specifically.

One of the myths that we have is that you always have to work harder to get ahead as a guy. Mindfulness Meditation shows how just untrue that assertion is:  it shows that by just sitting quiety for 1 or 2 10-15 minutes periods during your day you can rebuild your body, brain, personal psychology and hormones.  Again, “work smarter, not harder” applies perfectly here.

Here are a few of the stunning benefits for men of Mindfulness Meditation:

1. Brain Building for Career and Relationships. Several studies have noted Mindfulness Meditation’s ability to rebuild many parts of the human brain.  For example, one study found that it took just a few months to see increased “left anterior” brain activation. [1] This echoed a previous study on particpants with SAD (Social Anxiety Disorder), who were not only helped with their people-related issues but also saw increased activity in areas of the brain used for focus and attention. [2] And in those with mild cognitive impairment, Mindfulness Meditation increased both the density of the hippocampus (memory) and the “inferior frontal gyrus”. [4] However, it should be noted that one study showed improvement in the hippocampus in normal, healthy individuals. [5]

There are many reasons that cortisol will rip your health and sex life apart, but the primary ones are probably a) accelerated visceral fat, which is associated with cardiovascular disease and endothelial, a.k.a erectile dysfunction, b) brain shrinkage and c) testosterone reduction.  And overexcitation of the HPA Axis in general can lead to or accelerate many psychiatric disorders as well.

So anything that lowers cortisol and/or keeps it in check is a potent tool in your arsenal.  And Mindfulness Meditation has lowered cortisol in a number of studies with a wide variety of patients.

3.  Executive Function. There are few things more important to your career and relationships than executive function.  Wiki definites executive function as “cognitive processes that regulate, control, and manage other cognitive processes.” [10] It involves multitasking, reasoning, working memory and many, many other critical things that separate us from the rest of the animal kingdom.  And poor executive executive function is associated with “attention deficit hyperactivity disorder, depression, drug abuse, and antisocial behavior.” [11]

Mindfulness Meditation has been shown in several studies to be excellent at improving executive function in many key ways, including “increasing awareness of one’s thoughts, emotions, and actions have been shown to improve specific aspects of EF, including attention, cognitive control, and emotion regulation.” [11] Who can improve their executive function?  Studlies look promising for just about everyone and include groups as diverse as  and 2nd and 3rd graders. [12]

NOTE: Some of these studies are based on MBSR (Mindfulness Based Stress Reduction) which is mindfulness meditation plus some other things such as class instruction and yoga.  Nevertheless, the core of all these programs is just pure Mindfulness Meditation.

4.  High Blood Pressure (Hypertension). One of the biggest risk factors for erectile dysfunction and sexual dysfunction is high blood pressure.  High blood pressure has many apsects to it. Everyone knows that narrowing of the arteries from arteriosclerosis can lead to high blood pressure and on this site we often discuss how endothelial damage from a Western lifestyle can lead to decreased nitric oxide and hypertension.  However, for many men the primary component of their high blood pressure is stress-related Western lifestyle.  This is where Mindfulness Meditation can really make a difference and lower blood pressure. Many studies have shown just this, including cancer pateints [9] and junior high students. [13]

5. Social Life. This is odd, but sitting quietly doing Mindfulness Meditation can improve your social life.  As mentioned above, researchers found that people with Social Anxiety Disorder were greatly helped because their “stress reactivity” to social situations. [2] In other words, this type of meditation helps to keep you from overreacting and, again, this was also evidenced by decreased activity in the amygdala, the part of the brain involved in fear reactions.

6.  Depression.  The Peak Testosterone Forum is packed with men who are struggling or have recently struggled with depression.  Many are on depression medications such as SSRI’s.  MBSR has been thoroughly studied as a treatment for depression and has done very well in the studies overall, showing benefits for a variety of patients including some of the tougher treatment groups such as cancer patients. [9]

Admittedly, not all studies have shown improvement from MBSR.  However, another mindfulness approach called Mindfulness Based Cognitive Therapy (MBCT) has even been used very successfully even with patients who have experienced recurring bouts of major depression. One meta-analysis concluded that it prevented relapse into major depression at a very high rate. [20] The authors also noted that “in two studies, MBCT was at least as effective as maintenance antidepressant medication.”

7.  Amygdala (the Brain’s Stress Region) Reduction. There are some areas of the brain that you don’t want to build up.  In fact, researchers have noted that a decrease in one area of the brain, the amygdala that is responsible for panic and fair, is actually a good thing.  And, sure enough, Mindfulness Meditation shrinks this critical part of the brain, showing just how forcefully it reduces stress. [2] Another study noted the same shrinkage of the amygdala on “stressed but otherwise healthy” individuals, which covers just about everyone in modern, urban societies! [3]

8. Immunity. The same study that noted increased brain activity from meditation also found that meditators had a much better immune response against the influenza vaccine, thus likely providing very real protection against flus and other viruses. [1]

REFERENCES:

1) Psychosomatic Medicine, Jul/Aug 2003 vol. 65 no. 4 564-570, “Alterations in Brain and Immune Function Produced by Mindfulness Meditation”

2) Emotion, Feb 2010, 10(1):83-91, “Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder”

3) Soc Cogn Affect Neurosci (2010) 5 (1): 11-17, “Stress reduction correlates with structural changes in the amygdala”

4) BMC Complement Altern Med, 2012, 12(Suppl 1):P202, “Mindfulness based stress reduction in adults with mild cognitive impairment: a pilot study using fMRI”

5) Psychiatry Research: Neuroimaging, Jan 2011, 191(1):36-43, Mindfulness practice leads to increases in regional brain gray matter density”

6) Neuropsychobiology, 65(3), “Influence of Mindfulness Practice on Cortisol and Sleep in Long-Term and Short-Term Meditators”

7) Behaviour Research and Therapy, Nov 2012, 50(11):651 660, “Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia”

8)

9) Brain, Behavior and Immunity, 2007, “One year pre post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients”

10) https://en.wikipedia.org/wiki/Executive_functions

11) Child Development Perspectives, Article first published online: 21 JUN 2012, “Improving Executive Function and Its Neurobiological Mechanisms Through a Mindfulness-Based Intervention: Advances Within the Field of Developmental Neuroscience”

12) Journal of Applied School Psychology, 2010, 26:70 95, “Effects of Mindful Awareness Practices on Executive Functions in Elementary School Children”

13) Psychosomatic Medicine, Nov 1 2004, 66(6):909-914, “Impact of Meditation on Resting and Ambulatory Blood Pressure and Heart Rate in Youth”

14) Clinical Psychology Review, Aug 2011, 31(6):1032 1040, “The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis”

Now, just in case the importance of this escaped anyone, let me translate what this means:

The typical man in a modern, industrialized environment is stressed out with career, relationships, finances, commuting and the overstimulation of television, media and the internet. This type of man, though, is the ideal candidate to be helped from Mindfulness Meditation, since rebuilding one’s brain is clearly going to be of great benefit for both career and relationships. Seriously, how can increasing the density of neuroconnections in your brain not be good for almost everything you do in life as a male?

Also, many men have lived lives of depression, post traumatic stress disorder and other major cortisol-increasing stressors that can actually shrink the brain.  Now, thru this simple meditational technique, these men  have been give the chance to rebuild their brains and recover much of those lost years. Again, though, it is not just the stressed that will benefit according to some of the evidence, but healthy, “normal” individuals as well.

NOTE: Interested in giving it a try? Consider reading my link on How to Do Secular Meditation, which gets rid of all the religious verbiage associated with meditation and distils it down to just the most simple steps.

2.  Cortisol Reduction. Did you know that one study showed that cortisol levels did not change from the beginning of an Mindfulness session to the end. [6] Does this mean that it has no effect on cortisol? Actually, the same study showed that the longer one meditates, the lower the cortisol levels. And as you hopefully know from My Links on Cortisol, it is one of our most potent enemies.

The Brain and Testosterone - Peak Testosterone

Most hypogonadal men that go on HRT (testosterone therapy) expect it to ramp up their libido and erections almost right away.  However, what happens more often is that the testosterone first affects their brain.  I remember when I went on pellets, which got my testosterone levels up near 600 or 700.  I noticed my (mild) anxiety and dysthymia improving significantly.  And, when I went on testosterone cypionate, which boosted my testosterone further still, I could feel it right between the ears.  The evening of my first shot I told my wife that it felt like my brain was being rewired.  It took a few days for morning erections to begin and libido to rise.  But the brain boosting benefits came right away.

So let’s look at some of the key brain changes that researchers have noticed relating to testosterone:

1.  Dopamine.  Testosterone’s most pleasurable effect on the brain has got to be it’s dopamine-boosting powers.  In my link on Testosterone and Dopamine, I document how there are key parts of the brain that are heavily dependent on T to boost dopamine and that dopamine is one of the keys for one’s sex life.

Researchers have increasingly found that dopamine is also a huge key in fighting depression. [1] Many men have used Buproprion (Wellbutrin/Zyban) to overcome depression due its unique abilities to often help sexual function.  How does Wellbutrin work?  One of its modes of action is boost dopamine in certain important brain regions.  Gotta have it!

2.  Acetylcholine. Testosterone appears to boost acetylcholine, the “memory neurotransmitter” as well.  One study noted that “gonadectomy selectively reduces acetylcholine in the hippocampus.” [2] So low testosterone is not just hard on your sex life – it’s hard on your brain!

NOTE:  As a side note, this testosterone boost of acetylcholine is also probably good for your erectile strength.  Acetylcholine is kind of “Nitric Oxide Lite” and helps with vasodilation.  One animal study showed that testosterone boosted acetylcholine in the levantor ani muscle, which is part of your all-important pelvic musculature. [3]

3. Hippocampal Neurogenesis. Hippo what?  Researchers recently found that exercise actually created new cells in the rat hippocampus, which is the center of memory. [15]  The hippocampus is attacked by the plaques and tangles of Alzheimers for example. [14] Of course, this is HUGE and is an example of the “plasticity” of the brain and its ability to at least partially rebuild itself.

Okay, so exercise can rebuild the hippocampus.  But what does that have to do with testosterone?  Well, it turns out that testosterone plays an indirect role. Exercise boosts brain levels of testosterone – some of which is converted (via 5-alpha reductase) into DHT – and it is DHT which is responsible for the neurogenesis.

4.  Vasopressin. Oxytocin’s lesser known cousin, vasopressin regulates scores of activities in the body, including blood pressure, post-orgasmic response, memory and the CNS (central nervous system).  Researchers have noted that rats lose their vasopressin-related nerve fiber in certain parts of their CNS when testosterone is lowered.  And, when testosterone is restored, the nerve fiber density in these regions is restored. [9] This is yet another example where adding testosterone to a deficient animal is like watering a flower:  whatever is wilted and about to die comes back completely to life.  (Venous Leakage is yet another example.)

6.  Cognition. Yes, even your ability to think is affected profoundly by testosterone.  Studies, for example, have shown that testosterone increases spatial processing power in both young and older men. [13] So, if you’re looking for a nootropic AND you happen to be low T, testosterone may be your answer. It’s ability to improve many types of memory and increase cognition is hard to beat. In fact, some executives are now going on HRT just because of its brain-boosting abilities.  See my link on Testosterone for Executives in the Peak Testosterone Forum for more information.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

NOTE: According to one study, DHT did NOT improve working memory. [11] That is suprising considering its powers over the hippocampus mentioned in #3.

7.  Depression.  One of our biggest health problems is depression. This afflicts tens of millions of men worldwide every year. Of course, the standard treatment for years was to throw truckloads of SSRI’s at the problem, which have had tepid results at best. However, researchers are finally recognizing that in men with lowish testosterone, HRT can often greatly help. One meta-analysis found that “TT may have an antidepressant effect in depressed patients, especially those with hypogonadism or HIV/AIDS and elderly subpopulations.” [16] What is remarkable is that this study was willing to go on record and state that “the route by which TT [testosterone] is administered may play a role in treatment response.” in other words, they actually admitted that testosterone can have a place in proper treatment of depression (in men with low or lowish T).  For more information, see my link on Testosterone and Depression.

8. Anxiety.  Hypogonadism and high anxiety very often go together as I show in my link on Testosterone and Anxiety.

9. Gherlin. Gherlin is famous as the “Appetite Hormone” but could just as easily be thought of as a Brain Hormone because it plays such a pivotal role in the health of your key memory brain structure, the hippocampus. It turns out that being low testosterone leads to low gherlin levels and HRT (testosterone therapy) restores gherlin levels to baseline.  See my link on Testosterone and Appetite for more information.

CAUTION #1: According to famed oxytocin researcher Paul Zaks, testosterone is an oxytocin inhibitor. [4] Of course, oxytocin is the “Bonding, Empathy and Generosity Hormone” and so, according to his research, increasing testosterone could make one less empathetic, which obviously is not a good thing.  I think one has to be cautious with jumping to conclusions here for men with reasonable testosterone levels.  There is also considerable research that shows that it is the low testosterone males that are anxious and more likely to fight and be aggressive.  It does point out, though, that more not always be better.

One thing I have wondered, though, if this oxytocin-inhibiting property of testosterone is not partially ameliorated by the fact that, at least in animal studies, testosterone increases oxytocin binding. [5][7] One study even noted that castrated animals lost their oxytocin receptors in certain key brain regions and restoring testosterone brought back oxytocin receptors to youthful levels. [6] Oxytocin may also have a dark side:  researchers have found that it can increase envy and gloating.

CAUTION #2: One can make the argument that testosterone should be ramped up slowly rather than starting high and “seeing what happens” as is almost always the case. An example of this was one of our posters on The Peak Testosterone Forum that experienced an almost manic episode after going on testosterone pellets. This is a rare reaction, but it probably ties back to testosterone’s brain-boosting abilities. If a man is hypogonadal and suddenly triples his testosterone through HRT, that’s a lot of adjustment for the brain to handle in some cases all at once.

REFERENCES:

1)  Fundamental & Clinical Pharmacology, Dec 2004, 18(6):601-607, “Dopamine, depression and antidepressants”

2) Trends in Cognitive Sciences, Feb 2006, 10(2):77 82, “Thinking with your gonads: testosterone and cognition”

3) Journal of Neurobiology, Mar 1982, 13(2):153 161, March 1982″Testosterone increases acetylcholine receptor number in the levator ani muscle of the rat”

4) https://www.huffingtonpost.com/paul-j-zak/why-love-sometimes-sucks_b_1504253.html

5) Neuroendocrinology, 1989, 50:199 203, “Testosterone Modulates Oxytocin Binding in the Hypothalamus of Castrated Male Rats”

6) Brain Research, Feb 1998, 1(23):167 170, “Region-specific effect of testosterone on oxytocin receptor binding in the brain of the aged rat”

7) https://www.scientificamerican.com/article.cfm?id=oxytocin-hormone

8) Brain Research, Mar 1990, 511(1):129 140, “Gonadal steroids regulate oxytocin receptors but not vasopressin receptors in the brain of male and female rats. An autoradiographical study”

9) Brain Research, Nov 1988, 473(2):306 313, “Testosterone supplementation restores vasopressin innervation in the senescent rat brain”

10) Journal of Cognitive Neuroscience, May 2000, 12(3):407-414,”Sex Steroids Modify Working Memory”

11) Experimental Neurology, June 2003, 181(2):301 312, “Testosterone, but not nonaromatizable dihydrotestosterone, improves working memory and alters nerve growth factor levels in aged male rats”

12) Neurology, July 10 2001, 57(1):80-88, “Testosterone supplementation improves spatial and verbal memory in healthy older men”

13) Aging Male, 2006 Dec, 9(4):195-9, “Testosterone and the brain”

14) Arch Gen Psychiatry, 2006 Feb, 63(2):161-7, “Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression”

15) Proc Natl Acad Sci U S A, 2012 Aug 7,109(32):13100-5, “Mild exercise increases dihydrotestosterone in hippocampus providing evidence for androgenic mediation of neurogenesis”

16) Journal of Psychiatric Practice, Jul 2009, 15(4):289-305, “Testosterone and Depression: Systematic Review and Meta-Analysis”

Cialis, Dependency - Peak Testosterone

Can you become dependent on Cialis?  That is a question many guys, both young and middle-aged, ask themselves after a time.  Cialis has a long half-life, lasting most guys about 36 hours and so many men take it about three times a week and thus are covered virtually every day of the year.

Then the unthinkable happens:  they forget their prescription or maybe the prescription ran out.  This is when it gets terrifying for some men, because they find themselves having great difficulty getting an erection without their little yellow friend.  They then make the assumption:  no Cialis, no erections.

Most docs are no help and imply or directly tell their male patients with erectile dysfunction that losing one’s erectile strength is just a normal part of aging. The typical male walks out of the office thinking, “This pill is my only solution.”  Plus, let’s face it:  taking Cialis is SO easy.  You just pop a pill a few times of week and you’re rockin’ and rollin’

However, as time goes on, you may start to get headaches, or a little tinnitis or some visual issues. The nagging thought as to what these drugs are doing to you long term bothers you. You’ve read enough to know that no drug comes without side effects and you are beginning to have doubts as to the wisdom of taking these every day.

In addition, the research clearly shows that many men develop Cialis and Viagra Resistance.  This means that dosage for this drugs must be increased over time, because their effectiveness steadily decreases.

NOTE:  You may want to read my pages on the Dangers of Cialis or The Many Side Effects of PDE5 Inhibitors for additional information as well.

Regardless, there is a much more subtle reason to get off of Cialis (or Viagra):  it can hide major underlying health issues. If you can’t get an erection, there is almost always a reason and it is usually cardiovascular or low testosterone or both. These are not things that you want to sweep under the rug with a little pill that suddenly makes everything seem better.

Does taking that little pill magically clear the plaque out of your arteries?  Or does it miraculously get rid of the excessive inflammation that is damaging your endothelium hour-by-hour and day-by-day?  Of course, the answer is ‘no’ and so that is why I outline a program below for those of you who want to try to get off the juice.

CAUTION:  Please clear everything with your doctor first.

Get ready for a battle!  This is going to be one of the toughest things you’ve ever done.  Anything that risks your bedroom performance can be terrifying. But remember that this is fight

1.  Gradual Dose Reduction. Cut back on your Cialis dosage gradually.  If you are currently taking 20 mg every other day, then start by backing off to 15 mg, then 10 mg, then 5, etc.

2.  Exercise.  Exercise is a huge nitric oxide booster and blood pressure lowerer. Exercise throughout the day. Exercise several times per day.  Don’t kid yourself:  20 minutes per day isn’t going to cut it unless your job is very physically active.  You will be shocked at how much of a difference this makes.

3.  Saturated Fat. Unless you’re exercising like an Olympic athlete, you’ve got to reduce saturated fat to almost nothing. For the great majority of middle-aged men, saturated fat will slow down blood flow and damage their endothelium even further.  Read my link on Why Saturated Fat Can Be Bad for Men for more details.

4.  Largely Plant-Based Diet.  You need to go on a flexitarian, vegan, vegetarian, Low Fat (Ornish) Diet or some other plant-based diet.  Plant-based foods are what heal and stimulate your endothelium. You can, of course, also read my eBook called the Peak Erectile Strength Diet for foods that specifically stimulate blood flow and I also explain the latest research showing how and why plant foods are so powerful for erections. (I am not a “tree hugger.”  I’m just pointing out what the research shows.)

4.  OPTIONAL: Short Term Supplementation. If necessary, consider short term supplementation. I do not recommend most supplements long term, but they may be necessary to get you over the hump – no pun intended of course.  I have a link covering Erectile Dysfunction Supplements with some research behind them.  In addition, I have an eBook that covers some of the new research in this area Peak Erectile Strength Diet, i.e. taking more than one erectile supplement to get additive boosts in nitric oxide and erectile strength. (This is the latter half of the book.)

5.  Daily Erections.  If you’re not getting morning erectionss, you must force yourself to get erections.  Somehow, someway this has got to happen for your penile tissue to stay healthy and not harden or atrophy.  You need to essentially do what morning erections do:  build an erection that lasts for 10-20 minutes 2-3 times per day.

6. Testosterone. Get your testosterone checked if you have not already. Anyone with erectile difficulties should double check their testosterone, especially if they are having any of the classic Low Testosterone Symptoms.

Finally, build your confidence by checking for erectile strength. You’ve got to be confident that you can “pull the trigger” in the bedroom.  Avoid sex late at night when your are fatigued and testosterone is lower, i.e. be careful not to set yourself for failure.

Cialis, Tinnitus and Risks to Vision - Peak Testosterone

Most of my readers know that I urge caution when it comes to the new PDE5 inhibitors (Levitra, Cialis and Viagra) because a little known but relatively common side effect are vision and hearing disturbances.  Many men experience symptoms such as blurred vision, tinnitus, partial or total loss of hearing and so on.  (Stomach upset is also very common.) The reason for these disturbances is that there are other PDE enzyme systems in the stomach, ears and eyes and these drugs can affect them as well.

Researchers recently found, for example, that these drugs decrease blood flow to the optic nerve. This cannot be a good and will undoubtedly have long term effects. [1] Do you really need to trade blood flow to your eyes for blood flow to your penis? And what are the long term effects of decreased blood flow to the eye over the decades – it cannot be good!

Damage to the ears seems no less likely.  One senior reader wrote in with a story a very tragic story of possible long term vision damage and certain permanent tinnitus, i.e. ringing in the ears after Cialis usage. Here is his story exactly as written:

“I used the levitra at 10 mg and then the cialis at 20 mg. and they worked wonderfully just as advertised but about 3 weeks ago I developed tinnitus in my left ear the day after using the 20mg of cialis and my eyes were blurry for a bit. the ringing is still in my ear but the blurry vision is getting better. needless to say the chemical experiement is done for me.”

This man likely almost lost his vision and may experience some permanent vision loss from tadalafil usage.  Again, some people are more sensitive than others, but as I point in other links:  what are these drugs doing to you long term even if you don’t experience this kind of dramatic initial symptoms?

I asked him a few more questions and the response of the doctors was even more remarkable:

“hi lee and thanks for your input and time. the tinnitus i am afraid is permanent. I have been to ent doctor and he was very callous and actually said I will just have to learn to live with it. there is nothing he can do. I had a mri of the brain to see if there was a tumor or anything and he said it was clean. no tumor no stroke but i don’t have alot of faith in him or any doctor I have seen.

“I then went to an audiologist who said a hearing aid would help the hearing and lent me one. it did help mask some ringing in the daytime and he also said I will learn to tune it out eventually. dont know how that works in the quiet of the night however. I called and talked to the doctors office about getting another blood test for testosterone etc and they have yet to get back to me. “

“Both the family doctor and the urologist were interested in nothing but pushing their meds. when i told the family doctor about the tinnitus he said, really? you can get that from taking cialis? then he told me as did the urologist i should maybe switch to levitra and cut the dose down. the problem is trying to find a good and doctor who knows and cares really. i’ve been to quite a few and have yet to find one who does more than dispense meds. my vision blurriness is not a constant and seems to come and go and not as much as time passes”

A doctor that does not know Cialis can cause tinnitus?!?  Oy vay! This is one of Cialis’ primary side effects and virtually all drugs have side effects.  I can’t help but believe the physician was really trying to say, “You are such a rare case that I’ve never heard of it.”  However, that is simply NOT the case:  vision and hearing disturbances are quite common and well-documented in the literature.  Studies have even numerically evaluated the effect on other enzyme systems of these drugs. (I cover this in other links on my site.)

It is also important to comment, which I point out in my link on Viagra Resistance, many men become resistant to these drugs and have to increase their dosage over time.  This puts them at even greater risk of long term damage.

I’ll say the obvious:  get yourself on a good clean diet that promotes endothelial health.  The Mediterranean, DASH, Low Fat and Vegetarain diets are all good candidates.  Start exercising and get active.  Start cleaning out your arteries and improving your blood flow as all meds have risks.

NOTE: I have many other links on Viagra, Cialis and the PDE5 Inhibitors.  If you are interested, use the Search button at the top of the page.

REFERENCES:

1) https://www.drugs.com/viagra.html

Brain Supplements - Peak Testosterone

With a few notable exceptions such as Vitamin D and Magnesium, supplements have done poorly in studies on heart disease, cancer and other conditions. The medical profession is justified in its lack of enthusiasm as the miraculous claims and expectations have, for the most most part, turned out to be nothing but hype. There is, however, a notable exception: the brain. The brain is the most complex machine – nothing theological meant by that – in the universe and is a huge energy and biochemical hog. It requires huge inflows of vitamins, nutrients and benefits greatly from antioxidants and other phytoprotective foods.

Study after study have showed that your brain is at risk if you are low on many key nutrients.  Here are some examples:

REFERENCES:

1) https://news.bbc.co.uk/2/hi/health/8058183.stm

2) Journal of Neurology, Neurosurgery, and Psychiatry, 2009;80:722-729, “Association between 25-hydroxyvitamin D levels and cognitive performance in middle-aged and older European men”

3) Am J Epidem, 1999, 150(1):27-44

4) J of Nutr,Aug 1996,(126)8:1992-1999

5) Amer J of Clin Nutr,Sep 2005,82(3):627-635

6) Am J Med,2005;118:161 7; Psychosomatic Medicine,2006,68:547-554

7) Neurology,Mar 28 2000,54(6):1265-72

8) J Am Geriatr Soc,Jun 1997,45(6):718-24

9) https://www.medicalnewstoday.com/articles/61555.php Lancet, 2007 Jun 2, 369(9576):1876-82, “Efficacy of folic acid supplementation in stroke prevention: a meta-analysis.”

10) Lancet, 2007 Jan 20, 369(9557):208-16, “Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial”

Garlic and Vitamin C: Erectile Dysfunction Cure For Some

We have a few heavyweight nutraceutical erectile dysfunction cures that are growing in popularity on the Peak Testosterone Forum. One of them is garlic with Vitamin C. Researchers have long known that Vitamin C has a postive effect on endothelial function and artery health in general – something I document in my link on Vitamin C and Erectile Dysfunction – and garlic has been known for the same. However, to be honest, neither produces particularly spectacular results on its own.

1)  Nutrition Research, February 2007, 27(2):119 123, “Cellular effects of garlic supplements and antioxidant vitamins in lowering marginally high blood pressure in humans: pilot study”

2) https://www.peaktestosterone.com/forum/index.php?topic=3610.0

3) https://www.peaktestosterone.com/forum/index.php?topic=3980.0

Someone, though, got the bright idea to combine the two and see what would happen. The results were nothing short of spectacular and actually met or exceeded any single drug hypertension pharmaceutical out there. [1] It turns out that, somehow, Vitamin C and garlic provide synergistic effects that even exceeded the power of the two summed. Look at some of the spectacular results that this study achieved on marginally hypertensive patients:

1.  Increased endothelial nitric oxide by about three times baseline!

2.  Dropped systolic blood pressure from an average of about 142 mm to about 115 mm at the one week point!

3.  Lowered diastolic blood pressure from an average of about 92 mm to about 77 mm at the one week point!

Of course, this is going to ramp up blood flow to an incredible degree and so men with erectile dysfunction have been trying it.  I know that, at least on Peak Testosterone Forum, some men have been very pleasantly surprised, especially when you consider that neither of these are expensive – quite the opposite.  Look at what a couple of posterswrote:

“Hello. I’m 38 an healthy. I smoke weed and cigs. I have had problems with erections since I was 35. Some days good some days bad. Tried just about everything to help my erection. Nothing really helped. I till now I am a new man! Like I’m in my 20s! I started taking vitamin c about 2,000 to 4,000 milligrams a day. Saw a huge difference in erection! That was great! But I just found a breakthrough! Vitamin c works really well for erection, but take vitamin c with garlic an omg hard one like your 20. Rock hard. I was researching vitamin c when I stumbled upon an article. About researchers giving men in there 50s vitamin c with garlic. An it boosts nitric oxide by 300%!!! So I tried it an this us it. This is the combo that will fix you. It fixed me. I started taking both about a week ago. An I haven’t been this happy for long time. It works so well that I don’t think I could get this hard when I was 16!!” [2]

Now, if you read between the lines here, this guy likely damaged his endothelium with tobacoo and marijuana. (Inhaling the smoke from burning leaves is always hard on the lining of the arteries!)  He did so much damage that he actually developed early onset erectile dysfunction at age 35.  The garlic and Vitamin C actually “cured him” and brought him back to his youth.

Now does this mean it’s okay to smoke?  Of course not!  Eventually, nothing will work for him if he continues with the smoking: it’s really just a matter of time.  The real point is that this nutraceutical solution is so powerful that it can often overcome, at least temporarily, the effects of a negative lifestyle.

Yet another example was one of our senior posters who has a science background.  He is forever experimenting with different supplements and nutritional strategies and found that a combo of Pycnogenol, which indirectly boosts nitric oxide, and garlic dropped his prehypertensive systolic blood pressure by about 10 points from 125 to 113-116! [3] Again, this shows the synergies that can be achieved.  ( For more information, see my link on Pycnogenol and Erectile Dysfunction.

It should be added that both Vitamin C and garlic have health superpowers in many other key areas besides simply improving erectile dysfunction.  The available research shows that garlic is a potent cancer and arteriosclerosis fighter.  Vitamin C is no slouch either and helps with immunity, cortisol, skin aging and inflammation just for starters.  For more information, see my link on https://www.peaktestosterone.com/why_take_vitamin_c.

DOSAGE:  How much should you take?  Well, in the above study, participants took the following:

a)  2 grams/day of Vitamin C (2 1-gram tablets of an “ester-C.”)

b)  4 tablets of garlic, where each tablet contained 6 mg of allicin and 13.2 mg of alliin.

The article does not really specify how many times per day those in the study took the tabs as far as I can tell.  However, generally it is better to spread out one’s supplements to achieve more stable and steady plasma levels.

CAUTION:  Dr. Blaylock recommends taking Vitamin C on an empty stomach, because Vitamin C can increase iron absorption.  (Too much iron, which is a very common problem, is a neurotoxin and contributes to heart disease.) In addition, one study shows that Vitamin C increases nitrosamine output if there is fat in your stomach, i.e. what you ate has fat in it.

REFERENCES:

Vegetarianism and a Low Fat Diet: - Peak Testosterone

So why would anyone want to consume a Low Fat Vegetarian diet? Obviously, one could easily follow one or the other, so why put the two together?

NOTE: If you are a die-hard meat eater, then please do us both a favor and just skip this page.  I’m not trying to offend anyone here – just presenting men with an alternative that I believe will help their arteries, erections and general health.

My answer to that is simple: low fat vegetarianism is the safest way to follow BOTH the best of the supercultures around the globe and the latest research that we have to date. Now that is a bold statement that many men would consider controversial at best, but I think I can back that up with some good evidence which I will outline below.

Another thing to consider is that lacto-ovo-vegetarianism, whether low fat or not, has a nice advantage in my opinion, because it allows some dairy and eggs in one’s diet and that really improves the flavor for many Westerners.  It’s an adjustment, but not a quantum adjustment.  Of course, if you are going to go Low Fat vegetarian, you have to stick with largely non fat dairy/yogurts and egg whites, but that still allows for a substantial amount of good tasting food for most men.

1. Elite Supercultures. John Robbins wrote a health bestseller where he chose the four most elite supercultures from around the globe (Hunza, Vilcabambans, Abkhasians and Okainawans).  He did a great job at documenting their diet, exercise and social routines. These supercultures are simply astonishing to read about – see my page on https://www.peaktestosterone.com/ – because they simply have NO chronic disease. Imagine a society with NO hypertension, heart attacks, cancer, diabetes, autoimmune disease, Alzheimer’s, etc. These peoples actually have achieved nearly perfect health. The eyes of the Hunza do not even age! Their lenses do not atrophy and harden like ours!

You may be objecting and saying, “Well, sure, I could live without a heart attack or cancer if I died at age 43!”  However, these four people groups are known for incredible longevity.  John Robbins chose them because of the high number of people that live into their 90’s and past 100.  Again, someone in their late 80’s and 90’s in these cultures are anything but feeble:  they usually are walking long hours, climbing up hills and mountains with minds still sharp and full of humor and life.

These people have done with ease and simplicity what we have not been able to achieve in the West with the 100’s of billions that we have spent on health care. I would also add that there is fifth very similar group:  the Tarahumara native people of northern Mexico who also have incredible longevity and live a very similar lifestyle without hypertension, heart disease and all the other chronic disease conditions that plague the U.S. and Europe.

So how do they do it?  First of all, they don’t take Prozac or statins.  Amazing, eh?  They don’t even take supplements!  Can you imagine someone in their senior years not on four medications and a half dozen supplements?!? .

Remember: meat eaters are trying to play catch up.  Perhaps they will some day.  Perhaps some brand of Paleo will win eventually and become the new gold standard – who knows?  But, for now, it’s hard to beat vegetarian / plant-based eating, especially when you consider that many vegetarian foods tend to boost nitric oxide and lower blood pressure.  And, according to one large study, Vegetarians Have Equal or Better Testosterone. So you get solid testosterone, improved blood flow and nitric oxide and stellar longevity. What’s not to like??

NOTE: Realistically, most vegetarians probably eat a lot of wheat.  Wheat is a highly genetically modified food and is also high glycemic compared to all the other whole grains. Many vegetarians probably often eat a lot of fructose from fruit, dried fruit, honey. In other words, they often do many of the things that the omnivores accuse them of. But here is the key: in spite of it all their “sins”, they still have done better than meat eaters in study after study.  (You can read about my issues with wheat in this page on A Review of Wheat Belly by Dr. William Davis.

Now this is where I am headed:  eating an imperfect vegetarian produces good results.  Imagine what is possible if you tune a vegetian diet.  You start to see why the most elite supercultures live without chronic heart disease.  And this is where I argue that combining a low glycemic Low Fat Diet with vegetarian diet provides the best of all possible outcomes.  In other words, why not just eat like the above supercultures?

BAD SCIENCE: There were a few mortality studies that showed that low cholesterol increased mortality risks. As expected, the Paleo and Low Carb advocates jumped all over this without really thinking it through. Of course, a low fat diet, which leads to much lower cholesterol levels, is healthier as the above cultures all show. So why the negative mortality results? Let me quote from Dr. Gould, a doctor who successfully reversed arteriosclerosis in many of his patients: “In these large population studies, there is a small percentage of people who have preexisting medical conditions, such as cancer, depression, alcoholism, gastrointestinal diseases, or addictive behavior such as drug addiction or smoking, all of which reduce appetite and may impair nutrition in association with every low cholesterol levels. These preexisting conditions not only lower cholesterol levels but may also cause death unrelated to cardiovascular disease. Therefore, in such studies, there may be an association between death caused by the preexisting nonvascular disease and low cholesterol levels. However, if the people with these preexisting nonvascular medical conditions are screened out and removed from the analysis, there is no increase in deaths associated with the low cholesterol levels.” [1] He then cites three large population studies that support the above.

Look at the benefits that you would likely get from low glycemic Low Fat vegetarianism:

a) Diabetes and Prediabetes Reversal (Partial or Complete). Dr. Bernard has done extensive research and found that a plant-based, low glycemic, Low Fat Diet – contrary to what critics say about higher carb diets – usually partially or even completely reverse prediabetes and diabetes. Of course, exercise, weight loss and sometimes HRT (testosterone therapy) are required to gain complete victory. See my links on Low Fat Diets and Diatetes and Testosterone and Diabetes for more information.

b) Low Fat Diet Benefits. I have documented 10+ Benefits of a Low Fat Diet, including prostate cancer protection, telomere improvements, increased blood flow – most fats slow down blood flow – decreased blood pressure, an improved testosterone-to-estradiol ratio – the list goes on and on! And the one most important benefit for many men is a partial reversal of their arteriosclerosis. Most men over the age of about 35-40 with erectile dysfunction and/or low testosterone are going to have significant arteriosclerosis. This gives them a chance to improve that naturally and get the lining of those arteries pumping out more nitric oxide once again!

c) Fruit and Vegetable Benefits. The research-backed benefits of fruit and vegetable consumption also go on and on and includes everything from improved erections, decreased stroke, heart disease, diabetes and hypertension risk, less dementia, lowered inflammation and protection from many kinds of cancer.  (Try to purchase organic when possible.)  For details, see my link on 15 Benefits of Fruit and Vegetable Consumption.

So if you combine a Low Fat Diet with Vegetarianism, you are bound to get some incredible synergies.  By the way, do NOT listen to the standard Paleo and Low Carb arguments that eating a lot of fat is natural.  With the exception of fish, which is high in heart healthy, inflammation-lowering omega-3’s, and nuts, which are packed with arginine and antioxidants, virtually all foods prior to a few thousand years ago were low fat. Wild game is usually low fat.  Almost all plants and fruits are low fat. Low Fat is how humans developed and all the modern oils and fatty dairy are a modern invention.

Even if you believe that Paleo is the way to go, it’s impossibly impractical in my opinion.  Why?  Because it is very difficult to eat fish more than once a week without getting significant methylmercury and PCB exposure.  And modern livestock and poultry are almost always corn fed, hormone-injected and high fat. This is just not natural and makes eating meat like the natives impractical for modern man.  Sure, there is range-fed beef out there with good omega-3 levels and less fat.  But have you seen the price?  The great majority of us cannot afford range-fed beef or poultry and will end up eating the nasty stuff.

If I could find inexpensive low fat meat cuts out there, I would probably eat a little meat similar to the Okinawans or some of the other supercultures mentioned above.  By the way, the Apostle of Low Fat, Nathan Pritikin, ate meat regularly – but just a little – and he died with perfectly clean and clear arteries.  But I simply cannot afford it and don’t have time to drive all over the place looking for decent low fat cuts of meat.  It’s much easier just to stick to vegetarian.

REFERENCES:

1) Heal Your Heart, by K. Lance Gould, M.D., p. 67

Their secret is their lifestyle and, if you look at their diet, a couple of things stand out immediately:

Yes, the Masai and the Eskimos are impressive cultures with great cardiovascular health and eat a lot of meat and fat. But the best of the best supercultures with unprecedented longevity are cultures that rely almost entire on plants for their nutrition. In addition, we do not have access to the kinds of meats that the Masai and Eskimos (at a reasonable cost) for reasons I’ll discuss below.

2.  Vegetarians and Mortality. Low carb and Paleo folks love to criticize the way most vegetarians eat, saying that 1) grains high glycemic, anti-nutrient foods; the high carb levels cause loss of insulin/glucose control; and on and on.  However, these criticisms of vegetarian diets ignore one important fact:  vegetarians do VERY well in mortality studies.  Sure, many vegetarians eat too much wheat and refined carbs.  But, in spite of that, I document in my Vegetarians and Longevity page four large studies that show that vegetarians have the best mortality rates and live the longest.  Now Paleo and Low Carb folks argue that vegetarians live longer simply because they live healthier lifestyles, i.e. don’t smoke and manage their weight better.  There may be some truth to this, but the fact is that the research shows that a largely or entirely plant-based eating regimen is the current gold standard.

Wheat: Can Raise Cholesterol, Triglycerides, LDL - should i eat?.

Like the typical American, I grew up eating wheat and lots of it.  And I really enjoy the taste.  Furthermore, whole wheat has a powerful anti-cancer compound (phytic acid) and the germ is packed with vitamins and minerals. In spite of all these good things, I try not to touch the stuff.  As I’ve already mentioned, I don’t trust what modern agriculture has done to the wheat genome in the last fifty years, something that I discuss in My Review of Wheat Belly. But the main reasons that I avoid are what it does to a) blood sugar / insulin and b) lipids.

On this page I am mostly going to talk about the latter and show you how wheat can negatively impact lipids.  This is one of the big reasons someone going vegetarian, vegan or low fat can get themselves in trouble:  some men will substitute a bunch of wheat for the old way of eating.  As we’ll show below, this is likely to get them into trouble and we show wheat is a decided underperformer:

1. CON: Increase Cholesterol in Adults (Men and Women). This study took adults in the top half of cholesterol values and gave them either oat bran or wheat bran while on an American Heart Association Diet.  As I document in my page on How to Lower Your LDL Naturally, the oat bran lowered both LDL and total cholesterol. Wheat cereal, on the other hand, raised both total cholesterol and LDL by 3.3% and 4.0%, respectively. [1]

2. CON:  Neutral Cholesterol in Men with High Cholesterol.  Those with high cholesterol tend to experience bigger drops with medical and nutritional interventions than those whose cholesterol is already on the low side.  Basically, “the bigger they are, the harder they fall.”  Again, oat bran was shown in those with high cholesterol to powerfully lower cholesterol and LDL by 12+%!  [2]

3. CON: Neutral Cholesterol in Overweight Senior Men.  As in the above oat bran study, barley significantly lowered total cholesterol and LDL, where as wheat did nothing. [4] Again, that’s nothing to brag about in the world of plants.

4. CON: Increase of Particle Count, Small Particle LDL and Triglycerides.  Ouch!  One study basically found that oat bran improved every lipid parameter and wheat worsened it. Check out the abstract’s commentary below:”

“Time-by-treatment interactions (P < 0.05) for LDL cholesterol (oat: -2.5%; wheat: 8.0%), small LDL cholesterol (oat: -17.3%; wheat: 60.4%), LDL particle number (oat: -5.0%; wheat: 14.2%), and LDL:HDL cholesterol (oat: -6.3%; wheat: 14.2%) were observed. Time-by-treatment interactions were nearly significant for total cholesterol (oat: -2.5%; wheat: 6.3%; P = 0.08), triacylglycerol (oat: -6.6%; wheat: 22.0%; P = 0.07), and VLDL triacylglycerol (oat: -7.6%; wheat: 2.7%; P = 0.08).”

And notice that the wheat increased the all-important LDL particle count!  Those who have been doing a fair amount of reading on the subject will know that it is actually the LDL particle count that is even more important than total cholesterol or LDL itself.  Wheat increased this number and if you get that particle count high enough, it will literally “push” the LDL particles into your arterial walls.

1)  The Journal of Family Practice, 1991, 33(6):600-608, “Randomized, controlled, crossover trial of oat bran in hypercholesterolemic subjects”

2) Am J Clin Nutr, Oct 1991,54(4):678-683, “Lipid responses of hypercholesterolemic men to oat-bran and wheat-bran intake.”

3) LWT – Food Science and Technology, Aug 2005, 38(4):463 470, “Inhibitory effects of wheat bran extracts on human LDL oxidation and free radicals”

4) Am J Clin Nutr, May 1991, 53(5):1205-1209, “Barley and wheat foods: influence on plasma cholesterol concentrations in hypercholesterolemic men”

5) Am J Clin Nutr, Aug 2002,76(2):51-358, “High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men”

This goes right along with wheat’s ability to spike blood sugar and insulin.  Wheat has a uniquely high percentage of the type of starch that breaks down quickly and can spike blood sugar.  In my opinion, all wheat should be considered high glycemic – even whole wheat.

4. PRO: Provides Cholesterol Oxidation Protection.  In fairness to wheat, it does probably provide some proteciton against LDL oxidation. [3] Remember that it is oxidized LDL that is the bad boy of the cardiovascular world.

The clear message from the above studies when it comes to lipid management and control?:

Any grain but wheat!

Both oat bran and barley soundly beat wheat and we little doubt that almost any other grain would do the same.

NOTE: I emphasize the importance of it being oat bran and not oatmeal, especially instant, which can spike blood sugar post-meal in some men.

DHEA: Low Levels Could Be Deadly - Peak Testosterone

The great majority of physicians do not believe that there is such a thing as low DHEA. They argue that DHEA levels dramatically decrease with age, something I illustrate on my page DHEA Levels in Men by Age.and that a fall in DHEA is just a “part of life.”  An additional argument is given that DHEA is precursor to many downstream hormones, including testosterone, estradiol, DHT, and that this is probably it’s primary role.

However, I will show below that DHEA is doing much more than just acting as a building block.  In spite of these seemingly powerful arguments against DHEA Replacement Therapy, I want to give you the counterarguments to the above.  Here are 4 Powerful Reasons You Don’t Want Low DHEA:

1.  Increased Risk of Heart Disease.  Low DHEA values have been linked to an increased risk of heart disease in us men.. [2] This will almost always mean increased arterial plaque.  Now the question always arises as to whether or not low DHEA values actually contributed to heart disease or were just an “innocent bystander,” i.e. a third party witness.  The reason that this is very unlikely is that DHEA stimulates nitric oxide and even has a receptor in endothelial (arterial lining) tissue, something I discuss in page on the The Benefits of DHEA.  In other words, low levels of DHEA will likely lead to decreased blood flow, which is almost always associated with increasing levels of atherosclerosis.  And, as your arteries build up plaque, this creates a vicious cycle of less nitric oxide, less blood flow and so on.  Many other thins that lower nitric oxide, such as homocysteine and PPI’s, are associated with accelerated cardiovascular disease.

2. Lowered Immunity.  It is widely recognized that cortisol lowers immunity and DHEA boosts it. [3] Several studies to date have verified this in various forms.  I find it difficult to imagine how low DHEA, which will help immune function, can possibly be a bad thing, especially in middle-aged and senior adults, whose immune system is already on the decline anyway to aging.

3. Increased Insulin Resistance. Animal studies had clearly shown that DHEA levels were tied to insulin sensitivity.  In other words, as DHEA levels fall with aging, insulin resistance will tend to go up.  This was verified in a recent study on seniors that found that administering DHEA decreased the insulin resistance of senior men (and women).[6] Again, this is very reminiscent of what testosterone does for us.

4. Increased Mortality. If you put all these together, one can see just why DHEA should be part of most men’s anti-aging protocols, with powerful evidence being provided by the fact that lower DHEA-S levels are associated with an increased risk of dying:

“In men, most available evidence suggests an association with cardiovascular (CV) mortality rather than cancer mortality. Further, there are biologically plausible mechanisms for an effect of DHEA/-S on the development of CV disease.” [4]

Again, how can one argue that low levels of this key hormone are a natural and protective part of aging in light of the fact that low levels can lead to an eariler death?!

CONCLUSION: DHEA has an unusual history because about 20 years ago, it was touted as miracle anti-aging supplement and was literally thought to be a fountain of youth.  However, then a couple of large followup studies put it against the ropes and suddenly DHEA found itself almost completely out of favor.  It was seen for the most part as a harmless waste of money.  However, now everything has come full circle and the last six years has seen just one study after another documenting the positive effects of DHEA supplementation and the very serious consequences of having low levels.

One recent reviewer made a nice summary by saying that “DHEA modulates endothelial function, reduces inflammation, improves insulin sensitivity, blood flow, cellular immunity, body composition, bone metabolism, sexual function, and physical strength in frailty and provides neuroprotection, improves cognitive function, and memory enhancement. DHEA possesses pleiotropic effects and reduced levels of DHEA and DHEA-S may be associated with a host of pathologies; .” [5]  Yes, these words should remind you of the consequences the research laid out for standard hypogonadism (low testosterone).

REFERENCES:

3) Aging Cell,4(6):319 324, December 2005, “Raised cortisol:DHEAS ratios in the elderly after injury: potential impact upon neutrophil function and immunity”

4) J Steroid Biochem Mol Biol, 2015 Jan, 145:248-53, “DHEA and mortality: what is the nature of the association?”

5) J of Sexual Medicine, Nov 2011, 8(11):2960 2982, “Dehydroepiandrosterone (DHEA) A Precursor Steroid or an Active Hormone in Human Physiology (CME)

DHEA Replacement Therapy - Peak Testosterone

How many times have you had DHEA pulled by your physician?  Probably never.  That should be no surprise, considering that the great majority of physicians do not believe in DHEA Replacement Therapy.  However, in my opinion DRT (DHEA Replacement Therapy) should be almost as common as TRT (Testosterone Replacement Therapy). (I made up DRT, but I think it’s a good acronym.)  The reason is simple:  it is quite common for men to be very low in DHEA.  What is the difference between this and hypogonadism in men?

In addition, there are very powerful arguments for DHEA Replacement Therapy:  hormones that are good candidates for replacement are ones that commonly decrease with aging.  DHEA definitely fits in this category and, in fact, drops more as a percentage than any other hormone.  If you check out my page on DHEA Levels in Men by Age, you will see just how dramatically levels fall from the age of 30-40 to 80.

And, as is so often the case with these kind of hormonal drops with aging, low levels have been linked to a great many chronic disease conditions. So are we really supposed to believe that low DHEA levels are good for you? Isn’t it more logical to believe that this is just an unfortunate (but correctable) part of aging, such as is encountered with collapsing levels of testosterone, SOD, CoQ10, etc.?

And I would argue that we should handle DHEA in a manner very similar to testosterone:

WHY DON’T DOCTORS TREAT LOW DHEA? DHEA is not even on the radar of most physicians.  They are so busy with acute care that they cannot possibly test your for  DHEA.  If they do, DHEA has a huge lab range and, if you fall in that range, 99% of physicians will ignore the result – case closed.  Doctors are just now being trained in the most rudimentary knowledge regarding testosterone. Expecting them to understand the pros and cons of DHEA is just unrealistic at this point.  Most of them will hand you some Cialis or Prozac and send you on your way.

This is very unfortunate, because they are completely ignoring a flood of pro-DHEA research that has come out in the last ten years.  For example, there are risks with being deficient: The Risks of Low DHEA. I cover the many huge benefits of DHEA for men here. But let me give you a few teasers points and, again, these only apply to men that are low in DHEA (as measured by DHEA-S):

1. Nitric Oxide.  Men, take note:  DHEA stimulates nitric oxide production and has a receptor in endothelial (arterial lining) tissue, something I discuss in page on the The Benefits of DHEA. DHEA also generally boosts free testosterone (but not total) in men.  See my page on Testosterone and DHEA for more information.

So DHEA clearly seems appropriate from the aging standpoint, but, of course, the real test is whether or not DHEA Replacement Therapy has done well in the studies.  The answer is ‘yes,’ of course, and I document some key examples below.  I also want to mention that DHEA  got rid of my lifelong anxiety, something I discuss in my page on DHEA and Pregnenolone.

2. Lowers Inflammatory Cytokines. Cytokines are the inflammatory messengers associated with a host of chronic disease:  cancer, heart disease, autoimmune disease and Alzheimers.  The most potent and well-known cytokines are IL-6 and TNF alpha. A recent study gave a group of seniors between the ages of 65 and 75 50 mg of DHEA daily and observed that “there were significant decreases in the plasma concentrations of TNFa and IL-6 in response to 1 year of DHEA replacement.” [6]

3. Improved Insulin Resistance. One of the struggles for many of middle and senior age is an increase in insulin resistance.  The same study above found that “it was evident on evaluation of the data, that improvements in glucose tolerance in response to DHEA occurred only in those participants who had abnormal glucose tolerance. We, therefore, did a separate analysis on the glucose tolerance data of the participants who had abnormal glucose tolerance initially. The improvements in glucose tolerance and AUC after one year of DHEA replacement was considerably greater when the results are not diluted by the values obtained on the participants with normal glucose tolerance.” [6] A 2007 study found that DHEA helped lower advanced glycemic end produts and oxidative stress in diabetic patients, and it’s no wonder of course. [3]

4. Lowered Body Fat.  DHEA supplementation was found in one study to lower BOTH kinds of body fat: subcutaneous and visceral (belly or stomach). [4] This same study found that insulin sensitivity was improved as well and also included only senior patients (between the ages of 65 and 78).

You’re right – it doesn’t get much better than that!  Inflammation, insulin resistance and weight gain our biggest enemies as men age and DHEA is clearly a powerful weapon in our arsenal against all three of them.

REFERENCES:

1)  N Engl J Med, 2006; 355:1647-1659, “DHEA in Elderly Women and DHEA or Testosterone in Elderly Men”

2) New England Journal of Medicine, 1986, 315:1519-1524, “A prospective study of dehydroepiandrosterone sulfate, mortality and cardiovascular disease”

3) Diabetes Care, Nov 2007, 30(11):2922-2927, “Dehydroepiandrosterone Administration Counteracts Oxidative Imbalance and Advanced Glycation End Product Formation in Type 2 Diabetic Patients”

4) JAMA, Nov 10 2004, 292(18), “Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men”

6) Aging (Albany NY), 2011 May, 3(5):533 542, “Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans”

a) Test to see if ayou are “deficient” or very low in DHEA, actually DHEA-S in this case.

NOTE:  Testing is inexpensive and you do not need a doctor’s orders with these labs:  Cheap Men’s Lab Testing. It is always better to work with a doctor, naturopath or Life Extension Foundation when it comes to hormones in my opinion.

b) Treat if and only if you are low on the range or below the lab’s range.

c) Raise DHEA-S levels to physiological levels – perhaps upper mid in the lab range – using low dose DHEA, usually 15-50 mg/day.

d) Monitor symptoms and DHEA-S levels afterward.  (Occasional side effects are poor sleep, increased estradiol or PSA, etc.)

Again, this is exactly what any decent physician does with with testosterone and there is no reason to divert from this procedure with DHEA either.  I would add that my experience to date with DHEA has been excellent.  DHEA Replacement Therapy got rid of my lifelong struggle with anxiety. TRT got rid of about half of it and the addition of DHEA the other 50%, and you can read about it here if you are interested:  Lee Myer’s Experience with DHEA and Pregnenolone.

Chromosome and Telomere Killer - Peak Testosterone

Immortality.  Is it within our reach?  Can science dramatically extend human lifespan?

One of the first barriers that must be overcome for this to happen is to surpass the infamous Hayflick Limit, which is a practical limit on the number of divisions that a cell can undergo until it becomes a weak and doddering “senior citizen”, a.k.a senescent. Senescent white blood cells, for example, double one’s risk of cancer according to one study. [3] Still another study showed that bone loss [5] and fertility are correlated with telomere length. Other examples abound.

The reason for the notoriety of the Hayflick limit is that most cells, as they divide, lose just a little DNA off the end of their chromosomes, which is named a telomere.  Stem cells, though, overcome this shortening and, because of it, are cells that are practically immortal.  How do stem cells achieve the fountain of youth?  They do it, it turns out, through telomerase, an enzyme that essentially replaces the missing DNA on the end of the gene. In other words, increasing telomerase levels makes it theoretically possible that one’s cells never shorten and reach “old age”.

As you might expect, there has been considerable research on telomerase and the summary is this:  natural increases in telomerase have shown considerable promise, whereas artificial increases in telomerase have led to increases in cancer rates.  For example, one study used cancer resistant mice and then gave them extra telomerase and, indeed, the lifespan of the mice was increased. [1]  In other words, if you can limit cancer, you can likely increase lifespan.

This could perhaps be accomplished through some of the lifestyle changes that I recommend in my Cancer Prevention link. In other words, a lifestyle that both reduces cancer risk and increases telomerase may be ideal.  This is indicated in a study of very old Jews, average age 97, that showed that these centennarians had significantly longer telomeres. [2]

NEWS FLASH:  A groundbreaking 2010 study in the journal Nature reported some potentially incredible telomerase-related news.  Scientists created mice that aged very quickly by developing a line with low levels of telomerase. What was exciting was that when these mice had their telomerase reactivated through a clever chemical process, the mice regained their fertility and brain function and all without cancer. [15]  Of course, this is just an initial animal study, but it is a very promising first step.

So how can we increase telomerase in a (very likely) safe way in order to keep our telomeres nice and long, the way nature intended them?  Here are some of the key strategies from the latest research, which, you may notice, match many of the healthy strategies for your heart, brain and skin:

1)  Fish Oil.  Fish oil reduces oxidation of certain key metabolic processes and this is likely the reason that those with the highest levels of omega-3’s have the longest telomeres. [4]

2) Ornish Diet.  As we have mentioned elsewhere, the Low Fat (Ornish) Diet slows down telomere shortening.  And, of course, a Low Fat (Ornish) Diet will actually clear the plaque right out of your veins,  decrease erection-killing blood pressure as well and increase your telomerase activity. [16]

3) Sitting. The difference in telomere lengths between the most active and least was equivalent to about ten years of aging according to one study. [7] Sitting isn’t just hard on your bod – it’s hard on your chromosomes.

4) Exercise. Exercise may be king when it comes to slowing down telomere aging.  Older runners have telomeres 75% less aged than their sedentary counterparts. [8]  Research has shown that exercise activates telomerase.

5) Vitamin D.  Lower vitamin D levels are associated with shorter telomeres, at least in women. [9]

6) Stress and Cortisol. A number of studies have shown that stress shortens telomeres.  For example, one small study showed that women sexually abused as children had shortened telomeres, i.e. not only were they scarred emotionally but on the cellular level as well. [10]  The reason appears to be tied to the stress hormone cortisol, which has been shown to reduce telomerase activity. [13] A further verification of this was recently found in a study of women with chronic anxiety, who were found to have shorter telomere lengths. [17]

7) CAUTION:  Green Tea and Curry/Turmeric/Cursumin. Green Tea is a little scary.  The key ingredient in green tea, EGCG, has been found to be a powerful telomerase inhibitor. And, in some cases, this likely gives green tea its anti-cancer properties.  However, do you want cancer protection simply because your chromosomes have been shortened to senescence? [6] Turmeric has the same property and therefore I am cautious about using this as well, even though I love curry! [18]

8) Smoking. Smoking attacks just about every system in your body so why not your chromosomes as well, eh? [11]  This was verified in a study that showed that telomere length was actually affected in a dose-dependent manner, i.e. the more pack-years the person had smoked, the shorter their telomeres. [12]

9) Overweight. That spare tire around your middle likely accelerates aging according to one study (of women), which found that the more the weight and the higher the BMI, the shorter the telomeres. [14]

REFERENCES:

1) Cell, Nov 2008, 14;135(4):609-22, “Telomerase reverse transcriptase delays aging in cancer-resistant mice”

2)  https://www.eurekalert.org/pub_releases/2009-11/aeco-ltt111109.php

3) JAMA, Jul 7 2010, 304:69 – 75, “Telomere Length and Risk of Incident Cancer and Cancer Mortality

4) Journal of the American4) Journal of the American Medical Association, 2010, 303(3):250-257, Association of Marine Omega-3 Fatty Acid Levels With Telomeric Aging in Patients With Coronary Heart Disease

5) Mech Ageing Dev, 2005 Oct, 126(10):1115-22, “Telomere length versus hormonal and bone mineral status in6) Biochem Biophys Res Commun, 1998 Aug 19, 249(2):391-6, “Telomerase inhibition, telomere shortening, and senescence of cancer cells by tea catechin”

7) Arch Intern Med, 2008, 168[2]:154-158, https://pubs.ama-assn.org/media/2008a/0128.dtl

8) https://well.blogs.nytimes.com/2010/01/27/ phys-ed-how-exercising-keeps-your-cells-young/

9) The American Journal of Clinical Nutrition 86 (5):1420 5, “Higher serum vitamin D concentrations are associated with longer leukocyte telomere length in women”.

10) Biol Psychiatry, 2010 Mar 15, 67(6):531-4, Epub 2009 Oct 14, “Childhood maltreatment and telomere shortening: preliminary support for an effect of early stress on cellular aging”

11) Lancet, 2005, 366:662 664, “Obesity, cigarette smoking, and telomere length in women”

12) European Respiratory Journal, Mar 1 2006, 27(3):525-528, “Telomere shortening in smokers with and without COPD”

13) Brain, Behavior, and Immunity, May 2008, 22(4):600-605, “Reduced telomerase activity in human T lymphocytes exposed to cortisol”

14) Cancer Epidemiology, Biomarkers & Prevention, Mar 2009, 18:816, “Obesity and Weight Gain in Adulthood and Telomere Length”

15) Nature, 2010, Received 08 May 2010, Accepted 26 October 2010, Published online 28 November 2010, “Telomerase reactivation reverses tissue degeneration in aged telomerase-deficient mice”

16) The Lancet Oncology, 9(11):1048-1057, “Increased telomerase activity and comprehensive lifestyle changes: a pilot study”

17) PLoS ONE, 2012, 7(7):e40516. “High Phobic Anxiety Is Related to Lower Leukocyte Telomere Length in Women”

18) Cancer Letters, 8 Oct 2002, 184(1):1-6, “Curcumin inhibits telomerase activity through human telomerase reverse transcritpase in MCF-7 breast cancer cell line”

HCG Mono-therapy:Most Natural Way to Boost Testosterone ?

6) Can you tell us what dosage you are currently taking and give us some of the practical details such as needle gauge(s), needle length, self or office injections, frequency, etc.? Also, is the shot painful at all?

A.  My legs are muscular with no fat on them so I use a 1/2″ 27 ga needle. Most people should probably use at least an inch long needle to start off with and adjust down if its feasible. I was injecting 3x/week but i have recently gone to daily injections of 250 IU to see if that will reduce estrogen. I haven’t had labs done since I made the change.

7) Have you been satisifed with HCG Monotherapy – has it met your goals and been what you had hoped for?

A.  I have been happy with HCG monotherapy. The effects are subtle and gradual but very real. If you go in expecting a monster libido increase like you may get with a test injection that takes you up to 1200, you’ll be disappointed. But there have been numerous benefits that have happened over time once I got my estrogen down a bit.

8) My understanding is that the side effects of going on HCG are basically those of having standard testosterone therapy and/or elevated estradiol? Have you personally had any side effects from taking the HCG?

A.  I have experienced no side effects whatsoever other than spiked estrogen. My dr monitors red blood cell count in my labs as for trt but theres been no increase there. I do not believe HCG will produce that side effect which test injections can, but i dont mind that he’s monitoring it anyway just to be sure.

9) Has HCG helped you in the typical areas that men get relief from HRT, i.e. improved libido, increased morning erections and erectile strength, decreased mental fog, anxiety and depression?

A.  The positive effects I can report are: daily morning erections (but only once I started taking Arimidex) where they were rare before, increased penile sensitivity, much harder erection quality, and constant feeling of good mood and contentment. I was not depressed before going on it, but since going on it I feel like I am always in a good humor no matter what. The other thing is body composition has gradually changed. I am the same 6’3 205lbs I was a year ago, and I was muscular then and I lift weights regularly. But there has been a noticeable composition change with less fat and more muscle. I have not been tested for body fat, but looking at pictures and descriptions online I would estimate I have gone from around 20% body fat to around 15%. Libido has improved but it is subtle and dont expect miracles there:  the difference in erectile function is much greater than the improvement in desire.

10) What about Arimidex? Have you had to take anything to control estradiol? I have read many times that in some men HCG can really ramp up estradiol. Has that been the case for you?

A.  I am not aware of anyone who has successfully pursued HCG mono and not needed to control estrogen. HCG produces much more estrogen than exogenous test does. I would advise anyone who tries this route to not even start it unless their doctor is monitoring their estradiol and is willing to prescribe Arimidex if estrogen gets high. Because I can almost guarantee it will and you will not get any benefits without controlling it. All of the erectile function benefits did not occur for me until about a week and a half after I started taking Arimidex, as my estradiol had gone up to 49 from half the HCG dosage I currently take.

11) What do you think the future holds for you? Will you just stay on HCG Monotherapy as long as you can? Or will you switch to standard testosterone therapy once you are longer concerned about fertility?

A.  At some point I am sure I will move to more of a testosterone protocol, perhaps combined with HCG to prevent testicular atrophy. My sense is you get the best of both worlds this way, and get the mood and contentment benefits of HCG with the stronger libido benefits of testosterone. I also generally think it is more safe to not allow your testicles to atrophy, even if you dont need them for fertility, but that’s just my opinion/bias.

In summary, I think HCG Monotherapy is a good option for a small subset of people with low testosterone which I fall into, that of younger people who are in shape and otherwise healthy. This is a small minority of people with low t, so my guess is it will never be commonly prescribed or studied in detail. I think if someone is significantly overweight they should not pursue this route, as it will be even harder to control estrogen and getting it up high may do more harm than good.

Now since HCG can also increase testosterone in many men with secondary hypogonadism, it was just a matter of time before someone got the idea that maybe some men would do just fine with HCG alone and just skip the testosterone cypionate altogether. This treatment strategy is called “HCG Monotherapy” and seems to be growing in popularity.

What is interesting is that, because HCG is extremely similar to Leutinizing Hormone, some doctors and patients consider this a more natural solution than giving a man testosterone replacement therapy, because it stimulates the body’s own production of testosterone.  Of course, the practical side of administering HCG is that it really ramps up estradiol in most men, at least from what I have seen.  So, as you’ll see below, one often has to take more Arimidex than one would with just standard testosterone therapy, making this seem less natural perhaps when one considers the pharmaceutical involvement.

A couple of our Peak Testosterone Forum members have gone this route and one of them graciously agreed to answer some questions about his experience, which I have published below:

1) So you’re on HCG Monotherapy, i.e. you not taking Clomid or receiving testosterone therapy? Can you give us a little background and let us know what made you decide to go with this decision? Fertility I assume?

A.  Yes HCG Mono. I am concerned about fertility. Also, my endocrinologist was not comfortable putting someone as young as me (37 at the time) on exogenous test as he viewed it as a lifelong commitment I could never quit, presumably due to testicular atrophy. So in contrast to most he was more comfortable putting me on NCG or Clomid than exogenous T, and I didnt want clomid.

2) Can you let us know your testosterone numbers before and after starting the HCG Monotherapy? How much of a testosterone boost can the typical secondary hypogonadal male get in your opinion?

A.  I had been tested by my gp for several years in the 320-330 range. I have increased the dosage over time and am now at 500iu 3x/week and my last testosterone reading was 610. Others I have seen have gotten as high as 700.

3) How long have you been on HCG Monotherapy and were you on Clomid or testosterone prior to this?

A.  It’s been about a year now and was my first HRT experience.

4) How did you find a physician that knew how to handle this kind of treatment protocol? Are you currently satisfied with his or her level of expertise? My impression is that it is mostly fertility docs who handle this. Is that what you have seen?

A.  I looked on this endocrinologist’s website and he mentioned different forms of trt, ie gels, pellets, etc and he was fairly young, so I figured he might be more open minded. I am his first HCG patient clearly:  he does not seem to have any experience with it. He told me he has people on Clomid, but it won’t raise libido. He tried to get me to try Wellbutrin which acts on dopamine, but i was not comfortable with that. I have been leading the charge here if you will.

5) What I have heard is that HCG will not hurt fertility parameters and will often help men in this area. Is this what you understand as well?

A.  Thats what I understand and it is prescribed at higher dosages as a short term fertility aid.

Brain Killers - Peak Testosterone

I think we’d all agree that for us guys the most important part of the body is not actually our penis, but rather our brain. Right?  Well, even if you would put your brain second on the list, you have to admit that without it, life would never be the same.

So, with that thought in mind, we want to give you a list of things that can erase, shrink and disconnect your grey matter.  You would be suprised how many things can injure your precious neurons, dendrites and synapses. It is easy to build the brain at any age and it is easy to tear it down as well.

Here are some of the biggees lurking in your diet, lifestyle and environment that you may not have thought of:

1) Aluminum is proving to be one of the most brain toxic of all common substances.  This top is so large and important that I have given a separate link to Aluminum and Your Brain.

2) Excitotoxins are legalized brain poisons put everyday into packaged goods and all manner of edible products, including that Diet Coke you may have had this morning trying to be healthy.  Please, please read this incredibly important link on Excitotoxins for the benefit of yourself and your loved ones.

3) Blood Pressure and Metabolic Disorder. One large scale [1] study of 999 men – why not add one more guy, right? – showed that “cross-sectional measurements at age 70 showed that high 24-hour BP [blood pressure], nondipping, insulin resistance, and diabetes all were related to low cognitive function “.  A 2009 study found that the lower blood pressure number is ultracritical:  for every 10 point increase you get about a 7 percent increase in likelihood for “cognitivie impairment”, which is polite way of saying memory and thinking problems. [12] Blood pressure is also a very strong predictor of stroke which often does nasty things to your grey and white matter.

4) Insulin and Blood Sugar. Diabetes is VERY hard on the brain:  the ups and downs in diabetic blood sugar levels literally causes neurons to disconnect themselves.  Researchers have even found that pre-diabetes Metabolic Syndrome leads to the same slow destruction of the brain. [2] High blood sugar has been associated with both memory problems AND even shrinkage of the hippocampus, the part of the brain that handles working memory.  Read this link on how to avoid Metabolic Syndrome, or Syndrome X as it is sometimes called, which is the body’s pre-diabetic state where insulin and blood sugar start to go out of control. (This is the health curse of all people on a Western Diet.)

5) Advanced Glycation End Products (AGEs).  Advanced Glycation End Products, or AGE’s, occur as a normal byproduct of glucose metabolism.  However, they are produced at greatly accelerated rates when blood sugar is too high, etc.  Unfortunatly, these Advanced Glycation End Products are associated with a host of physiological ills, including dementia, Alzheimer’s Disease [3] and skin damage.  Please read this link for how to combat this neuroligical and metabolic nemesis.

6) Second Hand Smoke. Second hand smoke has been linked to cancer, heart disease and stroke. But the good news is that you probably won’t even remember what went wrong as scientists have just discovered that it’s also correlated with dementia. [4] So avoid second hand smoke like the plague or you might as well sign up for work in an an asbestos factory…

7) Saturated and High Fat Diets. Several studies (in older populations) show that saturated fat (and cholesterol and total fat) is associated with decreased cognition, i.e. a decreased ability to think, learn and process and information. In fact, one recent large study of Latin American and Asian populations showed that the more meat consumption, the more the dementia. [5]  In addition, a 2009 study on rats showed that a high fat diet (55%) impaired both cognition and exercise capacity. The animals essentially became “lazy and stupid”.  And many people eating fast food and/or Atkins-esque or Lower Carb Diets approach levels of 55% fat. [6] We know that in Western societies a high fat diet goes hand in hand with saturated fat and so, basically, these have the potential to “make you stupid”.  NOTE:  One of the positive things that the neurotransmitter glutamate does is activate NMDA receptors.  Scientists recently discovered that one of the saturated fats, palmitate, also plays an important role in activating and maintaining these same receptors which are critical for memory and learning. [13] (Palmitic acid is one of the most common saturated fats in plants and animals.)

8) Overweight. Researchers found a very significant increase in dementia in those whose waist was too big in midlife. [7] However, just being overweight, regardless of the location on the body, is likely to cause issues:  one recent UCLA study found that “overweight people had 4% less brain tissue than normal-weight adults”. [14] This is likely due to clogged arteries and vessels which lowers blood flow and leads to cell shrinkage. Another study based out of Sweden found that being overweight at midlife increased your likelihood of dementia by about 60%. [16]

9) High Cholesterol.  High cholesterol, among many other nasty things, has been associated now with Alzheimer’s and dementia. [8] The study found that “people with total cholesterol levels between 249 and 500 milligrams were one-and-a-half times more likely to develop Alzheimer’s disease than those people with cholesterol levels of less than 198 milligrams. People with total cholesterol levels of 221 to 248 milligrams were more than one-and-a-quarter times more likely to develop Alzheimer’s disease”. They were specifically talking about people who had cholesterol in their early 40’s by the way and this backs up other previous research. [9]  NOTE: The best way to lower high cholesterol is through the Low Fat (Ornish) Diet.

10) Stress. “Don’t get stressed out” is good advice for your brain.  It will age your cardiovascular system and literally rip apart your brain.  And the suprising thing is that many counterintuitive aspects of life are actually stressors for your body and mind.  For more information, read this link.  By the way, Depression is a form of stress and very often leads to elevated Cortisol levels.  High cortisol levels literally destroy your brain and some studies have shown that depressed individuals have a shrunken hippocampus, the center for memory.  Read here for more details.

11) Folate (Folic Acid) Deficiency.  A folate deficiency is associated with a three times greater risk of dementia according to recent research. [10]

12) Inflammation. Researchers have long suspected that inflammation was a leading component of Alzheimer’s and other dementias.  For example, many researchers have noticed that those taking NSAIDs (Advil, Ibuprofen, Motrin, etc.) have significantly better outcomes for Alzheimer’s.  (Unfortunately, NSAID’s are also associated with erectile dysfunction and a wide variety of GI disorders!) Furthermore, it was well-known that head traumas and all the associated inflammatory response was a major risk factor for developing Alzheimer’s later in life.  Just recently the suspicions were strongly confirmed in a September 8, 2009, print issue of Neurology study that showed that seniors with inflammation from an infection were had memory loss at twice the rate of someone without such an infection. And participants that happened to have high TNF alpha levels before the study had on average ten times the rate of memory loss. Please see this link on How to Lower Inflammation for more information.

13) Lack of Sleep. Evidence is continuing to mount that lack of sleep helps lead to dementia. Of course, this is no shock because anything that leads to increase arteriosclerosis, inflammation and high blood pressure is bound to lead to troubles for your grey matter. In addition, scientists recently found that it also directly increases beta amyloid and the associated plaques that are so characteristic of Alzheimer’s. [11]  You don’t want plaque in your brain anymore than you want it in your arteries!

14) CoQ10 Megadosing.  According to one animal study, megadosing on CoQ10 will damage hearing and memory. See this link on The Dangers of Supplementation for more details.

15) Heavy Alcohol Consumption. Chronic, heavy drinking is so hard on the brain that it actually shrinks it.  Furthermore, alcohol is neurotoxic and the reason appears to be that it actually stimulates glutamate – can you say Excitotoxin? – activity leading to neuronal death and injury. [15]

REFERENCES:

1) Hypertension,1998;31:780-786

2) Achieving Optimal Memory, Aaron Nelson, Ph. D, p.64, McGraw-Hill, 2005

3) Brain Research Reviews, Feb 1997, 23(1-2):134-143

4) BMJ-British Medical Journal (2009, February 13). Second-hand Smoke May Cause Dementia. ScienceDaily. Retrieved March 11

5) Amer J Clin Nutr, Received for publication February 3, 2009. Accepted for publication May 21, 2009; Emiliano Albanese, et al; “Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study”

6) FASEB J, 2009 Aug 10. [Epub ahead of print], Murray, et. al., “Deterioration of physical performance and cognitive function in rats with short-term high-fat feeding”

7) Neurology, Received August 15, 2007, Accepted December 14, 2007, “Central obesity and increased risk of dementia more than three decades later”, R. A. Whitmer PhD, et. al.

8) American Academy of Neurology (2008, April 16). High Cholesterol In Your 40s Increases Risk Of Alzheimer’s Disease. ScienceDaily.

9) NEUROLOGY 2007;68:751-756, “Serum cholesterol changes after midlife and late-life cognition”

10) J of Neurology, Neurosurgery, and Psychiatry, 2008;79:864-868, Published Online First: 5 Feb 2008,”Changes in folate, vitamin B12 and homocysteine associated with incident dementia”

11) Science, Science Express Index, DOI: 10.1126/science.1180962, Published Online September 24, 2009, Submitted on August 24, 2009, Accepted on September 11, 2009, “Amyloid- Dynamics Are Regulated by Orexin and the Sleep-Wake Cycle”, Jae-Eun Kang, et. al.

12) Neurology, 73(8):589-595, August 25, 2009, “Association of higher diastolic blood pressure levels with cognitive impairment”

13) Neuron, 2009 Oct 29, 64(2):213-26, “Dual palmitoylation of NR2 subunits regulates NMDA receptor trafficking”

14) Prevention, Jan 2010, p. 14.

15) Alcoholism: Clinical and Experimental Research, Published Online: 11 Apr 2006, 16(3):539-541, “Alcohol, Nitric Oxide, and Neurotoxicity: Is There a Connection? a Review”

16) International Journal of Obesity, 2009, 33:893 898; “Overweight in midlife and risk of dementia: a 40-year follow-up study”

Alcohol and Testosterone - Peak Testosterone

REFERENCES:

1) Biology of Reproduction, Jan 1 1990, 42(1):55-62, “Effects of chronic ethanol diet on pituitary-testicular function of the rat”

2) Alcoholism, Clinical and Experimental Res, 1997, 21(1):128-133, “Testicular function in asymptomatic chronic alcoholics : Relation to ethanol intake”

3) J of Endocrinology, 1997, 152:477-487, “Ethanol, growth hormone and testosterone in peripubertal rats”

4) Oxford Journals Medicine Alcohol and Alcoholism, 1987, 22:17-22, “ETHANOL-INDUCED INHIBITION OF TESTOSTERONE BIOSYNTHESIS IN VITRO: LACK OF ACETALDEHYDE EFFECT”

5) Int J Vitam Nutr Res, 1987, 57(3): 267-71, “Plasma testosterone in rats exposed to ethanol during vitamin E deficiency”

6) Endocrinology Vol, 1979, 105(4):888-895, “Alcohol-Induced Testicular Atrophy in the Adult Male Rat”

7) Alcohol, Jan-Feb 1984, 1(1):89-93, “Sex hormones and adrenocortical steroids in men acutely intoxicated with ethanol”

8) Bone, 2009 Sep, 45(3):449-54, Epub 2009 May 18, “Effect of alcohol consumption on bone mineral density and hormonal parameters in physically active male soldiers”

9) Alcoholism: Clinical and Experimental Research, Published Online 13 Apr 2006, 28(5):780-785

10) Mary Ann Emanuele, M.D., and Nicholas Emanuele, M.D., “Alcohol and the Male Reproductive System”,

Does alcohol help or hurt your testosterone?  That’s a question every guy should ask himself.  Alcohol is currently a much-loved chemical in the health media and blogging worlds.  After all, it is manly, helps with heart disease and is often ground zero of our social universe.

However, for those of us who want to optimize our hormonal and testosterone levels, alcohol, or ethanol as it is known scientifically,  is certainly no friend. Animal studies, for example, found that alcohol lowered testosterone levels in rats by about 40%. [1]  We also know that heavy drinkers (without liver disease) have significantly lowered sperm counts, sperm motility and free testosterone. [2]  By the way, alcohol does not just affect testosterone but growth hormone levels as well. [3]

The short term reason for this is that acetylaldehyde, the primary breakdown product of ethanol (alcohol), acts on the Leydig Cells directly to reduce testosterone production. Even small dosage levels affect testosterone production in isolated rat Leydig cells, a very bad sign indeed. [4] The drop in testosterone can even be more severe in those with depleted Vitamin E levels.  Researchers found drops in testosterone of 50% in one study! [5]  And consider this:  rats fed a 5% ethanol diet lose 50% of the weight of their testicles. [6] Ouch!

NOTE: Researchers at the National Institute of Health believe that alcohol lowers testosterone through four key mechanisms: 1) an increase in the opiod beta-endorphin, 2) a reduction in testicular nitric oxide, 3) oxidative damage, 4) cell damage (from increased oxidation). [10] All of these pathways will lower testosterone and explain why alcohol is such a potent testosterone lowerer, especially in those who drink more than moderately.

Okay, so alcohol is hard on rats and dogs – so what about humans? Sorry, but alcohol has been found to be just as tough on human testosterone.  One study found that (a heavy dose) of alcohol on 8 adult males lowered testosterone (and raised cortisol) for 24 hours afterward! [7]  A more recent study, almost twenty five years later, verified that drinkers in the armed forces had lower free and total testosterone (and higher estrogen levels). [8]

What if you don’t overdrink?  The results are a little less noxious according to one study out of the Netherlands.  These researchers found that moderate drinking lowered testosterone by 7% (but did raise HDL by 12%). [9]

Alcohol is also a notorious estrogen-increaser.  It does this by affecting the liver’s P450 enzyme subsystem in a negative way.  Basically, it slows down your body’s ability to process estrogen, allowing it to build up in your blood stream. That means, as good Peak Testosterone readers know, that testosterone will be reduced because estrogen is a testosterone lowerer.

If you think about it, alcohol fights your testosterone in almost every negative way possible:  its breakdown products directly lowers Leydig cell production and it increases cortisol and estrogen, both of which are known testosterone blockers!  And, as I have covered in another link on the Pros and Cons of Alcohol, drinking raises the risk for all GI cancers as well.

Many guys drink for social reasons and the heart benefits, but I just cannot see the advantage considering the fact that it can affect testosterone, estrogen and cortisol levels in such a negative way.  This is especially important for use middle aged and beyond guys who are already struggling with these three hormones just from the aging process!  If you are exercising with a Low Fat Diet, for example, your heart will be strongly protected anyway.  In other words, you don’t need alcohol.

And that’s my summary really:  you don’t really need alcohol, so why bother?  An occasional social drink is no big deal, but otherwise I’d stick to good, clean livin’ and optimizing your testosterone.  You need every last drop you can get!

Sex and the Health of Your Woman - Peak Testosterone

Let’s face it:  there are a hundred reasons for a woman not to have sex and you’ve probably heard just about every one of them. Lack of romance, stress, kids, schedules and on and on the list goes.  There is one reason, though, that most guys never think of:  her health.

That’s right – a woman’s lifestyle choices can lead her down a road of pain during intercourse, sexual dysfunction and debilitating disease. Yes, us men can do the same. In my one of my links, I discussed how important it is for a guy to be an Example of Good Health for the sake of his woman’s health.  On this page, I cover yet another reason (in a non-obnoxious, helpful way) to be a health leader:  your sex life as a couple may depend on it.

On this site, I cover many of the lifestyle issues that can affect male performance and erectile strength.  Below I’m going to cover some of the same issues for women:  lifestyle choices that can sabotage her ability or desire to make love.

Here is just a partial list as to how health can affect her sexual function:

1.  Female Sexual Dysfunction. Most guys think females don’t want sex because of “emotional” reasons. However, very often it is related to something the medical profession calls “female sexual dysfunction”.  Female sexual dysfunction is correlated with all the same kinds of lifestyle issues that plague our male sexual function.  For example, female sexual dysfunction has been found to be correlated with being overweight [6] and low levels of exercise [7].  Another study states that “high blood pressure, high cholesterol levels, smoking, and heart disease are associated with impotence in men and sexual dysfunction in women”. [9]

Again, this is all the same stuff that us guys struggle with and her sexual life depends on these every bit as much as yours.  Often it has to do with “blood flow” issues and thus is somewhat “erectile” in nature.  Blood flow to the clitoris and vaginal walls is critical for women as well.  In fact, one rather suprising reason that this is so important is that lubrication in females is tied to nitric oxide production, a fact I discuss in my link on Female Libido and Viagra.

NOTE:  Just as with guys, the Mediterranean Diet has been shown to improve sexual function in females with Metabolic Disorder. [8]

2) PCOS.  This condition, generally from being overweight and/or having Metabolic Disorder, results in higher-than-normal testosterone levels.  Sounds good right? Well, it’s not:  PCOS leads to ovarian cysts, infertility and has a common side effect of female sexual dysfunction as well. It is also a significant risk factor for heart disease. [5]  Exercise and losing weight and other Metabolic Syndrome Solutions are options to discuss with your doctor.

3) Endometriosis. This condition, where uterine cells slough off and attach themselves to surrounding tissues, is also frequently linked with being overweight. [4] Endometriosis can be very difficult and often leads to infertility, pain and female sexual dysfunction.

4) Uterine Fibroids.  These common and almost always benign growths can grow fairly large and cause heavy periods, severe cramping and other issues.  In addition, they quite frequently cause an afflicted woman pain during intercourse. The underlying cause at this points seems to be estrogen.  Dairy is actually a suspected risk factor by some experts, because of the natural estrogens present in cow’s milk.

Obviously, this list could go on and on, but I chose these because they are so common. Let’s start with PCOS:  this afflicts between 5 and 10 percent of American women. [10] Endometriosis is still more common and occurs in 8-15 percent of women in their reproductive years in the U.S.  Climbing the ladder, 20-40 percent of women have uterine fibroids of “significant size” and almost half of women between the ages of 50 and 74 report some kind of sexual dysfunction according to a Yale report. [11]

Again, encourage her (in a kind way) to exercise, eat right and take care of herself, or the odds start mounting – no pun intended – against you.

REFERENCES:

4) Gynecology and Obstrics, Apr 2009, 105(1):39-42, “Association of body mass index with severity of endometriosis in Korean women”

5) Arteriosclerosis, Thrombosis, and Vascular Biology, 1995, 15:821-826, “Coronary Heart Disease Risk Factors in Women With Polycystic Ovary Syndrome”

6) Menopause, 2009, 16(6):1188-1192, “Body mass index, urinary incontinence, and female sexual dysfunction: how they affect female postmenopausal health”

7) International Journal of Impotence Research, Jul/Aug 2008, 20:358-365, “Obesity and sexual dysfunction, male and female”

8) International Journal of Impotence Research, Sep/Oct 2007, 19:486-491″Mediterranean diet improves sexual function in women with the metabolic syndrome”

9) Urology, Nov 1999, 9(6):563-568, “Female sexual dysfunction: anatomy, physiology, evaluation and treatment options”

Androxal : Future Testosterone Therapy - Preserve Fertility.

REFERENCES:

1)  BJU Int. 2013 Jul 12, “Testosterone Restoration by Enclomiphene Citrate in Men with Secondary Hypogonadism: Pharmacodynamics and Pharmacokinetics”

2) https://clinicaltrials.gov/ct2/show/results/NCT01534208

3) Journal of Sexual Medicine, Jun 2013, 10(6):1628–1635, “Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel”

4) https://ir.reprosrx.com/releasedetail.cfm?ReleaseID=795239

5) https://ir.reprosrx.com/releasedetail.cfm?releaseid=757123

6) Fertil Steril, 2014 Sep, 102(3):720-7. doi: 10.1016/j.fertnstert.2014.06.004. Epub 2014 Jul 17, “Enclomiphene citrate stimulates testosterone production while preventing oligospermia: a randomized phase II clinical trial comparing topical testosterone”

7) https://www.ironmagazineforums.com/threads/201013-Enclomiphene-Citrate-the-Super-Clomid

8) Clinical Endocrinology News, AUA Annual Meeting, “AUA: Enclomiphene boosts testosterone without harming sprem production,” by Michele G. Sullivan

Androxal answers the biggest fears of testosterone therapy (HRT or TRT) that I see on The Peak Testosterone Forum:  concerns over the atrophy of the pituitary and/or loss of fertility. Some men have a “honeymoon period” on HRT for example.  Perhaps that is due to a slowly atrophying pituitary?  There are other better hormonal explanations in my opinion, but is hard to rule it out. In addition, many men and doctors wonder if, as the decades roll by, that some sort of medical or premature aging issue will crop up if one’s pituitary goes inactive due to the shutdown of standard TRT. (Note that the testicular function can be restored with HCG.  See my page on Testosterone Therapy and HCG for more information.)

There is another reason that a man on HRT should be concerned about the shutdown of his pituitary:  what if he has to go off of HRT? There are certain medical conditions – intractable high hematocrit, blood pressure or PSA for example – where a man can be forced of all testosterone therapies for a period of time and perhaps indefinitely.  This is not as uncommon as you might think.  What happens then?  The theory is that the patient just returns to his old baseline testosterone levels after a few months and proceeds as he did before HRT.  That sounds like a good theory and it often works out that way.  However, there are reports that some men do not snap back completely to their old testosterone level, especially as they age.  This could be lifestyle or other non-HRT-related factors of course.  However, it is also possible that it is due to an inactive pituitary.

How do we know that Androxal will really boost testosterone and keep the pituitary active?  Well, in a study funded as part of the FDA approval process, the following was found: [1]

“After six weeks of continuous use, the mean ± SD concentration of TT [total testosterone] at Day 42 C0hrTT, was 604 ± 160 ng/dL for men taking the highest of dose of enclomiphene citrate (enclomiphene, 25 mg daily) and 500 ± 278 ng in those men treated with transdermal testosterone. These values were higher than Day 1 values but not different from each other (p = 0.23, T-test). All three doses of enclomiphene increased C0hrTT, CavgTT, CmaxTT, CminTT and CrangeTT. Transdermal testosterone also raised TT [total testosterone], albeit with more variability, and with suppressed LH levels.”

In this case 25 mg of Androxal (enclomiphene citrate) actually raised testosterone to levels exceeding the testosterone gel they tested against and implied LH levels were improved.  (LH is a signaling hormone coming from the pituitary.)

2. Maintain Fertility.  One small study showed exactly what would be expected:  enclomiphene did a nice job of boosting fertility:

“Only men in the enclomiphene citrate group demonstrated increased LH and FSH. TT [total testosterone] decreased one month posttreatment to pretreatment values. Enclomiphene citrate elevated sperm counts in seven out of seven men at 3 months and six out of six men at 6 months with sperm concentrations in the 75–334 × 106/mL range.” [3]

Advantages of Standard Testosterone Therapy Over Androxal

1. Natural Molecule. I have always felt that HRT was natural, because it is generally bioidentical (or darn close in the case of the injectible esters).  Your body is used to it and even “craves” it if you are deficient.  However, this is not the case with enclomiphene.  No matter how you look at it, it’s an artificial, synthetic substance that may have some sort of unexpected impact.  At this time, it is difficult to say just how much of an issue this is, since we have very few details on side effects and adverse events.  But so far all SERMs have such a profile and I doubt that Androxal will be unique.

So the question becomes a matter of long term safety. My two cents – and I certainly don’t have a crystal ball any more than anyone else – is that well done HRT is very safe for the solid majority of men.  It has done very well in the studies overall and, furthermore, has been around for decades now.  Is Androxal something that can really be used for decades?  I will only say that it is a pretty rare medication that goes into the plasma without touching anything except its target receptor and then exits (along with any metabolites) gracefully without affecting something along the way.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

This may be shown by the side effect profile from the FDA Endpoint Classification Safety Study:

—7% and 3% of patients had an adverse event on 12.5 mg and 25 mg of daily Androxal, respectiviely. (In fairness, one could argue this is similar to testosterone and perhaps is due mostly due to issues related to increased testosterone levels.)

–3% and 7% of patients withdrew on daily dosages of 12.5 mg and 25 mg, respectively.  The reasons for this are unknown, but perhaps it was due to unpleasant side effects?

2. Higher Testosterone Levels. In my case, I have found that I need about 600+ ng/dl for morning erections to return and I believe that morning erections are important generally for penile health.  Notice that in the above study, the highest dosage of enclomiphene (25 mg) only achieved an average level of about 600 ng/dl.  And in the fertility study mentioned above, the average testosterone was only about 550 ng/dl.  Some men may want to go a bit higher and, short of taking off label amounts on enclomiphene, will not be able to do it.

This was echoed in a second study in 2015 that took 240 obese men with average testosterone of 200-230 ng/dl.  [8] Fertility parameters were improved significantly, so that’s good of course.  However, average testosterone levels in the enclomiphene group was only 450 ng/dl.  Again, many men are going to feel just a little better with their testosterone at this level.  See my page Normal Male Testosterone Levels for more information. (Some men will do great in the 400’s as the response to testosterone is highly variable.)

Interestingly enough, the phase 2 trails for FDA Approval produced even lower testosterone numbers.  The only participants allowed in the study were men with total testosterone under 250 ng/dl.  Men given 12.5 or 25 mg of Androxal daily raised their testosterone from an average of 217 and 210 ng/dl to 471 and 405 ng/dl, respectively.  That 405 ng/dl is just not that impressive in my opinion and I think that the majority of hypogonadal men would not get significant relief from their low testosterone symptoms at that level.  Perhaps physicians will give out 50 mg, though, and this will help.  Time will tell. [6][7] What I am wondering is if the zuclomiphine isomer within Clomid is actually responsible for a significant portion of Clomid’s testosterone boosting powers?

3. Tight Control of Testosterone. As of this writing, we do not know what dosages of Androxal will be available.  Patients have some ability to hit a target testosterone level via pill splitting, but injectible testosterones give much more granular control.  A man can target with about a 100 ng/dl a target testosterone level.

4. No Loss of Efficacy. I saw a surprising number of men on Clomid, whose testosterone levels would slowly drop in the first few months. Will some men on enclomiphene experience the same thing?  It’s difficult to say.

5. Tight Control of Estradiol.  Many men on The Peak Testosterone Forum want tight control of their estradiol levels as well and argue that control of E2 is just as important as control of one’s T.  Injectibles, especially more frequent subQ protocols, allow for this kind of estradiol management.

CONCLUSION:  Assuming Androxal is reasonably priced, I think it is safe to say that it will be very popular particularly with younger men who wish to maintain their fertility and with any man who has a concern with pituitary function.  However, I believe that many men will shy away from it, because it is synthetic and in many cases will not raise testosterone to normal youthful levels.

Artificial Sweeteners: What Few People Know.

Artificial sweeteners are incredibly popular and the reason is simple:  they seem like a fantasy, almost too good to be true.  Take the case of saccharin:  it is about three hundred times as sweet as sugar and yet is zero calories. That’s the allure:  we get all the sweetness that we want with no metabolic or weight gain consequences.

Unfortunately, the picture is not so simple.  Artificial sweeteners are not just a little artificial – they are very artifical and produce some very surprising (negative) effect, which we will cover below for each sweetener.

However, one thing that should be realized is that all artificial sweeteners will likely cause your problems and have been associated with obesity.  In fact, one study found that regular consumers of artificial sweeteners, in this case saccharin, had their brain’s reward system to sweets altered.  Basically, regular consumers of diet beverages responded more strongly to sweets, thus making them more vulnerable to overconsumption and, eventually, weight gain. [13]

NEWS FLASH:  One recent study found cancer-causing properties associated with aspartame and saccharin, two of the three sweeteners discussed below. [8]

Let’s start with the three most popular on the market today:

Aspartame, Equal or Nutrasweet

This sweetener is almost synonymous with the word “diet” and is ubiquitous in diet drinks, including Diet Coke and Diet Pepsi.  It is consumed in vast quantities by people around the globe and so it has to be safe, right? Unfortunately, nothing could be further from the truth.

If you haven’t heard, aspartame is quickly metabolized by the body and broken down into some nasty chemicals, including methanol, formaldehyde and aspartate.  The ensuing chemical soup is already linked to a variety of very serious conditions in both animal and human studies:

1.  Excitotoxin Syndrome.  This is a reversible but debilitating condition linked to the nasty excitotoxin, aspartate, that is metabolized from Aspartame.  You can read more here in my link on Excitotoxin Syndrome. I don’t know anyone who drinks more than, say, three Diet Cokes or Diet Pepsis that does not struggle with many of these symptoms.

2. Lymphoma and Leukemia. One animal study in a prestigious European journal already found “a statistically significant, dose-related increase in lymphomas and leukaemias in females” at about the equivalent level of three diet sodas per day. [1] This study was conducted on 1,800 rats and the control animals had no lymphomas.  In contrast, the animals consuming aspartame had 10 malignant gliomas, 1 medulloblastoma and 1 malignant meningioma!

3.  Kidney Decline.  Kidney decline is nasty, serious business (likely from the formaldehyde metabolized from aspartame) has now been linked to this condition in a study of nurses. [11] Read more here at this link in the News Flash on the bottom of this page on Excitotoxins.

4. Testosterone and Reproduction.  Numerous animal studies show that fetal excitotoxin exposure – excitotoxins pass rather easily through the placental barrier  – can lead to reproductive and hormonal difficulties later in life.  Read here about how Excitotoxins Can Decrease Testosterone. This may be an issue for us humans later in life, because cell phone and electrosmog exposure likely weaken our blood-brain barrier later in life.  (Excitotoxins also go largely unimpeded into the hypothlamus where they can do considerable damage as well.)

Saccharin or Sweet ‘n Low

Supposedly, the story of saccharin is like the story of death row inmates who are found later to be innocent and then freed upon the public at large.  Many people, health conscious or not, know about how saccharin was implicated as a cause of bladder cancer in a famous rat studies of 1977-1980.  [2] However, it didn’t take long for several flaws in the study to come out, including the fact that fat metabolism is different and the dosage was much, much beyond any reasonable amount that could be consumed by a human.

Now the pendulum has swung back in the other direction and many consider saccharin the safest of the artificial sweeteners.  I would argue caution for the following reason:

1.  Liver Irritation and Toxicity.  Saccharin can be hard on the liver [3] and is known for increasing aminotransferase levels, a sign of liver damage. One study on rats showed no liver cancer when saccharin alone was given to rats.  However, when another liver-cancer causing agent was administred, saccharin greatly accelerated the rate of cancer. [4] In other words, saccharin may simply accelerate any underlying liver problems, a very serious problem indeed in our day of chemicals and drugs, which often overtax our livers.  (In fairness, another similar study found no such toxicity. [5])  It should be noted, also, that one study showed DNA modifications from saccharin in mice. [6]

Sucralose or Splenda

So far sucralose has avoided the spotlight as far as negative press and deservedly so: it has had, as far as I know, only one valid negative study to date: one set of researchers found that it negatively effected intestinal flora and pH. [7]  If true, this is a very serious charge indeed as “gut flora”, one’s good intestinal bacteria, is critical for immune function and some digestive processes. Plus, the animals gained weight. However, more work is needed as this study has received some criticism for being insufficiently rigorous.

One last note: sucralose has been cited by Medscape as a possible migraine trigger in sensitive individuals: [9] This has not been verified, however, by a formal study nor do researchers know of any mechanism by which this might occur.

CAUTION: A lot of health-conscious people are running to Stevia and Agave as natural alternatives to sugar and alternative sweeteners. Yes, they are natural in the sense that they have been consumed as foods.  The agave plant is grown in Mexico and is touted as a “low glycemic” sweetener.  The problem is that it is relatively non-sweet in taste and, I just learned, very high (92%) in fructose. [12]  In other words, it would be very easy to pack on the pounds with agave syrup.  Furthermore, agave syrup does not contain fructose and the percentage goes up each year with increasingly modern manufacturing techniques that use higher and higher heat.  One study on Stevia should give most guys pause:  higher doses have led to decreases in testosterone and reduced sperm counts in laboratory animals. [10]

REFERENCES:

1) Eur J Oncol, 2005, (10)(2):00-00

2) Cancer Res, Mar 1980, 40:734-736 ,”Saccharin-induced hyperplasia of the Rat Urinary Bladder”

3) New Eng J of Med, July 14 1994, 331:134-135, “The Hepatotoxicity of Saccharin”

4) Envir Health Perspectives, 1983, 50:169-176, “Effect of DibutyInitrosamine and Saccharin on Glutamyl Transpeptidase-Positive Foci and Liver Cancer”

5)  Toxicological Sciences, Received March 28, 1988; accepted July 12, 1988, 12(2): 346-357, “The Effect of Lifetime Sodium Saccharin Dosing on Mice Initiated with the Carcinogen 2=Acetylaminofluorere”

6) Boll Soc Ital Biol Sper, Dec 15 1980, 56(23):2486-2491, “Renal and hapatic toxicity studies in mice treated with sodium saccharin: breaks in single-stranded DNA”

7) J of Toxicology and Envir Health, Part A, Jan 2008, 71(21): 1415-1429, “Splenda Alters Gut Microflora and Increases Intestinal P-Blycoprotein and Cytochrome P-450 in Male Rats”

8) Drug and Chemical Toxicity, 2008, 31(4):447-457, “Genotoxicity Testing of Low-Calories Sweeteners: Aspartame, Aesulfame-K and Saccharin”

9) https://www.medscape.com/viewarticle/545187_4

10) Journal of Ethnopharmacology, Nov 1999, 67(2):157-161, Received 30 November 1998;revised 22 December 1998;accepted 24 December 1998.Available online 10 September 1999., “Effects of chronic administration of Stevia rebaudiana on fertility in rats”

11) https://www.sciencedaily.com/releases/2009/11/091101132543.htm

12) https://www.cardiologistwife.com/Cardiologists_Wifes_Chocolate_Too_Diet/ Truvia_Splenda_sugar_alcohols_etc.html

13) Physiology & Behavior, Available online 11 May 2012, “Altered processing of sweet taste in the brain of diet soda drinkers”

If You Are Low: How to Increase Your Estradiol.

Assuming you are low estradiol, how could you increase it?

The last thing most of us guys over about 35 need is a boost in our estrogen levels.  As we age, most of us put on some body fat, which increases our aromatase stores, and the extra aromatase converts our testosterone into estradiol, the “bad” estrogen. (Read my link on How Extra Estrogen (Estradiol) Can Negatively Impact Male Health for more details.) However, this is NOT always the case and some men end up with estradiol levels that are too low and this also can cause major issues, including bone and libido loss for example.  (For more information, see Why Men Need Adequate Estradiol / Estrogen.)

Before, I go on, let me explain that I am using the word estrogen here, but estrogen is actually a family of three estrogens, estrone, estriol and estradiol.  Estradiol (E2) is the big gun in the family.  If you go to the doc and get an “estrogen test,” he should actually test your estradiol levels.  So, again, when I say “estrogen,” I am really talking about estradiol, because estradiol controls erectile, bone and brain function.

Let me lay out a very common scenario that I see on the Peak Testosterone Forum: a man writes in with, say, low testosterone of 330 ng/dl and also mentions that his estradiol level is 12 pg/ml.  His focus is almost always on the low testosterone, but what he does not realize is that the low estradiol is very likely causing him just as significant of issues.  Remember that a man’s estradiol comes from testosterone.  So, if testosterone is low, then a man can very easily be low estradiol as well.  And this will likely over the months and years lead to bone loss and eventually osteoporosis.

But there is another thing that comes along with low estradiol:  misery.  That’s right – recent study work has shown that most of the symptoms we associate with low testosterone can also be caused by low estradiol.  There is little difference between the two.

So here are Three Common Reasons that can Cause Low Male Estradiol (Estrogen) Levels, which is normally below about 15 pg/ml from what I have seen, but discuss with your doctor:

1.  Use of an Aromatase Inhibitor.  Some men need to boost their estradiol levels, because they have “crashed their estrogen” from taking Arimidex or a Suicide Inhibitor. In this case, usually all that is required is a two to three week wait time.

2. Low SHBG Men (on HRT). SHBG is a protein that bind to testosterone and estradiol and creates a “reserve” or pool of these critical hormones.  Some men, for reasons not totally understood yet, have very low SHBG levels.  This condition is usually tied to a suite of symptoms including insulin resistance and liver dysfunction that I outline in my link on Low SHBG. Practically speaking, a low SHBG guy will clear out his testosterone and estradiol so quickly, i.e. urinate them out of his system, that his plasma levels are too low.  This can give him mediocre HRT results and many other problems.  If you are low SHBG, please join us on the Peak Testosterone Forum and ask some questions there as this is a whole subject on its own.

3. High SHBG Men (not on HRT): High SHBG will naturally push down free estradiol levels.  So a man with low medium estradiol could end up with overly low free estradiol levels due to so much of his estradiol pool being bound up.

4. Low Testoserone. As discussed above, a big percentage of low testosterone men are also low estradiol, simply because they do not have enough base testosterone from which to convert to estradiol.

The bottom line is that many men need to actually boost their estradiol levels and below I discuss the good and bad ways tioactually do this:

1.  Boost Your Testosterone Naturally. The best way to pull up your estradiol levels is to increase your testosterone.  Again, as your T rises, more of it will be converted to estradiol by the aromatase enzyme and so your estradiol levels will go up in parallel.  There are many very common ways to boost testosterone naturally, including fixing a Vitamin D deficiency, varicocele, sleep disorder or hypothyroidism.  For other ideas see this page on How to Increase Your Testosterone Naturally.

2.  Hormone Replacement Therapy (HRT). Some men just cannot boost their testosterone levels naturally and will end up on some form of testosterone therapy.  This is the most common way that I see doctors boosting a man’s T levels.  Again, as testosterone rises, estradiol follows.  It can be a little tricky to get both testosterone and estradiol in the proper range but that is another subject.  See these links on Various Testosterone Therapies for more information.

So, on a practical level, docs usually raise a man’s estradiol by increasing his testosterone.  You can buy bioidentical estradiol creams – some women use them – but I have never heard of a physician prescribing them to one of their male patients.

All of these will increase your body fat, but they are unhealthy in the long term.  However, I mention them for general knowledge:

1) Body Fat. Body Fat=Estrogen. It’s a simple formula and it’s very true. As your fat cells grow – you don’t really get new fat cells – the more aromatase that accumulates in fat tissues. And aromatase is what converts your precious testosterone into estrogen. As testosterone falls and estrogen rises with increasing body fat levels, eventually a nasty point of secondary hypogonadism can be reached, where testosterone falls precipitously. This is why by losing weight, you can often get a substantial boost in testosterone, something I document in my new book 15 Natural Erectile Dysfunction Cures. Yes, some fat is good. Yes, some estrogen is good. But in modern societies, obesity is a plague and, more often than not, leads to too much of both.

2) Immoderate Alcohol Consumption. Alcohol is a notorious estrogen increaser. However, alcohol does not increase estrogen via the activity of the aromatase enzyme. It increases estrogen by inhibiting the P430 system of the liver which is responsible, among many other things, for clearing estrogen from the blood. In other words, alcohol leads to an increase in estrogen levels, because your body clears it from the blood more slowly.  Alcohol is associated with heart health, but if you are struggling with issues that seem to be related to estrogen (such as gynocomastia, loss of libido, low percentage of free testosterone, erectile dysfunction, etc.), I would lay off alcohol for awhile and see if it helps.

3) Food Additives. Researchers recently found two food additives that are xenoestrogens, i.e. environmental estrogens that can impact us.  The first food additive, propyl gallate, is a common preservative used to prevent fat spoliage in items such as baked goods, shortening, dried meats, candy, fresh pork sausage, mayonnaise and dried milk. The second additive, 4-hexyl resorcinol, is used to prevent discoloring in shrimp, lobsters and shellfish. These kind of xenoestrogens have been linked to reduced sperm counts (and increased breast cancer in women), but they likely affect us men as well. These do not measure on an estradiol blood test as far as I know but can definitely produce estrogenic symptoms.

4) Canned Products. Tomatoes are acidic and pull a toxin, Bisphenol-A, out of the lining of the tin can it is stored in.  Bisphenol-A is a xenoestrogen associated with various reproductive disorders in animals.  Even a very minute amount can have a negative effect. And in a recent Consumer Union study of various canned goods, the BPA problem was found to be much more widespread than previously imagined. [1] Almost every canned product tested, including green beans, Juicy Juice, soup, corn, chili and baby formula, had signficant BPA levels and researchers estimate that it would be very easy for someone to consume levels of BPA close and equivalent to that which caused reproductive issues in animals.  I recommend that you avoid canned goods until the FDA sorts this out. In addition, read my link on on Bisphenol-A for more details. This also does not measure on an estradiol blood test as far as I know but can definitely produce estrogenic symptoms.

REFERENCES:

1) https://www.prnewswire.com/news-releases/consumer- reports-tests-find-wide-range- of-bisphenol-a-in-canned-soups-juice-and-more-68723862.html

2) Prevention, Jan 2010, p. 101

3) Alessio Amadasi et al., “Identification of Xenoestrogens in Food Additives by an Integrated in Silico and in Vitro Approach, Chemical Research in Toxicology”, 2009; 22(1):52

How to Increase Your Estradiol LevelsHow NOT to Increase Your Estradiol Levels

Excitotoxins, MSG and Your Testosterone - Peak Testosterone

REFERENCES:

1) Eur J Oncol, 2005, (10)(2):00-00

2) Neuroendocrinology, 1978, 26:220-228; 1986, 42:158-166; 1980, 30:280-284

3) American Society of Nephrology (2009, November 2). Diets High In Sodium And Artificially Sweetened Soda Linked To Kidney Function Decline. ScienceDaily. Retrieved November 2, 2009, from https://www.sciencedaily.com /releases/2009/11/091101132543.htm

4) Neurology, 2009, 73:920-927, “Kidney function is associated with the rate of cognitive decline in the elderly”

5https://esciencenews.com/articles/2009/11/05/small.increases.phosphorus. mean.higher.risk.heart.disease

6)https://esciencenews.com/articles/2009/11/05/kidney.function.decline. increases.risk.heart.failure.and.premature.death

Sound unbelievable?  Well, here is a partial list of the hormonal vampires:

All of these ingredients have several things in common:  they are used in the food industry as “flavor enhancers” but are under the covers what biologists call excitotoxins and contain either aspartate or glutamate.  Glutamate is the most studied of the two compounds, but aspartate is definitely glutamate’s evil little sibling.

Together these two have something in common:  when ingested, they love to destroy neurons.  And, just as bad, when they destroy neurons in the right places, they can take out your entire hormonal cascade, including testosterone.

Animal studies, and not at overly high doses by the way, have shown that when pregnant mothers are fed glutamate the offspring is born normally but then during puberty a host of reproductive issues surface including shrunken testes. In other words, these molecules would better be called eunuch-o-toxins.

Interestingly, these key molecules are actually used by your brain for energy and as a type of neurotransmitter. In fact, they are involved in the switching mechanism of your neurons and are called excitotoxins because they literally overexcite the neurons to death if ingested in even relatively small quantities.  Neurons that receive too much glutamate or aspartate allow a flood of calcium – calcium is used for turning neurons on and off – into the cell.  The neurons under these conditions become swollen and damaged and eventually die.  So a little glutamate and aspartate is essential for the brain but too much is neuronal death.  Yes, your cells can literally get overexcited to death.

Furthermore, animals that are fed relatively low levels of glutamate can actually develop too many synaptic connections.  The brain becomes literally miswired.  In fact, studies show animals on glutamate become hyper and unable to perform normal tests of intelligence (for animals of course). This, of course, is because their brains are slowly getting mangled.  It is like taking a race horse or an elite bodybuilder and forcing him to work out until the muscles are literally shredded irreparably.

The tragedy is that many otherwise health-conscious people think that MSG, or monosodium glutamate, is only a health problem because it contains extra sodium or causes allergic-type reactions in sensitive people.  And probably an even greater tragedy is that many people, trying to be healthy by drinking diet sodas, are soaking their hypothalmuses (and in some cases brains) with excitotoxins. (Aspartame is so named because of the aspartate in its chemical composition which is released upon digestion in the stomach.)

So what do the studies show?  One animal study in a prestigious European journal already found “a statistically significant, dose-related increase in lymphomas and leukaemias in females” at about the equivalent level of three diet sodas per day. [1] This study was conducted on 1,800 rats and the control animals had no lymphomas.  In contrast, the animals aspartame had 10 malignant gliomas, 1 medulloblastoma and 1 malignant meningioma.  Yet somehow pro-aspartame proponents argue that this is not statistically significant!

Before I go on, I need to mention that, while I had read some basic information about excitotoxins, the book that really opened my eyes was Russell Blaylock’s The Taste That Kills. I cannot possibly do justice to this book in just one web page, but keep in mind that the author is a neurosurgeon and has packed this book with studes and references.

So why, you might ask, would the FDA allow these excitotoxins into our food supply?  Well, here is the FDA’s (extremely weak) argument:  the brain is protected by the blood-brain barrier which does not allow the passage of either glutamate or aspartate into your precious grey matter.  This is deadly and foolish thinking, because there are parts of your brain completely unprotected by the blood-brain barrier. Secondly, the blood brain barrier is not perfect and will under certain circumstances allow passage of glutamate and aspartate sized molecules directly into the brain.

But let’s focus on the problem that is going to be an issue for almost everyone.  There is a very key region of the brain where MSG and aspartate can march in and rape and pillage during their stay: the hypothalamus. This region of the brain essentially couples the nervous system and the endocrine system together. The hypothalamus pumps many key “factors” into the pituitary and the pituitary in turn controls your many of the hormones that you hold most dear as a male, including leutinizing hormone, i.e. LH, follicle-stimulating hormone, i.e. FSH, and growth hormone, i.e. GH.  And I should mention that testosterone is strongly effected by leutinizing hormone and, to a lesser extent, growth hormone.

Thus, it would stand to reason that damage to the hypothalamus from glutamate (and aspartate) could negatively effect all these key hormones effecting masculinity and fertility.  And that is exactly what the animal studies have found.  Growth hormone, leutinizing hormone, prolactin and several other hormones are all hit by the ravages of glutamate [2] resulting in animals that are so damaged that they obese with decreased fertility and often shrunken testes and pituitaries.

Do you know the foods and drinks that boost Nitric Oxide and repair the veins and artieries to your penis?  Then check out the Peak Erectile Strength Diet Program where I show you how to dramatically improve your erectile strength.

By the way, I should mention that these changes do not necessarily show up right away.  They often show up only when the animal goes through puberty.  In other words, the excitotoxin damage can sit their dormant for years, relatively unnoticed, yet hitting your body years later like a freight train.  How many middle aged guys out there have wondered why their testosterone has vaporized in middle age seemingly inexplicably due to the ravages of MSG ingestion during their formative years?  We will never know the answer to that question and, more importantly, nor should we have had to.

NOTE:  Do you feel like crap and don’t know why?  You may have Excitotoxin Syndrome.  If so, please read about it here.

Regardless, the damage to us middle aged and beyond guys from glutamate and aspartate is probably rather extensive.  Throughout the 60’s, many manufacturers laced baby food with glutamate! (And you older guys wonder why you’ve been having problems, eh?) In addition, many women probably at more glutamate at meals during the very vulnerable first trimester when our entire brain is much more exposed to all that our moms ate and drank.  Again, animal studies show horrific brain damage from just these situations.

Okay, you can’t the past – we all know that.  But how do you protect yourself from excitotoxins from this point forward?  First of all, do NOT ever consume any of the items on the list at the top of this link.  That’s a no-brainer – no pun intended.  In fact, I strongly recommend that you do not consume these even in minute amounts.

You also must be extremely careful when it comes to packaged foods (and eating out).  Somehow the food manufacturers got the FDA to not only allow MSG but to allow it in many foods without being labeled.  Monosodium glutamate can be added to your food under labels like “spices”, “natural flavorings” and so on in many cases without actually labelling it glutamate or anything similar. You also get substantail amounts of MSG generally in “sodium casseinate”, “autolyzed yeast extract” and “maltodextrin”. So beware! The only way to really protect yourself is to buy foods packaged without absolutely no ambiguous or vague entries whatsoever.

NOTE:  I have documented some of the Fast Food Chains and Restaurants that Pack their Foods with MSG.

Remember that you probably have considerable damage to your hypothalamus and possibly other regions of your brain from the past decades of your life.  Many neurological diseases are based on a critical threshold being passed.  For example, in the case of Parkinson’s, one can have 50, 60 or even 70% of the cells in a certain area of the brain destroyed without any symptoms showing up.  But once we you pass the 80% threshold, that is when the devastating symptoms of Parkinson’s manifest themselves.

There are probably many areas of your brain where you probably at the 50% point.  The last think you want to do is anything that may take you down the home stretch to neurological disease and possibly dementia.  Remember:  your brain and your hypothalamus in particular sit vulnerable and exposed like a little child.  You are the only one that can protect them.  I highly recommend that you read my link on the Brain as well for other critical ways to protect yourself.

NEWS FLASH: Researchers have just linked kidney decline to diet drink consumption. [3] Aspartame, the artificial sweetener in most diet drinks such as Diet Coke and Diet Pepsi, breaks down into formaldehyde. Formaldehyde can accumulate in the kidneys and other organs and cause damage. This can potentially have far-reaching consequences as kidney decline has been linked with cognitive decline and loss of memory in seniors. [4]  Kidney decline has also been linked to an increase in phosphorous [5] and ensuing heart disease. [6]

The bottom line:  preserve what you got!  “Your grey matter is all that matters”.

Orgasmic Dysfunction: How to Improve It - Peak Testosterone

What’s the best natural high in life?  I think almost every guy would answer an orgasm.  Well, not every guy:  it turns out that lot of men have found that an orgasm isn’t always an orgasm.  Men think of poor orgasms as a woman’s issue, but trust me – it is quite common among us males as well. In fact, a fairly high percentage of men actually dread the Big O believe it or not, because it leads to embarrassment or even debilitation.  Researchers have even developed a term for this:  “orgasmic dysfunction.” And so this isn’t a page on how to improve your orgasm if you are young and healthy, but rather how to improve it if something has gone wrong along the way.

have already covered Anorgasmia in Men.  However, there are a host of related problems that I want to cover on this page instead, many of which I have seen on the The Peak Testosterone Forum.  Below are Five Common Orgasmic Dysfunction Conditions:

1. Weak Orgasms.   One reader wrote in with the following description:

“still having mild libido (compared to before), erections in bed with gf are there but sometimes I lose them and not so strong, mild orgasms, but I still can orgasm no problem and I have a morning erection once every week or so, but it fades by the time I stand up, before they would last minutes. but I noticed when I wake up in the later hours of the night I have a full erection” [1]

Men in this category often describe orgasms as almost boring believe it or not.

SOLUTION (FOR SOME MEN):  I have found that low testosterone men often regain powerful orgasms once they go on a well-managed HRT (testosterone therapy) program.  High and low estradiol can also make for weak orgasms, so a good protocol run by knowledgeable physician is critical. [7]

2. Debilitating Orgasms. This is a strange one, but a few of our posters have found orgasms almost incapacitating.  For example, look at this description from one of senior members (with long term low testosterone):

“Ok guys a bit of a weird topic here and not something I would normally discuss, but fairly profound for me so I though I would share to see if anyone else has experienced something similar. Most of my adult life I have avoided masturbation because afterwards I would get extremely tired and God forbid I did it twice I would be basically catatonic. I probably started to experience this in my early thirties the most and in business I had to make sure I didn’t masturbate the day before meetings or I always felt off.” [4]

I am not sure exactly what causes this but assume it is some sort of neurotransmitter depletion in the brain, especially in a low testosterone environment.

SOLUTION (AT LEAST FOR THIS SPECIFIC POSTER): I can tell you that this specific individaul was greatly improved through HRT (testosterone therapy.  Of course, HRT does not always work this smoothly for a hypogonadal man, but it is important to point out just what a pivotal role a man’s T plays in an orgasm.

3. Delayed Orgasms. One man with Hashimoto’s (autoimmune hypothyroidism) and low testosterone said he “always had problems achieving orgasm.” [2] Of course, this is similar to anorgasmia, where a man cannot achieve an orgasm at all.  It can be due to many factors, but low testosterone, high estradiol and elevated prolactin are common culprits.

1) https://peaktestosterone.com/forum/index.php?topic=2239.msg20782#msg20782

2) https://peaktestosterone.com/forum/index.php?topic=3342.msg28798#msg28798

3) https://peaktestosterone.com/forum/index.php?topic=1207.msg14082#msg14082

4) https://peaktestosterone.com/forum/index.php?topic=1763.0

5) https://www.harvardprostateknowledge.org/a -harvard-expert-shares-his-thoughts-on-testosterone-replacement-therapy

6) https://peaktestosterone.com/forum/index.php?topic=1243.msg14839#msg14839

7) https://peaktestosterone.com/forum/index.php?topic=1697.msg16341#msg16341

8) https://peaktestosterone.com/forum/index.php?topic=1461.msg13926#msg13926

9) https://peaktestosterone.com/forum/index.php?topic=1601.msg15419#msg15419

10) https://peaktestosterone.com/forum/index.php?topic=4043.msg33646#msg33646

11) Asian Journal of Andrology, May 2007, 9(3):403 407, “Yohimbine in the treatment of orgasmic dysfunction”

12) The American Journal of Psychiatry, November 01, 2001, 158(11), “Efficacy of Sildenafil Citrate for the Treatment of Erectile Dysfunction in Men Taking Serotonin Reuptake Inhibitors”

13) https://peaktestosterone.com/forum/index.php?topic=3838.msg32072#msg32072

14) https://peaktestosterone.com/forum/index.php?topic=2893.msg25633#msg25633

15) https://peaktestosterone.com/forum/index.php?topic=2613.msg24596#msg24596

4. Unpleasurable Orgasm. “First I started to notice that my penis became numb according to Morgentaler, one of the low T symptoms. Then GRADUALLY I lost libido, and also gradually I lost orgasmic sensation. I could maintain erection, have sex, but ejaculation did not result in orgasm. Plus on the top of that I started to experience premature ejaculation. The intercourse was under 1 minute and this is it. I had no control over it.” [3]  T of 325 [4]

5. “Dead D ck“. The reader in #4 referred to Dr. Morgentaler, who is probably my favorite urologist on planet earth:  all us guys on HRT owe him a big debt.  He stated that in a state of low testosterone “men may experience other symptoms, such as more difficulty achieving an orgasm, less-intense orgasms, a smaller amount of fluid from ejaculation, and a feeling of numbness in the penis when they see or experience something that would normally be arousing.”  [5] High and low estradiol can also take the wind out of one’s sails.

NOTE:  You may also want to check out my related pages on the Male Refractory Period and How to Lower Your Prolactin Levels.

“Not quite like being a kid, but WOW. I haven’t felt this good in YEARS. My sleeping is all screwed up from the Australia trip, but with only three hours sleep yesterday I got up before 6am and did my full work out, and THEN after work I dug out a huge garden bed all by myself. Finished the night with sex that ABSOLUTELY felt more like it did when I was younger. My whole body was alive, and the orgasm was incredibly strong. It just usually doesn’t work that way anymore. I’m a T believer!” [6]

Of course, not everyone experiences this dramatic of a turn around with HRT.  Some guys write in after three months asking when they will feel anything at all!  Furthermore, I remember one man wrote in and said that he was able to achieve an erection and orgasm with testosterone levels at 158!  So there are many exceptions to the rule.  One of the reasons is that estradiol and prolactin also often play a major role.

But what if all of these hormones are respectable and yet you still are having orgasmic dysfunction?  Below I list some other Possible Culprits for Lousy O’s.  And remember:  one of my prime directives on this site is to make you a certified Orgasmatarian. What is an Orgasmatarian? Simply someone who is healthy enough to achieve an orgasm and erection, because these are such key indicators of general health in us males.

Here are some solutions that have worked either on the forum or in the research and, yes, all of them should be cleared by your doctor first!

1. Medications and Recreational Drugs. Prescriptions drugs are notorious for causing orgasm issues.  For example, one man wrote in and said that “Paxil has been wonderful except that I can’t orgasm with it. If I only take half a pill, I can, but then my anxiety starts to creep up.” [8] We have had the same commentary for Propecia and Epistane. Of course, virtually any recreational or prescription narcotic or painkiller can make it to where a man cannot orgasm.  Alcohol in excess can do the same as well.  (Moderate drinking can be a vasodilator and help actually.)  So one of the first places to check is with your doc and your pharmacist.

NOTE: Do your research, but, if you have orgasmic dysfunction from Propecia, reportedly men have often been helped with progresterone.  [13]

2. Yohimbine. This extract did very well in a study on men with orgasmic dysfunction (20 mg per day). [11] Researchers noted that “of the 29 patients who completed the treatment, 16 managed to reach orgasm and were able to ejaculate either during masturbation or sexual intercourse.”  Curing over half of the patients with one supplement is pretty impressive considering the gravity of their issue.  On the forum, Yohimbine HCL has the reputation for being more safe than yohimbe itself and with less of the common side effects such as light headedness, palpitations, elevations in blood pressure etc.

CAUTION:  Always check with your doctor first, especially if you are on any medications:  yohimbine is an alpha blocker and thus can lower blood pressure and increase blood flow.  This sounds good, but it can also lead to priapism and potentially dangerously low blood pressure, etc.  Any erection over a couple of hours should be treated in the E.R. immediately.

3. Clomid. Many men boost their testosterone nicely using Clomid in order to preserve fertility.  However, they don’t realize how powerful the estrogenic effects of Clomid are and how they can mute or dampen one’s O’s.

4. Optimize Your Nerve Function.  Obviously sensitivity can play a role and a little neuropathy is not going to help things.  See my pages on Neuropathy and Erectile Dysfunction for more information. (A related disorder can be Retrograde Ejaculation and Low Semen Volume.)

5.  Boosting Nitric Oxide. There is definitely an NO component often in orgasmic issues and men with orgasmic and erectile dysfunction issues from antidepressants can get a lot of help from Viagra for example. [12] Of course, I emphasize Natural Ways to Boost Your Nitric Oxide instead.  Prelox, an herbal No booster, helped one of our posters, who stated that “after a few weeks I notice benefits, particularly in pleasure of orgasm. (The manufacturers claim the two ingredients work synergistically.)” [15]

6. Dopamine. Strategies that boost dopamine will likely help with orgasmic dysfunction as well.  We had one poster take a dopamine-boosting drug (used for erectile dysfunction by some) with some success. [14] He discontinued because of side effects from this drug (Zyprima), but it just goes to show the power of dopamine:  For a more holistic approach, you may want to look at my links Natural Dopamine Increasers and Sleep and Dopamine for some starter information.

Binge Drinking and Testosterone-High prolactin lead to lowered dopamine,

We had an 18-year-old man on our Peak Testosterone Forum who reported huge swings in prolactin:

“Prolactin was: 6.5 ng/ml, 33ng/ml, 16ng/ml, 7ng/ml, 7.1 ng/ml (2-17ng/ml).” [1]

The top of the normal range for prolactin is usually around 15, and so these are clearly big swings.  This isn’t the first time that we’ve seen that on the forum. What would cause these kind of wild swings in prolactin?  I believe that the root issue may be fluctuations in thyroid hormone output, and below I cite some evidence that this may be the case. In fact, this man had had four TSH reads, and three of them were over the new hypothyroidism threshold of 3.0 mUI/l.  He did have a read of 2.2, but many alternative practitioners consider 2.0 to be the true cutoff for hypothyroidism.  The bottom line is that much of his history indicates low thyroid function.

NOTE:  High prolactin can lead to lowered dopamine, lowered libido, occasional gynecomastia and lowered testosterone levels.  See my page on Testosterone, Prolactin and Prolactinomas for some information. And keep in mind that elevated prolactin should always be discussed with a doctor as some tumors (prolactinomas) secrete prolactin.

“The serum prolactin level was found to be elevated (>14.0 ng/ml) in 39 per cent of patients with untreated primary hypothyroidism, none of whom were receiving drugs known to affect serum prolactin levels.” [2]

Clearly, that seem just a bit beyond coincidental, eh?  (However, this study did not find nearly as significant of a link with male patients.  As I’ll show below, this is likely still significant for many men.)  It would take years before resarchers discovered the mechanism underlying this correlation.  Did hypothyroidism cause elevated prolactin or the other way around?

3.  2011 Study on Subclinical Hypothyroid Patients. Probably the most important population one could examine are those with subclinical hypothyrodism, defined as men and women with TSH < 10.0 mui/l,, since we get very few men on the Peak Testosterone Forum who have a TSH over 10.  On the hand, low grade hypothyrodism, treated and untreated, is very common.  This is the conidition that one 2011 study looked at and found:

“Sixty-two (13%) patients were males and 419 (87%) were females. The mean age of the patients was 32.53 10.13 years. Ninty-eight patients (91 females 7 males) had high prolactin. Prevalence of hyperprolactinemia in subclinical hypothyroidism was 20.4%. (11% in men and 22% in women).” [4]

MECHANISM OF ACTION:  So which is the chicken and which is the egg?  It turns out that TRH stimulates both TSH and prolactin. TRH is the upstream hormone secreted by the hypothalamus that in turn triggers the pituitary to secrete TSH which in turn tells the thyroid to produce T3 and T4.  So clearly any type of hypothyroidism that would lead to elevated TRH levels would likely cause increased prolactin.  And this is indeed the case generally with primary hypothyroidism for example.

Finally, let’s look at the original case mentioned above where the man had wild swings in prolactin on the Peak Testosterone Forum. Could this man be experiencing some kind of primary hypothyroidism?  His antibody counts were negative, so it would not appear to be Hashimoto’s.  There is one other fairly common cause of prmary hypothyroidism in men:  an iodine deficiency.  This actually does occur suprisingly often according to several studies.  One study on school girls in the U.K. found that “urinary iodine measurements indicative of mild iodine deficiency were present in 51%  of participants, moderate deficiency in 16%, and severe deficiency in 1%.” [5] (Children are usually studied, because an iodine deficiency lowers IQ.)

Therefore, if you are seeing big changes in prolactin, it may be prudent to talk to a (knowledgeable) practitioner in thyroid hormones and an endocrinologist (in case of a tumor) as well.  (CAUTION: Be very careful with supplementing iodine:  it can lead to improved symptoms for a few months and then a severe crash of your thyroid hormones.  Dosage is important and co-supplementing with selenium as well.)

NOTE:  You may also be interested in my page on How to Lower Prolactin Levels as well.

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=8871.15

2) Amer J of Medicine, May 1978, 64(5):782 787, “Serum prolactin levels in untreated primary hypothyroldism”

3) Prolactin: Physiology and Clinical Significance, 1973, D.F. Horrobin, p. 133.

4) Caspian J Intern Med. 2011 Spring; 2(2): 229 233, “Hyperprolactinemia in association with subclinical hypothyroidism”

5) Lancet, 2011 Jun 11, 377(9782):2007-12, “Iodine status of UK schoolgirls: a cross-sectional survey”

So let’s look at the research evidence for the same thing – that hypothyroidism can cause elevated prolactin and just why this occurs.  Here are a few studies that show just this:

1. Several Hypothyroid Disorders Linked Very Early to High Prolactin. Patients and physicians were reporting that often low thyroid function was linked to hyperprolactinemia (high prolactin).  Furthremore, physicians had noted that this occurred frequently with several medical conditions:

“Two clinical syndromes have now been clearly shown to relate primary hypothyroidism (and therefore probably TRH hypersecretion) with excess prolactin secretion. These are the association of galactorrhea, amenorrhea, and primary hypothyroidism in post-pubertal individuals and of precocious puberty, glactorrhea and primary hypothyridism in children.” [3]

2. 1978 Study on Men and Women with Primary Hypothyroidism.  Notice this statement in one study from the same time period:

Creatine: How It Can Help for the Plant-Based and Vegetarians.

REFERENCES:

1)   The Journal of Physiology, Jun 2006, 573(2):525-534, “Creatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength training”

2) EBS Lett, 2004 Jan 16, 557(1-3):243-7, “Creatine increases IGF-I and myogenic regulatory factor mRNA in C(2)C(12) cells”

3) Med Sci Sports Exerc. 2005 May, 37(5):731-6, “Increased IGF mRNA in human skeletal muscle after creatine supplementation”

4) Mol Nutr Food Res, 2009 Sep, 53(9):1187-204, “Creatine supplementation prevents the inhibition of myogenic differentiation in oxidatively injured C2C12 murine myoblasts”

5) https://www.brjb.com.br/files/brjb_128_4201012_id2.pdf, “Benefits of creatine supplementation in older adults”

6) Amino Acids, 2011 May, 40(5):1349-62, “Use of creatine in the elderly and evidence for effects on cognitive function in young and old”

7) Clinical Chemistry, 1989, 35(8), p.1802

8) Kidney International, 2003, 64:1331 1337; “Creatine supplementation decreases homocysteine in an animal model of uremia”

10) Behaviour, Appetite and Obesity, Received February 03 2010, “The influence of creatine supplementation on the cognitive functioning of vegetarians and omnivores”

11) Nutrition, 2004 Jul-Aug, 20(7-8):696-703, “Nutritional considerations for vegetarian athletes”

12) Int J Sport Nutr Exerc Metab, 2002 Sep, 12(3):336-48, “Effect of creatine supplementation and a lacto-ovo-vegetarian diet on muscle creatine concentration”

The advantages of plant-based eating are many and include everything from improved mortality rates to potentially short term and long term testosterone. (See my link on Plant-Based Nutrition and Vegetarians and Testosterone for some basic information.) I also eat a plant-based diet, because it the foundation of what I call Orgasmatarianism, eating to maximize nitric oxide and erectile strength and minimizing the chance for future erectile dysfunction.

NOTE: I actually do eat a little meat, which is why I actually prefer the label plant-based.  My own dietary regimen includes the consumption of abundant egg whites along with some undenatured whey – what I call the Whey of Life – and nonfat milk.

Eating plant-based has really helped me and I would never go back, but I do have to admit something:  there are some nutrients that are predominantly in meats and animal products that have incredible advantages.  Examples of this are Vitamin B12, Choline and the subject of this page:  creatine.

Many men, especially those involved in sports or bodybuilding, have heard of some of the common advantages of creatine.  I would like to quickly cover some of these that, although well-covered in the popular health press, many men may not have heard of them:

CAUTION: Creatine has a lot of nice properties, but may put some men at risk. For example, did you know that one study says creatine raises DHT levels and may put some men at risk who have kidney issues? For more information, see my link on Potential Creatine Dangers.

1. Satellite Cells. One of the most important things you can do for your long term health is maintain your muscle mass over the decades. And, actually, most men will slowly lose muscle mass over the years from poor diet, loss of testosterone and a sedentary lifestyle. To build (and repair) muscle, you need a certain kind of specialized cell called “satellite cells”.  Testosterone, the amino acid leucine – present in Branched Chain Amino Acids and whey – and IGF-1 are all well-known to the bodybuilding and athletic communities.  And all three of these have part of their reputation based on the fact that they increase muscle satellite cell counts.

However, it’s not just these big boys that will increase satellite cells:  creatine has been shown in a few animal and human studies to do the same thing. [1]  Again, this is absolutely critical for “hypertrophy” or “muscle-building.”

2.  IGF-1.  Everyone has heard of testosterone, but IGF-1 is another hormone absolutely critical for muscle growth and development.  IGF-1 and Growth Hormone often go hand-in-hand and have many important properties for maintaining a youthful physique. This is where creatine comes in again:  it increases the activity of muscle IGF-1 according to both in vitro and in vivo studies. [2][3]

3.  Muscle Oxidation. Weight lifting and strength training can put a significant oxidative (free radical) load on the body.  And is it any wonder consider that cells are damaged and must be rebuilt?  It turns out that creatine actually is highly protective of muscle tissue by increasing oxidative protection. Researchers have discovered that it does this not only by acting as an antioxidant but by stimulating other metabolic antioxidant activities. [4]

Furthermore, the benefits of creatine supplementation probably increase as you age.  The reason is probably most that muscle mass is so cardioprotective as the years go by.  As mentioned, most men (and women) slowly lose muscle – about 10 pounds per decade! – and replace it with fat.  Let’s say that you are one of the few that still weight the same as you do in college.  You may be feeling good about yourself not realizing that you have probably lost at least 10 pounds of muscle and replaced it with 10 pounds of fat (unless you are a pretty avid exerciser).

Studies on seniors and the elderly have found one benefit after another from creatine supplementation:  muscle building, increased strength, increased fat free mass and so on. [5] However, one very interesting benefit is improved cognition. One study on seniors found this from dosages of “about 20 g/day for 5 days or about 2 g/day for 30 days.” [6]

These benefits to both young and old are actually remarkable when you consider that there is considerable creatine in meat and most people in modern societies eat a lot of meat. However, to even get a 5 gram dose of creatine would require one to eat 2.5 pounds of raw beef as cooking the beef removes most of the creatine. Fish has more creatine per unit weight, but, again, cooking removes most of it.

Regardless, carnivores have higher muscle creatine levels on average than vegetarians, because, even after cooking, their dietary consumption of creatine is much higher.  For this reason, one study that compared vegetarians to carnivores found on average that meat-eaters had about 60% higher plasma creatine levels for example. [7]

NOTE:  One nice benefit of creatine supplement is that it likely lowers homocysteine levels in some populations, at least according to some animal studies. [8]

And this leads to an important question that researchers decided to study:  would vegetarians actually get the most benefit from creatine supplementation, since they tend to get the least amount in their diet? The studies have been somewhat limited, but, so far, the results seem to show that vegetarians would definitely benefit in certain key areas from additional supplemental creatine.  Here are a few examples from the research:

1. Cognition.  Two studies now have shown that creatine supplementation significantly helps the brain. It all started with a study of male and female vegetarians that showed improvements in both working memory and intelligence from creatine supplementation. [9] A follow-up study on female vegetarians found that they signficantly improved memory (and choice reaction time in certain ways). [9] Again, most men think of creatine as helping muscles only, but it profoundly improves mitochodrial function and that, in turn, help the brain and all its heavy processing activities.

2.  Exercise Performance. There is evidence that lower creatine levels affect max level exercise performance and that vegetarians would benefit from supplementation. [11]

3.  Muscle Benefits.  Vegetarians should get all the muscle benefits of omnivores, because with creatine supplementation, their muscle creatine levels quickly equal that of meat-eaters.  This is because muscle can only store so much creatine anyway, so supplementation quickly “levels the playing field”.  So, if you’re plant-based or vegetarian, get ready to “rock” with creatine.

4.  Lowering Post-Exercise Inflammation. Creatine does a nice job of lowering both TNF alpha and CRP (C-Reactive Protein) according to one recent study. See #21 on my page on How to Lower Inflammation for more details.

CAUTION: Creatine was fairly recently studied by Brazilian scientists, who monitored kidney function in young men who consumed higher dosages (10 grams/day) of creatine for about 90 days.  Their conclusion?  Creatine caused absolutely no issues in kideny function.  However, a little more caution is definitely in order, perhaps, for middle-aged and beyond men with kidney issues.  It is probably wise to drink some extra water when consuming creatine and, of course, talk to your doctor as there have been reports of men with kidney issues having trouble with creatine.

9) Proc. R. Soc. Lond. B, Oct 2003, 270(1529):2147-2150, “Oral creatine monohydrate supplementation improves brain performance: a double blind, placebo controlled, cross over trial”

Zinc and Testosterone - Peak Testosterone

Scientists have for decades known that a zinc deficiency is associated with decreased testosterone production and other medical conditions.  However, lately zinc has been considered a big disappointment by researchers.  Studies have shown, for example, that it does not generally increase testosterone significantly or protect from colds as originally thought.

But does that mean you should give up on this mineral altogether?  No way!  Some guys, like Casanova, have reported near miraculous powers from supplemental zinc. Could there by something to it?  Below are five reasons that zinc may in some cases dramatically boost testosterone and substantially improve your sex life:

NOTE:  ZMA is a special formulation of zinc and magnesium.  The Magnesium is a nice side benefit of ZMA and will likely help you sleep better and avoid Metabolic Syndrome and heart disease. An alternative way of getting your zinc is through oysters, although I certainly wouldn’t recommend doing that every day.  But we had one poster write in the following:

“On the subject of shellfish, here’s another anomaly: one night recently I ate a large plate of raw oysters for dinner, and later experienced very firm nocturnal erections and very sexual dreams (practically to the point of nocturnal emission). This, when it’s very rare for me to have a nocturnal erection at all, and never a firm one. I never put much stock in oysters’ reputation as an aphrodisiac, but I am now convinced there is something to it.” [13] Casanova himself ate several dozen oysters every day for its supposed aphrodisiacal super powers and oysters do have a lot of zinc.

1.  Testosterone.  Some research has shown that zinc can increase testosterone.  It all started when an absorbable form of Zinc called ZMA (which also contains Magnesium), was created by Victor Conte of Barry Bonds fame.  Mr. Conte backed a study that shows a nice increase (34%) in testotserone in young athletes taking ZMA. [1]

1) Med and Sci in Sports & Exerc,1999, 31:483

2) European J of Clin Nutr, 2009, 63:65-70

3) Intl J Sports Med,2001,22(7)537-543

4) Am J Med Sci, 1993 Apr, 305(4):199-202, “Treatment of Wilson’s disease with zinc XII: dose regimen requirements”

5) J Nutr, 1996 Apr, 126(4):842-8, “Dietary zinc deficiency alters 5 alpha-reduction and aromatization of testosterone and androgen and estrogen receptors in rat liver”

6) Neuropharmacology, 2009, 56:531 540, “Zinc regulates the dopamine transporter in a membrane potential and chloride dependent manner”

7) Pol J Pharmacol, 2003, 55:1143 1147, “EFFECT OF ZINC SUPPLEMENTATION ON ANTIDEPRESSANT THERAPY IN UNIPOLAR DEPRESSION: A PRELIMINARY PLACEBO-CONTROLLED STUDY”

8) Journal of Neuroscience Research, 1 April 2005, 80(1):145-149, “Zinc modulation of serotonin uptake in the adult rat corpus callosum”

9) Physiol Behav, 2008 Oct 20, 95(3):365-9, “Zinc deficiency induces depression-like symptoms in adult rats”

10) Am J Clin Nutr July, 1975, 28(7):764-774, “Coronary heart disease: the zinc/copper hypothesis”

11) Biol Psychiatry. 1982 Apr;17(4):513-32, “Zinc, the brain and behavior”

12) Am J Clin Nutr July 1992 vol. 56 no. 1 148-157, “Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men”

13) https://peaktestosterone.com/forum/index.php?topic=628.msg5816#msg5816

14) https://peaktestosterone.com/forum/index.php?topic=758.msg7141#msg7141

15) 1) Systems Biology in Reproductive Medicine, 1981, 7(1):69-73, “Effect of Zinc Administration on Plasma Testosterone, Dihydrotestosterone, and Sperm Count”

16) J Hum Reprod Sci. 2010 Sep-Dec; 3(3): 124 128, “Relationship between seminal plasma zinc and semen quality in a subfertile population”

Sounds good, eh? Unfortunately, subsequent research has cast doubt on Mr. Conte’s work and showed no testosterone increase with ZMA. [2]  One theory is that supplemention does not boost testosterone except perhaps in individuals who are zinc-depleted.  Furthermore, it is tough to determine who is really depleted in zinc and who is not.  Some experts recommed, for example, the zinc taste test to determine this.  Regardless, it seems that normal, healthy individuals receive little to no benefit as far as testosterone.

However, there is also another interesting explanation.  One study on infertile men showed that zinc increased testosterone only in men who were lower in testosterone (less than 480 ng/dl). [15] Therefore, if you have low testosterone, it may be worth it to try some zinc and see if you can get a little boost. To test your DHT, check out these links:  Reasonable Testosterone Labs and The Cheapest Lab Tests for men for some ideas. I have not used most of the labs, so do your own due diligence and am just passing along information that I have picked up on the Peak Testosteorne Forum.

NOTE:  Zinc may also boost DHT in some men, which could be good or bad depending on your situation.  See my link on Zinc and DHT for more information.

So who might be zinc depleted?  One misconception is that, if you happen to be having a lot of sex – you lucky dog! – that you may be making yourself zinc depeleted.  However, one study shows that only about 0.3 to 0.45 mg of Zinc, or 2-3% of your body’s RDA, is lost during ejaculation. [16] I also frequently get emails from heavy porn users who have lost their sexual desire and/or erectile strength.  (I am talking about guys clearly addicted and spending hours per day and ejaculating 3+ times in a 24 hour period.)  There are probably a variety of reasons for their sexual dysfunctions, but low grade zinc depletion does not appear to be one of them.  (There is also now evidence that are “numbing” their dopamine receptors as well.)

2.  Brain Activities: Sleep and Learning.  A combination of zinc, magnesium – yes, this is starting to sound a lot like ZMA – and melatonin has been found in one study to be a potent insomnia cure. (See this link on Sleep Aids for more information.) A couple of our posters on The Peak Testosterone Forum have commented how much taking ZMA helps their sleep and, of course, ZMA is one third zinc. This poster recommended taking it about 40 minutes before bed:

“ZMA ..oh yes I like…not only the zinc as Peak mentioned to help keep T at a max (and help with everything in your body!!) but the magnesium is fantastic for helping to induce sleep. I only have one cap a day usually 40 mins before bed and it definitely makes you sleepy. One cap only equates to 10mg of zinc (about 100% RDA) and 150mg of mag which is only 40% RDA.”[14]

So there is evidence that zinc plays a role in sleep quality and/or duration.  Zinc affects the brain in other ways as well.  For example, one study review pointed out the importance of zinc to learning, memory and neuron maintenance / regeneration: “The highest levels of zinc are found in the hippocampus in synaptic vesicles, boutons, and mossy fibers…Zinc plays an important role in axonal and synaptic transmission and is necessary for nucleic acid metabolism and brain tubulin growth and phosphorylation. Lack of zinc has been implicated in impaired DNA, RNA, and protein synthesis during brain development…Furthermore, in children insufficient levels of zinc have been associated with lowered learning ability, apathy, lethargy, and mental retardation.” [11] I’ll just point out that the hippocampus is the center of memory and is involved in some higher order thinking processes as well.

3.  Estrogen.  Zinc actually inhibits the aromatase enzyme, especially in zinc-depleted individuals, and therefore could decrease estrogen. [5]  (It may also inhibit the conversion of testosterone to DHT, which could help your prostate and hair!)  At worst it is another tool in our arsenal to optimize and maintain our estrogen at reasonable levels. And, of course, this may be another reason that zinc is a testosterone booster for some men but not others.

4. Dopamine. Researchers have found that zinc is one of the most important minerals regulating dopamine. [6] It turns out that zinc is present in your neuron’s synapses and plays several major roles in neurotransmission. Zinc is known for “inhibiting the uptake” of dopamine, which means that dopamine stays around in your systems (brain) for a longer period of time. And, yes, more dopamine generally means better sex as I document in my link on Natural Dopamine Increasers . (Dopamine disorders are associated with migraines, Restless Leg Syndrome and other conditions.)

5. Depression. Zinc is a proven depression fighter. Several studies have shown that zinc levels tend to be lower in certain types of patients with depression and, furthermore, supplemental zinc has even been shown to help in treatment (25 mg along with an SSRI). [6] And, recently, researchers created depression (in animals) by inducing a zinc deficiency.

Of course, there is now a strong link established between Depression and Your Sex Life.

BONUS: Zinc can also significantly increase semen volume, something that some men are concernd about.  For other factors, see my link Naturay Ways to Increase Your Semen Volume.

Zinc – Dosage and Dangers

Zinc has some powerful properties that can really help us males. Because of this, it is very easy for to get overly enthusiastic. Zinc is extremely powerful and has a definite clinical range, i.e. you can hurt yourself if you overdo it in the ways listed below.  Again, stick to the 1-2 RDA range for zinc.

CAUTIONS: Copper Deficincy: Some experts caution about taking zinc supplementation, because it can lead to a copper deficiency. Copper is critical for the health of your heart and your collagen among other things. It doesn’t take much zinc to have a negative effect on your copper metabolism, because the two compete in the intestine for absorption. Researchers have found that it is the zinc to copper ratio that is critical and obviously taking zinc supplementation will affect this ratio significantly.

As an example, the RDA of zinc for an adult male is 11 mg and most zinc supplements have 2-3 times that, i.e. 20-35 mg or so. This is troublesome, because there is a disease (Wilson’s Syndrome) where copper accumulates in various tissues. Researchers will actually give supplemental zinc in order to reverse this condition. How much zinc do they give? One study found that only 75 mg daily will quickly start depleting copper. [4] Remember that this 75 mg is intended to yield results in just 10 days.

Now imagine a guy taking 35 mg of zinc for testosterone for months or years. It is certainly possible that he could experience lowered copper levels and this could potentially lead to elevated inflammation and the steadily increasing hypertension associated with copper deficiency. Again, there is no study showing that this is occurring, but it is certainly possilble.

CAUTION: My HRT clinic, in guys whose estradiol is not too high, will use a combination of zinc (15-30 mg) and copper (2-4 mg) per day to pull down E2 (estradiol) levels a little.  Zinc and copper compete and so many experts worry that giving supplemental could lead to copper depletion and inflammation.  However, I have some concerns with this, because copper has been implicated in a number of neurological diseases and excesses are hard on neurons. These same experts believe that we are slowly poisoning ourselves in many cases with copper pipes. You’ll have to do your own research and decide where you stand on the issue.

CAUTION #2: Neuron Damage. Before you go popping zinc like breath mints, keep in mind that some studies indicate that too much zinc is just as hard on your brain and neurons as too little.  Most minerals have a rather tight range and zinc appears to be no exception.

CAUTION #3: Heart Disease. There was a whole theory of heart disease that centered around the correct balance of copper to zinc. [10] Admittedly, this theory is outdated, but we can still learn something from it:  too much zinc can elevate cholesterol levels and possibly contribute to hyperlipidemia. (You do not want too much copper either:  it is very hard on the brain. When it comes to essential minerals, moderation and balance are definite keys.)

OTHER CAUTIONS:   There are other potential risks in taking too much zinc, from neurotoxicity to cancer to metabolic issues and I summarize some of the latest research in my page on The Potential Dangers of Zinc Supplementation.

Testosterone and Painkillers. (Yes, It's Ugly.) - Peak Testosterone

–Over 200 million opiate prescriptions are written every year.  That’s over a billion pills in one year!

–There are at least 2 million people addicted or abusing painkillers each year.

When I talk about painkillers, which include such household names as oxycodone, hydrocodone, codeine, morphine, fentanyl, methadone, Demerol, Dilatid, and Oxycontin, I am referring on this page to the opiates.  These are in the same class of compounds as heroin and cocaine and bind to the same receptor.  The other more “mild” painkillers have their own problems.  NSAIDs are notorious for ripping up the GI tract, and Tylenol lowers glutathione levels, always a bad idea.

Do Painkillers Lower Testosterone?

Many men addicted to painkillers do not realize that many studies now show that these medications will lower testosterone if you use them long enough:  How does this occur?  It induces a sort of partial secondary hypogonadism, i.e. negatively impacts the HP part of the HPT axis by suppressing the hypothalamus’ secretion of gonadotropin-releasing hormone.

1.  A 2016 study showed greatly increased odds of low testosterone for men on painkillers.  The biggest drops in testosterone, 27% and 38%, were seen in senior aged men between the ages of 60 and 70 and 70+, respectively. [3]

2. A 2009 study attempted to deal more with the legitimate use of those using opiod painkillers and noted that the endocrine system should be monitored when these medications have to be used. [4] As you will see below, it would be hard to patch all the holes however.

3. A 2015 study showed the growing prevalence and recognition of this and coined the term OPIAD, “Opiate Induced Androgen Deficiency.”

3.  Another 2009 study noted that painkillers negatively impacted virtually all the major hormones that we men hold dear for sexual and cognitive performance,  body composition and muscle gains:

“Sustained-action opioids used on a daily basis for more than a month have a number of adverse effects on human endocrine function.5-14 For example, opioids decrease levels of the gonadal sex hormones, growth hormone, cortisol, and dehydroepiandrosterone sulfate (DHEAS).6,9 Opioids also blunt the cortisol response to corticotropin.” [5]

NOTE:  I cover other nasty issues in my page on illegal drugs here:  Cocaine, Heroin and Erectile Dysfunction. On there I discuss a study that shows methodone users having testosterone 43% less than controls.

Notice that your hormones start going downhill after just one month. This is how quickly painkillers do their damage on the brain, and their effect is all encompassing.  If you’ve ever been around someone addicted to these medications, you know that they can create aggressiveness, irritability, withdrawal, depression and anxiety, etc.  And it’s no wonder considering that their hormones are all under seige!

What About Pain Associated with TRT (Testosterone Replacement Therapy)?

TRT (testosterone replacement therapy) should be a health-benefitting, bedroom-boosting change for a hypogonadal man.  I know it has been a life-saver for me.  However, occasionally on the Peak Testosterone Forum I will get a complaint that TRT actually causes pain or discomfort.  Below I outline the kinds of pain-related issues that men can run into with exogenous testosterone:

1.  Back and Joint Pain (Part I). This is actually fairly common in men starting on HRT.  And the reason is simple:  men feel better (on well done) testosterone therapy and start working out more often and harder.  It is very easy to overdo it. Libido is up usually and so you want to impress the every female within a five mail radius and so you’re adding a few extra plates on the bar without even thinking about it.

Of course, the solution here is to ramp up your workouts S-L-O-W-L-Y and gradually.  You don’t have to be ready for the Olympics in two weeks, so just scale back a little and enjoy your newfound recovery and recuperative powers.

2.  Back and Joint Pain (Part II). There are can be a potentially more serious problem causing this kind of pain:  low estradiol.  Some men are very sensitive to Arimidex (and other aromatase inhibitors) and find their estradiol levels plummeting after using them.  When estradiol levels fall below about 12 pg/ml, joints can start hurting and aching.  And, unfortunately it usually takes a couple weeks for estradiol levels to climb back up to their steady state, baseline level.  This can even take longer a little longer if a Suicide Inhibitor was used.

3. Testicular Pain. When receiving exogenous testosterone, i.e. standard HRT, the testes actually shut down partially. Basically, the body begins to rely on the new source of testosterone and signals the testes that it can shut down (partially). This “shutting down” can actually cause some men some testicular discomfort. Look at what this poster wrote:

“I am on testosterone, so this does not apply to your situation. But, I had some cramping and electrical jolt feelings down there about 3 weeks after starting cream. My doc at the time said it was because they were stopping production and shutting down. Maybe any change in T production, whether up or down, causes some sensation.” [1]

By the way, this same man got rid of this pain by adding HCG to his regimen.  HCG stimulates the testes, assuming you are not primary hypogonadal, to begin some testosterone production.  For this reason, men on HRT often add HCG to their regimen in order to increase their testicular volume.  Look at what this man wrote about how HCG got rid of his pain:

“They said that part of shutting down/catabolism of the testicles could be intense pain and that HCG would help in this area. They sent me a couple of vials of HCG, I did my research, and gave it a shot for a few weeks. Lo and behold, after my 2nd injection, my pain was down by 50%. By my 3rd shot it was gone altogether.” [2]

However, I should add that HCG itself can sometimes cause some pain due to the testes growth.  Discuss with your doctor of course.

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4.  Nipple Pain. It is possible for a man to start on HRT and experience nipple sensitivity, even pain.  This is quite common with steroid users, who go ultra-high with testosterone.  And it does happen from time to time with men on standard HRT as well.  The solution can usually be solved with Arimidex (anastrazole), which lowers estradiol.  Other AIs or SERMs may be employed, such as letrazole or tamoxifen, although this is uncommon from what I have seen.  Losing weight will likely help and/or zinc.

5. Deliver Method Pain. Many of the “delivery systems” can cause pain in certain cases. For example, it is possible to end up with the following:

a) an abscess or ulcer with injections

b) severe local rash with patches

c)  infections with pellets

Based on what I have seen, a) is very uncommon, b) is quite common and causes almost everyone to quit patches and c) is quite common but many urologists successfully avoid these potential infections by giving antibiotics the day before the procedure.  Again, talk to your doctor about his or her experience with these type of risks.

CAUTION: If you go on Arimidex or another aromatase inhibitor, be sure to monitor your estradiol with the lab’s most sensitive test.  Some men are very sensitive to AI’s and their estradiol levels will go down to the basement.  You need these very accurate tests to properly detect the numbers involved.

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=1705.0

2) https://peaktestosterone.com/forum/index.php?topic=2021.0

3) Pain Medicine, Dec 2015, 16(12):2235 2242, “Effect of Opioids on Testosterone Levels: Cross-Sectional Study using NHANES”

4) Clin J Pain, 2009 Feb, 25(2):170-5, “The impact of opioids on the endocrine system”

5) The Journal of the American Osteopathic Association, Jan 2009, 109:20-25, “Opioid-Induced Endocrinopathy”

6) https://www.sciencedaily.com/releases/2013/06/130617142047.htm

8) NEJM, 1975, 292:882-887, “Function of the Male Sex Organs in Heroin and Methadone Users”

Nitric Oxide and Testosterone - Peak Testosterone

What’s more important, testosterone or nitric oxide? I couldn’t answer that one and I doubt you can either – both of these molecules just impact too many functions and systems to declare a clear victor. What is important to note, though, is the INTERACTION of these two on each other and how they partner to improve men’s health in, literally, a hundred different ways. Both of these have been found by multiple studies to impact endothelial function, i.e. nitric oxide and blood flow, sexual health, brain function, sleep, mood, exercise and athletic performance and so on. Yes, they affect almost everything we hold dear as males.

Let’s start with testosterone and its role in protecting nitric oxide. Having ample testosterone levels is a key, researchers have found, to maintaining arterial health. I cover this in my page on Testosterone and Heart Disease. The quick summary is that testosterone actually optimizes and even boosts nitric oxide levels through action on eNOS, the same enzyme that Viagra works on.  Testosterone also lowers arterial inflammation according to a couple of studies. [8] Its actions are so important to your cardiovascular system that low testosterone levels have been shown to be a significant risk factor for many chronic cardiovascular diseases, a fact I will go into in more detail below. And this is one of the things I found so exasperating when doctors are unwilling to treat low testosterone: they put their male patients at risk for many nasty medical conditions, especially heart disease.

And then let’s examine the most glaring example:  low testosterone tends to accelerate hardening of the arteries and arteriosclerosis.  And these conditions can definitely affect your nitric oxide levels in the medium and long terms.  How?  Simple:  arteries covered with plaque cannot produce sufficient nitric oxide for things like erections and safe blood pressure levels.  Of course, there are other problems with hardening and narrowing of the arteries – like a heart attack or stroke! – but this limiting of nitric oxide output is one of the symptoms that a man will generally first notice.  As many of you know, it first shows up often as erectile dysfunction.  And it is very common in the U.S. for a man in his 40’s or 50’s to begin to experience the beginnings of prehypertension/hypertension as well.

1)  The Journal of Urology, Aug 2000, 164(2):371-375, “TESTOSTERONE SUPPLEMENTATION FOR ERECTILE DYSFUNCTION: RESULTS OF A META-ANALYSIS”

2) The Journal of Neuroscience, 15 Jan 1997, 17(2):774-785, “Pontine Nitric Oxide Modulates Acetylcholine Release, Rapid Eye Movement Sleep Generation, and Respiratory Rate”

3) AJP – Regu Physiol, Jan 1, 1994, 266(1):R151-R157, “Inhibition of nitric oxide synthesis suppresses sleep in rabbits”

4) Brain Research, Jan 1999, 816(1):209 219, “Endogenous nitric oxide in the rat pons promotes sleep”

5) Sleep Medicine Reviews, Apr 2005, 9(2):101 113, “Nitric Oxide and sleep”

6) BJU International, Dec 2005, 96(9):1323 1332, “An open-label, multicentre, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in men na ve to phosphodiesterase 5 inhibitor therapy”

7) Neuroscience, Jan 1998, 83(3):867 875, “Nitric oxide synthase-containing neurons in the human hypothalamus: reduced number of immunoreactive cells in the paraventricular nucleus of depressive patients and schizophrenics”

8) Mol. Hum. Reprod, 2010, 16(10):761-769, “Endothelial regulation of eNOS, PAI-1 and t-PA by testosterone and dihydrotestosterone in vitro and in vivo”

All of this explains why so often on The Peak Testosterone Forum, I see men with BOTH testosterone and nitric oxide related issues.  They likely tend to snowball downward together.  And I believe this is shown in the studies, where a significant percentage of men given HRT (testosterone therapy) are not cured of their erectile dysfunction, a subject that I cover in my link on Viagra Failure.

Likewise, HRT often fails to cure erectile dysfunction on its own.  One meta-analysis, where researchers aggregate or pool studies together, showed that about 57% of patients with erectile dysfunction responded to testosterone therapy. [1] Of course, that implies that in about 43% of patients, HRT did not really help. NOTE: My guess is that there would probably have a higher response rate if it was properly managed, i.e. testosterone levels were raised significantly and estradiol levels were managed as well.

So testosterone, in particular low testosterone, can affect nitric oxide.  What about the other way around?  Well, let’s look at what I call The Three Main Natural Engines of Testosterone Production. In all three cases, I will show that low nitric oxide levels can negatively impact every one of them:

2.  Sexual Intercourse.  Of course, sexual intercourse and nitric oxide go hand in hand and Viagra proved that forever by putting million of men “back in the game”.  Viagra works, of course, by slowing the breakdown of endothelial nitric oxide, allowing levels to build up more quickly.  One study found that both Viagra and Cialis increased the frequency of sexual intercourse in men by a little over 40%. [6] One study of Cialis usage showed that it did, indeed, give a modest increase in testosterone and a nice boost to the T/E2 ratio.  See my link on The Testosterone-to-Estradiol Ratio for more information.

3.  Mood and Attitude. I document many cases where the mind and Testosterone are very related.  Competition and victory can very substantially raise testosterone.  Depression can lower it  Once again, this ties in with the fact that low nitric oxide levels can definitely affect mood.  In its extreme form, it has been implicated as being a factor at times in clinical depression and schizophrenia. [7] For more information, see my links on Testosterone and the Mind and Testosterone and Depression for more information.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

So, although I do not have a study to prove it, it is very likely that low nitric oxide can lower testosterone and low testosterone can lower nitric oxide levels over time.  Clearly this could create a viscous circle and is part of the explanation as to how men living a Western lifestyle spiral downard in health terms so rapidly after about the age of 40 or 45.

The good news?  There is hope if you’re willing to go natural, because there are natural ways to actually reverse, or at least significantly partially reverse these simultaneous decreases in nitric oxide and testosterone.  Here are some examples:

1.  Testosterone. There are literally dozens of ways to naturally reverse some of the smaller losses in testosterone through lifestyle changes and I have outlined these in my link on How to Increase Your Testosterone Naturally. Now by far the biggest of these is weight loss. Men who lose massive amounts of weight can in some cases literally more than double their testosterone levels. Some men, though, simply cannot increase the testosterone enough through lifestyle changes alone and will have to consider HRT (Hormone Replacement Therapy).   However, in my opinion if this is well-managed and well-monitored and the patient is brought to normal levels of testosterone, then this can still be considered a natural solution. The reason is that one is simply replacing testosterone that is missing from normal aging or from damage.

2.  Nitric Oxide. Again, there are dozens of ways to boost your nitric oxide.  One is through consumption of high nitrate foods, something I discuss in My Review of Beet the Odds . (This methodology is ultracritical for you 40+ men.) Still another is through following the principles of my book, The Peak Erectile Strength Diet , which is all about foods that will increase nitric oxide and blood flow.  If you go through the links listed here in my Improving Your Erectile Strength section, you will come across many other strategies as well.

I should also add that you can heal you arteries by actually reversing some of that arterial plaque.  I cover this in my link on How to Clear Your Arteries.

The important thing is that if you raise testosterone, you will also likely raise nitric oxide levels.  And, if you raise nitric oxide, you will be improving sleep, the frequency of sexual intercourse and mood, all of which will very likely boost testosterone.  Yes, you should be able to not only halt the decline, but actually turn back the clock significantly.

REFERENCES:

Niacin: Potential Dangers - Peak Testosterone

1.  Megadosing. In order a major change in lipids, which is niacin’s mainstay, high dosages have to be taken.  Patients typically take at least 1,000 mg per day and that is about 1,600% of the daily RDA!

2.  Severe Flushing. One the guys on our site had a “bad trip” on niacin.  Taking the high dosages above will almost always cause severe flushing.  Check out this man’s description:

“Something weird happened today as well. I am taking niacing for the last 3 weeks. It was a slow release niacin, and if I take it with meal – no effect. If it is on empty stomach, I feel skin tingling, and hands show red rash. It is itchy sometimes, but goes away after 30-60 minutes. This effect is well know with niacin. Today I took a different brand, 500 mg, NON-slow release, in the morning, on empty stomach. On the way to work I felt nuclear tingling, my face and hands went purple. I went to bathroom – turns out my whole body was red as if I had a massive sunburn. Then heart went into racing mode. In about 2 hrs it all subsided, but it was rather scary s__t.” [9]

3. Liver Toxicity. Increased liver enzymes results in a small subset of patients.

REBUTTAL: These patients can simply lower the dosage or switch to a form (immediate release) that is less hard on the liver.  Furthermore, when under a doctor’s care, this appears to be a pretty rare issue:

“Although serious hepatic toxicity from niacin administration has been reported, it is largely confined to the use of slow-release formulations given as unregulated nutritional supplements.” [12]

5. A Rise in Uric Acid. Niacin occasionally causes an undesireable increase in uric acid.  Potentially this could lead to gout, although I have never read of that being the case.  One doctor treats this with allopurinol. [11]

6. Methylation. Niacin can lead to methylation issues in some men.  For example, men with certain MTHFR variants are cautioned to “use extreme caution when supplementing with niacin, which can dampen methylation.” [13]

7. Insulin Resistance. Thx to Torrential on the Peak Testosterone Forum for this one. I will quote from his post:

“I am bringing up this older thread to add another potential risk of long term niacin use. I have been taking 1,500mg Slo-Niacin daily for several months to help improve my lipid profile. It worked: Triglicerides way down, HDL up. I dropped down to 1,000mg daily and my Trig went up again; now back to 1,500mg daily. Liver enzymes fine btw. But my A1C level has been troublesome, creeping upward even as I clean up my act and take steps that should be driving it down. My new doc wants me on Metformin, which I will start soon.”

“However, today I found this on examine.com:”

“‘Current evidence suggests prolonged niacin supplementation increases insulin resistance because it hinders the ability of insulin to suppress glucose synthesis in the liver. This causes an increase in blood glucose levels, which leads to lowered insulin sensitivity over time, since the relevant receptor is eventually desensitized to the elevated glucose levels in the blood. https://examine.com/supplements/Vitamin+B3/‘”

“The article discusses not only higher fasting blood glucose levels but higher insulin levels. Well, crap. Those things are worse than high triglycerides. Should I drop niacin?”

8. Possible Increased Risks of Infections, Gastrointestinal Disorders and Bleeding. Okay, I usually like to give “short and sweet” summaries of information, but I think in this case the long version is the one that is appropriate.  The reason is that there are two recent studies of niacin that showed fairly similar adverse event profiles, i.e. increased risks of infections, GI and bleeding issues.  Fans of niacin like to discuss only the first study, which was quite flawed, and ignore the second.  Below I’ll discuss both studies.

Study #1: Niacin + Laropiprant Study (2014).   This study in my opinion was poorly designed and almost seems calculated to protect pharmaceutical interests.  Let me start with some facts about growing niacin sales:

“The use of niacin in the US and Canada is increasing, with investigators reporting that nearly 700,000 prescriptions per month were being written in the US at the end of 2009, an increase of 191% from 2002 [1]. In Canada, the use of niacin increased sevenfold, with nearly 14,000 prescriptions written at the end of 2009. In both the US and Canada, the increase in the use of niacin outpaced the use of statin therapy.” [1]

Notice the incredible number of prescriptions for niacin and notice that it could be perceived as quickly gaining traction on the statin market.  I am sure this did not go without notice, since statins are some of the most profitable pharmaceuticals to manufacture and sell.  In 2011 they totaled over $30 billion in sales!

So what would you expect to happen if a relatively inexpensive vitamin begin to outperform and chip into sales of one of the most lucrative pharmaceutical lines of business?  Well, if you are a bit jaded, you might expect that the following sequence of events would occur:

a) A study would be set up with the least effective, most commonly liver toxic form of high dose niacin. [3]

b) It would be coupled with a controversial and unsafe medication.

c) Non-ideal patients would be chosen for treatment, i.e. those that do not have very high LDL or triglycerides – the sweet spot for niacin. [5]

d) Niacin would be blamed for any issues even though two medications were involved.

Sounds far-fetched, right?  Well, this is exactly what happened!  So, in spite of the fact that slow-release niacin does not raise HDL as much and more often causes liver issues, this was the form chosen for the study.  Furthermore, they added a weird medication called laropiprant into the mix to reduce the flushing from niacin, but laropiprant has the opposite effect on protasglandins that niacin does, so the drugs may have been fighting each other in certain pathways.

In spite of this poor design, the study seems to solely attach niacin and states that it does the following:

–Increases the risk of diabetes by 32%

–“There were also highly significant excesses of other recognized adverse effects of niacin, including gastrointestinal, musculoskeletal, and skin-related serious adverse events.” [4]

–“The excess of gastrointestingal serious adverse events in the niacin-laropiprant group as compated with the placebo group (4.8% vs. 3.8%) included bleeding and peptic ulceration, as well as other problems in the the upper and lower gastrointestingal tracts (mostly dyspepsia and diarrhea, respectivey.” [4]

The bottom line is that this study received significant criticism, the drug was pulled from the market and, because two medications were involved simultaneously, no definitive conclusions could be drawn.  What was needed was a study with JUST niacin.  It turns out that there was just such a study a few year prior:

Study #2.  AIM-HIGH Study (2011 and 2014 Summary. It turns out that there was just the kind of study that we need just a few years prior to the NEJM to study #1.  In the case of this study, they had a cohort with just time-release niacin and also carefully kept track of adverse events. [7] Perfect!

So what did this study find?  Well, all you niacin-lovers out there would like to hear that niacin was a saint with almost no adverse events.  Unfortunately, that did not prove to be the case.  In fact, this better designed study found many of the same similar negative increases:

“There were significant between-group differences in the numbers of serious adverse events in the System Organ Class categories of gastrointestinal disorders (7.4% vs. 5.5%).”

–“…infections and infestations (8.1% vs. 5.8%).  Although the full list of serious adverse events suggests certain similarities with the data from HPS2-THRIVE, particularly regarding serious adverse infectious events…”

–“..the nonsignificant numerical excess in adverse bleeding events with niacin cannot be considered definitive.” [8]

If these sound familiar, it’s because they are almost identical to those found in #1.  Now, admittedly, statistical significance was not always achieved, but it is quite suspicious that increases were found in the exact same categories as the 2014 research.

Even worse, heart outcomes were just not there. They found NO improvement in cardiovascular outcomes from the niacin.  And this is odd, because look at the positive changes in lipids:

–HDL rose from 35 to 42 mg/dl

–Triglcyerides dropped from 164 to 122 mg/dl

–LDL-C dropped from 74 to 62 mg/dl

Does this mean that niacin is worthless and ineffective?  Let me give you several reasons why it would be hasty to jump to this conclusion:

a. Lipids Not That High.  In the above study, the patients were already on a statin and another cholesterol-lowering medication.  So their lipids had already been sigificantly lowered, which is obvious if you look at their starting point above.  Again, as Dr. Gould pointed out with study #1, this is not really niacin’s “sweet spot.”  Clearly, the incremental benefit of adding another medication on top of another is going to be less.  This is generally with high blood pressure, diabetes and other classes of medications as well.

b. Improving Lipids Helps.  Many, many studies have shown that improving lipids can improve cardiovascular mortality and events.

c. Triglcyerides Still High.  With heart disease, you must  improve ALL areas according to the work of the men I call The Plaque Regressing Doctors. If you’ll notice, the triglycerides of these participants is still quite high.  122 is simply not that good. My guess is that the niacin helped slow down plaque buildup but did not stop it completely, because their triglcyeride levels were still too beefy.  See my page on HDL, LDL and Triglyceride Targets to Reverse Arterial Plaque.

d, Niacin Meta-Analysis. There were recently a large meta-analysis done, which is a study of studies, that pooled together all the niacin research to date and concluded the following:

“Eleven eligible trials including 9,959 subjects were identified. Niacin use was associated with a significant reduction in the composite endpoints of any CVD event and major coronary heart disease event. No significant association was observed between niacin therapy and stroke incidence. The magnitude of on-treatment high-density lipoprotein cholesterol difference between treatment arms was not significantly associated with the magnitude of the effect of niacin on outcomes.” [9]

Basically, the conclusion was that a) niacin helps signficantly heart disease except for stroke and b) HDL appears to have nothing to do with it.

MY CONCLUSION: Niacin has some very impressive meta-analysis cardiovascular results and heart disease is the number killer of men.  That said, a case can be made that high dose niacin increases the risk of some rather serious side effects and adverse events.  In my case, I am going to continue to try solve my issues using more natural means.

1) Medscape, “Niacin Use Increased Nearly 200% Over Seven-Year Period,” Michael O’Riordan, June 10, 2013

2) https://www.telegraph.co.uk/news/health/news/8267876/Statins-the-drug-firms-goldmine.html

3) Heal Your Heart, by Dr. K. Lance Gould, p. 176-177.

4) N Engl J Med, 2014 Jul 17, 371(3):203-12, “Effects of extended-release niacin with laropiprant in high-risk patients”

5) https://www.miaware.org/positron-emission-tomogrophy/dr-k-lance-gould-weighs-in-on-nih-niaspan-study-cancellation

6) https://www.reuters.com/article/2014/11/10/us-merck-zetia-idUSKCN0IU26J20141110

7) N Engl J Med 2011, Dec 15 2011, The AIM-HIGH Investigators, “Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy”

8) N Engl J Med, 2014, 371:288-290, “Safety Profile of Extended-Release Niacin in the AIM-HIGH Trial”

9) https://www.peaktestosterone.com/forum/index.php?topic=5318.0

10) https://johnlamattina.wordpress.com/2011/11/21/does-niacin-still-have-a-role-in-cardioprotection/

11) https://www.athero.org/commentaries/comm547.pdf

12) Am J Cardiol. 2007 Mar 19;99(6A):22C-31C, “Safety considerations with niacin therapy”

13) https://www.jillcarnahan.com/2014/02/23/health-tips-for-anyone-with-a-mthfr-gene-mutation/

Decide on Estradiol Target for Ideal Libido and Erectile Strength

Decide on an Ideal Estradiol Level for Erectile Function and Libido.

We have had considerable debate on The Peak Testosterone Forum about the ideal estradiol levels for a man, especially after he has gone on HRT (testeosterone therapy). There is one very common school of thought out there that I have seen from  guys on the Forum that have more savvy TRT and anti-aging physicians:

–20-30 pg/ml is the ideal range for men of all ages (according to this way of thinking)

CAUTION: 20-30 pg/ml comes from the old way of measuring estradiol in men, which the labs are no longer using. More research needs to be done to correlate the old versus the new tests.

According to this philosophy, going either too high or too low can lead to a lower libido and decreased erectile strength. And these proponents insist that guys usually feel better in this range.  Where does this theory come from?  That’s a good question as there are very few studies of estradiol on men.  We can conclude that the above range grew out of practical clinical experience and the fact that these are youthful estradiol levels, something I document on this page:  Normal Estradiol Levels in Men. Furthermore, if you read through that link, you will see that actually the research shows that male estradiol levels stay pretty flat through one’s younger, middle and senior age years, i.e. there does not appear to be a andropause-like dramatic drop off in levels as is so common with testosterone.

However, there are naysayers out there.  First of all, many physicians have absolutely no idea that estradiol can effect men.  Basically, they look to see if your estradiol is out of the lab’s range and, if so, send you to an endocrinologist and  wash their hands of the whole affair.  And there is some evidence that certain subpopulations, such as HIV+ men, may need higher levels of estradiol. [3] There are even other physicians that actually believe that high estradiol is good for men.  Now where they got this idea, I do not know.  Research has shown that high estradiol is associated with  Arterial Plaque and likely Prostate Cancer and BPH (Enlarged Prostate). In addition, there are a host of well-accepted and somewhat dabilitating symptoms and side effects of high estradiol levels, such as bloating, water retention, moodiness and lowered libido that make high estradiol all the more controversial.

1)  NEJM, 2013; 369:1011-102, “Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men”

2) https://www.peaktestosterone.com/forum/index.php?topic=8242.0

3) Osteoporos Int, 2015 Oct 28, “Serum total estradiol, but not testosterone is associated with reduced bone mineral density (BMD) in HIV-infected men: a cross-sectional, observational study”

So where did some doctors get the idea that high estradiol levels are good for men?

I suspect that it came out of a landmark study that examined carefully the testosterone levels of men who went on a testosterone-lowering medication and then were divided into two groups.  One group (cohort 1) had no aromatase inhibitor and the second group (cohort 2) had a very high dose of an aromatase inhibitor.  Each cohort was further divided into groups given 0, 1.25, 2.5, 5.0, or 10 mg of testosterone gel.

What was the purpose of creating so many groups and subgroups?  Basically, the researchers were subdividing men into mini-groups with widely varying testosterone and estradiol levels. They then could compare the man’s erectile strength and libido before the study to after the study and try to come up with some conclusions.

In fact, assuming that high estradiol is good clearly ignores one beautiful aspect of this study:  it clearly gives you the ideal levels for testosterone and estradiol if one examines which subgroups had the best erectile and libido scores. [1] Using this simple criterion would lead one to choose the following top two combinations of testosterone therapy and AI:

a) #1: 10 mg of testosterone and no AI was the clear winner in both libido and erectile strength

b) #2: 5 mg of testosterone and no AI was in second place, because it led to a little less sexual desire than #1 (10 mg of testosterone with no AI)

Let’s look at the average testosterone and estradiol levels associated with #1 and #2: [1]

a) Total testosterone = 805 ng/dl; Estradiol = 33.5 pg/ml

b) Total testosterone = 470 ng/dl; Estradiol = 18.2 pg/ml

NOTE: I got asked if the above test was using LC-MS/MS.  (As of this reading, the LC-MS/MS test is the only one accurate enough for men).  The fact that they got a reading of 18.2 pg/ml indicates that it is LC-MS/MS as the older assays cannot read that low.  And, if you read the full study, it states clearly that “the serum level of estradiol was measured with the use of liquid chromatography tandem mass spectroscopy, with a threshold for detection of 1.25 pg per milliliter.” [1]

Clearly, these ideal estradiol levels do not contradict the above 20-30 pg/ml rule given above:  18.2 pg/ml is only 9% below the bottom of the range and 33.5 pg/ml is only 11.7% above the top of the range.  And I do not think that anyone would call 33.5 pg/ml “high estradiol.”

The bottom line is that even this study argues strongly that youthful levels of testosterone and estradiol lead to optimal libido and erectile strength.  Using the results of this study to arrive at any other conclusion is a real stretch in my opinion.

CAUTION: There have been a few men who have done well on high levels of estradiol.  There is no hard and fast rule that applies to everyone.  One of our forum moderators, for example, wrote the following: “I feel really good when I’m in the low 40’s on Labcorp’s range of 8-35 pg/ml. My libido skyrockets, energy and sleep quality are improved, and my joints feel great.” [2]

In addition, discuss any desired protocol changes with your doctor first.  Your specific medical situation may require some type of different strategy.

REFERENCES:

Depression and the Brain - Peak Testosterone

In my link on Testosterone and Depression, I discuss how testosterone can lower depression and depression can lower testosterone. In fact, the latter scenario recently showed up in a study where researchers found that depression was very predictive of low testosterone. In fact, they found that there were three things that forecasted and thus probably causative of low T and that was a) obesity, b) smoking and c) depression:

“On average, testosterone levels did not decline significantly over five years; rather, they decreased less than 1 percent each year, the authors reported. However, when the investigators analyzed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study. “Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed…” [1]

Basically, what this study did was look at men who were depressed at the start of the study and then followed them five years later.  At five years they found that depression was a major risk factor for low T.  Now why would depression (likely) cause low testosterone?

2. Platelet Nitric Oxide. Another study found that platelet nitric oxide levels were higher in depressed patients who were untreated when compared to controls. [3]

Isn’t more nitric oxide always better?  Again, not when created in excess and the body does do this sometimes. Remember that nitric oxide is a free radical.  Sure, it is a very important free radical that dilates your arteries, creates erections and acts as a brain neurotransmitter among other things.  But too much of it has been implicated as a root cause in the following brain disorders:

And, sticking to the subject at hand, elevated nitric oxide has been implicated in depression as well. [8] And it is no wonder:  researchers have found that “nitric oxide modulates norepinephrine, serotonin, dopamine, glutamate, the major neurotransmitters involved in the neurobiology of major depression.” [7]  Furthermore, oxidative stress has been coupled with depression as well in a number of studies and reviews.  So it is not just nitric oxide that is getting increased but other free radicals in general as well. [12][13]

Of course, oxidative load and inflammation are intimately linked and one of the most important studies showed that untreated depressed patients were higher in oxidative stress and IL-6, one of the “killer” inflammatory cytokines that is associated with many chronic diseases and conditions. [11] And, most importantly, treatment for depression brought IL-6 and oxidative stress back into line. Of course, the moral of the story is that it is actually dangerous to leave depression untreated for an extended period of time, since it can leave a man exposed to chronic inflammation and oxidation, both of which destroy tissues, trigger nasty metabolic reactions and possibly permanently damage his testosterone.

Now I have some natural solutions that have been shown to help with many types of depression in my page on Depression Cures. But depression should always be taken seriously and, as I hope you see from the above, is every bit as much a medical condition as a psychological one. In other words, depression appears to be a huge stressor that raises inflammation and oxidative stress that can negatively impact the brain and body permanently.  I believe that scientists will soon discover that depression can, if allowed to go on long enough, even lead to lowered testosterone as the initial study I mentioned showed.

REFERENCES:

1)  https://www.sciencedaily.com/releases/2012/06/120623144944.htm

2) Journal of Affective Disorders, Mar 2001, 63(1-3):221 224, “Elevated plasma nitrate levels in depressive states”

3) Psychiatry Research, Oct 2013, 209(3):447-452, “Increase in nitric oxide levels and mitochondrial membrane potential in platelets of untreated patients with major depression”

4) Progress in Neuro-Psychopharmacology and Biological Psychiatry, Aug 2006, 30(6):1091-1096, “Increased plasma nitric oxide level associated with suicide attempt in depressive patients”

5) https://www.schizophrenia.com/sznews/archives/005764.html#

6) Neurotox Res, 2012 Nov, 22(4):251-64, “Nitric oxide-mediated oxidative damage and the progressive demise of motor neurons in ALS”

7) Nitric Oxide, Apr 30 2011, 24(3):125 131, “Nitric oxide and major depression”

8) Journal of Affective Disorders, Mar 2001, 63(1-3):221-224, “Brief report Elevated plasma nitrate levels in depressive states”

9) Neuropsychobiology, 2002,45:57 61, ” Possible Role of Nitric Oxide and Adrenomedullin in Bipolar Affective Disorder”

10) Nature Medicine, 1999, 5:1403 – 1409, “Inducible nitric oxide synthase stimulates dopaminergic neurodegeneration in the MPTP model of Parkinson disease”

11) Brain Behav Immun, 2013 Jul, 31:143-52, “Dysregulated relationship of inflammation and oxidative stress in major depression”

12) Psychiatry Res, 2013 Apr 30, 206(2-3):213-6, “Increased oxidative stress in patients with depression and its relationship to treatment”

13) Curr Pharm Des, 2012, 18(36):5890-9, “The role of oxidative stress in depressive disorders”

The answer lies is just what depression does to the brain.  It turns out that depression greatly increases:

Any one of these can do damage, but if you put all three together, it is definitely a dangerous scenario.  (Yes, nitric oxide in moderation is a good thing, but, in excess, can destroy as we will discuss below.)  And this undoubtedly explains why depression hammers the brain and unwires neurons.  Depression has been found in a couple of studies to actually, over time, shrink the hippocampus.  In my page on Testosterone and Depression, I discuss how depression is basically a stressor and stressors generally result in a, b and c above.

Does depression really increase nitric oxide?  Several studies indicate that that is indeed the case:

1. Plasma Nitric Oxide. One (admittedly small) study found that plasma (blood) nitric oxide levels were significantly higher in depressed patients than in controls. [2]

Retin-A: Is It Safe? - Peak Testosterone

Hopefully, you have read my link on Using Retin-A for wrinkle reduction and are now wondering just how safe is this product. After all, Retin-A (tretinoin) is the “gold standard” for topical reduction of wrinkles and also is a powerhouse in the treatment of acne as well.

Again, Retin-A is nothing more than a form of Vitamin A that irritates the skin and cause regrowth.  It literally forces your face to grow new, more “baby-like” skin.  (You do have to be careful not to overapply as tretinoin can increase irritation, inflammation and sun damage if used incorrectly.)

Because Retin-A is so widely used, there has been considerable research as to its safety.  Below is a summary of some of the most interesting points.

1. Hayflick Limit (Telomeres and Telomerase). One concern with tretinoin use is that it does cause your face to regenerate new skin.  As your skin cells recycle, some have been concerned that eventually the skin cells would reach the point where they no longer divide easily and become dysfunction, “old” cells.  In other words, does Retin-A possibly trade an improved look in one’s younger years for a worse look in your older years?

This is definitely a valid question as one of the theories of aging has to do with shortened telomeres.  (See my link on Telomerase and Aging for more details.)  Again, as the cell divides, it loses a little bit of genetic material off its ends (telomeres) and some tissues begin to have problems at that point.  However, this appears not to be an issue with Retin-A (although there has been definitive study to date). There are millions of Retin-A users and there has been no observed end-of-life accelerated aging. (Talk to your doc of course.)

One of the reasons for this may be that the Hayflick Limit does not seem to apply to skin cells (fibroblasts) that make collagen.  These powerhouses have shown a Hayflick Limit in a “test tube” but humans clearly have many more cell divisions than this laboratory limit. Both telomeres and telomerase appear to be preserved virtually indefinitely. [1]

2. Retinoic Acid.  Retinoic acid is the chemical name for Retinol, the close retinoid cousin of Retin-A, that is used in literally hundreds of skin care products for wrinkle reduction. Retinoic acid has been shown to extend the Hayflick Limit by 50% in the lab. [2] Again, fibroblasts do not seem to be governed by the Hayflick Limit in live human subjects, but it is comforting to note that retinoids seem to actually improve the situation.

3. Sun Damage. One protocol for those who use Retin-A is sun avoidance, because it can lead to increased risk for sun burn. Therefore, one concern is that perhaps it would accelerate photoaging and/or sun damage. A couple of studies have actually shown the exact opposite.  For example, one study on mice, who were photoaged with UV lamps, documented that those treated with retinoic acid had less damage than those that were untreated. [3]  Once again, tretinoin has been shown to actually heal.

REFERENCES:

1) Arch Gerontol Geriatr, 2002 May-Jun, 34(3):275-86, “Promise and problems in relating cellular senescence in vitro to aging in vivo”

2) https://www.smartskincare.com/aging/aging-mechanisms_cellular-clock.html

3) Connect Tissue Res, 1984, 12(2):139-50, “Topical retinoic acid enhances the repair of ultraviolet damaged dermal connective tissue”

DHEA Dosage and Target Levels - Peak Testosterone

REFERENCES:

1) https://raypeat.com/articles/articles/three-hormones.shtml

2) https://www.lef.org/Protocols/Metabolic-Health/Dhea-Restoration/Page-les

3) https://www.peaktestosterone.com/forum/index.php?topic=7610.0

4) Feeling Fat, Fuzzy or Frazzled, by Dr. Shames, p. 163

5) J Clin Endocrinol Metab, 1994 Jun, 78(6):1360-7, “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age”

6) https://www.peaktestosterone.com/forum/index.php?topic=7610.0

On this page, I will be talking about the standard DHEA dosages that I see out there. However, even discussing the subject makes some assumptions in my mind. First of all, I don’t think anyone should supplement that is not actually low in DHEA-S. Furthermore, I believe that this kind of “protocol” should be followed:

a) Talk to a doc or LEF, naturopath or Life Extension Foundation and find out if you have any contraindications.  (High PSA, arrhythmia, etc.)  Read my page on DHEA Dangers.

b) Get a DHEA-S blood draw and, if low, proceed to b.

c) Discuss with  a doc or LEF, naturopath or Life Extension Foundation an appropriate dosage.  Of course, I recommend reading below

c)  Find your target DHEA-S levels.  I have seen docs and the LEF generally target a range of 350-500 ug/dl approximately.

d) Re-measure after a few weeks and verify you have hit your target levels.

CAUTION:   My labs were 108 ug/dl, which is very low, and this is the sole reason that I tried it. Again, you do not want to even consider taking DHEA in my opinion unless you are low in DHEA-S and you do not want to go too high in DHEA-S after you begin taking DHEA either. Set a target with your physician or naturopath. From what I have seen, usually the upper mid range of DHEA-S is what is targeted and where men often feel best.

1. Ray Peat (~4 mg daily).  Ray Peat, a respected blogger with a Ph. D. in Biology wrote:

“Young people produce about 12 to 15 milligrams of DHEA per day, and that amount decreases by about 2 mg. per day for every decade after the age of 30. This is one of the reasons that young people eat more without getting fat, and tolerate cold weather better: DHEA, like the thyroid hormone, increases our heat production and ability to burn calories. At the age of 50, about 4 mg of DHEA per day will usually restore the level of DHEA in the blood to a youthful level. It is important to avoid taking more than needed, since some people (especially if they are deficient in progesterone, pregnenolone, or thyroid) can turn the excess into estrogen or testosterone, and large amounts of those sex hormones can disturb the function of the thymus gland and the liver.” [1]

His comment about 4 mg restoring youthful levels does not mesh with that of LEF, where around 25 mg is used to get men back to youthful levels.  Studies that I have seen also mention a higher dosage to get to youthful levels. As I always say:  measure yourself and see if you are hitting your target levels.  You can do that with these cheap Self-Testing Testosterone Labs.

2. Dr Shames (5-10 mg daily). Dr. Shames is one of the pioneering thyroid and adrenal fatigue physicians.  He writes in his book that it is a “potent medication” that should be limited in his opinion to 5-10 mg daily. [4]

CAUTION: I always recommend, when it comes to hormones, working with a knowledgeable physician, naturopath or organization such as Life Extenson Foundation.  Also, some countries do not allow over the counter purchases of DHEA.

3. LEF (15-50 mg daily). To find the dosage appropriate for me, I called Life Extension Foundation and they recommended 25 mg for a man on testosterone therapy like myself.  However, their page says that one may need between 15 and 50 mg in order to achieve target levels of DHEA-S.  What are these target levels?   According to their web site as of this writing, the stated goal for adult men is to keep DHEAS levels between 350 and 500 ug/dl. [2] This is what I call a “replacement philosophy,” where the goal is simply to restore a give hormone to youthful levels. The contrast to this is going “supraphysiological,” i.e. raising hormones past what is normal and natural.  This often leads to problems in my opinion whether you are talking about testosterone, estradiol, DHEA, melatonin, etc.

One of the moderators on the Peak Testosterone Forum provided an example of this when he took 25 mg of DHEA and yet it only boosted his levels of DHEA-S to ~220 ug/dl. []

4. IGF-1 (25 mg).  On my page DHEA and IGF-1, I make a case that 25 mg should probably be your upper limit on DHEA, in order to avoid raising your IGF-1 levels too much.  (Not everyone reacts the same to a given dosage, so the best thing is to measure your IGF-1 before and after using on of these Hormone Labs in my opinion.)

5. Well Known TRT Doctors (25 mg daily). Dr. Shippen is one of the early pioneers of testosterone therapy and seems to be well-respected by his patients.  (I have no affiliation.)  He wrote the TRT classic The Testosterone Syndrome years ago that was clearly ahead of its day. According to one of our senior posters on testosterone therapy, Dr. Shippen prescribed 25 mg of oral DHEA per day.  Dr. Shippen prefers this brand.  Like me, this man is on HRT (testosterone therapy) that includes a combination of testosterone cypionate and daily HCG.  Does this mean that Dr. Shippen always recommends 25 mg?  Of course not.  I am sure he tailors based on your preexisting DHEA-S levels, whether you are on TRT and a number of other factors, i.e. you’d have to set up an appointment to verify. [3]

In addition, you can read in my post on How DHEA and Pregnenalone Cured My Anxiety how Dr. Justin Saya put me on a similar dosage of 25 mg of DHEA per day (oral before bed). Again, you would have to call Dr. Saya and make an appt to find his dosage for you inidividually.

6.Diabetes and Prediabetes (25-50 mg daily). This is an involved subject as the studies are mixed.  In my opinion, the data overall suggests that  men struggling with blood sugar issues and high cholesterol can improve insulin sensitivity and normalize blood sugar levels with reasonable dosages of DHEA.  Of course, if you are diabetic in particular, it is critical to talk to your doctor first before making any changes.

7. Mood, Depression, Anxiety and Cognition (50 mg). Dosages in the successful studies for these conditions tend to be 50 mg from what I have seen.  For example, one study of middle-aged and senior men and women 40-70 years found that 50 mg “was associated with a remarkable increase in perceived physical and psychological well-being for both men (67%) and women (84%) .” [5]

Low Fat Diet: Dangers? - Peak Testosterone

I eat a Low Fat Diet and love it.  I am currently eating a low fat, whole foods lacto ovo vegetarian diet.  One thing that I have noticed is that Low Fat now is extremely unpopular right now with men, at least here in the U.S.  As far as I can tell, Paleo and Low Carb fans have almost completely taken over the American health universe.  And, because of this, I have heard time and again of all the dangers of low fat and how low fat eating is responsible for all of our health ills, etc.  The latter accusation is ridiculous, of course, because so few American eat a Low Fat Diet.  I personally do not know anyone who eats a Low Fat Diet and I doubt most of you do either.

Anyway, most of the objections that you hear about Low Fat Diets are just silly.  But a few require serious consideration and I believe we can lump them into five general categories, which I summarize below:

1. Increased Arteriosclerosis. Dr. William Davis is one of the leading clinicans practicing plaque reversal and author of the popular book Track Your Plaque. He is probably the most popular speaker and writer that I know of in the cardiovascular arenta and has popularized his own flavor of reversing arteriosclerosis that has moved away from of the previous low fat-based techiques used by, say, the well-known Dr. Ornish. In fact, Dr. Davis is openly critical of Low Fat Diets and clearly states that some people will acclerate their plaque on a Low Fat Diet, not reverse it.

Now this is definitely a controversial assertion, because Dr. Dean Ornish showed in his studies that Low Fat Diets could reverse plaque. In fact, it was Dr. Ornish who really popularized the notion. Critics note, however, that participants in Dr. Ornish’s studies underwent some weight loss and almost any diet can reverse plaque during weight loss. In fact, one recent study showed just that by putting participants on a low fat, low carb or Mediterranean Diet and all of them reversed IMT plaque approximately equally. [1] (IMT is intima-media thickness, i.e. the amount of plaque in the neck artery.)  So any arterial study needs to show success under weight maintenance conditions to truly be valid.

However, let’s go back to Dr.Davis’ assertion that in some men a Low Fat Diet is a foe rather than a friend and may actually add arterial plaque instead of reversing it. The reason, according to Dr. Davis, is that low fat usually means high carbs and high carbs for some men means that their lipid profile will switch to the deadly “pattern B” mode.  Pattern B is simply when your cholesterol profile has a greater percentage of atherogenic small LDL particles and increased triglcyerides.

REBUTTAL:  Prior to Dr. Davis, there were a couple of huge clinician researchers that were well-established in plaque reversal:  Drs. Esselstyn and Gould. Both of these researchers used Low Fat Diets as the base of their treatment strategy.  Dr. Esselstyn is part of the Cleveland Heart Clinic and is world renowned in his research on reducing arterial plaque and author of a back entitled Prevent and Reverse Heart Disease.  His formula is pretty simple: [2]

And one last comment:  this is where the work of Dr. Gould comes in.  Dr. Esselstyn only reversed arterial plaque in three quarters of his patients.  However, Dr. Gould was able to reverse it in virtually everyone by putting them on a Low Fat Diet and coupling it with a statin.  This is very impressive to say the least, because heart patients often only have a few more years to live and this essentially allows them to gain back decades of their life by reversing arteriosclerosis.  I know many people do not like statins and I don’t either  – see my page on The Dangers of Statins – but for those with arteriosclerosis, this is a critical situation.

As a side note, I actually feel that this is what happened to me. In my late 40’s I developed a significant amount of erectile dysfunction after years of a fast food and questionable eating habits. I also had had decades of low testosterone – something you can read about in My Personal Health Story – and low T is known for leading to hardening of the arteries. I tried consuming coconut oil and diets that I modeled after the Tokeluau and Pukapuka. These are essentially classic Paleo Diets and they simply did not work for me – quite the opposite. I got immediate relief, though, from eating Low Fat. And here is my point: I had a Heart Scan, also called a Calcium Score, in 2013 and they found that my cardiac arteries were perfectly clear! Basically, I had apparently cleared out all the arterial plaque from the decades previous through eating Low Fat, something you can read about in my page My Heart Scan Results.

2. Vitamin E. One of the criticisms of Low Fat Diets that you quite often hear is that fat in the diet is required to trigger the release of bile from the liver and, therefore, those that consume a Low Fat Diet could be deficient in Vitamin E. For example, children who have blocked or missing bile ducts can become Vitamin E deficient and require supplementation. [3] Furthermore, low fat critics often state that other fat soluble vitamins (A, D and K) may be poorly absorbed in a low fat environment.

REBUTTAL:  A “Low Fat” Diet is really not low fat. Even the most strict Low Fat Diet is around 10% of calories as total fat.  So, if a man consumes 2,500 calories in a day, 250 calories would be from fat.  This translates to 28 grams of fat, which is a significant amount of fat.  I know of no evidence that those eating Low Fat Diets have been shown to be deficient in any of the above vitamins.  If this was an issue with Low Fat Diets, it would have been exposed years ago.  And consider this:

Wild game is around 10% fat.  Most of the plant foods that we eat are around 10% fat.  Furthermore, the supercultures with the greatest longevity and nearly impeccable health records eat in the 10-20% fat range. How can the healthiest cultures on planet earth all be deficient in vitamins A, E and K?

And, if you are concerned about it, simply raise your fat levels to 15%.  I have never eaten a pure 10% and have somehow managed to clear out my arteries for example. But raising your fat levels to 15% will add another another 14 grams of fat per day.  This allows for a few nuts or some dressings/sauces that can really add flavor to what you are eating.

3. Your Cholesterol Will Be Too Low For Your Brain’s Needs. The human brain needs a large amount of cholesterol and I have seen stats that about a quarter of all the body’s cholesterol is between our ears. Based on these observations, some say that a Low Fat Diet will lead to cognitive, memory and psychological issues due to lack of proper supply of cholesterol.  Other similar criticisms come from the fact that pregnenalone, a key brain hormone, is synthesized from cholesterol (LDL specifically) and, so the thinking goes, low cholesterol will lead to deficiencies here as well.  Adding fuel to the fire was the fact that a mortality study showed that low cholesterol levels were correlated with an increased risk for possibly non-heart disease deaths and possibly suicide.

REBUTTAL:  The body manufacturers virtually all the cholesterol that we need.  We simply do not need to add cholesterol to our diet or eat a lot of fat to artificially inflate cholesterol levels.  And think about this:

The Father of the Modern Paleo Movement is a researcher named Loren Cordain.  One of his earlier research projects was a study of all the primal cultures in the world.  His motive was to document how these ultrahealthy cultures ate and one thing that he found would shock most modern Paleo folks:  EVERY culture had cholesterol below 150.

Of course, this hurts the you-gotta-have-beefy-cholesterol theories.  If every one of our healthiest cultures has cholesterol below 150, then how can low cholesterol be unhealthy?  In fact, couldn’t it be argued that low cholesterol is actually the most brain healthy way to live?  After all, in these cultures dementia and Alzheimers is unheard of.  One of the low fat researchers has uncovered a significant body of evidence that increased levels of saturated fat is associated with Alzheimer’s risk. [4] And the extra fat in our diet is likely a root cause of many migraines.  Researchers explained that “a review of the literature indicates that high levels of blood lipids and high levels of free fatty acids are among the important factors involved in triggering migraine headaches. Under these conditions, platelet aggregability, which is associated with decreased serotonin and heightened prostaglandin levels, is increased. This leads to vasodilation, the immediate precursor of migraine headache. A high-fat diet is one factor that may directly affect this process.” [5] This study put migraine-suffering women on a Low Fat Diet and they experienced significant relief.

As far as the supposedly negative mortality studies, Dr. Gould explained:

“In these large population studies, there is a small percentage of people who have preexisting medical conditions, such as cancer, depression, alcoholism, gastrointestinal disease, or addictive behavior such as drug addiction or smoking, all of which reduce appetitie and may impair nutrition in association with very low cholesterol levels.  These preexisting conditions not only lower cholesterol levels but may also cause death unrelated to cardiovascular disease.  Therefore, in such studies, there may be an association between death caused by the preexisting nonvascular disease and low cholesterol levels.  However, if the people with these preexisting nonvascular medical conditions are screened out and removed from the analysis, there is no increase in deaths associated with low cholesterol levels.” [6]

4. Weight Loss is Harder. One third of all men in the U.S. are overweight and one third are obese.  So weight loss is a big issue in most Western countries.  When a guy is 40 or 50 pounds overweight, he wants to lose weight and lose it quickly.  One study shows that low carb diets are the fastest way to lose weight.  Anecdotally, many men have reported that this is true, assuring its superstardom in the health world.

REBUTTAL: Low carb diets cause rapid loss of liver glycogen stores, which are bound up in a bunch of water.  When someone loses weight via low carb, there is an initial rapid burst of water loss on top of the regular weight loss.  Atkins himself admitted this was a huge problem, because the minute that the dieter starts adding in carbs again and increasing glycogen stores, the water weight comes right back on.

Plus, Low Fat Diets have the huge advantage of weight loss without suffering.  Okay, that’s a slight exaggeration, but higher carb diets tend to have much greater volume and bulk than high fat diets.  This allows a man to eat until his stomach is largely full and thus feel minimal hunger.  Example:  a large baby carrot is about 5 calories.  To even get 200 calories, one would have to eat 40 baby carrots!  If you do a Low Fat Diet correctly, you can lose weight almost effortlessly.  Yes, that’s part of the reason that a lot of Asian peoples are thin.

5. Carb Intolerance. There is a school of thought out there now that some men are “carb intolerant,” i.e. simply cannot handle carbs any more.  The backbone of this theory is that some men have essentially entered the prediabetic, Metabolic Syndrome stage and even moderate carbs will give them fatigue, brain fog and, in some cases, high blood pressure.  Phil Maffetone, the overtraining expert, and others have two week carbohydrate intolerance tests out there to see if you are in this category.

REBUTTAL:  Perhaps this is the case for some men.  However, consider if the following five criterion were met:

a) all simple carbohydrates including wheat were avoided

b) fructose was limited to 50 grams per day or less

c) testosterone levels were maintained at youthful levels

d) all carbs were low glycemic (non-wheat whole grains, legumes, beans, etc.)

e) exercise was at least an hour per day

Of course, a man with testosterone of 400 ng/dl is going to struggle:  low testosterone raises insulin levels.  But how many men with youthful T levels who are exercising an hour per day need lower carbs??  I’m sure it happens, but my experience is that most men who have youthful health and hormones have youthful appetities and metabolisms based on what I have seen on The Peak Testosterone Forum.

And one other important comment: Dr. Neal Barnard has a book on reversing diabetes and he directly addressed this issue by doing a study of men with high A1C placed on a low glycemic, Low Fat Diet. The high carbs made these diabetics worse, right? Actually, the results were impressive and the opposite: he found that he could lower their A1C as much as medication even though the men were eating a high carb diet. I discuss all of this in a page on Low Fat and Diabetes. Remember that insulin resistance is caused by the buildup of lipids (fats) within the cells and a Low Fat Diet, even though it is high carb, greatly helps this process.

REFERENCES:

1) Circulation, 2010, 121: 1200-1208, “Dietary Intervention to Reverse Carotid Atherosclerosis”

2)  https://www.heartattackproof.com/reversal01.htm

3) Am J Clin Nutr, 1984 Aug, 40(2):246-50, “Serum vitamin E levels in children with corrected biliary atresia”

4) https://www.nealbarnard.org/books/brain/

5) J of Women’s Health and Gender-Based Med, May 7 2009, 8(5), “The Influence of a Low-Fat Diet on Incidence and Severity of Migraine Headaches”

6) Heal Your Heart:  How You Can Prevent or Reverse Heart Disease, Dr. K Lance Gould, M.D., p. 67.

7) https://philmaffetone.com/2-week-test

What Dr. Esselstyn did was to follow his patients for five years.  And keep in mind that all of his patients were heart disease pateints. Dr. Esselstyn found that those that did not follow his program had an average of close to 4 cardiac events in five years on average. It means that these patients had one case of angina, a heart attack, or maybe a stroke on average about every year and a quarter. The contrast between those who did follow his program was striking: they had NO cardiac events. (There was one arrhythmia case which could not be attributed to diet.)  In other words, Esselstyn’s Low Fat Diet program gave these heart patients back their life and made them essentially free from heart disease.

And, wait, it gets better:  arterial examinations showed that ALL of the complaint patients arrested their heart disease and three fourths of them reversed it! [2] Now how many guys that have erectile dysfunction need to reverse plaque? Well, I don’t know what percentage, but it’s got to be a big percentage.  This is verified by the fact that the research shows that the average man has some kind of a cardiac even five years after his first signs of erectile dysfunction. And the reason is simple: you can have quite a bit of plaque in a neck or heart artery and not suffer from a heart attack or angina initially. However, that same plaque in your penile arteries will cause you substantial erectile dysfunction. Once those penile arteries are covered in plaque, nitric oxide levels go down significantly.

Brain and Dopamine - Peak Testosterone

Dopamine is every guy’s favorite neurotransmitter.  Oo la la – it’s the “reward and pleasure neurotransmitter.” Of course, if we’re not careful, it can turn almost any one of us into one of Pavlov’s dogs if we’re not careful.

But dopamine is a lot more than just the pleasure hormone.  It can actually boost your erections.  That’s right – dopamine agonists (receptor stimulator) have been studied as actual erectile dysfunction medications.  I have had men write in who have taken the dopamine precursor supplement tyrosine – see below – and restored their morning erections. Look at what Wiki wrote about Apomorphine, a dopamine agonist:

“For treatment of erectile dysfunction, it is believed that dopamine receptors in the hypothalamic region of the brain are the main target, as although dopamine receptors in the penis do facilitate erection, they do so far more weakly than those in the brain.” [14] Yes, indeed, the brain has as much to do with erections as the penis.

However, many men living the modern, industrialized lifestyle can find their dopamine levels actually depleted. Several studies have found that higher fat diets, for example, create insulin resistance in the brain, which can significantly drop dopamine levels. [1]  Sitting can lead to depressed dopamine levels as well. [2]  Addictions to fatty and sugary foods, based on an animal study, can lead to overstimulation of the brain reward system and dulled dopaminergic response. [3]

And the signs of this are everywhere.  Migraines are tied to lower dopamine levels. RLS (Restless Leg Syndrome) has also strongly been linked to low brain dopamine levels.  Most studies show the prevalence of RLS to be between 5-10% of the adult population for example. [4] Furthermore, researchers are now discovering that depression, a modern epidemic by any standards, may be related in many individuals to low dopamine levels. [5]  This may explain why SSRI’s are so often ineffective.

Is dopamine important?  You bet it is:  every bit as important to the male as testosterone.  Dopamine plays a strong role in libido, motivation, energy, learning and cognition.

Adding to the issues are the fact that there is so little information on ways to naturally raise your dopamine.  In my opinion, the great majority of the information out there grossly misses the mark.  You will find most sites recommend various supplements, such as L-Theanine (of green tea fame), NADH, Mucuna Pruriens and Withania somnifera (Indian Ginseng).  I’ve even seen cough syrup recommended:  the active ingredient, Dextromorphan (DXM), is a dopamine agonist (stimulator)!

CAUTION: Watch out for DXM.  Many experts think it leads to Olney’s (brain) lesions.  And cough syrup is no longer recommended for young children.

In my opinion, these are all avoiding most of the root causes of dopamine depletion.  You have to ask yourself if you are seriously going to take these herbs and supplements for the rest of your life?  How do you know what the side effects are after decades of use?

Below I list easy ways to boost brain dopamine levels and, unless you have significant neurodegenerative disease, should naturally restore your dopamine levels without a lot of pills and capsules:

1.  Exercise. Exercise leads to a dramatic boost in dopamine almost immediately after exercise. [6] Our bodies were made to move and exercise and it simply isn’t natural for us to be sitting for hours in front of a TV or computer. Most of the supplements, herbs and pills to boost dopamine will simply be trying to cover up the fact that we are putting our bodies in motion throughout the day.

2.  Stand. If you can’t exercise for some reason, then at least stand for awhile. Standing has been shown to be very effective in raising dopamine levels. [2]

3. Sex. It’s no secret that an orgasm boosts dopamine and a whole lot of other brain neurotransmitters. In fact, researchers have shown that an orgasm stimulates the same parts of the brain as that stimulated on the opiates such as cocaine and heroin.

4. High Fat Diets. As mentioned above, watch out for higher fat diets mentioned above as researchers know this can cause issues if overdone. Note that all the Paleo Diets can easily turn high fat. A lot of guys on a Paleo Diet are avid exercisers and so this may compensate, but beware.

5. Eat Less. Interestingly enough, certain stressors can counterintuitively raise dopamine levels.  Normally, we think of dopamine as the “reward neurotransmitter.”  However, a sleepless night can increase dopamine. [7] And so can a reduction in calories.  Researchers believe that reducing calories can help Parkinson’s patients, who have experienced 80+% destruction of their dopamine-producing cells. [8] Most of the supercultures with extreme longevity in the world – see my review on John Robbin’s Healthy at 100 – eat lower levels of calories and their brains are largely preserved into their senior years without disease.

6. Flavanoids. A diet rich in flavanoids (berries, tea, raw cacao, etc.) have been found to protect the brain from Parkinson’s. [9] This means that the cells in the substantia nigra, which produces brain dopamine, have been substantially guarded from the oxidative damage to heavy metal and free radical – see below – damage.  The more of these healthy cells you have, the higher your brain dopamine levels are going to be.

7. Metals and Excitotoxins. Avoid heavy metals. Iron and copper have now been heavily implicated in causing Parkinson’s. [10] The copper in our pipes, for example, slowly accumulates in tissues and leads to increased oxidative damage in the brain, especially those of the substantia nigra.

8. Excitotoxins. Watch out for excitotoxins.  There are many reasons that the blood-brain-barrier (BBB) can be compromised and, if it is, the MSG, autolyzed yeast extracts, aspartame and hydrolyzed proteins (in standard wheys, fast and processed foods) will rip through your neurons like a blender. See my links on Testosterone and Excitotoxins, the Blood-Brain-Barrier and Excitotoxins and Fast Food, Excitotoxins and Whey and Excitotoxins for more information.

9. CoQ10. CoQ10 is a relatively safe supplement that appears to preserve brain dopamine levels.  This is one of the reasons that it can play a role in Migraine Prevention and has been found helpful in the treatment of RLS (Restless Leg Syndrome) as well. Preliminary evidence shows that it may slow the progression of Parkinson’s [11] and can provide relief for those with already existing Parkinson’s. [12]  The only caution that I know of with CoQ10 is that one study showed that higher levels were tied to breast cancer risk.

10. Protein.  If you read my link on Food and Appetite, you will find that protein, if done right, tends to increase brain dopamine levels.

11. Zinc. Zinc has many talents, but one its many benefits is regulating dopamine levels. Getting more zinc may help and this link on Zinc and Testosterone explains how.

12. Tyrosine. Tyrosine is an amino acid very common in high protein foods and even gets its name from the Latin word for cheese. It also can give some people a nice boost in dopamine. Long term safety is not really known and it is recommended that one experiment with 250 mg or at the most 500 mg on an empty stomach (or with a low protein meal). Side effects reported include heart flutter and restlessness. (It is the awareness and alertness neurotransmitter after all.)

13.  Sleep. Make sure you get your sleep.  Researchers have recently found in several studies that lack of sleep decreases dopamine receptor sensitivity, which then has many negative downstream effects.  For more information see my link on Sleep and Dopamine.

14.  Music. “Sex, Drugs and Rock ‘n Roll!” What do those have in common? They all boost dopamine. Actually, researchers did not know definitively that music boosted dopamine until a 2011 study showed conclusively, using radioactive chemicals that bound to participants’ dopamine, that not only did music cause the brain to release dopamine but even the anticipation of music (that we like) could do the same. [15][16] Talk about a cheap and easy brain booster!

15. Mucuna Pruriens. This prolactin-controlling, dopamine-increasing extract from the legume called the “velvet bean” has even been used by some in treatment of Parkinson’s. Animals studies show that it increase dopamine in certain key areas of the brain. [17] It will also likely help many men with infertility and testosterone as well.

CAUTION:  Melatonin Supplementation. Obviously, getting adequate melatonin before bed is a good thing.  Furthermore, supplemental melatonin is part of a multisupplement Sleep Aid cocktail that was recently found to be effective in patients suffering with insomnia.  Nevertheless, some caution with supplemental melatonin may be in order, since it low dopamine levels. [13]  Normal melatonin is important, though, and its antioxidant powers likely protect the cells of the substantia nigra.

REFERENCES:

1)  https://www.mc.vanderbilt.edu/ vanderbiltmedicine/index.html?article=8110

2) Life Sciences, 11 Jun 1979, 24(24):2273-2277, “Plasma dopamine responses to standing and exercise in man”

3) https://healthland.time.com/2010/03/29/understanding-junk-food-addiction-in-lab-rats/

4) https://www.medicine.ox.ac.uk/bandolier/booth/RLS/RLSprev.html

5) hthttps://www.primarypsychiatry.com/aspx/articledetail?articleid=1066

6) J Lab Clin Med, 1984 Jul, 104(1):77-85, “Increased conjugated dopamine in plasma after exercise training”

7) https://www.sciencedaily.com/releases/ 2008/08/080819213033.htm

8) https://www.ohsu.edu/ohsuedu/newspub/releases/111405diet.cfm

9) https://www.yourhealthbase.com/Parkinson’s.htm

10) https://www.webmd.com/parkinsons-disease/news/20110214/berries-may-ward-off-parkinsons-disease

11) https://www.medscape.co; Arch Neurol, 2002, 59:1523, 1541-1550

12) Neuroscience Letters 341 (2003) 201–20, “Coenzyme Q10 supplementation provides mild symptomatic bene?t in patients with Parkinson’s disease”

13) Cell Mol Neurobiol, 2001 Dec, 21(6):605-16, “Melatonin-dopamine interactions: from basic neurochemistry to a clinical setting”

14) https://en.wikipedia.org/wiki/Apomorphine

15) Nat Neurosci, 2011 Feb, 14(2):257-62,”Anatomically distinct dopamine release during anticipation and experience of peak emotion to music”

16) https://www.nytimes.com/2013/06/09/opinion/sunday/why-music-makes-our-brain-sing.html?_r=0

17) Phytotherapy Research, Sep 2004, 18(8):706–712, “Neuroprotective effects of the antiparkinson drug Mucuna pruriens”

Progesterone in Men: Some Risks and Rewards.

Progesterone is known as a “female hormone,” since it plays a significant role in ovulation, pregnancy and fertility in women.  What most men don’t realize is that plasma levels of progesterone are surprisingly high in men and appear to play a significant role in male health.  Surprisingly, it can also help some men in the bedroom and many alternative and anti-aging physicians are actually using progesterone to help cure erectile dysfunction and other male-related health issues, something I will discuss below.

Although progesterone therapy has certainly not gone mainstream in men, it certainly has many impressive benefits, which are outlined below.  Again, here are some reasons progesterone is growing in popularity for middle-aged and beyond men:

CAUTION: Progesterone should only be administered under the care of a knowledgeable physician.  Not everyone feels good on progesterone.  One man wrote that “I tried using a very small amount of progesterone cream but even the recommended small amount for men made me feel lousy the following morningm so I stopped using it after only a few days.” [9] In addition, please read my page on The Potential Dangers of Progesterone for additional important information.

1. 5-Alpha-Reductase Inhibition. This enzyme is responsible for converting testosterone into DHT.  DHT is a powerful hormone in males and is responsible in part for libido, muscle growth and many other male functions.  However, too much DHT can be hard on the prostate and lead to hair loss.  Progesterone, which decreases with aging, is a significant inhibitor of 5-alpha reductase. [2]

2. Erectile Dysfunction Treatment. There are some anecdotal reports, admittedly from non-peer reviewed sources, that indicate that progesterone can be a near miraculous cure for some men with erectile dysfunction, especially when combined with HRT (testosterone therapy).  I cover this in my page on Progesterone and Erectile Dysfunction.

3. Noradrenaline Control and Reduction.  It looks progesterone can help control and even reduce noradrenaline. [5] This stress hormone is known for being the “anti-erection” hormone in the sense that it actually provides necessary feedback from men getting spontaneous erections.  However, too much noradrenaline puts the brakes on one’s hardness factor.

1)   Psychoneuroendocrinology, Apr 2004, 29(3):339 354, “Administration of progesterone produces mild sedative-like effects in men and women”

2) The Journal of Clinical Endocrinology & Metabolism, Jan 1 1974, 38(1):142-147, “Inhibition of Testosterone Conversion to Dihydrotestosterone in Men Treated Percutaneously by Progesterone”

3) Clin Endocrinol (Oxf), 1980 Nov, 13(5):409-12, “Leydig cell tumour of the testis with gynaecomastia and elevated oestrogen, progesterone and prolactin levels: case report”

4) Plast Reconstr Surg, 2000 Oct, 106(5):1011-3, “Estrogen and progesterone receptors in gynecomastia”

5) Gynecol Obstet Invest, 1993, 36:234 238, “Progesterone Reduces Sympathetic Tone without Changing Blood Pressure or Fluid Balance in Men”

6) Br Med J (Clin Res Ed), 1985 Jan 5, 290(6461):13 14.”Natural progesterone and antihypertensive action”

7) The Aging Male, 2004, Vol. 7(3):236-257, “Progesterone: the forgotten hormone in men?”

8) https://peaktestosterone.com/forum/index.php?topic=2111.5;wap2

9) https://peaktestosterone.com/forum/index.php?topic=2270.5;wap2

10) https://peaktestosterone.com/forum/index.php?topic=244.0

11) J Endocrinol. 1981 Jul;90(1):97-102, “Effects of testosterone, pregnenolone, progesterone and cortisol on pituitary and testicular function in male golden hamsters with gonadal atrophy induced by short photoperiods”

12) Fertility and Sterility, 1992, 58(6):1191-1198, “Direct effects of progesterone and antiprogesterone on human sperm hyperactivated motility and acrosome reaction”

NOTE:  Are you high or low in progesterone?  You can find out yourself through one of these Testosterone and Hormone Labs.

4. High Blood Pressure. Progesterone, likely from the effects of #2, can improve blood pressure a little in men and, of course, hypertension is one of the leading risk factors for erectile dysfunction. [5][6] For more information, see this link on High Blood Pressure and Erectile Dysfunction.

5. Sleep Improvement. Progesterone plays an important role in sleep and sleep quality. [7] Some commentators believe this is progesterone’s primary role, because Sleep is So Critical to Male Health.

7. Fertility. Sperm hyperactivation may not sound like a good thing, but it’s actually important in order for the egg to be fertilized.  Progresterone is actually one of the major factors responsible for this. [12] You can get your levels checked at one of these Man Friendly Labs.

NOTE:  One of the Peak Testosterone Forum members reported  that progesterone restroed the size of his testes: [8] “As a side note, (just thought about this ), I do have a fair amount of testicular atrophy going on because I was so low testosterone for so many years. I found that using progesterone cream stopped the atrophy. You can find more about this by googleing men and progesterone.” However, the above does not make sense to me and was contradicted by an animal study. [11]

DOSAGES:  The dose that physicians seem to be using is based on a couple of reports that I have received on the Peak Testosterone Forum and are in the 10-50 mg/day range when it comes to the creams.  Again, I do not know about long term safety and nor does anyone else, but here is what these men reported:

“I use Source Naturals natural progesterone cream, which has 500 mg progesterone per ounce, or 22 mg per 1/4 teaspoon. I use about 1/4 teaspoon twice a day. Don’t go by the instructions on the package, as these are for perimenopausal women. I use it every day without a break.”  [9]

“I have been discussing a progesterone/Testosterone compound with my physician. He states that he has many of his patients on a compounded cream of prog/test (10mg/50mg daily) from a pharmacy in town. He said that the progesterone will help block some of the estrogen, therefore blocking some estrogen side effects.” [10]

Does Testosterone Therapy Cause Prostate Cancer? - Peak Testosterone

Another huge question in the minds of many men on TRT (testosterone therapy) such as myself is whether or not it will increase risk for prostate cancer.  Several large, well done studies – see below – have showed this not to be the case and that testosterone therapy does not appear to increase prostate cancer risk. Of course, since I am on HRT, this is what I want to believe, especially since I feel so much better with subQ cypionate injections.  However, nothing in this life is usually that clean cut and so I want to start out by issuing several cautions:

1. There are standard contraindications to TRT, such as liver problems and high RBC’s/hematocrit/hemoglobin.  However, probably front and center would have to be prostate issues, including an enlarged prostate or past/existing prostate cancer that need to be discussed with your physician.

2. Some of the pro-testosterone has been funded by those who have received money from testosterone manufacturers.

3. My urologist, who is a smart guy and graduated from an Ivy League university, absolutely insists that TRT (testosterone therapy) increases risk by 3-4% in men and that he has seen this in his practice.  Some urologists feel this way.

REFERENCES:

18) Cancer, Epidemiology, Biomarkers Preview, v.6, 1997, p967-9

19) Prostate, v.27, 1995, p. 25-31

20) Journal of Clinical Endocrinology and Metabolism, v82, 1997, p571-5

21) Int l Journal of Andrology, v.25,2002, p119-125

22) Cancer Research v.59,1999, p4161-4; Amer Journal of Clinical Oncology v20,1997,p605-8;Journal of urology, v163, 2000,p824-7; Prostate v47, 2001, p52-8; Journal of the American medical Assoc, v276, 1996, p1904-6

23) Am J Clin Nutr. 2007 Feb;85(2):523-9

24) UUrology,2007,70:672-676

25) Amer J of Epidem,2008,167(1):71-77

26) PLoS ONE, 2008, 3(7):e2568

27) Cancer Epidemiology, Biomarkers & Prev, Nov 1, 2007, 16:2213, “Cholesterol-Lowering Drugs and Advanced Prostate Cancer Incidence in a Large U.S. Cohort”

28) Cancer Epidemiol Biomarkers Prev 2009, 18:2807-2813, “Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the Prostate Cancer Prevention Trial”

29) Cancer Epidemiol Biomarkers Prev 2009; 18:2814-2821, “Prediagnostic total and high-density lipoprotein cholesterol and risk of cancer”

Cancer Epidemiol Biomarkers Prev, 2009;18:2805-2806, 2807-2813, 2814-2821

31) Harvard Men’s Health Watch, June 2007

32) CA Cancer J Clin, 2004, 54:68,”TOMATOES BEAT LYCOPENE ALONE FOR PROSTATE CANCER PROTECTION”, https://caonline.amcancersoc.org/cgi/content/full/54/2/68

33) https://www.northwestern.edu/ newscenter/stories/2010/11/soy-prostate-cancer.html, Northwestern University Newscenter, Nov 8 2010, “Soy May Stop Prostate Cancer Spread: Experimental soy-based drug shows benefits in men with localized prostate cancer”

34) The Lancet, 1 January 2011, 377(9759):31-41,”Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials”

35) https://www.dailymail.co.uk/health/article-2359466/Taking-omega-3-fish-oil-supplements-increase-risk-aggressive-prostate-cancer-70.html

36) JAMA, 2011, 306(14):1549-1556, “Vitamin E and the Risk of Prostate Cancer The Selenium and Vitamin E Cancer Prevention Trial (SELECT)”

37) J Natl Cancer Inst, 2000 Dec 20, 92(24):2018-23, “Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer”

38) https://www.medicalnewstoday.com/articles/260338.php

39) European Urology, Jan 2015, 65(1):115-123,”A New Era of Testosterone and Prostate Cancer: From Physiology to Clinical Implications

40) EUROPEAN UROLOGY, 2012, 62:765 767, “Goodbye Androgen Hypothesis, Hello Saturation Model”

41) Journal of Urology, Accepted: May 29, 2015; Published Online: June 08, 2015, “Long-Term Exposure to Testosterone Therapy and the Risk of High Grade Prostate Cancer”

There are many problems with the TRT-causes-prostate-cancer way of thinking and considerable research data began to cast doubts in the minds of many.  Let’s look at some of the research that show the exact opposite of the testosterone-fuels-prostate-cancer theory

1. STUDY: Higher Testosterone = Lower Prostate Cancer.  A huge epidemiological study of 28,000+ men found that the higher the T-levels , the lower the incidence of prostate cancer. [18] John Hopkins researchers found men without prostate cancer had average T-levels of 636 ng/ml while prostate cancer patients average levels of 473. [19] Again, if increasing testosterone is dangerous to the prostate, one would not expect this result.

2. STUDY: Testosterone Therapy Does Not Increase the Risk of Aggressive Prostate Cancer. What you really care about is avoiding the aggressive from of prostate cancer, which can spread easily and kill you in a matter of months. [40]  A recent (2015) study by the Journal of Urology showed no increase the nasty form of prostate cancer, again completely counterintuitive to the standard model. [41] By the way, this study looked over a fairly long time frame of five years.

NOTE:  You should also check out my page How to Lower Your PSA, which shows the latest research on how to lower your PSA, and my page that discusses the research on How to Prevent Prostate Cancer.

3. STUDIES: High Testosterone Increases Survival from PC.  Several studies have shown that the higher one s testosterone, the better the chance of survival from prostate cancer. [22] Why would higher testosterone protect men from prostate cancer if testosterone is what causes and spreads it in the first place?  Again, that does not seem to add up.

4. STUDIES:  Low Testosterone Increases the Risk of Prostate Cancer.  A recent research summary pointed out that most studies show that low testosterone, and not high testosterone, increase the risk of more advanced forms of prostate cancer and the likelihood of developing cancer even after the prostate has been removed. [39] From this data, one can only argue that testosterone appears to be protective not harmful.

5. STUDY: Natural Testosterone Shrinks the Prostate. The University of Utah studied 214 identical twins and found that the size of the prostate one of the curses of middle and older aged males was inversely related to T-levels. [20] Does somthing that decreases prostate size really increase prostate cancer risk?  I guess anything is possible, eh?  (Prostate size does NOT necessarily have anything to do with prostate cancer.  You can have a small prostate and nasty aggressive prostate cancer.  My point is that usually things that are natural and healthy for the body come in packages and improve health in many complementary ways.)

6. STUDY: Supplemental Testosterone Shrinks the Prostate. Similar to #2, one study showed that men given supplemental testosterone actually shrank their prostates! [21] Again, testosterone seems generally prostate friendly and not the opposite.

NEW MODEL: The Saturation Model.  All of the above data lead a small group of researchers to come up with a completely different model relating testosterone to PC and dubbed it The Saturation Model. The pioneers were Drs. Muller and Morgentaler, who point out that the data seems to point out that testosterone has a finite, limited ability to fuel prostate cancer.  Dr. Morgentaler, in my opinion, argues eloquently for this view and develops it fully in a landmark paper in the journal European Urology. [40] There he states that testosterone can stimulate prostate cancer growth at very low levels of testosterone and then additional testosterone makes no difference.  This is why the pharmaceutical lowering of testosterone to essentially castrate a man does help with prostate cancer:  Furthermore, this is why raising testosterone past, say, a 100 ng/dl makes no real difference in prostate cancer rates.  It simply does not matter any more, because testosterone has done all the prostate stimulation that it is going to do back at 100 (or whatever the very low T number is).

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

CAUTION: Of course, I encourage you to talk to your doctor:  it is his job to stay up on the latest research and, of course, he will have experience in his own practice as well.  Perhaps some subpopulation of men is at risk for prostate cancer and he or she is aware of this link.  In general, though, the saturation model makes a lot of sense to me.  However, I do want to point out that some men go on testosterone therapy and increase their testosterone quite high and estradiol increases with it of course.  Furthermore, many men, at least here in the U.S., are overweight or obese and so their estradiol levels shoot up to unnaturally high levels, much greater than during their youth generally.  And most doctors ignore these high levels of estradiol and do not encourage their patients to lose weight, lower their dosage or perhaps manage their estradiol.  The reason that I bring this up is that there is some evidence that higher estradiol levels are linked to prostate cancer risk, something I outline in my page High Estradiol, Prostate Cancer and BPH (Enlarged Prostate), although it does not show up in the above studies as far as I know. Again, discuss with your doctor.

NOTE:   I have struggled with a mildly elevated PSA after going on TRT, but so far there is no evidence of prostate cancer but rather inflammation.  You can read about this in my pages High PSA But No Cancer and My Recent 4kScore Test Results.

How the Food Industry Is Risking Your Health - Peak Testosterone

Almost all of us have looked in horror at a packaged food with, literally, forty or fifty ingredients.  The thought crosses all of our minds, “Do they really know all these ingredients are safe for me and my family?”  Let me answer that for you:  “No!”

In fact, not only do that know whether it is safe for you, but they do not care. Actually, I am sure that there are those in the food industry with a conscience, but my opinion is that those type of companies and individuals are few and far between.

Let me give just one example.  In 2008 a journal article highlighted the dangers of a chemical called diacetyl, a chemical used to give buttered popcorn its flavor and added to many other products as well.  Diacetyl has, after years of use, been linked to “severe lung disease” and a condition called “bronchiolitis obliterans”.  And guess what?  Researchers found toxic levels, which is only a few parts per million, all over various facilites that they examined. [1]  Now why would they put a chemical like this within ten miles of a plant that handles food??  Ignorance?  I doubt it in this case.

But, for all their culinary and chemical genius, they are creating a toxic cesspool in your kitchen. Common sense tells you that you cannot just take everything you come up with a chem lab and throw into your pasta sauce and have it be safe.  But these people have no common sense and no conscience.

Here is another example:  titanium dioxide.  Titanium dioxide has been classified as a potenially mutagenic by the Internation Agency for Research on Cancer (IARC) as an IARC Group 2B, which means a “possible carcinogen to humans”. Now one would think that something that is potentially carcinogenic would not be in any products, much less something you would put in your mouth, right?  Wrong!  It is nearly ubiquitous, being found in a wide variety of home and consumer products including tooth pastes and foods. The argument is that it is safe when consumed because it cannot get to the lungs, but I would argue, “Why put a toxic chemical into our food, even if it is toxic in a different usage??”  Get the crap out of my plate and my toothpaste!

Another example is sodium nitrite which is added to meats and packaged foods containing meats by the bucket.  Nitrites can in a heated environment (like in a frying pan), or, in an acidic environment (like in your stomach), create carcinogens.  Now why would you pour that all over our meat supply?  Of course, if you eat a plaque-reducing Low Fat Diet, you won’t have to worry about that, but it still highlights the irresponsibility of the food industry.

By the way, this is only for the chemicals that you know about.  If the packaging says “natural flavoring”, “artificial flavoring” or “spices”, you have absolutely no idea what they are putting into it.  “Flavors” are considered proprietary and necessary to protect the manufacturer.  However, what the consumer does not realize is that literally dozens of untested, unproven chemicals are thrown into the “flavor” mix and none of it is revealed on the package.

Look at what the ingredients that are hidden in a typical strawberry milk shake for example: “amyl acetate, amyl butyrate, amyl valerate, anethol, anisyl formate, benzyl acetate, benzyl isobutyrate, butyric acid, cinnamyl isobutyrate, cinnamyl valerate, cognac essential oil, diacetyl, dipropyl ketone, ethyl acetate, ethyl amyl ketone, ethyl butyrate, ethyl cinnamate, ethyl heptanoate, ethyl heptylate, ethyl lactate, ethyl methylphenylglycidate, ethyl nitrate, ethyl propionate, ethyl valerate, heliotropin, hydroxyphenyl-2-butanone (10 percent solution in alcohol), a-ionone, isobutyl anthranilate, isobutyl butyrate, lemon essential oil, maltol, 4-methylacetophenone, methyl anthranilate, methyl benzoate, methyl cinnamate, methyl heptine carbonate, methyl naphthyl ketone, methyl salicylate, mint essential oil, neroli essential oil, nerolin, neryl isobutyrate, orris butter, phenethyl alcohol, rose, rum ether, g-undecalactone, vanillin, and solvent “. [3]

This is all done by people called flavorists. Flavorists work their way through the food industry via an apprentice system.  Some have Ph.D.’s and some have little education, but it doesn’t really matter because it is considered more art than science.  Our reaction to food has been scrutinized and microanalyzed to where they know just what chemicals to add to give it the color, crunchiness, gumminess, slipperiness and so on. In the industry, they call this the rheological (or flow-related) properites of food. Books have been written about the rheology of food and it basically boils down to throwing a bunch of chemicals into your food, many of which can be disguissed as natural or artifical flavors.

Another of my favorites is diethylene glycol, which is a nasty chemical that has caused caused deaths around the globe in various tainted and contaminated products. It is used in hydraulic and brake fluids, coolants and other industrial uses.  It also makes its way into our food supply in trace amounts through polyethylene glycol, which is used in toothpastes, eye drops, and some foods. In the U.S. “only” 0.2% diethylene glycol is allowed in any ingested polyethylene glycol products. [6] Natural News reports that “Aldehyde C-17, flavoring for cherry ice cream, is an inflammable liquid used in dyes, plastics, and rubber. Piperonal, used in place of vanilla, is a lice killer. Ethyl Acetate, a pineapple flavor, can also clean leather and textiles.” [7] Bon appetit!

You also often get a nasty dose of some very toxic chemicals in the packaging process of many foods.  A great example is microwave popcorn which has a nasty carcinogen (PFOA) that vaporizes and disperses onto your popcorn when you heat it in the microwave. Somebody really thought that one out, eh?  (Read this Wikipedia link for an extensive list of studies showing just how toxic this stuff is.)

Canned tomato products are other great examples in this category.  Tomatoes are acidic and pull a toxin, bisphenol-A (BPA), out of the lining of the tin can it is stored in.  BPA is a xenoestrogen associated with various reproductive disorders in animals. Even a very minute amount can have a negative effect. And in a recent Consumer Union study of various canned goods, the BPA problem was found to be much more widespread than previously imagined. [5] Almost every canned product tested, including green beans, Juicy Juice, soup, corn, chili and baby formula, had signficant BPA levels and researchers estimate that it would be very easy for someone to consume levels of BPA close and equivalent to that which caused reproductive issues in animals.  I recommend that you avoid canned goods until the FDA sorts this out.

Notice that I have not even talked yet about Excitotoxins or partially hydrogenated oils.  The bottom line is, unless you know every ingredient on the package and it does not say “artifical flavors”, “natural flavors”, “spices” or anything similar, don’t buy it and don’t use it. In general, it is much better to prepare your own food, even if it is simple, than to eat food prepared by flavorists and the food industry.

NEWS FLASH:  Processed foods have just been linked to depression. [4] This is not surprising since they are full of excitotoxins, transfats, high glycemic foods and who-knows-what-chemicals and low in vitamins, antioxidants and minerals.  Your brain, more than any other organ in the body, needs an abundant supply of vitamins and minerals as well as protection from free radical damage and poor blood flow.  You will only get the opposite effect from processed foods.

REFERENCES

1) J of Occupational and Environ Hygiene, Nov 2008, 5(11):679-688(10), “Diacetyl Exposures in the Flavor Manufacturing Industry”

2) https://www.ccohs.ca/headlines/text186.html

3) https://rense.com/general7/whyy.htm

4) The Brit J of Psychiatry, 2009, 195: 408-413, “Dietary pattern and depressive symptoms in middle age”

5) https://www.prnewswire.com/news-releases/consumer-reports- tests-find-wide-range-of-bisphenol-a- in-canned-soups-juice-and-more-68723862.html

6) https://en.wikipedia.org/wiki/Diethylene_glycol

7) https://www.naturalnews.com/ 023849_ice_cream_chemicals_harmful_chemicals.html

In some cases, it undoubtedly is ignorance.  Researchers recently found two food additives that are xenoestrogens, i.e. environmental estrogens that can impact us.  The first food additive, propyl gallate, is a common preservative used to prevent fat spoliage in items such as baked goods, shortening, dried meats, candy, fresh pork sausage, mayonnaise and dried milk. The second additive, 4-hexyl resorcinol, is used to prevent discoloring in shrimp, lobsters and shellfish.

So, in the case of these food additiives, the food industry probably just never bothered to test whether or not these were endocrine disruptors.  In my opinion, it is inexusable to throw a bunch of chemicals into something that people are going to eat just to add texture or a certain flavor or for any reason when it is has not been tested for years. (By the way, an increasing number of tainted products from China have been spread throughout the globe as well.)

This is what you MUST realize:  the flavor industry is very mature and extremely sophisticated in knowing how to sell food.  They know the exact chemical that gives marshmellow its flavor.  They have equipment to analyze the hundreds of chemicals that make up the flavor of coffee or a strawberry.  They know how to give something proper texture, color and crunchiness.

Pomegranate Juice and Erectile Dysfunction - Peak Testosterone

Pomegranate juice has amassed a significant body of research showing that it can improve many health markers, particularly cardiovascular, that are linked to improved erections.  And Peak Testosterone readers know the maxim:  “if it’s good for the heart, it’s good for the penis.”  (Thanks to Dr. Lamm for that concept.) And it is true, because if you lower blood pressure, increase nitric oxide, reverse plaque and improve lipids – all of these things will almost always help any erectile dysfunction you may be struggling with.  Verifying this is a showing pomegrantate juice improved erectile function in 42 men with ED. [2]

This is something that I have seen confirmed on the Peak Testosterone Forum. Look at the comments of this man:

“Back to the individual labs that we call our own bodies, I have to say the POM juice has had a very noticeable positive effect for me over the last three months. In reading further on these few threads, I have added more nitrate friendly veggies multiple times per day when possible. I can’t eat a whole bag of arugula like PeakT, but I try. Lately I have added 1.5g of Citrulline and grape seed extract pill (subbing in for Pycnogenol). I would agree with the one comment that if your anxiety/stress levels shoot up, or sleep is disturbed, this protocol can’t overcome it with immediacy of Viagra/Cialis. However, on a regular basis, I have noticed a big difference, especially overnight and in the mornings. FYI, I drink 4-6 oz of POM brand with my breakfast.” [11]

Pomegranate juice certainly does not work that well for everyone, but we have an ongoing poll that shows that 17% of men who tried it feel it has improved libido and erections and another 17% that feel it has helped erections but not necessarily libido. [12] That’s about a third of the guys out there and is not a bad percentage for one juice. The research clearly backs up pomegranate’s excellent erectile and arterial properties.

You do have to watch for a fading effect with pomegranate juice, i.e. it works very well for a week or two or a month or two and then fades in efficacy.  Of course, one should not be relying on any one juice, food, supplement, etc. for their erectile strength:  it needs to a holistic, comprehenisve program based on what I have seen.  But pomegranate juice can be a nice tool in your arsensal.

Anyway, below are 7 Signs That Pomegranate Juice Will Improve Your Erectile Dysfunction:

1. Plaque Reversal (Sometimes).  You put all these properties together and Pomegranate Juice becomes a near magic elixir that actually partially reversed artheriosclerosis in one study!  You read that right – pomegranate juice can actually clear off some of the plaque in your arteries assuming you take it faithfully for three, six or even twelve months. [1] Here is a quote from Lef.org’s site about this study: “Remarkably, patients drinking 1.7 oz of pomegranate juice experienced a whopping 35% reduction in the IMT score and a 44% improvement in carotid artery blood flow”. IMT is the thickness between inner and middle layers of the artery.

REFERENCES:

1) Clin Nutr. 2004 Jun;23(3):423-33, “”Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation””

2) International Journal of Impotence Research, Nov/Dec 2007,19(6):564 567

3) Nitric Oxide, 2006 Sep, 15(2):93-102

4) Intl J for Vitamin and Nutrition Res, May 2006, 76(3):147-151

5) The J of Nutritional Biochem, 16(9):570-576, Sep 2005, B. Fuhrman, et. al., “Pomegranate juice inhibits oxidized LDL uptake and cholesterol biosynthesis in macrophages”

6) Clin Nutr 2004;23(3):423-33

7) Amer J of Cardiology, 98(5):705-706, Sep 1 2006, “Rhabdomyolysis Associated With Pomegranate Juice Consumption”, Alexey V. Sorokin, et. al.

8) The American Journal of Cardiology, Oct2009, 104(7):936-942, “Effects of Consumption of Pomegranate Juice on Carotid Intima Media Thickness in Men and Women at Moderate Risk for Coronary Heart Disease”

9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355694/

10) Am J Clin Nutr, 2000, 71:1062 76., “Pomegranate juice consumption reduces oxidative stress, atherogenic modifications to LDL, and platelet aggregation: studies in humans and in atherosclerotic apolipoprotein E deficient mice”

11) https://www.peaktestosterone.com/forum/index.php?topic=3693.0

12) https://www.peaktestosterone.com/forum/index.php?topic=3317.0

13) https://center4research.org/i-saw-it-on-the-internet/pomegranate-prostate/

The participants in this study were men with narrowing of the arteries (stenosis) due to arterial plaque buildup. This seems to be pomegranate juice’s “sweet spot”:  improving arterial health in men under oxidative stress and narrowing of the arteries.

One subsequent study studied giving 8 oz of pomegranate juice to middle and senior-aged men (and women) without significant narrowing of the arteries but at moderate risk for heart disease. [8] It found that pomegranate juice did not actually reverse arteriosclerosis in this case but would likely slow progression in those under oxidative stress, HDL or triglyceride issues.  Of course, this describes a huge subset of the population in any modern industrialized society.

So pomegranate juice may or may not reverse your arterial plaque, depending on the status of your health.

2. Increase Nitric Oxide. Are there other reasons to take pomegranate?  Yes!  One of the studies mentioned above [1] showed an average 20% drop in blood pressure. The reason for this is simple:  it will significantly increase Nitric Oxide output!  Yes, the same stuff that Viagra increases, pomegranate will do the same and one study showed as much as 50% in heart cells!

Of course, many supplements, fruits, vegetables and even a few grains will increase your Nitric Oxide levels. Researchers in one study looked at many of the heavy hitters in this category and concluded that Pomegranate Juice was “much more potent than Concord grape juice, blueberry juice, red wine, ascorbic acid [Vitamin C], and DL-alpha-tocopherol [Vitamin D]”. [3] See my book The Peak Erectile Strength Diet for more information.

3. Lowers Total Cholesterol and LDL. Arterial plaque can narrow and age your arteries and the penile arteries are always affected simultaneously. One of the ways that we can help protect the lining of our arteries is by lowering our LDL and pomegrante will do this for you. [4] One study found little change in lipids in health individuals, so this may vary as well based on your health status.

4. Inhibits Oxidized LDL. Oxidized LDL is what does the actual damage and pomegranate juice has been shown to limit this a variety of ways. [5] One set of authors wrote that “most importantly, PJ treatment significantly and substantially inhibited the progression of atherosclerotic lesions. PJ inhibited atherogenic modifications of LDL, including its retention, oxidation, and aggregation.” [10]

5. Lowers Blood Pressure. Probably the biggest and most consistent cause of erectile dysfunction is elevated blood pressure.  dramatically lowers blood pressure. [6]

6. Fertility.  There is an animal study showing that pomegranate improves sperm quality.  See my page on Natural Ways to Improve Fertility for details.

7. Prostate. There is some evidence that pomegranate juice may help fight against prostate cancer.  However, the primary study was funded by POM (as are some of the above studies), so many commentators feel that the more research is needed. [13]

CAUTION:  Pomegranate Juice can potentially interfere with certain medications including statins, calcium channel blockers, immunosuppressants,  antiarrhythmics and others.  The issue is that Pomegranate Juice (and Grapefruit Juice) affect the P450 3A4 enzyme system within the liver, i.e. absorption of certain drugs can be affected.  One journal documented a serious muscle tissue breakdown case that occurred from Pomegranate Juice interacting with a statin. [7]  Please consult with your doctor or pharmacist for possible interactions. In addition, please read my link on The Potential Side Effects of Pomegranate Juice : there was an animal study showing it increase the risk of Parkinson’s.

CAUTION: #2  Again, talk to your doctor if you are on any medications:   there are three reported cases of priapism occurring in men simultaneously taking Viagra. [8] Again, pomegranate juice is very powerful.

Secondary Hypogonadism - Peak Testosterone

REFERENCES:

1) Medical Hypotheses, April 1998, 50(4):331-333, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

2) International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

3) Med Hypotheses, 1998 Apr, 50(4):331-3, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

Secondary hypogonadism is usually considered to be the result of a defect in the pituitary or hypothalamus. The reasons is that leutinizing hormone is actually secreted from the pituitary gland after receiving signals of gonadotropin-releasing hormone (GnRH) from the hypothalamus. So reductions in either GnRH or LH can result in secondary hypogonadism.

CAUTION: One paper, though, commented that hypothalamic hypogonadism was the most common of this type of secondary loss of testosterone. [3] I am not in the least bit surprised due to the Abundance of Potentially Testosterone-Lowering Excitotoxins in our food and drinks, which can easily hammer the hypothalamus, which for the most part lies unprotected in front of the blood brain barrier. Diet drinks, fast foods and processed foods all often contain aspartame, MSG, autolyzed yeast extract and/or hydrolyzed proteins, all of which have high levels of excitotoxins.  Almost all modern wheys have high levels as well.  Read my link Whey of Death for more information.

Tumors on the pituitary or hypothalamus can, of course, cause this as well.

But it should be pointed that there is probably a hidden, often underdiagnosed cause of secondary hypoganadism that often goes undetected:

Free Testosterone-to-Estrogen Ratio Reduction.  As men gain weight, they begin to simultaneously experience reduced free tes tosterone levels and increased estrogen levels. [1][3] One very interesting (but small) study actually took men with secondary hypothalamic hypogonadism and treated them GnRH. [2] Because they had true secondary hypogonadism, their testes were reactivated and their T was restored to the upper end of the range. As a second stage to the experiment, the researchers began adding estradiol into the blood streams of these men and, as expected, their testosterone began dropping.

NOTE:  Any increase in estradiol can wreck havoc on erectile function.  Recent animal studies show that rising estradiol levels lead to delayed orgasm and nerve difficulties.

Researchers are very concerned that xenoestrogens (environmental estrogens) may play a role in this process as well.

How do researchers diagnose secondary hypogonadism?  One clue is when a man has lowish LH and FSH readings and also has low testosterone.  (High prolactin levels and low testosterone are often an indication of a Prolactinoma on the Pituitary.) Some doctors will often check for secondary hypogonadism by administering something that stimulates the testes, such as HCG. If testosterone rises significantly, then that is a sign the testes are fine and the body’s messaging systems are actually dysfunctional.

This kind of knowledge and experience is where a good endocrinologist (or an anti-aging, sports medicine or fertility physician) can come into play.  Some urologists are also becoming very knowledgeable in hormones.  Thus it is really up to the patient to find out how much his doctor knows about endocrinological issues.  As always, caveat emptor…

How to Get Off of Cialis and Viagra - Peak Testosterone

Many of the men on the Peak Testosterone Forum would like to stop Viagra or Cialis but just don’t know how. Some research indicates that you can Become Dependent on PDE5 Inhibitors and so greater dosages are needed to achieve the same effect. And since these are medications with frequent and significant side effects and so, as the dose increases, so does the chance for issues. Men realize this at a certain point and try to quit, but it’s not easy.

That is why I was excited when one of the members (TimeZones) of our forum was able to successfully stop Cialis and Viagra and, more importantly, did it using purely natural strategies. In fact, when you read his protocol, it’s basically just common sense and living the way the most elite supercultures live.  I guess it is no shock that it would work well to restore erectile function as well.  (See my pages on A Reveiew of the Longest-Lived Supercultures for additional details and my header page on PDE5 Inhibitors for some basic information on the pros and cons of Levitra, Cialis and Viagra.)

Just how did he do it?  Here is how he described his protocol in this thread:

DISCIPLINES: “The BIG THINGS you want TO DO are: WALK (at least an hour per day) JUICE (celery especially, followed by spring mixes) EAT HEALTHY (plant based, low/no fat, unprocessed, moderate/low carb)“

DIET:  “And you know what’s funny? The diet I’m on now is exactly what Jack LaLanne and Dr. Esselstyn (google “Forks Over Knives”) preached/have been preaching for years. I only found out that my diet mirrored Jack’s after googling the name on my juicer (it’s a Jack LaLanne brand juicer). Anyhow, moderate fish, 5-6 egg whites per day, and plants with more plants and pounds more juiced vegetables is the way to go…I used to think that taking PDE5i’s would — and should — cure ED while buttering up foods, adding olive oil to everything I ate because “it’s a healthy oil,” having saturated fats (e.g. cheese, animal products), etc etc then wondering why 10+ mg of cialis wouldn’t work. Now, I see that my diet is more linked to my ED than anything else.”

EXERCISE:  Plenty of WALKING (2 hours per day).

DIET PART 2: ” Again, the BIG THINGS you want to AVOID are: FATS (avocados, oils of all types [especially canola and olive]) STAYING SEDENTARY BAD DIET (anything that isn’t whole foods and plant based IS POISON)

SUPPLEMENTS: I have experimented with garlic and vitamin C, but in general, L-citrulline is the best supplement ..Cacao and ginseng are good, too.

I had many questions for him and did a follow up interview shown below.  First a few important comments and cautions:

1) Why a low fat diet?  The primary reason is that saturated fat lowers nitric oxide and sludges up the arteries. Young guys can usually eat a lot of saturated fat and not notice the different in their erections.  However, as arterial plaque builds up and a guy ages, he becomes more and more sensitive to it.  Wild game and most natural foods are relatively low fat:  we simply weren’t designed to handle the fat-marbled high fat industrial meats.

NOTE: Of course, it’s always prudent to implement lifestyle changes, because erectile dysfunction is often a sign of the beginnings of heart disease. However, I do want to point out that we also had a Peak Testosterone Forum member Quit Cialis Cold Turkey.

A. I had a history of competitive bodybuilding (AAS use) and long-distance cycling. I have always been fit, but these were the main culprits.

Q. What made you want to quit? I believe you had some nasty side effects, right?

A. I wanted to quit due to the development of PED5i tolerance development. In other words, I saw that if I continued down the path I was taking of daily cialis/viagra that total tolerance would develop.

Q. How much were you taking at the time, what drug and how often?

A. I was taking 20 mg of cialis every other day when using cialis, and when using viagra, I was taking 50-100 mg per day.

Q. And how long had you been taking PDE5 inhibitors?

A. I had been taking PED5i’s since age 28.

Q. You mentioned that you walked two hours every day. So do you walk two hours straight or break it up?

A. I walk for two hours straight. I haven’t experimented with breaking it up, but that’s a good idea that I may look into.

Q. Why not throw some jogging in there? (I like the idea of just walking so as not to overtrain, but I was wondering what your reasoning was.)

A. I have foot and knee issues, so I don’t jog. I may start jogging once my foot issues clear up. Thanks for the suggestion.

Q. Are you doing any other kind of exercise, such as weight training or HIIT?

A. I do light weight training 1x-3x per week. I don’t do any HIIT.

Q. Why two hours? Have you tried walking a lesser amount of time, but it didn’t work?

A. Two hours seems to be the most natural time to be outdoors at a stretch. I’ve been walking upwards of 3 hours, some days. Lesser time doesn’t seem to be as effective toward ED amelioration, either.

Q. Are you consuming a low fat diet? 10-15% of calories probably?

A. Yes, I consume a low fat diet. 10-15% would be an overestimate, even. I’m guessing that it’s 10% maximum.

Q. You mentioned that you follow a cross of Jack LaLanne and Dr. Esselstyn’s diet? In other words, you’re 95% vegan except for those egg whites, eh?

A. That’s correct. With the exception of fish and egg whites, my diet is exactly what Dr. Esselstyn uses. Jack LaLanne’s diet is exactly like mine. I didn’t try to mimic Jack LaLanne’s diet, either; it just came naturally to me through trial and error.

Q. How do you implement this? Cooking? Smoothies?

A. I do a lot of juicing. More on that later. As far as cooking goes, I don’t do much of it. Most of the food I eat is done with a rice cooker where I basically put different grains and legumes into a pot, and then when its almost finished cooking, I’ll put whatever vegetables I want inside with everything else. I bake salmon fillets and eat sardines out of a can. Egg whites are fairly easy to get precooked at Trader Joes.

Q. How important of a role do you think high nitrate foods plays in your protocol? And how much of those are you consuming roughly? Can you give us an exmample of a typical day?

A. High nitrate foods are very important. Probably the most important. I consume the majority of my high nitrate foods using a juicer. Celery, beets, kale, spinach, arugula, etc etc.

Here’s a typical day:

Morning:

Lunch:

Dinner:

Following meals most days I’ll have a couple of kyolic garlic pills and a cayenne pepper extract pill.

Q. Where do you get your carbs? Do you consume any wheat or refined carbs?

A. I don’t get much wheat. I avoid anything refined or processed.

Q. So you have no nuts or oils of any kinds?

A. No, I don’t have any of those. Occasionally I’ll sprinkle chia seeds over one of my meals.

Do you get morning erections?

A. No. I get them at night. The ones I get at night are the ones I use as a judge for how well my diet/activity during the day affected things.

Interview on Quitting Cialis and Viagra

2) Why primarily plants with some fish and egg whites?  Plants increase blood flow, lower blood pressure and raise nitric oxide.  This is the subject of my book The Peak Erectile Strength Diet.

3) CAUTIONS:  You have to be careful with raw cocoa as many of them were found to have high levels of cadmium.  Also, you want to get at least 10% fat in your diet from what I have read to ensure mineral and vitamin absorption.  The supercultures mentioned above are usually in the 15-20% range, but I feel better, like TimeZones, nearer 10%..

Below are the follow up questions I asked him, which outlines the underlying causes of his Cialis and Viagra usage and how he was able to quit:

GUEST INTERVIEWEE: TimeZones

Q. What is your age and how long do you think you had erectile dysfunction before you started your new program?

A. I’m 33 and my ED started at 28. My protocol started at age 32 and has been ongoing, since.

Best HRT: My Vote is For SubQ Cypionate - Peak Testosterone

I’ve been on HRT now for over six years and it has been quite the uphill battle at times.  Initially, I tried Androgel, compounded creams, Testopel pellets and intramuscular testosterone cypionate injections in that order. Androgel did nothing for me, but all of the other options brought improvements to my life and health.  However, it was unquestionably subQ testosterone cypionate that seemed to solve all of my problems, i.e. provide nice, steady levels of testosterone and estradiol with no side effects or the necessity of taking an aromatase inhibitor such as Arimidex (anastrazole).

For those who don’t know, subQ means subcutaneous, i.e. injecting into the subcutanteous fat layer.  It is commonly used for a number of medicines including insulin and so docs are generally well familiar and even comfortable with it. My current protocol is 50 mg twice weekly into the abdominals.  Of course, if you try this protocol, your doctor will give you instructions as to how he or she wants you to do it.  Here is some starter info in this thread  How to Do Different Kinds of Testosterone Cypionate Injections if you want more information.

But, before I to into more detail as to why I think subQ is so the best protocol out there for most guys, let me cover the significant disadvantages that I see with the other delivery systems.  Please keep in mind that these are just my opinion and what works for me:  you and your doc have to decide what is best for you.

1.  Topicals. First of all, I have kids and a wife and I was always concerned they might be getting some exposure.  I always washed myself and covered the area, so I doubt it was ever an issue.  But it was just a nagging doubt that seemed to linger.  However, a more realistic concern is one uncovered by ZRT Labs – thanks Sam for the rec!  – that showed that the topical testosterones create a non-physiological and unnatrual distribution of testosterone within the body – something I cover in link on Potential Risks Associated with Testosterone Therapy – where very high testosterone and estradiol levels exist in the capillaries.  Assuming this is true, I figured it cannot be a good thing.  (Besides, Androgel never boosted my T a ng!)

In addition, topicals tend to jack up DHT levels to supraphysiological levels.  I have seen many time on the Peak Testosterone Forum, men with 2, 3 or even 4 times the upper value of the lab range for DHT in men that are on topical (transdermal) testosterone. This is essentially a “steroid” level of DHT, and I cannot see any good coming out of that long term. Time will tell I guess.

2.  Longer Term Solutions (Pellets and Undecanoate). Both testosterone pellets (implants) and testosterone undecanoate (Nebido / Aveed) are solutions that do not need to be done weekly or daily but rather every 2-3 months (roughly).  As such, they are very convenient for some men.  However, the problem is that these delivery systems give a fairly slow ride up to peaking levels and then a slow ramp down.  Some men are not going to feel as good during the pretty quick ramp up and down.  I basically had a few good weeks out of 3 months and that was about it.  It gave me a taste as to what HRT could do for me, but did not give me reliable results.  Plus, some men will find that, when the pellets or undecanoate hits peaking levels that they are too high in estradiol..  And it will be difficult for a doctor to prescribe Arimidex or maybe DIM / chrysin, because the levels change significantly from week-to-week.  There are other issues, but I’ll let you read my page on Testosterone Pellets for more information if you are interested.

3.  Intramuscular Cypionate. I am very thankful that I was put on intramuscular cypionate by my former HRT clinic:  it restored my morning erections for the first time in my life and got rid of three decades of mild depression virtually overnight.  That said, even weekly cypionate give you a pretty wild ride with your testosterone and estradiol.  I ended up with a little gyno because of it and, for awhile I was on Arimidex as well.

While each of the above provided improvement over the former, I did not like the battle with even mild gynecomastia, nor swings that I felt weekly.  And this is where subQ stepped in.  Look at what subQ testosterone cypionate injections did for me:

For all these reasons, I think that I can make a compelling case for subQ testosterone cypionate being the best overall choice out there.  Men who are Low SHBG may feel better using a shorter ester such as propionate. However, we have had at least one low SHBG man who has successfully used cypionate.

I also like the fact that I seem to feel better with each passing month that goes by.  This might just be coincidence, but I feel that, as time has gone on, morning erections are coming more steadily and more strongly and the body is almost “healing” itself from the years of either low or unsteady testosterone levels.

The Best HRT? I Say SubQ Cypionate

Saw Palmetto and Facial Hair - Peak Testosterone

I recently had a young reader write in and ask if Saw Palmetto could prevent facial hair growth and development. What he had noticed is that he had had very little facial hair growth for the last year or so since taking Saw Palmetto and was wondering if there was a correlation.

Saw Palmetto is known for its DHT-lowering capabilities and has been used to treat enlarged prostate and hair loss, two conditions related to DHT levels. In fact, some experts have observed that Saw Palmetto not only lowers the rate of DHT formation but also its binding abilities as well. [1]  However, in spite of its superpowers, clinical use of Saw Palmetto has been limited and results controversial.

CAUTION:  Some of you may wonder why a young guy would take Saw Palmetto in the first place, because they rarely have hair loss or enlarged prostate?  The answer is often steroid use. Some of the steroids will raise DHT levels and young guys will take Saw Palmetto for preventative measures.  (They will also often take estrogen blockers as well.)

1) INTERNATIONAL UROLOGY AND NEPHROLOGY, 33(2):217-225, “Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH)”

2) Journal of Clinical Endocrinology & Metabolism, 76:524-528, “The androgen control of sebum production. Studies of subjects with dihydrotestosterone deficiency and complete androgen insensitivity”

3) British Journal of Dermatology, Nov 1982, 107(5):559-564, “Relationship between plasma testosterone and dihydrotestosterone concentrations and male facial hair growth”

4) https://www.nytimes.com/2007/10/25/fashion/25Skin.html

5) The Journal of Alternative and Complementary Medicine, April 2002, 8(2):143-152, “A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-?-Reductase in the Treatment of Androgenetic Alopecia”

HRT Levels (Estradiol) - Peak Testosterone

HRT LevelsOne question I get from time to time is:

What HRT levels should I shoot for?

Men that ask this question are looking for the ideal testosterone (T) and estradiol (E2) level necessary to get them over their low testosterone symptoms.  And oftentimes they ask me this question, becuase, quite frankly, their doctors seem to know very little about ths subject.  Based on what I have seen in  the Peak Testosterone Forum, the typical endocrinologist will tell a man that his testosterone of 300 ng/dl is just fine and maybe hand him some Cialis.  They will even suggest psychotherapy or just ask the man to leave since their “hands are tied”.  And, unfortunately, most PCPs are just woefully ignorant in this area.

The HRT clinics, and now many urologists are getting on board, take a completely different approach.  They usually have very specific HRT targets that are based, quite frankly, on the fact that they are generally effective.  While it is true that going on HRT is an involved decision and isn’t for everyone, the explosion of HRT clinics in the U.S. is simply because it makes most low testosterone men feel better.  And I am an exmple of that.

However, one key to their success is that they have honed over the years, through trail and error, specific T and E2 levels that seem to work very well on average at least.  For this reason, I want to discuss the HRT levels used by most of the HRT clinics from what I have seen. In fact, I’ll use my own clinic’s protocol as an example.  It has been very successful, is proud of its track record of safety and operates in multiple states.  (I have no affiliation with them.)

Here is how they handle things from what I have seen:

1.  They do several screens to make sure a man does not have existing or past prostate cancer or any other containdications.

2.  They also make sure that the man is low testosterone.  For them the definition is total testosterone < 450 ng/dl.l.

3.  They do weekly injections of testosterone cypionate.  .

4. They target peak and trough total testosterone of 1000-1200 ng/dl and 600-800 ng/dl, respectively.  Testosterone reads are done at the trough, i.e. 7 days after the shot.  Peak testosterone is then assumed to be about 300 ng/dl above the trough.

5.  They dose with Arimidex if necessary to bring estradiol (E2) between 20 and 30 pg/ml.  Armidex, a half dose, is taken on the fourth day after the injection to coincide with the peak.  A second half dose is taken two days later.

6.  They regularly ask their patients about how they are doing.  For example, some men will feel aggressive, overly alert and perhaps having trouble going to sleep.  This is time to back off a little on their testosterone dosage.  There is some tweaking that can occur in other words.

8.  If a man’s PSA goes over 2.5 or if the PSA increases by 1.0 within a rolling year time period (even if less than 2.5), then they will refer out to a urologist and get a urological clearance.

Again, this protocol is similar to many other HRT clinics.  It is very simple and has been honed by years of trial and error.  There are quite a few variables that had to be worked out, such as injection frequency, timing of Arimidex, intramuscular versus subQ and so on.  But when you get the right mix, the short and medium term results – HRT on this level has not really been done long term – seem to be excellent.

At my HRT clinic, for example, they said that they do not really need to advertise:  patients come mostly by word of mouth.  The solid majority of their men just love HRT with this kind of protocol and wouldn’t have it any other way.  It is greatly helping their sex life, their relationships with women and their relationships at work. Furthermore, for some men, mirculous things often happen.  I had my morning erections restored after decades of not having any.  A high percentage of type II diabetics find that they no longer need insulin any more.  Many men suddenly shed pounds and put on muscle like never before.  And many half-dead husbands say that they are finally chasing their wives around the bedroom again and that can be good for the relationship.

CAUTION: HRT does NOT always work like this.  Sometime there are multiple causes for low libido and erectile dysfunction for example.  In addition, there are certain groups that generally should not use HRT, such as men with advanced kidney disease and high RBC (red blood cell counts) or existing/past prostate cancer (although the latter is controversial).  If you have any medical conditions, do your homework and discuss with your doctor.  If you have hypertension, discuss with your doctor as well.  An occasional side effect of testosterone treatment is elevated blood pressure in men with existing hypertension.

The bottom line is that you are probably not going to do that if your doctor has you on Androgel with testosteorne of 350.  Nor are you likely to see much improvement if your estradiol is 55.  The HRT clinics have learned all these numbers the hard way over the edecades.

Now the above approach is quite “mechanical.”  However, you should be prepared that many doctors use a completely different approach.  Here are a few examples:

1.  Bioavailable or Free Testosterone.  One of our posters stated that his doctor targeted bioavailable testosteorne and liked to see 300 or more.  And with estradiol he liked teenage number between 15 and 22 pg/ml.

2.  Going By Feel Only.  One forum poster stated that his doctor went completely by “feel”, i.e. had a complete emphasis on sympotms.  Here is what he wrote:

“The HRT doctor will find out in a couple of weeks that I am on Testosterone injections because I am using his office to get the blood work done. I am using the HRT doctor to get the blood work done because my PCP doesnt want me to look at (or know) what my testosterone level is at. My pcp wants me to go by how I feel not by what number I am at. I agree with him to a point but I still want to know. Is that wrong?” [2]

So it’s either feast or famine when it comes to symptoms I guess!  Some endocrinologists could care less if you are just barely limping through life miserable with low testosterone symtpoms:  they just care whether you are above or below that magic 260 ng/dl number of the range.  And then you have a physicians like this who does not even trust the number for use in treatment.

NOTE:  Many HRT clinics will now offer HCG to the mix for a very reasonable price.  This is affectionately called “The Trifecta” by those who use the cypionate, Arimidex (anastrozole) and HCG triad.  HCG does nothing for some men.  However, for still others it 1) boosts mood, 2) may help with fertility in some cases and 3) reverses any testicular shrnikage.  Injection levels vary widely and I will cover that on another page soon.

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=1652.msg15890#msg15890

2) https://www.peaktestosterone.com/forum/index.php?topic=1577.0

Cortisol and Arrythmia - Peak Testosterone

Ever felt like your heart was skipping a beat?  A lot of us have from time to time.  Interestingly enough, arrhythmias can result from a rapid heart rate (tachyarrhythmias) or slowed heart rate (bradyarrhythmias).  Atrial fibrillation is another common term and is the most common type of arrythmia and means “irregular heartbeat”.

So is a heart palpitation, or arrythmia, a big deal? It is definitely something that you don’t want to play around with as it can be a sign of serious conditions such as heart disease, thyroid problems, anemia and changes in the heart muscle itself.  Better safe than sorry when it comes to the organ that is supplying oxygen and nutrients to the brain, don’t you think?  Plus, arrythmias are associated with long term health issues such as stroke and mortality, i.e. death. [1]

This is an involved subject, but below I list 14 Research-Backed  Causes of Arrhythmia, some of which are quite common and yet not that well-known:

CAUTION:  If you have a arrhythmia, always discuss any changes with your physician first.

1.  Minoxidil (Rogaine). Minoxidil, the common hair loss formulation for men, has a fairly common side effect of arrthymia and can actually change the heart.  See my link on Hair Loss for details.

Need to boost your Nitric Oxide naturally through food, drink and supplements? Check out Lee Myer’s book here: The Peak Erectile Strength Diet

Or do you need the most comprehensive testosterone book in Amazon? Here it is: Natural Versus Testosterone Therapy

2.  Caffeine. Heart palpitations can occur in people sensitive to caffeine.  If you’re one of them, I would still recommend decaf green tea because of the many health benefits.

3.  Nicotine and Alcohol.  Both of these are risk factors for arrhythmias.

4.  Excitotoxins and Free Glutamine. A couple of studies out there have linked glutamate with arrhythias and it is widely reported around the web as well, especially in guys using commercial wheys. [11] And it makes sense, because they overheat standard wheys which frees up a lot of the glutamate in the whey, turning it into “MSG” effectively. Look at what these authors wrote:

“Central sympathetic stimulation was achieved by intracerebroventricular injection of the excitatory amino acid L-glutamate (10 µmol), associated with inhibition of nitric oxide synthesis with L-NAME (40 mg/kg, iv). Glutamate triggered ventricular arrhythmia and persistent ST-segment shifts in the ECG, indicating myocardial ischemia.” [12]

Remember that free glutamine (in commercial wheys, autolyzed yeast extract, etc.) has trouble crossing the blood brain barrier, but it is a neurotransmitter and can apparently impact the ventricular nodes of the heart and lead to arrhythmias if levels get high enough.  You can probably avoid issues by simply using CFM wheys.  Read my links on Whey and Excitotoxins and Undenatured (CFM) Wheys – A Better Choice.

5. Low Carb Diets. Some men get heart palpitations while on a low carb diet.  Researchers have found that the high ketone levels – a low carb diet is sometimes called The Ketogenic Diet – can cause the nodes in the heart to struggle, something I cover in my page on  Low Carb Diets and Arrhythmias.

6. DHEA.  Ray Sahelian has reported that medium and higher dosages of this supplement can lead to dangerous heart murmurs.

7. Hypoglycemia.  One of our the members on the Peak Testosterone Forum told the story as to how he had some starch and triggered some arrhythmia. Of course, the healthiest and longest lived cultures on planet earth eat starch, so this did not make sense to me. It turns out there was more to the story: he was consuming a lot of maltodextrin:

“But recently (2 months ago) I have been having very strange “heartbeats”,exaclty the same as many years ago when I was having maltodextrin that was included in a protein shake I used to drink. I called a cardiologist and when I explained him my sympthoms, he told me that I must be eating something that was causing that,that it was not a problem of my heart. Anyway,he asked me about if I was abusing on any starch and when I told him about maltodextrin, he told me that that was the problem. I quit on that and bingo! the problem dissapeared imediately. Now, when I started having the problem again,I checked the ingredients on my actual protein shakes and also I went to forums and a lot o people blame certain whey proteins. I’m testing on switching to Casein and another brand of whey and I think I’m doing better.” [13]

Why was maltodextrin likely the problem?  The reasons is that it has an extremely high glycemic index – well over 100!  In other words, it really spikes blood sugar and insulin if you take a lot of it and that was what the poster was doing.  This very likely sent him into a hypoglycermic state which is linked with these sorts of issues.  And, in fact, some recent studies have found that this is the case with hypoglycemic states experienced by diabetics. [14]

8.  Drugs and Supplements. You should be suspicious of almost all drugs and supplements.  Yes, even supplements can zap you, especially those with ephedrine. [2]

9. Noradrenaline and Viagra. Anything that increases noradrenaline can increase the risk of an arrhythmia.  These include yohimbe, popular in many supplements, and Viagra. [3][8][9] In fairness, Viagra has sometimes shown positive changes in stroke and arrthymia paramters as well. (Discuss with your physician.)

10.  Stress, Sleep and Cortisol. Stress is a well-accepted arrhythmia-inducer. One study of women with breast cancer found that better sleep improved their cortisol response and, seemingly, reduced arrhythmias on average. [5]  Researcher in India found a direct correlation between stress hormone levels in the blood and severity of arrhythmia for example. [6]

11.  Electrolyes. Imbalances in electrolytes, sodium and potassium, can lead to heart palpitations. [4] Of course, Peak Testosterone readers are probably eating either a Low Fat Diet or a Mediterranean Diet and, therefore, a balanced distribution of both. If all else fails, have a banana.

12.  Insulin and Hypoglycemia. Hypolglycemia is common palpitation-inducer. This could be an issue for those dieting or struggling with pre-diabetes, diabetes and perhaps Metabolic Syndrome.

13. Creatine Supplementation. This is probably the number one muscle supplement used by bodybuilders, weight lifters and other athletes around the globe.  What many do not realize is that creatine is foundational in heart contractions and creatine supplementation has well-known side effect of heart murmurs and palpitations. [7]

14. Subclinical Hyperthyroidism. Many people have subclinical hyperthyroidism – around 1-2% of the population – where their TSH is ver low (< 0.1) and yet they are not treated because their T3 and T4 are n range.  It turns out that such people are at an increased risk of atrial fibrillation. [10]

15. Cardiorespiratory Fitness. At least in overweight patients with a-fib, those who had low fitness levels had almost five times the risk of a-fib when compared with those of high fitness:

“After four years of follow up, 17 percent of patients in the low cardiorespiratory fitness group were free from arrhythmia, compared to 76 percent in the adequate group and 84 percent in the high group.” [15]

Of course, talk to your doctor first and ask him/her to design a program for you.

REFERENCES:

1) https://www.cardiologyonline.com/journal_articles/Pulse_pressure.htm

2) J Am Coll Cardiol, 2004; 44:1675-1678, “Ephedrine increases ventricular arrhythmias in conscious dogs after myocardial infarction”;  Wien Klin Wochenschr, 2006 Sep, 118(17-18):558-61, “Ventricular tachycardia induced by abuse of ephedrine in a young healthy woman”

3) https://www.news.cornell.edu/chronicle/02/1.24.02/Weill_research.html

4) Natl Med J India, 1995 Jan-Feb, 8(1):13-4, “Correction of serum electrolyte imbalance prevents cardiac arrhythmia during amphotericin B administration”

5) J Clin Sleep Med, 2008 Oct 15, 4(5):441-9, “Vagal regulation, cortisol, and sleep disruption in women with metastatic breast cancer”

6) Stress and its management by yoga By K. N. Udupa, R. C. Prasad, p. 235.

7) Pharmacotherapy, 2005, 25(5):762-764, “Lone atrial fibrillation associated with creatine monohydrate supplementation”

8) Journal of Medical Case Reports, 2007, 1:65, “Ventricular tachycardia after administration of sildenafil citrate: a case report”

9) Neurology November 13, 2001, 57(9):1730-1731, “Transient ischemic attack and stroke associated with sildenafil (Viagra) use”

10) Postgrad Med J, 2004, 80:394-398, “Subclinical hyperthyroidism: to treat or not to treat?”

11) Pharmacology, 2014, 93:4-9, “Increasing Glutamate Promotes Ischemia-Reperfusion-Induced Ventricular Arrhythmias in Rats in vivo”

12) Braz J Med Biol Res, Jan 2003, 36(1):85-95, “Protective effects of centrally acting sympathomodulatory drugs on myocardial ischemia induced by sympathetic overactivity in rabbits”

13) https://www.peaktestosterone.com/forum/index.php?topic=6549.0

15) https://www.sciencedaily.com/releases/2015/08/150821141717.htm

14) Diabetes, 2014 May, 63(5):1738-47, “Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk”

Cialis, Dangers - Peak Testosterone

Cialis (tadalafil) is yet another medication that is both sinner and saint.  We have already presented many of Cialis’ excellent properties and you can read my link on The Long Term Benefits of Cialis for more details.  However, Cialis also has a darker side as well, one that your doctor is unlikely to tell you about.  It is important to examine the potentially ugly side of any drug, but especially Cialis since most guys are so glad to get rid of their erectile dysfunction that they think, “Side effects, schmide effects – I’m in the saddle again!”

NOTE:  Cialis has recently come out with a Cialis Daily lower dose version that can keep a guy in the game 24/7.  Eli Lilly’s info page is here.

Below are some of the concerns that researchers and medical professionals have noted with Cialis on a daily basis:

1)  Brain. Headaches are extemely common with Cialis (tadalafil).  In one 4 week study, 7.2 percent of patients experienced headaches. [1] This is almost one out of every 14 patients and shows that Cialis is affecting something in the brain.  Viagra, a fellow PDE5 Inhibitor like Cialis, has actually been studied more extensively and found to effect the brain on the neurotransmitter level.  For example, researchers have found that it 1) causes anxiety in rodents and 2) exhibits some antidepressant like qualities. [2] The bottom line is that Cialis and the other PDE5 inhibitors are clearly affecting the brain in a profound way and researchers have almost no understanding as to how.  So I will ask the question, “Is something that causes headaches in one out of 14 men really going to be good for your long term health after decades of use?”

2) Backache and Muscle Pain. These are quite common with Cialis and often do not go away for 24-48 hours. [3] Again, what is disconcerting is that researchers have no explanation. Just what is Cialis affecting?

3) Retina.  Cialis also effects PDE6 to a significant extent.  PDE6 is another related phosphodiesterase enzyme and is present in the retina.  Here are the kind of all-too-common side effects reported with regular tadalafil (Cialis) use: “Transient changes in vision, transient and mild impairment in color discrimination, eye pain, eyelid swelling, electroretinographic abnormalities, abnormal histopathologic findings,4 pupil-sparing third nerve palsy, and central serous choroidopathy have been reported.” [4] Again, after decades of use, what is this going to do to your vision?

4) Cortisol. Cortisol is one of the biggest enemies of the middle-aged and beyond male.  If too high for too long of a time, it decreases testosterone, increases visceral fat, increases insulin resistance and destroys neurons just for starters. [5]  Now Cialis has also been found to improve the testosterone to estrogen ratio, but the truth is that we just do not  know if the increase in cortisol could cause long term issues.  Could it slightly increase the chances for visceral fat?  metabolic syndrome?  We just don’t know.

REFERENCES:

1) European Urology, Sep 2004, 46(3):362-369, “Efficacy and Treatment Satisfaction with On-Demand Tadalafil (Cialis ) in Men with Erectile Dysfunction”

2) J Neural Transm, 2007 Sep 7, “Appearance of antidepressant-like effect by sildenafil in rats after central muscarinic receptor blockade: evidence from behavioural and neuro-receptor studies”

3) https://www.pharmainfo.net/reviews/pde5-target-erectile-dysfunction

4) Archives of Ophthalmology, Jul 2006, 124(7), “Tadalafil-Induced Subretinal and Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and Ciliary Body) Melanoma”

5) J Clin Endocrinol Metab, 2008 Sep, 93(9):3510-4, Epub 2008 Jun 17, “The type 5 phosphodiesterase inhibitor tadalafil influences salivary cortisol, testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise in healthy men”

Potential Testosterone Injection Dangers - Peak Testosterone

But are injections safe?  Or are there hidden dangers to some men giving themselves testosterone shots?  It turns out that that there is a recent study that actually examines that question directly.  Furhtermore, it compares injections to two other protocols:  patches and topicals.  Surprisingly to men like myself enjoying cypionate injections, this study asserts that injections are not as safe as other either patches or topicals.  Furthermore, the study was a very large one that pulled in massive patient populations from both the U.S. and the U.K.  The authors made the following potentially distrubing conclusions for those of us on testosterones shots: [1]

–Injections had a 26% higher risk of “cardiovascular events,” meaning heart attack, stroke or angina (chest pain) than topicals.

–Injections had a 16% higher risk of hospitalizations than  topicals.

–Injections had a 34% higher risk of death than topicals.

This was basically the conclusion of a female endocrinologist (Dr. Margarent Weirman), who stated in an accompanying editorial, that “the study raises the issue of whether injectable depo-testosterone or other formulations that consistently result in levels outside the physiologic range should be restricted or at least more carefully monitored for [CV] risk. [2]

This is a huge admission in my opinion, because Dr. Weirman is an endocrinologist admitting that driving men supraphysiological, i.e. greater than 1200 ng/dl, could be putting men at risk for cardiovascular issues. The reason that this is so significant is that, at least from what I have seen, it is generally endocrinologists who are administering these kind of injection protocols.  For reasons that are completely unclear to me to this day, they typically will give a man a massive dose of testosterone cypionate (200-400 mg), which shoots the poor patients testosterone and estradiol through the roof. These protocols are always on an every 2-3 week schedule and about 10 days after the injection the poor guy’s testosterone actually crashes through his old levels and for a few days.  This means that he will end up with testosterone lower than his old baseline!  I document in this page:  Testosterone Cypionate – Weekly Versus Every Two Weeks?

Some of you may be wondering why this kind of protocol would increase risk for cardiovascular problems.  The reason is likely that elevated estradiol increases the risk of clotting and clotting is what strokes and heart attacks are all about.  A heart attack begins with a clot in the arteries and a stroke is simply a clot that reaches the brain.

CONCLUSION:  In my opinion, injectibles will be exonerated by future research when a frequent and physiological profile is followed, but I certainly cannot prove that. I try to follow a safe philosophy and am currently using a subQ testosterone cypionate protocol myself and inject every other day and my latest total testosterone lab draws were 700 and 800 ng/dl.  These are the numbers of a healthy middle-aged male and equivalent to what is reached by many men on the topicals.  This helps keep my estradiol at a reasonable level:  my last read was 27 pg/ml, i.e. my testosterone and estradiol are within normal youthful ranges.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

However, I am playing by the rules and not all men on TRT do.  Some men (and their physicians) let blood pressure and hemtocrit / hemoglobin go too high.  Some men have clotting disorders.  And, finally, some men on testosterone deliberately go above 1200 ng/dl, which sends their estradiol through the roof generally.  I see this fairly often on The Peak Testosterone Forum, where men are clearly deliberatly injecting way too much testosterone. They are not going to steroid levels, but they are definitely going above 1200 during part of the week.

NOTE:  See also my page on Other Potential Risks of Testosterone Therapy.

1)   JAMA Intern Med, 2015 Jul 1;175(7):1187-96, “Comparative Safety of Testosterone Dosage Forms”

2) JAMA Intern Med. 2015;175(7):1197-1198, “Risks of Different Testosterone Preparations: Too Much, Too Little, Just Right”

Look Into Fertility Concerns - Peak Testosterone

Unfortunately, many doctors forget to tell their patients just one little detail:  HRT dramatically lowers sperm counts!  For example, one of our posters asked forum member the following story:

“I went to my GP about 9 months ago with the usual symptoms and tested at total T of 360. (I’m 35.) He gave me a 400mg shot “to try” and I seemed to respond. Retested about 3 months later at 280, got another huge 400mg shot and seemed to respond again. So he went ahead and prescribed me test enanthate, and I’ve been shooting about 50mg every 5 days* with so-so results.” [3]

Then he asked this question: “I still want kids. Have I sterilized myself? My doc said that fertility is likely to be off already with low T and that replacing to physiologic levels won’t suppress it further — and may help. If I understand what I’ve read here, this is NOT the consensus view.”

So this doctor not only did not tell him about the issue, but actually said that HRT might improve his fertility!  Apparently, this doctor did not realize that testosterone is actually a pretty significant contraceptive. (Don’t rely on it though!) For example, one study of Chinese men looked at testosterone undecanoate, which is now approved as Nebido here in the U.S., and found that it was incredibly effective as a contraceptive:  “the mean serum testosterone concentration increased 131%, and the mean serum LH and FSH concentrations decreased 72% and 70%, respectively, after TU injections during the treatment period.”  [1]

And sure there are men who successfully get their woman pregnant while on HRT.  It only takes one little swimmer to do it, eh? However, it is more the exception than the rule. Any loss of fertility can be a huge stressor for some couples.  Women in particular can become despondent and depressed, but the stress can really hit the male as well.  One study on infertile couples showed that ACTH levels rose in the guys, indicating HPA difficulties.  And this increased stress caused  lower sperm counts and motility in the study participants. [4] Thus, infertility can create even greater infertility and create a downward spiral.

CAUTION:  Because of all this, you want to do all you can to stack the cards in your favor if you want kids. Below I give you some of the standard treatment methodologies to handle low testosterone and preserve or increase fertility, so that you can discuss things with your doctor and ask all the right questions.  Don’t forget that there are both “production issues” and “obstruction issues.”  Male factor infertility is not always just a hormonal issue and sometime you can get “blockage” issues.  It’s always smart to talk to a fertility specialist if you can afford it.  Some urologists even handle fertility and have built up this expertise. Take some of the discussion points on this page to him or her.

So, if HRT causes such a loss in fertility, then how can a man boost his T and preserve his fertility at the same time?  Or does he have to choose between one or the other?

It turns out that there are a number of options for men in this category that can solve these sorts of issues.  Let’s take a minute and look at each:

1.  HCG Monotherapy (with HMG as needed).  One option that I see is an increasing number of men undergoing HCG Monotherapy, as opposed to the standard “HRT Trifecta” of testosterone cypionate, HCG and Arimidex.  HCG is commonly given now to men in conjunction with testosterone to preserve testicular size/volume primarily.  However, HCG can also be given by itself in order to stimulate the man’s own natural testosterone production.  The reason that this works is that most men with low T actually have secondary hypogonadism where the pituitary or hypothalamus is the broken link.  As it turns out, HCG is an LH (leutinizing hormone) analog and will mimic the effects of LH on the testes, i.e. stimulate them to produce testosterone, assuming the testes are in good shape of course.

I should also mention that usually some low dose Arimidex needs to be taken with this kind of treatment, because estradiol levels can ramp up significantly.  So it is monotherapy in the sense that no testosterone is given, but, in reality, there is often a second pharmaceutical involved.  For more information, see my link The Hows and Whys of HCG Monotherapy.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

And, actually, sometimes HMG is added to the regimen as well if a man’s fertility parameters (from a semen analyis) have not responded after a few months.  HMG is actually a combination of FSH (follical stimulating hormone) and LH, with each brand being a little different formulation.  The FSH actually much more directly stimulates sperm production than HCG, which primarily induces testosterone production.

The HCG/HMG combination can take awhile to work, usually around 6-9 months before you begin to see reasonable increases in sperm counts and so on.  This method is not foolproof and has a mixed track record. [5] Your fertility doctor can give you a good idea as to whether or not you are a good candidate.

2. HCG + HRT.  Dr. Lipshultz has several studies under his belt showing that most men on HRT can maintain their fertility if they add in low dose HCG.  One study put men either on injections or daily transdermal (topical) testosterone gels and then added in 500 IU every other day of HCG.  The abstract states the remarkable results that “no impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup.” [6] Fertility is so important that I encourage you to talk to fertility specialist and come up with a treatment plan that will work for your situation rather than just go by this one study.  But, yes, it looks like you can have your cake and eat it too!

3) Clomid. When you think of fertility medications, Clomid is probably the name that first pops into most everyone’s mind.  It is used by both men and women, of course, and is often the first line medication because of it’s convenience,  relatively low cost and ability to stimulate sperm production.  What could be simpler?  No injections.  No needles.  Just take a pill.

And it works very well for some men, who get both nice boosts in testosterone, sperm counts and libido.  We had a man on Peak Testosterone Forum whose testosterone went up to 1500 ng/dl on Clomid!  Sot it can give a substantial boost.  One study found more modest, yet significant increases from 248 to 610 ng/dl with a 25 mg daily dosage.  (See my link on Clomid and Testosterone for details.) And sperm counts can go from a couple million to a 100 million in just a couple of months as well.

However, the reality regarding Clomid is far from the ideal generally speaking and there are a number of persistent issues that plague this medication:

a) There is very often no libido boost whatsoever in men taking Clomid.  Their testosterone may triple and yet they have no real increase in sexual desire.

b) It often stops working or at least loses efficacy after a few months.  Some women interested in getting pregnant bypass this concern by trying to “harvest” their husband’s sperm during those few months for a future IVF.  Yeah, that probably won’t be the last time you’re milked…

c)  Clomid can display estrogen-like effects in the brain and increase moodiness and other related symptoms.

d)  There are some concerns about long term effects and I outline these in my link on Potential Long Terms Risks of Clomid Therapy.

Again, some men seem to thrive on it and do very well and, unfortunately, there is no good way to predict who will do well and who will not.

4. Armidex Monotherapy. This is not very common from what I have seen, but some fertility specialists will put young men on Armidex by itself.  Men get their estradiol, the most potent estrogen, through an enzyme called aromatase (that is stored primarily in fat cells) that converts some testosterone into estradiol.  Arimidex (anastrozole) is an aromatase inhibitor and thus slows down this conversion of testosterone into estradiol.  Therefore, it will raise both testosterone and lower estradiol simultaneously and can preserve fertility.  (It doesn’t seem to have a good reputation for actually raising fertility, but talk to your doctor about this.)

How much can Armidex raise testosterone?  You can read about it more in my link on Testosterone and Arimidex, where I discuss a study where Arimidex increased testosterone by 62% and decreased estradiol by 24%.

5. Combinations of the Above. You can find every combination imagineable.  HCG + Arimidex; Clomid + Arimidex; HCG + Clomid + Arimidex.  And some doctors use letrazole instead of Arimidex (anastrozole).  If you go to a fertility specialist, he will test you in every way – ultrasounds, hormone blood draws, genetic and semen analysis, etc. – and then will decide on the best course of action.

1) The Journal of Clinical Endocrinology & Metabolism, Feb 1 2003, 8(2):562-568, “A Multicenter Contraceptive Efficacy Study of Injectable Testosterone Undecanoate in Healthy Chinese Men”

2) The Journal of Clinical Endocrinology & Metabolism, Oct 1 1993, 77(4):1028-1032, “Body composition and muscle strength in healthy men receiving testosterone enanthate for contraception”

3) https://peaktestosterone.com/forum/index.php?topic=701.0

4) Neuroendocrinology Letters, 2005, “Levels of plasma ACTH in men from infertile couples”

5) Andrologia, 1981 May-Jun, 13(3):187-97, “A modern approach to the gonadotropin treatment in oligozoospermia”

6) The Journal of Urology, February 2013, 189(2):647 650, “Concomitant Intramuscular Human Chorionic Gonadotropin Preserves Spermatogenesis in Men Undergoing Testosterone Replacement Therapy”

Testosterone and Parasites - Peak Testosterone

No, most of blood work was off the insurance. I paid from my pocket.

As a suggestion, I would recommend people to get info on parasites affecting the nervous system as well as endocrine. A search by nervous system parasites/ bacteria will show a lot of them. Prasites, listeria, bartonellas, Lymes, etc. for some time I thought to have Lyme, I did the test on the IGM and IGG and came negative. Not happy I went for the western blot and pcr dna. I was sure i hadn’t had Lyme at that point. I also tested for other tick borne diseases.

Q. Can you tell us exactly what parasite was found and the diagnosis?

A. Taenia saginata, a parasite that can reach 10 meters in the host intestine.

Q. How were you treated and how long did it take to recover? What are your current testosterone levels and did your LH/FSH go down within range?

A. I took a single dose of prazinquantel at 30mg/kg. i had some symptoms on the treatment, like malaise, pain in abdomen, vomit. The testosterone went up to 350-500-670 in 6 months.

Fsh and lh came down but slight above the normal range the last time i tested, about 2 months ago.

Based on what you have heard and read, should every hypogonadal man get tested for parasites and tropical bacteria regularly or only those who travel and/or have lost their testosterone unusually rapidly?

I believe so, parasites and also enterovirus, enterobacteria, etc. e-coli may produce the same symptoms or can wreck the sex steroids, this because, by a work of god, e-coli also has sex steroids receptors. This is crazy but true.

Q. What kind of doctor(s) can do this kind of testing? Is there any way for a man to do some of this testing on his own if insurance will not cover it?

A. Sincerely, i just went to a tropical disease specialist because I tried everything else before.

If the tropical specialist didn’t help me, I probably had gone to an oncologist. I was willing to talk to everyone. I got tested on a tropical institute, but I believe that any lab with molecular biology can do these lab works.

Q. Can a bacterial or viral invader create the same kind of symptoms as a parasite?

A. I dont know, maybe. I just know the means where I’ve been, but literature exists. (I dont have them organized but one of these days i can send to you some references.)

Q. Did any of the doctors provide any insight as to how a parasite could cause a loss in testosterone? What have you found from your own research?

A. No, every doc told me I was crazy. They told me doctor google is mined with bad info.

Luckily, I found that paper refered to on the forum. In the case of taenias and other pathogens, they have the ability to modulate sex steroids, change estrogens, especially fsh and lh.

Q. I know that you have done some personal research on how parasites, bacteria, etc. can negatively impact the VDR (Vitamin D Receptor). Can you tell us a bit more about this? What happens with the receptor and what does it impact? And does this have anything to do with your ensuing hypogonadism?

A. I found some stuff on this reading the Marshall Protocol. I found it by luck. But I didn’t pay close attention to them. They seemed a bit fundamentalist and they used an exotic vdr agonist, Benicar.

I went for other sites and research on vdr and found some interesting stuff but didn’t explore very deep.

Q. I have a relative from a foreign country and everyone in the family gets de-parasited once per year. From what you have read, is this a good idea in the U.S. or do we not have enough of a problem?

A. They do the right thing. I believe everyone should do an annual treatment or one cycle per year.

I believe Americans should get de-parasited too: the U.S. imports a lot of food from everywhere.

Pathogens are everywhere. And they are the source of disease, changes in immunity, autoimmune diseases and chronic diseases too. Several parasites and bacteria cause cancer too. That’s also proven.

STEP 14:  GET TESTED FOR PERTINENT PARASITES AND BACTERIA. This man’s story brings up the question as to how many men out there are suffering from low testosterone and other health issues without realizing that the root cause is some kind of bacterial or parasitic invader. Unfortunately, there is very little research on parasite-endocrine and bacterial-endocrine interactions.  And, as you’ll see below, trying to get doctors to test for it was like trying to change the direction that the earth is spinning.

But I would argue that the battle may be worth it and that’s why I have included it as step (to consider) in the Peak Testosterone Program.  Isn’t it common sense that almost any nasty underlying pathogen is going to negatively impact your HPA axis in one way or the other?  So why do not some basic testing?  For example, there is some evidence that recurring mycoplasma (walking pneumonia) can lower testosterone and cause many of the symptoms that we see in men.  See my page on The Dangers of Mycoplasma for some information.

So, if the other doors are just not opening, it would seem some testing for parasites and various bacteria would be in order.  As this story illustrates, it does happen and probably happens more than we realize.  What makes things even worse here in the U.S. is that we don’t have a big parasite problem and so the great majority of people would never even think of getting examined for parasites even if they’ve travelled or eaten a lot of sushi, etc.

Below is the interview:

GUEST INTERVIEW: Prof

NOTE: Read this thread to check out his original post on the forum

Q. You said you were losing testosterone at the rate of about 5-10% per year, right? Just how low did your testosterone get?

A. My lowest was 2.60 with fsh at 26 and lh at 19

Q. What other symptoms were you having? And did you have any symptoms that were not a classic low testosterone symptom?

A.I was sensing some neurological problems, i even had some episodes of panic attacks, not in the final stage but some years ago. Even when my testosterone was at 500 with fsh at 24 and lh at 17, which is also odd, i was having insomnia, restlessness, fatigue, strange pains, difficulty waking up in the morning, and more. Appetite was normal.

Q. I re-read your story and I admired the fact that you wanted to find the root cause. How long were you experiencing pretty bad symptoms? Did you ever get tempted to go on HRT or HCG?

A. I started to notice some changes for about 8 years from now and I kept saying to doctors that I might had an infectious disease of some kind. I proposed to be checked up for some bacteria but they all refused. Even so I did them on my own, but I knew nothing about diseases. My hemograms and general markers were all great. I know now that parasites have great abilities to disguise themselves. They are very smart to the point of changing immune responses, and others. In my case, endocrinal ones.

One time I proposed to a doctor to take HCG but he refused, later, about one year ago, a Ph.D. proposed to me to get HCG shots, but this time I had some more knowledge and knew that HCG would increase LH even more, so I didn’t take the NCG, but I did bought them. They are still in the fridge 🙂 He told me to inject 1500ui 2x per week, for 6 months at least.

Q. How did you get the idea that this was pathogen/parasite-related? Why not a toxin or genetic issue for example? What clued you in?

A. I put every hypothesis in the table. In the beginning I was searching for toxins, I was also looking for Listeria, since I was eating a lot of sushi and fusion cuisine. I learn that food importation may bring bacteria, parasites and stuff. Even mosquitoes in fruit containers. That is why you may live in US and oddly get a disease from a country without having been there.

I can tell you that over the years I looked for everything. Testing for parasites was an idea of my doctor.

Q. You said your LH and FSH went very high. Do you have any numbers for us? Of course, this is a sign of primary hypogonadism. Does this mean the parasite was somehow actually attacking the testes? Or just what was it that caused the risk in LH/FSH?

A. My LH was near 20 and Fsh at 22-27. The strangest thing was, that I still had testosterone. This was the big big mystery for all doctors. Most of them said that was impossible. With fsh and lh like that my testosterone should be at 100 or less. My prolactin was normal, estrogen was 20, shbg was 22 on average. Zinc was good at 90, vitamin b12 was excellent. Everything was fine, surprisingly.

Q. So how did you end up getting tested for this parasite? I believe you did some testing on your own and then went to a Tropical Disease Specialist. Can you give us a few details in case someone else is interested in finding out about that. Also, was this all covered by insurance?

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

45+ Ways to Possibly Raise Testosterone Level Naturally?

Many men with low testosterone do not want to immediately jump on testosterone therapy and with good reason.  I personally have had a great experience overall, but not all men are so lucky.  And it is also a fair amount of time and expense, etc.  Anyway, for many reasons many men are looking for natural ways to increase their testosterone.  See my page  Fixing Your Testosterone With Natural Methods (Greater Than 25%) for some of the bigger gun methodologies to do that.  And you’ll also want to scan through this page where I include some of the strategies that are a little more “off the beaten path.”

Below you will see that twenty years of research have given us abundant ways to boost testosterone. I would guess many of the things on this list will surprise you:  they are the opposite of what most of the bodybuilding magazines and health food stores will tell you.

One caution that I have is that I tried for years to raise my testosterone through lifestyle changes, i.e. diet, sleep, supplements, etc., and nothing budged my testosterone.  And I see this quite often on The Peak Testosterone Forum: some men seem to have actual damage to some part of their HPT (hypothalamus, pituitary and testes) axis. In those cases, going natural just does not work for reasons that we do no understand yet.  Of course, it does not hurt to try, and I especially encourage the younger men to do that.

Increase TestosteroneSTEP 6B:  Examine other alternative ways to raise your testosterone naturally:40+ Ways to Increase and Protect Your Testosterone

Axiron Side Effects - Peak Testosterone

And, of course, results for Axiron can be good. We had one man who wrote into The Peak Testosterone Forum that “I cannot speak to Androgel…but I am on Axiron. That stuff along with a healthier diet (low sugar, low fat, less meat, more plants), a little weight loss, and exercise is making for a great recovery for me… so far. My advice to you is DON’T GET DISCOURAGED!” [1]

Of course, that is most definitely not always the case and, as I’ll discuss below, Axiron has some rather nasty what I will call “side effects”. Since it is HRT, it, of course, has all the standard side effects of testosterone therapy, including occasional acne, enlarged prostate, increased PSA, blood clotting, edema and so on. But that is not what I am talking about here. Axiron has some unique problems that should be pointed out to patients but often isn’t.

CAUTION: Do not halt any medication without first discussing it with a physician.

1) Axiron Failure. All the topicals have a big problem: they often dont work! Poor absorption is the “dirty secret” of these medications and physicians, sometimes due to lack of knowledge, do not properly warn their patients of this possibility. This is a huge issue with other topical testosterones, which I cover in my links on Testosterone and Androgel and Androgel versus Testim. However, it can also occur with Axiron as well and here is an example:

“About me: I am 40 years old. I have Hashimoto’s disease although I’m not on thyroid medication yet. I’ve been diagnosed with low T. (1st test 248, 2nd test 298) I’ve seen my primary care physician and one endocrinologist. I will be seeing a second endocrinologist soon. About one month ago I went on Axiron. After 3 weeks of 60mg (one wipe of 30mg per armpit) my testosterone level tested at 241. [2]”

In fact, notice something unusual about what this man wrote:  his testosterone actually went DOWN on the Axiron.  Admittedly, the decrease was very small, but why would testosterone go down when one would expect at least a certain percentage of the product to be absorbed.  Even if the product does not work well or effeciently, one would expect at least some increase.  In the case of Testosterone Pellets or injections, this would never occur as far as I know.

However, with the topicals, this situation appears to be all too common.  Here is another example of a completely exasperated forum poster:

“I am a 50yo male and began Axiron 30 days ago. It did take 3 doctors to get prescribed. Third was the charm. My initial total and free levels were 374 (range: 250 – 1100, quest) and 63.4 (range: 35.0 – 155.0, quest). I am a pretty fit guy at about 12% body fat, but for the last year or two I have had decreasing energy, a complete drop off in libido, and decline in general feeling of wellness. Also body fat % has been climbing no matter what I do with diet or in the gym. My GP ordered the first blood work which are the numbers above. He said I’m in the normal range (bla, bla, bla) nothing he can do. He then sent me to an endo who said basically the same thing even after asking me about all of my symptoms (that obviously he could care less about). Tried a third doctor who gets it! He said “well, you are in the normal range but at the very low end of normal. Based on your symptoms, I see no reason we can’t try you on a trial period of TRT (test replacement therapy).” I explained I have a 3 year old daughter running around at home so he recommended Axiron (applied under the armpits). So here we are now 30 days later after 60mg/day (1 pump each arm) with my follow up blood work. My numbers went DOWN! What??? My total is now 310 and my free is below normal range at 4.01. [3]

NOTE: I covered some of the advantages of Axiron in An Interview with an Axiron User.

2. Rashes and Skin Irritation. If there’s one place I can think of that I wouldn’t want a rash, it would be in my armpit. Well, actually, I can think of a few others. The armpit is a pretty sensitive area and it is quite common for the gel to cause issues in men. It is kind of tough to focus at work when it feels like someone has inserted a braning iron into one of your armpits, eh? The Axiron site actually states, though, that is quite common: “The most common adverse events include: skin redness or irritation where AXIRON is applied…” [4]

Am I saying you should not try Axiron if you are a low testosterone guy? Certain not. But “eyes wide open” as I always say. And one thing I think is very important: make sure your physician will monitor you to make sure that you do not have the side effect of “Axiron Failure” that I discuss above. For more information on other reads to discuss with your physician, see my link on Testosterone Tests.

REFERENCES:

1) https://www.peaktestosterone.com/forum/index.php?topic=392.msg3561#msg3561

2) https://www.peaktestosterone.com/forum/index.php?topic=500.msg4578#msg4578

3) https://www.peaktestosterone.com/forum/index.php?topic=997.msg9205#msg9205

4)

Natural TNF Alpha Inhibitors - Peaktestosterone

What would you want to inhibit TNF (TNF-alpha or Tumor Necrosis Factor)? Simple – it is the Root of All Evi! Think I’m exagerrating? As I covered in my link on Erectile Dysfunction and Inflammation, TNF-alpha is a major contributor to erectile dysfuntion, heart disease, autoimmune disease and cancer. That’s why controlling TNF should be one of your major priorities as a male and this page is one of the most important on my site.

So what is TNF?  TNF is just one of the body’s “inflammatory cytokines” used to handle infections and inflammation.  Like estrogen, a little is essential and good.  However, also like estrogen, most guys don’t have trouble with too little, they have trouble with too much. Our modern lifestyle raises TNF to unhealthy levels and, eventually, these increased levels kill us.  It’s easy to make the case that too much TNF-alpha is the biggest killer of males in modern societies.

TNF is so potent that they now have anti-TNF drugs used to treat conditions such as rheumatoid arthritis.  Of course, drastic disease sometimes require drastic action, but consider this:  below I document many natural ways to lower this potentially toxic cytokine.  Of course, the answer is ‘yes’ and below you’ll see many of the same players known for

5. Turmeric / Curcumin.  Many studies have shown that this spice, present in yellow mustard and curry, inhibits TNF production. [4]

6. Green Tea / EGCG. EGCG is one of the most potent of all plant phytochemicals and has a host of miraculous properties. Multiple studies show that EGCG limits TNF-alpha production. [5]

7. Vitamin E / Alpha Tocopherol. This vitamin not only limits TNF release in arteries but also prevents oxidation of LDL and many other processes that lead to arteriosclerosis. [6] Although scientists have studies alpha tocopherol, it is probably prudent to only take mixed tocopherol Vitamin E because the alpha form can lower levels of the others (gamma, etc.).

8.  Ashwagandha.  This traditional ayurvedic herb has been shown to reduce TNF-alpha output. [7] It has many other uses, including a Natural Sleep Aid (see no. 18) as well.

9. Magnesium. There is strong evidence that low magnesium levels can negatively affect TNF levels. [8] Of course, one can easily get enough magnesium from a well-rounded, plant-based diet, but still many in modern societies do not. [8] See my link on The Boron and Testosterone for more information.

10. Tart Cherry Juice. This cherry juice is, well, tart, but is well worth the effort as it tightly clamps down on rising TNF alpha levels.  It is so powerful at controlling inflammation that is can reduce post-exercise muscle soreness and is used by many athletes already.  See my link on Inflammation and Juicing for more information.

11. Progressive Muscle Relaxation (PMR). One of the most powerful ways to control TNF alpha levels is actually not a food, juice or supplement but rather a time-proven relaxation technique. PMR was developed originally as psychological tool but has since proven itself to help with many health-related issues. I discuss these at length in my link The Many Health Benefits of Progressive Muscle Relaxation for Men.

NOTE:  TNF alpha is not the only cytokine that needs to be controlled.  For other natural ways to lower inflammation, see my link on Inflammation. In addition, many foods and a number of supplements favorably alter the upstream TNF inflammatory signaling.. Alpha lipoic acid and an extract of Korean Ginseng are examples of this. [10][11] [12] It should be noted, though, that other extract of Ginseng have actually stimulated TNF-alpha itself. [13]  Quercetin, the miracle phytochemical in apples and onions, is also in this category.

CAUTION:  The only potentially negative affect of cocoa that I know is that it does seem to stimulate TNF-alpha. [9]  The same thing has been found in certain Korean Ginseng extracts as well. [12]

REFERENCES:

1) Am J Clin Nutr, Jan 1996, 63:116-122, “The effect on human tumor necrosis factor alpha and interleukin 1 beta production of diets enriched in n-3 fatty acids from vegetable oil or fish oil”

2) BioFactors, 2008, 32(1-4):179-183, “Functions of coenzyme Q_{10} in inflammation and gene expression”

3) Eur J Nutr, 2005, 44:348–354, “A Mediterranean dietary style influences TNF-alpha and VCAM-1 coronary blood levels in unstable angina patients”

4) Phytomedicine, 2005 Jun, 12(6-7):445-52, “The effect of turmeric extracts on inflammatory mediator production”

5) Cancer Detect Prev, 2000, 24(1):91-9, “A new concept of tumor promotion by tumor necrosis factor-alpha, and cancer preventive agents (-)-epigallocatechin gallate and green tea–a review”

6) Current Opinion in Lipidology, Feb 1998, 9(1):11-15, “The effects of alpha-tocopherol on critical cells in atherogenesis”

7) https://hot24.weebly.com/uploads/5/2/3/8/5238782/ alternative_treatment_for_cancer_new.pdf#page=276

8) Magnes Res, 2004 Sep, 17(3):189-96, “Elevated concentrations of TNF-alpha are related to low serum magnesium levels in obese subjects”

9) Dev Immunol, 2002 Sep, 9(3):135-41, “Modulation of TNF-alpha secretion in peripheral blood mononuclear cells by cocoa flavanols and procyanidins”

10) International Immunopharmacology, Feb 2008, 8(2):362-370, “Alpha-lipoic acid inhibits TNF-? induced NF-?B activation through blocking of MEKK1–MKK4–IKK signaling cascades”

11) FASEB Journal, 2001, 15:2423-2432, “?-Lipoic acid inhibits TNF-?-induced NF-?B activation and adhesion molecule expression in human aortic endothelial cells”

12) International Immunopharmacology, October 2007, 7(10):1286-1291, “Anti-arthritic effect of ginsenoside Rb1 on collagen induced arthritis in mice”

13) Phytomedicine, 2002 Jul, 9(5):398-404, “Extractable polysaccharides of Panax quinquefolius L. (North American ginseng) root stimulate TNFalpha production by alveolar macrophages”

1. Fish Oil.  It’s no secret that omega-3’s are one of your most potent inflammation fighters and studies have shown this to be true in the case of tnf as well. In one study of healthy volunteers, tnf-alpha synthesis was dramatically reduced by 74% as fish oil dosage was increased to about 9 grams per day.  [1]  NOTE:  This is a hefty dose and higher than what is normally recommended for typical fish oil supplementation. Going with a smaller dosage should result in significant reductions according to this study.

2. Exercise. Moderate exercise can powerfully lower exercise and decrease baseline levels of TNF alpha and IL-6, your body’s two most powerful inflammatory chemicals. See this page for information: Exercise and Inflammation for more information.

3. CoQ10.  A number of studies have shown that this antioxidant molecule reduces tnf levels. [2] This is yet another example as to the Danger of Statins.

Â4. Mediterranean Diet. One study the degree of adherence to a Mediterranean Diet was inversely related to TNF-alpha levels. [3] In other words, the more the Mediterranean Diet, the less the tnf. For more information about how to improve mortality, heart disease and erectile strength, read this link on The Power of the Mediterranean Diet.

What If Your PSA Increases After Testosterone Therapy? - Peak Testosterone

None of us on HRT like to think about it, but testosterone therapy can have side effects. One of them that can occur in some men is an increase in PSA, the most commmon marker that urologists and other physicians use to monitor prostate health, including prostate cancer. Look at what this poster in the Peak Testosterone Forum reported:

“I have just got my bloods back after being on TRT for 10 months:

So they seem good – SHBG is getting better, DHEA is down a lot but that is probably because I haven’t been able to get hold of DHEA tablets for ages and I’m not sure this is necessary. The one thing that concerned me is that PSA is up – do I need to address this? Prior results were 1.28 in 2012 and 0.97 in July 2014.” [1]

Before I go on, let me mention that many men and a few urologists now think that PSA is absolutely worthless and do not like to use it.  Or, if they do use, they only use it with very rapid jumps and very high values. Of course, you’ll have to discuss with your doctor his or her stance, but I feel that you should not ignore a rising PSA, for several important reasons that I will discuss below.  One of the practical reasons that you may no have thought about:  an increase PSA could take you immediately off of testosterone therapy. Most doctors, if they see a big enough jump, will require urological clearance before they will allow you to continue testosterone therapy..

And some of you may even know that this is exactly what happened to me about two years ago.  My PSA had consistently been 1.4 or less on testosterone cyiponate but then suddenly jumped to 6.3!  I won’t go into the whole story, because I have covered what happened in considerable detail here:  High PSA But No Cancer. But suffice it to say, I was taken off of testosterone immediately, and one month later my T levels had dropped to 111 ng/dl.  Fortunately, they found it was not prostate cancer as far as they could tell and let me back on TRT.

Personally, I am glad that they did not ignore it, and the reason is that there are almost always three reasons that one’s PSA would jump:

–Increased inflammation, i.e. likely some kind of prostatitis

–Prostate cancer

–An enlarged prostate

In my opinion, none of these should be ignored and can potentially affect your long term health. This is how my urologist – I did have some input – handled the situation in chronological order:

1. Test for Bacterial Prostatitis. Most prostatitis is non-bacterial, but it is a relatively inexpensive and simple test, so most doctors will do this pretty early in the troubleshooting game.  In my case, this came back negative, and so my urologist went on with the following:

2. 12-Sample Prostate Biopsy. This procedure is quite “invasive,” but it is an outpatient procedure and generally not painful.  Prostate biopsies are controversial now, and many in the medical community think they are overused.  Nevertheless, I found it comforting that they found no cancer in any of the samples and a couple with inflammation.  This pointed strongly to inflammation being the core issue causing my elevated PSA.  I am not sure how I still feel about biopsies, because some experts are concerned about “needle tracking,” which is the idea that a biopsy needle often punctures a prostate cancer nodule and spreads it.  In other words, biopsies could potentially be dangerous. [9] Some urologists are using MRI’s now.

3. 4kScore.  I later did a 4kScore, something I discuss on my page My 4kScore Test for Prostate Cancer. One could argue that this blood test should really be done first, because it has a pretty high accuracy rate at predicting whether or not you have the aggressive form of prostate cancer.  (It does not tell you if you have the “non-aggressive, standard” form of PSA.)  This is very important, because it is the aggressive form that can (almost always) kill you:  it can easily metasticize and, as you know, this gets incredibly serious and life threatening very quickly.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

What if you have the non-aggressive form of prostate cancer?  This is actually very common.  Studies have shown that roughly half of all middle-aged men have (at a minimum) small nodules of this in kind of prostate cancer.  Generally, urologists are not nearly as concerned about this form of cancer, because it is usually very slow-growing, literally taking multiple decades to grow.  Furthermore, the story of one man shows that it probably can be regressed with supplements – discuss with your doctor of course – and is something I document here:  A Prostate Cancer Cure?

4. Supplement and Diet Strategy. In my case, my 4kScore showed that I almost for sure did not have the aggressive form of prostate cancer and, as I mentioned, my biopsy strongly indicated that inflammation was the root cause of my problem.  Because of this, I implemented a “protocol” that, according to the research, should combat inflammation.  My current protocol makes use of turmeric extract and flaxseed, for example, both of which have done well in the studies.  I can say, that my latest PSA read was 1.75, which was nearly back to my old levels of 1.4.  I have many pages here:  Summary Page for Prostate Issues.  You may want to read my pages on How to Lower Your PSA Naturally for example.

By the way, inflammation is a root cause for both prostate cancer and the non-baterial prostatits.  In my opinion, this makes fighting inflammation a no-brainer preventative strategy.  There are many ways to do this and mine is just one.

5. Measure Your Estradiol. BPH (enlarged prostate) can increase your PSA.  (My prostate was quite small and so that was definitely not my issue.)  But I mention this, because both BPH and prostate cancer can be fueled by high estradiol values.  For this reason pulling your estradiol (with the Best Estradiol Test for Men may be prudent.  See my pages on High Estradiol and BPH / Prostate Cancer for additional details.

CAUTION: Of course, please discuss everything with your physician:  he or she gets paid to stay up with the latest research and, hopefully, has considerable expertise from his or her practice.  They also know your medical history.  My story above is simply illustrative to give you some core ideas to discuss with your doctor.

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=7172.0

2) https://www.mrisusa.com/testosterone-risks-prostate-cancer.php

Postprandial Glucose Levels: Affect T, Erections and Diabetes

What is the most important health test?  Right at the top of the list should probably be postprandial (post-meal) blood glucose levels, because this number affects erections and hormone levels for literally hours after the meal.  It also is a powerful predictor (like low SHBG) of your chances of developing diabetes.  The tragedy is that so few men know about this health marker or how to test for it.  Their erectile strength is weak; they feel lousy; they are suffering with fatigue; and yet they do not realize one simple and inexpensive test could help them troubleshoot a powerful root cause issue in many cases.  I know I see it all the time on Peak Testosterone Forum.

REFERENCES:

1)   Clinical Diabetes, Apr 2002, 20(2):71-76, “Is Postprandial Glucose Control Important? Is It Practical In Primary Care Settings?”

2) Diabetes, 1987 Jun,36(6):689-92, “Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program”

3) Diabetes Metab, 2000 Sep, 26(4):282-6, “The DECODE study. Diabetes epidemiology: collaborative analysis of diagnostic criteria in Europe”

4) Diabetes Res Clin Pract, 1992 Aug, 17(2):111-23, “A comparison of the relationships of the glucose tolerance test and the glycated haemoglobin assay with diabetic vascular disease in the community. The Islington Diabetes Survey”

5) Clinical Diabetes, Oct 2004, 22(4):169-172, “Targeting Plasma Glucose: Preprandial Versus Postprandial”

6) Clinical Therapeutics, 2005, 27(Suppl 2):S42–S56, “Postprandial glucose regulation: New data and new implications”

7) Journal of Psychosomatic Research, Jul 2010, 69(1):33–41, “Fatigue in patients with diabetes: A review”

What most men do not realize is that what you put on your plate sends a huge wave of lipids and blood glucose through your arteries and arterioles. The latter is something you can easily track and monitor at home and on this page we go into why it is so important and how you can get a powerful sense as to whether or not you are on track or not.  Doctors will rarely pull or test this number unless you have already developed full-blown diabetes.  However, long before you reach this point, you will have likely suffered for years with prediabetes and the softer erections and altered hormone levels that this syndrome brings with it.

I will go into some of the mechanics on another page, but realize that Walmart, Amazon and other large retailers sell electronic monitors that will give you a reading in seconds.  You basically “lance” (prick) you finger, put a drop of blood on a test strip and insert the test strip into the monitor. However, first let’s go over some of the very critical research that shows just Why Postprandial Glucose Levels Are So Important and What Is the Best Target Level for us men:

NOTE: If you have already developed type II (adult onset) diabetes, the condition can often be reversed with diet and exercise.  See my pages on  Reversing Diabetes with a Low Fat Diet (Dr. Bernard) and Reversing Diabetes Using Dr. Whitaker’s Approach. You can also partially reverse diabetes often with HRT, something I discuss in my page on Testosterone and Diabetes.

Why Care About Postprandial Blood Glucose Levels?

Blood glucose levels may seem dry and unglamorous, but – trust me – they can hit you right where it counts:

1. Erections and Blood Flow. As insulin resistance mounts and insulin levels rise, endothelial dysfunction sets in and worsens.  What this means is that nitric oxide decreases and your arteries start to have difficulties in dilating, which in turn means that blood flow is decreased.  This will happen throughout your body, i.e. it will affect the arteries in your penis and can lead to erectile dysfunction and/or a decrease in hardness factor. Examples of this are studies in which diabetics are given insulin and endothelial function improves significantly [6]

2. Long Term Increase in Arterial Plaque.  The same study mentioned in #1 documented that Repaglinide, an anti-diabetic drug,” achieved regression of carotid atherosclerosis (intima-media thickness) in 52% of patients versus 18 % for glyburide over 1 year, although levels of HbAlc and CV risk factors were similar for both treatment groups.” [6]

3. Increase in Cardiovascular Mortality.  Elevated fasting insulin levels are known for microvessel damage and elevated postprandial glucose levels for macrovessel damage.  Basically, this means that those post-meal blood glucose waves can damage your arteries and, unfortunately, increases our risk of an early and untimely death.

4. Decreased Testosterone. One study found that giving a man a significant dose of glucose will lower his post-meal testosterone levels by 25%.  See my page Testosterone and Glucose for more information.

5. Fatigue. As you begin to lose your insulin sensitivity, fatigue is a common complaint.  Blood glucose is your primary fuel and, once insulin resistance sets in, your body is struggling with managing it.  Hypoglycemia can occur and result in alterations to the HPA axis.  Diabetics, in paricular can really struggle with energy according to this research commentary:

“Fatigue is a common and distressing complaint among people with diabetes and likely to hinder the ability to perform daily diabetes self-management tasks.” [7]

Why Is the Ideal Postprandial Blood Glucose Level?

1. Healthy Subjects Postprandial Blood Glucose Less Than 120 mg/dl (Possibly 140).  Researchers have pointed out that “in healthy, nondiabetic subjects, 2-hour postprandial blood glucose levels are usually <120 and rarely >140 mg/dl. Glucose levels peak at 1 h after the start of the meal and then return to preprandial levels within 2-3h.This rise and fall of postprandial glucose levels is mediated by the first-phase insulin response, in which large amounts of endogenous insulin are released, usually within 10 min, in response to nutrient intake. In individuals with type 2 diabetes, the first-phase insulin response is severely diminished or absent, resulting in persistently elevated postprandial glucose throughout most of the day.” [1]

2. Postprandial Well Below 157 mg/dl. The Honolulu Heart Study showed that those with postprandial glucose levels above 157 mg/dl had twice the risk of fatal coronary heart disease and, of course, heart disease is the #1 killer of men. [2] Of course, if 157 mg/dl causes this much death and destruction, one clearly wants to be well below that level! This corroborates well with #1 obviously.  Also, note that the researchers were looking at non-diabetics, so this is relevant for the great majority of men reading this.

3. Postprandial (Two Hour) Below 140 mg/dl. This the current recommendation of the American College of Endocrinology and the American Diabetic Association, both of which based this advice on the fact that the European DECODE study found the best mortality rates for those with postprandial glucose peaks below 140 mg/dl. [3] This is the number that I see most often quoted as the beginning of the “danger zone” for damage and future medical issues.

4. Starling’s Curve of the Pancreas. One powerful argument for maintaining glucose levels below 140 mg/dl is the fact that this is point at which the pancreas will no longer be able to produce enough insulin to control blood glucose levels.  Basically, this is the point “when the dam breaks.”  One author wrote that “normally, fasting glucose maintenance mostly depends on glucose production by the liver. In the progression of type 2 diabetes, insulin output is able to increase with the increasing glucose level until the FBG reaches about 140 mg/dl, at which point the β-cell insulin output cannot keep pace with the increased glucose load, and the fasting insulin concentration decreases. This is sometimes referred to as Starling’s Curve of the Pancreas. At this time, hepatic [liver] glucose production begins to increase because insufficient insulin is available for suppression.” [5]

CONCLUSION: Purchase a blood glucose monitor and make sure your blood sugar never gets over 140 after a meal.  And, ideally, it would never go over 120.  To understand the details as to how to do this, see my page on How to Test for Insulin Resistance.

NOTE: Several studies have confirmed that postprandial blood glucose is an independent predictor of heart disease, even when things like fasting blood glucose and A1C are taken into account.  In other words, it’s a Big Gun and should be monitored pretty regularly by every man on planet earth over the age of 25.  Furthermore, research supports that postprandial glucose peaks are actually a better predictor of insulin-related cardiovascular issues than fasting plasma blood glucose levels. [4]

Aromatase Inhibitors ( Arimidex, Femara, Aromasin, etc. )

1)   https://www.rxlist.com/arimidex-drug/clinical-pharmacology.htm

2) Journal of Clinical Oncology, Feb 1 2002, 20(3):751-757, “Influence of Letrozole and Anastrozole on Total Body Aromatization and Plasma Estrogen Levels in Postmenopausal Breast Cancer Patients Evaluated in a Randomized, Cross-Over Study”

3) The Journal of Clinical Endocrinology & Metabolism, Dec 1 2003 88(12):5951-5956, “Pharmacokinetics and Dose Finding of a Potent Aromatase Inhibitor, Aromasin (Exemestane), in Young Males”

If you frequent the board on the Peak Testosterone Forum, you will find that there are a big percentage of men that are on an aromatase inhibitor, especially Arimidex (anastrozole).  In fact, you’ll find that, even though I am attempting to run a natural men’s health web site, I myself am on Arimidex (albeit at a very low dosage).  What gives?  Is this sheer hypocrisy or madness?  Or is there a non-disturbing, rational explanation for this?

Before we go into this, let’s discuss just what an aromatase inhibitor does.  Aromatase is the enzyme that converts testosterone into estradiol is us men.  As it turns out, both aging and the weight gain that accompanies aging leads to greater conversion of our testosterone into estradiol, the “bad estrogen”, that is responsible for so many well-known issues in men, including (often) prostate issues, gynocomastia and erectile/libido/hormonal problems.  Aromatase is in fat cells and as our fat cells expand from a sedentary lifestyle and/or overeating, we men can easily end up with too much aromatase.

NOTE: Aromatase is also involved in the creation of estrone via conversion from androstendione.

This is where the aromatase inhibitors come in. They work by binding to aromatase, thus taking it “out of commission”.  So why would so many men be on AI’s (aromatase inhibitors)? First of all, a few men on the Forum have tried aromatase inhibitors for medical reasons.  For example, estradiol can play a major role in gynocomastia.  An aromatase inhibitor such as  Arimidex (anastrozole) – occasionally letrozole is used – is used quite commonly to prevent or reverse gyno.  (Tomoxifen, which is a SERM, is also used and actually goes after prolactin and probably estrogen receptors in your chest/breast tissue.)

These usages of AI’s are relatively uncommon. However, it is Arimidex’s usage in HRT (testosterone therapy) that has now become increasingly common.  From what I have seen, if a man goes over a total testosterone of about 600 ng/dl, he will very likely need an aromatase inhibitor.  In fact, one of the biggest reasons that I see for issues with HRT is when doctors do not treat the elevated estradiol levels that can occur boosting a man’s testosterone.  The symptoms are very similar to those for low testosterone:  mood crashes, loss of libido, erectile dysfunction and so on.

That said, many doctors do know about the importance of managing estradiol with testosterone replacement and will give their patients Arimidex.  The dosage is usually very low – .5 to 1.0 mg/ week split it into two – compared to that given to prostate or breat cancer patients.  Many men are now going to HRT clinics as well and these almost universally prescribe Arimidex, because  testosterone levels are typically pushed into the 800-1200 range (peak).  The purpose of the Arimidex is to get men into the 20-30 pg/ml range.  And there have been literally dozens of men on Arimidex on the forum following this or a similar protocol.

It should be pointed out though that men can easily get over high estradiol levels from the following situations as well:

2.  Being on Clomid to boost testosterone (and preserve testicular function and fertility) or get off of HRT.

3.  Being on HCG Monotherapy.  (See my page on HCG Monotherapy for more information.)

So, if you put all these cases together, many more men may be using an aromatase inhibitor than you might think, especially as  testosterone therapies, both standard and alternative, have grown and expanded in popularity over the last decade.  And almost all of them are using Arimidex.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

Why, then, the Arimidex obsession?  Well, first of all, it is now quite reasonably priced after going generic a couple of years ago.  And it has broad application and relatively few side effects if a) used at a lower dosage and b) plasma estradiol levels are regularly monitored and managed.

NOTE:  Arimidex is very powerful and higher dosages (1 mg/day) will lower “estradiol by approximately 70% within 24 hours and by approximately 80% after 14 days of daily dosing.” [1] Other studies have shown that you can get even greater reduction in estradiol levels however. [2]

However, there are definitely other aromatase inhibitor options out there and a couple of them may be more applicable, i.e. discuss with your doctor if appropriate:

1.  Letrozole (Femara). One study (in women) showed that Arimidex could achieve almost total suppression of estradiol levels but was still detectable.  However, letrozole was even more powerful and could achieve total suppression of estradiol to where it could not even be detected! [2]  Now you have to be careful in going too low with estradiol as it can actually be dangerous and lead to osteoporosis, mood and erectile issues, etc., something I document in my link on “Do Men Need Estrogen?”.

However, in some cases, that slight extra horsepower from letrozole can help with gynocomastia, at least according to the “common knowledge” on the steroid forums. The general feedback is that anastrozole can prevent gyno usually, but letrozole can actually reverse it (in some cases).  Discuss with your physician of course as letrozole has a repulation for more side effects.

2.  Suicide Inhibitors (such as Aromasin). These “type I” type of aromaste inhibitors do their work using a little different technique:  they actually bind to the aromatase enzyme and permanently and irreversibly take it out of commission.  This may seem really ugly, but the body rebuilds those enzymes after a few weeks usually.  These type of inhibitors are popular in the steroid community and men that are doing HRT on their own (which I don’t advise).  However, I have not seen many HRT clinics, urologists, endos or PCPs. using them.

One study on young men showed that 25 and 50 mg dosages both reduced plasma estradiol levels by about a third in 14 days, which is not a bad reduction. [3] I cover these types of aromatase inhibitors in more detail in my link on Suicide Inhibitors.

SIDE EFFECTS: Side effects are minimal on these drugs assuming that estradiol levels are kept in a safe range. Most of the nasty side effects come from men and women who have greatly suppressed their estradiol due to cancer treatment. However, it should be pointed out that Arimidex, for example, affects liver enzymes and may also raise inflammatory cytokines.  I hope to do a page on this soon.

Losing Weight Can Double or Triple Testosterone in Many Men

There are a lot of questions surrounding weight loss and testosterone.  On this page we are going to cover a lot of very important ground, so be ready!  Here are the basic topics that we are going to deal with below:

I. Hypogonadal testosterone levels caused by being very overweight or being obese

II. How weight loss can double testosterone levels

III. How rapid weight loss and intense exercise can destroy – yes, destroy – your testosterone levels

IV. How TRT (Testosterone Replacement Therapy) can help with weight loss

Of course, if you are only interested in one of these topics, skip ahead to the pertinent section.

I. Testosterone Therapy and Weight Loss

One study on severely obese men found that their average testosterone was 223 ng/dl. [3] That hurts just to think about it!  This is VERY low testosterone and will often lead to many of the classic low testosterone symptoms:  low libido, erectile dysfunction, loss of morning erections, fatigue, depression, osteoporosis, anemia, hardening of the arteries, etc.  They then compared these men to age-matched controls, whose average testosterone was 599 ng/dl, and found that the difference was 268%!  What happens is that profound weight gain halts testosterone signaling from the hypothalamus. Basically, your hypothalamus gets fooled into thinking that you have a lot of testosterone – due to the fact that your estradiol is so high – and GnRH drops like a rock.  So, ironically, your testes are ready to go and able to pump out testosterone, but there’s nothing there to flip on the switch!

How does your hypothalamus get fooled?  The reason is that as you gain weight, your aromatase levels increase dramatically and this extra aromatase converts your testosterone into estradiol, the “bad estrogen.”  This leads to ever-increasing levels of free estradiol to free testosterone and, when this ratio goes high enough, it shuts down the hypothalamus output as mentioned above. [4][5] And, again, as we’ll show below, the low testosterone levels will also make it MUCH more difficult to maintain one’s weight, creating a vicious circle of testosterone loss and weight gain.

It should be noted that this does not just apply to the morbidly obese.  One study of men with significant visceral fat showed that dropping about 35 pounds led to a 15 percent increase in free testosterone. [1] Other research showed that losing between 57 and 283 pounds produced even more significant changes in testosterone:  average total testosterone levels went 240 to 377 ng/dl, a sizeable 58% rise on average. Free testosterone also increased by 41%. [2] Again, the men who lost the most amount of weight probably doubled their testosterone levels.

This is why on the Peak Testosterone Forum I always try to ask men with low testosterone how overweight they are.  I am not trying to get personal, but feel that it is important to let them know that weight loss can very significantly boost their T in most cases.  And it will also lower estradiol which will very favorably alter their all-important testosterone-to-estradiol ratio.  I discuss this and other strategies in my page on How to Improve Your Testosterone-to-Estrogen (Estradiol) Ratio.

Have I seen this in real life?  One of our longest term posters reported:

“I have a friend who weighed 238 pounds, his testosterone fluctuated between 439-500 Ng/dl. Once he spent a few years reducing his weight to 170, changing his diet, exercising, getting hydrated, his testosterone went back up to the 750-800 ng/dl range.” [9]

If being overweight can make you hypogonadal and weight loss can double or more your testosterone (in some cases), then obviously you want to lose weight as rapidly as possible, right?  And you probably want to add in some intense exercise to accelerate the process even more, correct?  Wrong! That might seem logical, but nothing could be further from the truth  unless perhaps you are a man not on TRT (testosterone replacement therapy).

This was shown powerfully in a study that I documented in my page on A Protocol to Lose Weight Rapidly and Maintain Muscle. The participants in this study did something remarkable: they combined a wide variety of intense exercises with a 40% reduction in calories and lost 11 pounds and either maintained or even gained some muscle. This is not an easy thing to do and so I did a page on that.

However, one of the guys on the Peak Testosterone Forum read the fine print and noticed that the testosterone levels of the men in the study dropped from 507 to 126 ng/dl! That is an ugly fall in testosterone and left those men severely hypogonadal.

IV. Testosterone Therapy and Weight Loss

Okay, so we know that gaining weight can lower testosterone.  What about going the “other direction?”  If you add (external or exogenous) testosterone, will you lower body fat? It turns out that many studies say ‘yes’, especially if you are hypogonadal. Let’s check out a few examples:

1. Hypogonadal Males.  One study found that giving hypogonadal males testosterone enanthate, which is very similar to the cypionate that is used in the U.S., resulted in a loss of 13% subcutaneous fat. [6] Remember:  participants were not put on any type of an exercise program but rather just lost weight – somewhat miraculously – from the HRT itself.  Yes, that’s the Power of T!

2.  Middle-aged Obese Males. Giving HRT to middle-aged, obese males lowered visceral fat but not subcutaneous fat in study. [7] Visceral fat is “belly (or stomach) fat” and is deadly.  It is commonly associated with insulin resistance and MetS (Metabolic Syndrome).  Of course, obese males will very likely be low or lowish in testosterone and may even be hypogonadal.

Another study showed that weight loss (with testosterone undecanoate) may be more pronounced on the obese and found that “More than half of the men (53%) lost at least 33 lbs., and almost a third lost 44 lbs. or more weight. Similarly, 86% of the men had a least a 2-inch reduction in waist circumference and 46% dropped 6 inches or more.”  These are impressive numbers and what was really remarkable is that the men kept losing weight generally all the way through the five year point.  This is the opposite of what usually happens with dieting where the typical guys’ weight yo yo’s back and forth. [11]

3.  Prostate Cancer Patients. As you may know, prostate cancer patients are often given anti-androgen pharmaceuticals and in one study this lowered patient testosterone levels by almost 80%.  As might be expected, weight increased by 1.8% after 12 months and the percent fat mass increased by 11% after about 12 months.

4.  Steroid Users.  One study noted that lean body mass increased in a somewhat dose dependent manner with men on HRT gaining a little Lean Body Mass and those on steroids gaining still more.  As you know, steroid users go “supraphysiological,” i.e. beyond the typical max values experienced by a young male (~1200 ng/dl).  Thus, researchers could look at values even well beyond 1200 and see that HRT made a difference.  (Steroids can also shut off your testosterone completely if done incorrectly.)

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

If you look at the cases above, particularly #1 and #2, you see that testosterone works very well for the special cases where men are likely deficient in testosterone.  But what about in normal, health males?  Well, one study looked at this and found that, even though total testosterone was only increased by 30%, visceral fat accumulation was fought off in healthy senior males. [10] So testosterone therapy will likely improve outcomes for almost any man.

Now I do want to issue a caution here:  I have heard that some of the HRT clinics are putting out ridiculous ads where they claim that testosterone will melt the pounds off of you like lipo.  This is simply not the case.  The studies (overall) show that testosterone therapy results in mild weight loss and is an aid in management of the same.  The big guns are always diet and exercise and, I would argue, sleep.

What about your erectile strength?  Can weight loss improve that as well?  Of course, anything that boosts your testosterone and testosterone-to-estradiol ratio is likely to help improve your bedroom performance.  But weight loss goes way beyond just improving your hormones.  For every pound lost, you drop a point in cholesterol for example.

A similar drop in C-Reactive protein – a standard measure whole body inflammation – occurs with each pound lost as well.  This drop in inflammation is very important, because “circulating CRP levels were significantly higher in obese men with erectile dysfunction as compared with obese men without erectile dysfunction.” [8] Arterial inflammation can lead to endothelial dysfunction and arteriosclerosis, both of which can lead to erection problems in the short and long term, respectively.  For more information see my page on Weight Loss and Erectile Dysfunction.

REFERENCES:

1) Total testosterone was improved as well.) [Diabetes, Obesity and Metabolism, May 2004, 6(3):208 215, “Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome”

2) The Journal of Clinical Endocrinology & Metabolism, May 1 1988, 66(5):1019-1023, “Effect of Massive Weight Loss on Hypothalamic Pituitary-Gonadal Function in Obese Men”

3) The Journal of Clinical Endocrinology & Metabolism, Dec 1 1977, 45(6):1211-1219, “Low Serum Testosterone and Sex-Hormone-Binding-Globulin in Massively Obese Men”

4) Medical Hypotheses, April 1998, 50(4):331-333, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”][International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

5) Med Hypotheses, 1998 Apr, 50(4):331-3, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

6) Journal of Clirncal Endocrinology and Metabolism, 81(12), “Increase in Bone Density and Lean Body Mass during Testosterone Administration in Men with Acquired Hypogonadism”

7) International Journal of Obesity and Related Metabolic Disorders, 1992, 16(12):991-997], “The effects of testosterone treatment on body composition and metabolism in middle-aged obese men”

8) Journal of Endocrinological Investigation, 2004, 27(7):665-669, “Erectile dysfunction associates with endothelial dysfunction and raised proinflammatory cytokine levels in obese men”

9) https://peaktestosterone.com/forum/index.php?topic=401.30

10) The Journal of Clinical Endocrinology & Metabolism January 1, 2008 vol. 93 no. 1 139-146, “Testosterone Therapy Prevents Gain in Visceral Adipose Tissue and Loss of Skeletal Muscle in Nonobese Aging M”

11) https://www.worldhealth.net/news/testosterone-therapy-helps-trim-mens-waistlines/

Yoga: How it Can Help Your Woman with Menopause - Peak Testosterone

Many of you men reading this article are on HRT (testosterone therapy). You are now walking around with the testosterone and libido of a 25-year-old, yet you are afraid to walk through the minefield to get within ten feet of your wife Why? Because she is not so fortunate. She has also lost her hormones but has no replacement therapy to help her. Yes, she’s going through menopause and she is hurting.

Of course, all women experience at some point the neurological and biological changes in response to the altered hormonal environment typical of menopause. However, even though menopause is a normal, natural event in all women s life, it is usually not a fun one. So is there any hope and any help for you and your woman? Hopefully, one day there will be some research-backed hormonal therapies, but in the meantime you have a powerful tool in your arsenal: yoga. A high percentage of woman love yoga. Most of your wives and girlfriends will not go to a gym or hit the track. But, if you get them a membership to a yoga studio, they’ll be there religiously week after week.

Many men dismiss yoga, but, before you do, let me tell you a fact: it is a proven bedroom booster – something that we will cover in more detail below. Yes, that means that you don t have to tick off making love from the to do list, mon. Pierre. Just look at all the menopausal symptoms that have been shown in one study after another to be improved by yoga: :

1. HPA Axis. Many menopausal women suffer from overexcitation of their HPA (hypothalamus-pituitary-adrenal) axis. This can occur because of depression or other reasons as well. [1] This is where yoga can step in, since it is a proven HPA soother. [2]

2. Mood. Study after study after study has shown that yoga helps mood. And what premenopausal or menopausal woman does not need a little help with mood, eh? For example, it helped with “tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia, and confusion-bewilderment” in psychiatric patients. [3] A study on college students put yoga head-to-head with other forms of exercise such as swimming and fencing. Only yoga substantially improved mood and participants were “significantly less anxious, tense, depressed, angry, fatigued, and confused.” [4] (Another very similar study found swimming and yoga approximately equal in mood-improving benefits.) [5] And one interesting study on young, professional musicians showed that yoga helped them mood disturbances (and performance anxiety). [6]

3. Sexual Function. Menopause can really put the brakes on your love making attempts. Lubrication and desire go down for almost all women during this time. The good news is that yoga can help with One study of healthy, sexually active women showed that yoga helped with MANY parameters of sexual function, including “desire, arousal, lubrication, orgasm, pain, and overall satisfaction.” What else could you ask for, big boy? [7] Also, guess which group showed the greatest improvement? Women over the age of 45! (The yoga was done daily for one hour. See the reference and it talks about the 22 yoga postures used in this study.)

4. Depression. Some women experience depression during menopause, especially women who have a long perimenopause.. [8] Can yoga help these women. The answer is that many studies and many styles of yoga have been found to help with depression. The most popular form of yoga in the U.S. is probably Iyengar yoga and it was found to significantly improve depression in young adults. [9] Iyengar yoga emphasizes poses or postures. However, the yoga traditions that emphasize breating and meditation have also done very well in studies on depression. For example, one study of SKY (Sudarshan Kriya Yoga) found results almost as good as electroshock therapy and a pharmaceutical – not bad for something with virtually no side effects. [10]

5. Anxiety. Menopause and anxiety are almost synonymous. One study found that the severity and frequency of hot flashes were associated with anxiety levels. [11] What can help? Yoga is a proven anxiety-buster and much of it’s effectiveness probably comes from its ability to increase GABA levels. [12] Some anxiety drugs work by increasing GABA levels and, therefore, it appears that yoga is a more natural alternative sans side effects.

6. Cardiovascular Disease. Heart disease increases rapidly at menopause and is probably explained primarily by insulin resistance (prediabetes). This is an area where yoga excels and one review found that ” beneficial changes overall in several IRS-related indices of CVD risk, including glucose tolerance and insulin sensitivity, lipid profiles, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation, and cardiovagal function.” [13] By the way, there is signficant evidence that the sexual health of women is just as related to cardiovascular and endothelial health as our own, something I cover in my link on Female Libido and Viagra.

7. Stress and Cortisol. Yoga can also help to combat the stress and pain associated with menopause. Many studies have shown that yoga can decrease pain and stress. One of the most intesting was one with Hatha yoha where the women not only decreased stress levels but also their baseline cortisol. [14] Of course, cortisol is a proven neuron-killer and has been tied to the aging of the hippocampus. Cortisol also increases the risk for cardiovascular disease and is tied to various psychiatric disorders.

Of course, what really needs to happen is for someone to come up with a safe HRT protocol for women. (The issue is breast cancer risk.) However, in the meantime, practicing yoga during those premenopausal years can make the transition into this phase SO much easier. And, of course, having her start up yoga during menopause will make a big difference as well. Many women feel helpless during this time, but yoga can help her gain control back over her life. And, yes, she will probably share those benefits with you in due time.

Remember: all the benefits on cortisol and stress can come your way too. Plus, yoga builds core strength in some of the deeper muscle tissues and prevents injury by developing flexibiity. So don’t just keep yourself busy while the wife is out doing yoga: consider making it something you both do together.

Every women is different as far as what form of exercise she enjoys. See this link on Female Libido and Exercise and Other Research-Backed Ways to Boost Her Desire (without being obnoxious)!

GUEST AUTHOR:  Many thanks to Cristina C., certified Yoga Nidra Instructor, Hypnotherapist and Life Coach.

REFERENCES:

1)  Maturitas, 20 Sep 2006, 55(2):150-155, “Menopause, mild psychological stress and salivary cortisol: Influence of long-term hormone replacement therapy (HRT)”

2) The Journal of Alternative and Complementary Medicine. January 2010, 16(1): 3-12, “The Health Benefits of Yoga and Exercise: A Review of Comparison Studies”

3) Psychiatric Rehabilitation Journal, 2005, 28(4):399-402, “The Effects of Yoga on Mood in Psychiatric Inpatients”

4) Research Quarterly for Exercise and Sport, 1988, 59(2), “Stress Reduction and Mood Enhancement in Four Exercise Modes: Swimming, Body Conditioning, Hatha Yoga, and Fencing”

5) Perceptual and Motor Skills, 1992, 75:1331-1343, “MOOD ALTERATION WITH YOGA AND SWIMMING-AEROBIC EXERCISE MAY NOT BE NECESSARY”

6) Appl Psychophysiol Biofeedback, 2009, 34:279-289, “Yoga Ameliorates Performance Anxiety and Mood Disturbance in Young Professional Musicians”

7) https://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2010/April/yoga-may-help-improve-womens-sexual-function

8) Annals of Epidemiology, May 1994, 4(3):214 220, “A longitudinal analysis of the association between menopause and depression Results from the Massachusetts women’s health study”

9) Alternative Therapies in health and Medicine, “A YOGA INTERVENTION FOR YOUNG ADULTS WITH ELEVATED SYMPTOMS OF DEPRESSION”

10) Journal of Affective Disorders, Jan-Mar 2000, 57(1-3):255 259, “Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine”

11) Menopause, May/June 2005, 12(3):258-266, “The role of anxiety and hormonal changes in menopausal hot flashes”

12) Altern Complement Med, 2010 Nov, 16(11):1145-52, “Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study”

13) J Am Board Fam Med, November-December 2005, 18(6):491-519, “Risk Indices Associated with the Insulin Resistance Syndrome, Cardiovascular Disease, and Possible Protection with Yoga: A Systematic Review”

14) Annals of Behavioral Medicine, Oct 2004, 28(2):114-118, “Effects of hatha yoga and african dance on perceived stress, affect, and salivary cortisol”

Hibiscus Tea: How To Make It - Peak Testosterone

Imagine a drink with no caffeine and no fructose that will drop your blood pressure, increase blood flow and very likely help with your erections. (For the research evidence for all of this, see this page: Hibiscus Tea and Erectile Dysfunction.) That drink would be hibiscus tea and, better yet, it’s very cheap and accessible. Here in Arizona, hibiscus tea is extremely common and is sold in bulk as Jamaica in all the hispanic grocery stores. It is very common in Mexican and related restaurants, but sugar is always added to it.  While delicious that way, I don’t recommend the sugar of course.  It is fairly bitter, but, when you consider all the that is doing for you, it’s well worth getting accomodated to the taste.

“So how do you make hibiscus tea?”  That is a question that a few men have asked me on the Peak Testosterone Forum, and I answer it below.

STEP 1.  First of all, let’s look how the hibiscus tea looks when you buy it raw and in bulk.  It’s a rich, dark, purple color and, again, will be sold by the name Jamaica in big tubs or possibly even in open bins side by side with things like the beans.  This is a much cheaper and more potent way to get your hibiscus.  Sure, you can buy it in cute little tea bags, but I’m not sure how much good that will do you.

CAUTIONS:  If you have low blood pressure, talk to your doctor first before using hibiscus tea:  it’s that powerful.

Basically, you just take a handful of the raw hibiscus – see below – and put it in a glass container as shown below:

STEP 2. Then you pour in hot water right on top of the hibiscus.  I usually use a 2 standard plastic bottles to one handful of Hibiscus.  As you can see below, the water turns dark purple almost immediately.  I let it sit for a few minutes, but that’s all that is necessary:

STEP 3. The final step is easy:  you just pour the mixture of water and hibiscus through a sieve which will leave you with a just the hibiscus tea.  All I can say is “Enjoy!” and tell your partner to watch out!

Weight Loss and Erections - Peak Testosterone

So what does your weight have to do with your erections?  Everything it turns out.  I often get emails from men who are 40+ pounds overweight and are looking for a miracle supplement or pill to help with their erectile dysfunction.  Below we’ll show the research that shows the answer lies around their waistline.

In fact, few men really understand just what a profound difference losing weight can have on their sex life.  Let’s start with just some of the research that shows what weight loss can do to your testosterone and, of course, testosterone is one of the keys to erectile strength.  One study of men with abdominal obesity showed that dropping about 35 pounds led to a 15 percent increase in free testosterone and significant increases in total testosterone as well too. [1]

These numbers just show the tip of the iceberg though.  Another study looked at a broader sample of obese men and then followed them as they lost even more weight than the above study – between about 60 and 280 pounds – and found very significant changes in T. Total testosterone levels climbed from an average of 240 to 377, a very significant 58% increase. Free testosterone was boosted by 41% as well. (Free estrogen also decreased.)

NOTE:  Remember that cutting back on calories more than about 15% from your baseline can actually reduce testosterone levels, at least in the short term.  So, in general, you probably want to lose weight gradually.  Talk to your physician.

1) Diabetes, Obesity and Metabolism, May 2004, 6(3):208–215, “Changes in sex hormone-binding globulin and testosterone during weight loss and weight maintenance in abdominally obese men with the metabolic syndrome”

2) The Journal of Clinical Endocrinology & Metabolism, May 1 1988,66(5):1019-1023, “Effect of Massive Weight Loss on Hypothalamic Pituitary-Gonadal Function in Obese Men”

3) Am J Physiol Endocrinol Metab, 2007 Sep, 293(3):E713-25, “Macrophage TNF-alpha contributes to insulin resistance and hepatic steatosis in diet-induced obesity”

4) Comparing Effects of a Low-energy Diet and a High-protein Low-fat Diet on Sexual and Endothelial Function, Urinary Tract Symptoms, and Inflammation in Obese Diabetic Men. The Journal of Sexual Medicine, 2011]

5) International Journal of Impotence Research, 2005, 17:391–398. “Obesity, the metabolic syndrome, and sexual dysfunction”

6) JAMA. 2004, 291(24):2978-2984, “Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men”

7) Arch Intern Med, 2007, 167(1):31-39, “The Effect of Weight Loss on C-Reactive Protein”

8) Nutrition Research Reviews, 2008, 21, 117–13, “Obesity and in?ammation: the effects of weight loss”

9) J Sex Med, 2008, 5:2454–2463, “Low levels of androgens in men with erectile dysfunction and obesity” .

So what will raising your testosterone this much do for you?  As you hopefully know from looking around this site, increasing testosterone will increase libido, help with venous leakage and increase nitric oxide levels.  Not bad, eh?

The benefits in dropping those pounds go far beyond just changes in testosterone levels, however.  Losing weight dramatically alters your inflammation profile. One study showed that for every 1 kg (2.2 pounds) lost, CRP (C-Reactive Protein) levels lowered by 0.13. [7] And, as I document in this link on Inflammation and Erectile Dysfunction, CRP is a risk factor for both heart disease and erectile dysfunction.

By the way, the increased weight and tnf alpha also increases insulin resistance.  And insulin resistance, over time, becomes the hallmark symptom of Metabolic Syndrome, which I have renamed Erectile Dysfunction Syndrome, because of how hard it is on your erections.

Does this mean dropping pounds can help?  One study of obese, diabetic men showed that even losing 5% of body weight significantly improved both libido and sexual function. [4]  And what if you lose even more weight? Here the results can be dowright astonishing.  A one year study of obese men without major health issues such as hypertension or diabetes found significant improvements in erectile dysfunction with exercise and weight loss of 10% of body weight. [6]    [5]

And one study that categorized men into categories according to their BMI found clearly that the more overweight, then 1) the lower the testosterone and 2) the greater the erectile dysfunction. [9] Again, there are many health ways to lose weight and many keys to doing the same. Just go to the Search link at the top of any page on this web site and type in “weight” and you’ll find many helpful links.

REFERENCES:

Metabolic Syndrome: Testosterone Can Greatly Improve It - PT

Metabolic Syndrome is a curse on modern society and a risk factor for cardiovascular disease, erectile dysfunction and many other chronic diseases. It is extraordinarily common and probably around 50 million Americans have the condition.  We’ll discuss just exactly what it is, but, before I go on, I want to start by saying that below I will give a “miracle solution” for the Metabolic Sydrome.  This solution had an 83% success rate, which means it completely reversed the Metabolic Syndrome in about 5 out of 6 of the males in the study!  Not bad, eh?

Living in a developed country ain’t as easy as it sounds.  Our lives of comparitive luxury lead us (unless we are careful) to a loss of blood sugar and insulin control in middle age and beyond.  Of course, this manifests itself eventually in the full blown plague of type II diabetes. But long before diabetes sets in, prediabetes will rear its ugly head. Similar to the way that prehypertension is now considered a huge warning sign before full-fledged hypertension, prediabetes was found to be a potent medical condition in and of itself.

Prediabetes is actually insulin resistance, an ugly condition where insulin receptors and processing lose their sensitivity. This allows blood sugar levels to build up and eventually damage accumulates to the beta cells of the pancreas and diabetes results.  One curious thing about prediabetes is the fact that it is usually accompanied by a suite of symptoms including high blood pressure,  stomach/visceral fat, low HDL, and high triglycerides (and elevated glucose).

And even though it sounds somewhat benign because it is termed prediabetes, implying it’s not yet a problem, Metabolic Syndrome has been tied to an increased risk of cardiovascular death and all-cause mortality. [1][2] As mentioned above, it also been linked to erection issues, a fact I cover in my link on Metabolic Syndrome and Erectile Dysfunction.

But what does Metabolic Syndrome have to do with low testosterone? Low testosterone raises insulin levels very significantly and I go into detail about this fact in my link on Testosterone and Insulin. And this is the reason that it directly worsens Metabolic Syndrome. For example, one study of middle-aged men found that those in the lowest fourth of total testosterone were 1.9-2.5X as likely to develop Metabolic Syndrome over the next 11 years. The threshold for the quartile of total testosterone was 450 ng/dl (15.6 nmol/l). [3] 450 ng/dl would be considered reasonable testosterone by most doctors and yet this study indicates that many men may be getting into trouble near this threshold.

1) Circulation, 2004, 110:1245-1250, “Impact of the Metabolic Syndrome on Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in United States Adults”

2) JAMA, 2002, 288(21):2709-2716, “The Metabolic Syndrome and Total and Cardiovascular Disease Mortality in Middle-aged Men”

3) Diabetes Care. May 2004 v27 i5 p1036(6), “Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men”

4) Journal of Andrology, November/December 2009, 30(6), “Fifty-two–Week Treatment With Diet and Exercise Plus Transdermal Testosterone Reverses the Metabolic Syndrome and Improves Glycemic Control in Men With Newly Diagnosed Type 2 Diabetes and Subnormal Plasma Testosterone”

5) Nature Reviews Endocrinology, December 2009, 5:673-681, “Testosterone deficiency, insulin resistance and the metabolic syndrome”

6) The Journal of Urology, Sep 2005, “HYPOGONADISM AND METABOLIC SYNDROME: IMPLICATIONS FOR TESTOSTERONE THERAPY”

I often have men writing into The Peak Testosterone Forum in the 400’s who just don’t feel well.  This is undoubtedly one of the primary reasons:  they are beginning to lose insulin sensitivity.  Some good tests for men to monitor are a post-prandial blood glucose, A1C, and fasting blood glucose.

So we know that Metabolic Syndrome is nasty and can be accelerated by low testosterone.  But is there a solution for men who have already developed the condition?

Yes!  One study showed that 83% of men who ate a supervised diet, exercised and went on testosterone therapy completely reversed their Metabolic Syndrome. [4] By simply engaging in various natural and quasi-natural solutions:  exercise, diet and adding Bioidentical Testosterone back to more youthful levels, a man can (generally) undo this nasty condition.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

Think of how difficult it is is to treat and reverse cancer.  Or consider how many chronic diseases cannot be reversed at all, such as Parkinson’s and Alzheimer’s.  But, fortunately, with Metabolic Syndrome, the great majority of men can actually escape this death trap.  And that is good news!

NOTE:  See also my link on Testosterone and Diabetes, where I discuss a similar anecdotal story on the reversal of diabetes. And how does testosterone work its magic on Metabolic Syndrome and insulin resistance?  One review lists a number of reasons: [5]

1. “Influencing the commitment of pluripotent stem cells” [in muscle, i.e. accelerating muscle growth].

2. Insulin sensitivity of muscle cells is increased by augmenting mitochondrial capacity

3. Insulin sensitivity of muscle cells is increased by “fostering expression of oxidative phosphorylation genes”

4. Protectig pancreatic β cells” [which produce insulin]

5 “Influence of inflammatory cytokines” (See this page on Testosterone and Inflammation for more information.)

It would be remarkable if a drug or supplement did any one of these five things, but having one thing doing all five??  Well, no wonder testosterone can usually produce downright spectacular results for men with Metabolic Sydrome (or adult onset diabetes)!

Do You Have Symptoms of High Estradiol? - Peak Testosterone

See if you have the standard high estradiol symptoms in men:

In Step 1 you pulled your estradiol and, hopefully, with the best test your lab has to offer.  If your estradiol was below about 15 pg/ml – discuss with your doctor what he or she actually considers to be low estradiol – then you want to see if you have the standard symptoms to go along with it.  Here are 10 Classic Symptoms of High Estradiol in Men:

–Moodiness.

–Low libido

–Gyno (gynecomastia)

–Bloating / water retention.

–Anxiety

–Erectile dysfunction

–Depression

–Poor sleep

–Loss of morning erections

–“Mental fog”

–Fatigue

LONG TERM: There is evidence that high estradiol levels in men can increase the risk of stroke, accelerate arterial plaque and be a causative factor in BPH (enlarged prostate) and prostate cancer.  See my pages on High Estradiol and Prostate Cancer and High Estradiol and Arterial Plaque for more information.

Hopefully, you have a knowledgeable and proactive physician that will pull your estradiol for you and discuss results.  If he/she will not, due to costs or whatever other reason, you can pull estradiol yourself without a doctor’s order through one of these inexpensive labs:  Testosterone Labs.

Alpha-Carotene (Likely) for Powerful Prevention - Peak Testosterone

Due to my high PSA, I am always on the hunt for new Prostate Cancer preventative measures, especially “easy” ones that are lifestyle-related. One of the best ones that I have come across recently is alpha-carotene consumption. There is a class of phytonutrients, i.e. plant-based chemicals in food, that called carotenoids. These include a lot of heavy hitters that many of you health fanatics will have come across in your reading, including alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin and lycopene.

Lycopene, for example, already has some solid study results (coupled with soy) against men with existing prostate cancer.  I plan to cover that in another page soon.  But what about its lesser known cousin, alpha-carotene?  Well, there have been two studies to date, including a very recent one, that look very promising:

1. 2005 Carotenoid Study. This study looked at a broad range of carotenoids and concluded that five major carotenoids – alpha-cryptoxanthin, alpha-carotene, trans-beta-carotene, and lutein and zeaxanthin – would help prevent prostate cancer but not necessarily treat it. [1]  In other words, consuming these before you have full-blown PC will likely help but not necessarily after.  Notice that alpha-carotene is in this list.

This study looked at plasma levels of these compounds, i.e. this was based primarily on food and digestion. By the way, it is not that shocking that it does not help after one is diagnosed with prostate cancer.  This is quite common, because medium and larger-sized tumors are notoriously tough to treat.

NOTE: If you have existing prostate or other cancer(s), be sure to run any changes by your doctor first.  Cancer is tricky stuff.  Also, if you are a smoker, you should take note that those cigarrettes deplete carotenoids from your plasma! In other words, the population that probably needs these phytochemicals the most is selectively removing them from their system…

2.  2014 Study on Japanese Men. This study found that vegetable consumption and beta-carotene consumption did not improve prostate cancer risk.  However, both the highest and second highest beat-carotene quintiles had about half the risk of developing prostate cancer. [2] This is a HUGE drop for just one nutrient.  Again, this study looked at plasma levels, which is measuring what these men digested through food, and was only looking at prostate cancer prevention (not treatment).  Clearly, this is indicating that alpha-carotene is likely a big gun in the battle against prostate cancer.

COOKING:  Let me tell you what is beautiful:  alpha-carotene (along with beta-carotene and lycopene) are made more bioavailable by cooking.  This is not that common but is the reason that catsup and tomato paste are actually potent sources of lycopene for example.

FOOD SOURCES:  So how do you get alpha-carotene?  Is it in food?  Of course, many men know that beta-carotene is prevalent in carrots and sweet potatoes and lycopene in tomatoes and watermelon.  However, few guys can name a vegetable with alpha-carotene in it – at least I couldn’t.  It turns out that, while there are many vegetable sources of alpha-carotene, only a couple of them are pretty significant in size:  carrots and pumpkin.  A cup of canned pumpkin will supply, for example, 11.7 mg of alpha-carotene. [3] I always wondered why pumpkin was on Dr. William Li’s anti-angiogenesis foods. [4]  Now I know! Besides the fact that canned goods here in the U.S. usually have Toxic Bisphenol-A, pumpkin is just not something that most men consume on a regular basis.  The only way most men get pumpkin is in pumpkin pie, which hardly can be classed as a cancer preventative. So that essentially leaves carrots.

I am proud to say that I snack on organic baby carrots from Trader Joe’s almost every day.  I find them to be an easy snack food that is low glycemic and, of course, packed with nutrients.  Little did I know that I was getting a decent dose of alpha-carotene while I was at it.  A medium carrot supplies about 2.1 mg of alpha-carotene and I am eating probably a half bag of baby carrots on average.  I don’t know how many medium carrots that translates to, but I’d guess around 4.

So the bottom line is start munching on those carrots – hopefully organic – and get some solid cancer prevention going on!.

REFERENCES:

1) Nutr Cancer, 2005, 53(2):127-34, “Relationship between plasma carotenoids and prostate cancer”

2) Br J Cancer, 2014 Feb 4, 110(3):792-6. doi: 10.1038/bjc.2013.685. Epub 2013 Oct 29, “Relationship between vegetable and carotene intake and risk of prostate cancer: the JACC study”

3) https://lpi.oregonstate.edu/infocenter/phytochemicals/carotenoids/

4) https://blog.ted.com/2010/02/10/dr_william_lis/

How I Improved My PSA Score From 6.3 to 1.75 - Peak Testosterone

As some of you may know, my PSA shot up from about 1.4 ng/ml to a high of 6.3 in early December of 2013.  Yeah, Merry Christmas!  I was immediately forced off of HRT (testosterone therapy) for a month and ended up with a prostate biopsy.  Fortunately, they found Only Inflammation and No Cancer.

This was a sobering experience for me as I consider myself to be very healthy overall.  To this day, I still do not really know what caused the prostate inflammation.  However, I do have good news:  last week (4/25/2014) I found that my PSA was down to 2.0!  So it took about five months, but I almost have my PSA back down to my original baseline levels.  I had an interim read of 3.9 as well, even though my prostate was likely still inflamed from the biopsy, so I was showing improvement almost right away.

Of course, I’d like to have a baseline PSA less than 1.0 like some of the young guys on the Peak Testosterone Forum, but I’m on HRT, am sexually active – hallelujah! – and exercise every day. All of these will tend to raise PSA and so a PSA of 1.4 is not too unreasonable for a guy in his early 50’s in my opinion.

And, of course, I am very excited that I have reduced my PSA now by over three times in just a few months and thought I’d share – humbly of course – what I have done.  Before I go on, let me say thanks to Mike Shedlock who gave me the core ideas for a good deal of what you see below on the supplement side of things and who was a role model for all of us by dropping his PSA with an innovative nutraceutical solution. I cover all this in my link on A Cure For Prostate Cancer and am a regular reader of Mike Shedlock’s blog at Global Economic Analysis.

REFERENCES:

1)  Nutr Cancer, 2007, 58(1):35-42, “Relationship of dietary protein and soy isoflavones to serum IGF-1 and IGF binding proteins in the Prostate Cancer Lifestyle Trial”

2) https://www.med.nyu.edu/content?ChunkIID=21757

3) https://lpi.oregonstate.edu/infocenter/phytochemicals/i3c/

CAUTION: I want to caution anyone reading this with actual prostate cancer.  PC is a tricky disease and you have to be careful.  I highly recommend that you run anything that you are considering below by your urologist and a good oncologist.  (Most urologists are woefully ignorant on the underlying cancer mechanisms behind prostate cancer from what I have seen.)  And, of course, stay up on the latest research and share it with me!

NOTE:  Almost everything in my current regimen is anti-inflammatory.  Both prostatitis and prostate cancer are, in general improved by anti-inflammatory strategies, so this is a pretty safe bet in my opinion.  I should point out that the long term effects of supplements, especially megadosing are largely unknown.

NOTE: I am not anti-meat as you can see in my link on Low Fat Meats. However, some study work shows that veganism lowers IGF-1 to more natural cancer-protecting levels, so I am currently playing it safe.

NEWS FLASH: My latest PSA in mid late 2015 was 1.75.  I was very please with that, because this is almost to my old levels when I first started testosterone cypionate.  Lately, the only direct PSA-lowering strategies have been turmeric extract and flaxseed, along with my standard plant-based flexitarian diet, exercise routines and anti-aging supplement strategy.

As you can see,I took MISH’s PSA-lowering protocol as my starting point and simply did a few tweaks. Keep in mind, though, that he dropped his PSA dramatically and he had actual prostate cancer detected, so his results are particularly impressive.

Prelox Review - Peak Testosterone

There are thousands of natural alternatives to Viagra, but Prelox seems to be the only one supported by independent clinical trials. It is available, without prescription, from companies such as Boots. The literature states that the ingredients, L-arginine and Pycnogenal (made from bark of the French Marine Pine) acting in combination, increase Nitric Oxide levels and hence cGMP, – which is, in a way, what Viagra does.

During the second month on Prelox, and a month into the LI-ESWT course, I noticed no further improvements. I continued with four tablets a day for the first month, and then reduced to two a day.

However, my three real girlfriend tests showed no improvement. .

I restarted Prelox in a casual way on 30th July (average two a day) and stopped four weeks later in order to better judge the effect off the additional shockwave course.

L-arginine is a precursor to Nitric Oxide – which forms the cGMP, and the French Marine Pine bark is related to the West African Yohimbe pine tree, the bark of which known for its pro-sexual effect. The two ingredients are said to combine to produce greater effect together than each on its own could produce.

A Bulgarian clinical trial reported normal erections returned to 92% of impotent men after two months of twice daily doses. The claim is vague, as even men considered impotent experience normal erections , – usually alone at 6 am. But the report states that average speed of erection decreased from 10 minutes for men taking just L-arginine for a month, to two minutes after the two months on Prelox. And duration of erection increased from two minutes to fifteen.

The University Hospital of New York also did a trial, which claimed 81% of the patients, after six weeks on Prelox, had improved sexual ability. Their daily dose was four tablets a day throughout the course. (The dose recommended on the Prelox box is four tablets a day for the first fortnight and, and two or four a day thereafter.)

Only 70% of the New York men estimated an improved IIEF-EF score. So, oddly, 11% of men had an increased ability but not an increased score. Disappointingly the average increase in IIEF-EF score was only 10%. Perhaps 1.5 points? This improvement is about half the increase of the men undergoing Professor Vardi s sham Shockwave therapy.

Most unimpressive fact was that just ten of the 37 men s partners noticed an improvement. So perhaps Prelox little no better than a placebo. Oddly, of the men themselves, 27 of the 37 thought it was easier to initiate an erection, and 26 thought it easier to sustain an erection. Why did the partners not notice?

The New York study also reported that Viagra gave a dramatically enhanced effect when both products are taken in combination . But Viagra on its own can give a dramatically enhanced effect .

I started Prelox on 2nd November 2012. The instruction leaflet states you should experience maximum sexual wellness after approximately four weeks . In the first few weeks I noticed a strange taste that stayed with me most of the time, a slightly upset stomach and an increased need to visit the lavatory; but this reduced after a month. The reported side effects of flushing or headaches were just detectable, occasionally. In addition there is a slightly dehydrated dry mouth feeling, and I generally awoke with a sweat-soaked pyjama top. Dehydration is also a side effect of yohimbine.

Prozac (Fluoxetine): Prolactin Increaser In Some Men - Peak Testosterone

Depression is one of the largest health issues in the U.S.  The CDC estimates the prevalence at about 10% of the general population. [1] (The rate is even higher in middle-aged adults.)  Of course, it will come as no surprise, then, that antidepressant medication usage is also at an all-time here as well.  A 2011 Harvard Health newsletter reported back in 2011 that:

“14% of non-Hispanic white people take antidepressants compared with just 4% of non-Hispanic blacks and 3% of Mexican Americans” [2]

As a side note, an amazing stat from the same newsletter was that almost one in four American women in their 40’s and 50’s are taking an antidepressant.  Probably the biggest player is this new movement is Prozac, the blockbuster drug whose name is synonymous with antidepressants.  Even though it is a fairly old drug, around 25 million prescriptions are still fulfilled each year!

Now the percentage of men may be relatively small, but keep in mind that a) the study was small and b) the threshold was 16.5 ng/ml. This is fairly high prolactin in my opinion.  The abstract also points out that the average prolactin level actually increased from 6.4 to 10.0, a 56% increase. Now, from what I have seen on the forum, often men with even modest increases in prolactin sometimes experience lowered libido and some erectile dysfunction with similar numbers.

Remember that, in general, increasing prolactin means decreasing dopamine and that is what an orgasm is all about, eh?  I have a page on men that Cannot Orgasm that explains how elevated prolactin can cause anorgasmia. So, yes, only 5% of the men went over the arbitrary threshold of 16.5, but a much higher percentage likely experienced some issues from the prolactin increase.

Why does Prozac increase prolactin so consistently?  It likely has to do with serotonin.  It is no secret that Prozac and other SSRI’s raise serotonin levels and, in turn, sertotonin controls prolactin. Researchers found out very early, via an animal study, that Prozac increases prolactin not by decreasing dopamine but by but stimulating secretion of prolactin releasing factor. [4]

CAUTION:  Do not go off any medication without discussing it first with your doctor.  SSRI’s can be particularly problematic as some researchers have noted extreme depression during transitional phases, i.e. stopping treatment, switching medications, etc.

NOTE: Depression can definitely have a major hormonal component.  Hypothyroidism and hypogonadism are common root causes of depression and can worsen existing depression as well.  See my page on Testosterone and Depression for more information. Also, I have a page on Natural Depression Cures that can greatly help most men struggling with moderate or mild depression.

REFERENCES:

1) https://www.cdc.gov/features/dsdepression/

2) https://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624

3) https://www.peaktestosterone.com/forum/index.php?topic=4705.msg39155#msg39155

4) J Clin Psychiatry, 2006 Jun, 67(6):952-7, “Serum prolactin levels among outpatients with major depressive disorder during the acute phase of treatment with fluoxetine”

5) Life Sciences, Jun 1978, 22(24):2209 2213, “Evidence that serotonin neurons stimulate secretion of prolactin releasing factor”

Unfortunately, tweaking the brain is not an easy thing to do and these medications are rife with side effects, including sexual, hormonal and erectile.  We have had a number of men visit the Peak Testosterone Forum and complain about these kind of issues.  One of our senior posters himself had a very bad experience Prozac for example:

“Now, the worst case here wouldn’t be 50:50 (although that would arguably have pretty bad sides for males or females), but when both T and E approach zero, which is where I was for a few weeks after a doctor fucked up and put me on fluoxetine, which zipped my already virtually nonexistent T level, and with it my E2. Ungodly terrible sides, including anxiety, suicidal depression, fatigue, and insomnia like you wouldn’t believe. ” [3]

So what causes all the sexual (and in men erectile) dysfunction with Prozac (and undoubtedly some of the other antidepressants)?  Number one on the list may be the fact that it apparently often decreases testosterone levels, something I discuss in my page on Testosterone and Prozac. However, another root cause is that Prozac often increases prolactin in men (and women).  In fact, one study found the following:

“Specifically, 2 (4.5%) of 44 men and 8 (22.2%) of 36 women with normal prolactin levels at baseline developed hyperprolactinemia following treatment with fluoxetine.” [4]

Dangers of Lipids - Peak Testosterone

I was taking phosphatidlycholine for a month or so as an anti-aging supplement. Ray Kurzweil had recommended it for skin health and said that the age-related loss of phosphatidlycholine was one of the primary reasons for skin aging. He actually took IV infusions of the stuff. So I started taking it just to try it out but then stopped for reasons I’ll outline below.

One of the senior members (JustAskin) on the Peak Testosterone Forum also noticed that phosphatidylcholine produced some incredible lipid improvements:

Before phosphatidlycholine: Total Cholesterol=182; Triglycerides=113; HDL=36; LDL=105

After phosphatidlycholine:  Total Cholesterol=156; Triglycerides=88; HDL=46; LDL=90

Yes, those are impressive results and almost rivalthat of a statin. Is there any research backing up this drop?  Dr. Davis’ web site verifies these improvements, and I quote an excerpt below.  (Keep in mind that lecithin is mostly phosphatidylcholine.)

“In 1958, that Dr. Lester M. Morrison, director of a research unit at Los Angeles County General Hospital, first published (Geriatrics, January, 1958) his findings that lecithin could be used to lower cholesterol levels. In fact, Dr. Morrison reported that ‘lecithin was found to be the most effective cholesterol lowering agent tested.’ He reported that 80% of his patients suffering from high serum cholesterol levels showed an average decrease of 41% in serum cholesterol after taking lecithin for several weeks. Instead of “blocking” absorption of cholesterol in the digestive tract as other cholesterol reducing agents did, lecithin enhanced the metabolism of cholesterol in the digestive system and aided in its transport through the circulatoiy system.” [1]

1) https://www.curezone.org/forums/am.asp?i=1755801

2) J Nutr, First published December 16, 2015, “Plasma Concentrations of Trimethylamine-N-oxide Are Directly Associated with Dairy Food Consumption and Low-Grade Inflammation in a German Adult Population”

3) https://chriskresser.com/choline-and-tmao-eggs-still-dont-cause-heart-disease/

4) J Am Heart Assoc, 2016 Feb 22;5(2), “Trimethylamine N-Oxide Promotes Vascular Inflammation Through Signaling of Mitogen-Activated Protein Kinase and Nuclear Factor-?B”

5) https://www.consultantlive.com/cardiovascular-diseases/atherosclerosis-tmao-and-evidence-%E2%80%9Cinfectious%E2%80%9D-hypothesis

6) Cancer Science, 104(10, “Accumulated phosphatidylcholine (16:0/16:1) in human colorectal cancer; possible involvement of LPCAT4”

7) Crit Rev Biochem Mol Biol. 2013 Jan-Feb;48(1):20-38, “The role of phosphatidylcholine and choline metabolites to cell proliferation and survival”

But there are Two Potential Dangers with Phosphatidylcholine that stopped me from taking it at least for the time being:

1. TMAO and Arterial Plaque.  Many health conscious men know of the recent carnitine and TMAO studies. What they don’t realize is that both choline, as in phophatidylcholine, AND carnitine can increase plasma TMAO levels. Now, before I go on, I want to mention that these studies are quite controversial, and you will see a lot of bloodshed around the web on the subject.  The quick summary of these studies is that meat, particularly red meats, are high in carnitine, which converts much of your gut flora to carnitine-loving bacteria that crank out a potentially dangerous chemical called TMAO.

CONS:  Critics point out that epidemiological studies simply do not show a very strong association between heart disease and red meat consumption.  Since red meat has the highest levels of phosphatidylcholine, then why, if TMAO is such a factor, isn’t there a more obvious association?  That a great question, and I am sure will be the subject of considerable debate over the next decade.

These sorts of issues are what are really giving the researchers fits actually.  For example, there is research that shows that fish may increase TMAO levels much more than red meat or eggs, because fish contains TMAO.  However, consuming fish is associated with improved outcomes. Thus, the actual causes of increased TMAO levels may not be what everyone predicted. [3]

PROS: The evidence is strong that TMAO can cause heart disease.  I think just about everyone has that concern.  For example, a recent study found that TMAO increases vascular inflammation. [4] Another study shows that higher TMAO concentrations are associated with increased TNF alpha levels, the diabolical inflammatory messenger at ground zero for heart disease, cancer and many autoimmune illnesses. [2] And I don’t know of anything that increases inflammation that is not going to be very bad for your heart.  Furthermore, Dr. Hazen’s group were able “to establish circulating TMAO level as an independent predictor of death, MI, and stroke even in an otherwise low-risk group.” [5] The increase in risk was pretty large – around 43%.

So one could argue:  why risk consuming phosphatidylcholine until more study work comes out showing the factors that increase TMAO in the blood and how that relates to heart and chronic disease?  This is basically my take on things. I am not going to risk blowing out my arteries out or potentially affecting my bedroom performance until more information about what actually increases plasma TMAO is available. Other will disagree with me of course, and that’s fine: we all have to assess risks versus rewards.

WORK AROUND SOLUTION? So does this mean one should not take phosphatidlycholine?  Well, I am not yet convinced of that.  After all, it is absolutely critical and highly prevalent in our cellular membranes.  My guess is that the issue has to do with the delivery system.  Remember that Ray Kurzweil took phosphatidlycholine via IV.  And this should bypass the gut issue and leave gut flora untouched and unaffected.

2. Cancer? Here is something that your local supplement manufacturer will probably not tell you:  phosphatidylcholine is found concentrated in several types of cancer cells.  This association is so powerful in the case of colon cancer cells, for example, that a recent study suggested its use as a biomarker of cancer. [6]

Of course, the question that immediately comes to mind is whether or not phosphatidylcholine causes cancer or is merely used and accumulated by cancer cells.  My guess is that it is the latter.  However, one pro-cancer line of evidence comes from the fact that “evidence has accrued that phosphatidylcholine, the major phospholipid component of eukaryotic membranes, as well as choline metabolites derived from its synthesis and catabolism, contribute to both proliferative growth and programmed cell death.” [7]

Remember that I had a high PSA read and so I will not do anything that might fuel cancer.  Personally, I think my way of thinking is prudcent for any man over 40, considering that about half of men over the age of 40 have small prostate cancer nodules.  Again, until more information comes out, it simply does not seem worth the risk to me.

Testosterone, Insulin and Insulin Resistance - Peak Testosterone

What is the worst thing about low testosterone? Well, that would be a tough choice, but I suspect most guys would pick an atrophied penis as #1. (See my link on Venous Leakage.) However, arguably the most insidious aspect of low testosterone probably has to do with its negative impact on insulin. Very few men know that the lower T levels are correlated with higher insulin levels.

This is very dangerous for middle and senior-aged urban-dwelling males, who are generally fighting elevated insulin levels from unhealthy lifestyle choices in the first place. Of course, the main job of insulin is to push blood sugar (glucose) into cells, so more insulin might seem like a good thing. In fact, bodybuilders love insulin and will often eat a high glycemic meal before and after lifting just to pump up insulin and drive nutrients into muscle cells.

Unfortunately, elevated insulin over time leads to insulin resistance, or prediabetes, and results generally from lack of exercise, a high fat diet, high glycemic load meals and/or being overweight. And, if prediabetes is allowed to run its full course, a man will find himself with either full-blown Metabolic Syndrome or Diabetes.

NOTE: Many men have a family history of diabetes or perhaps high triglycerides or Fasting Insulin.  These can all be risk factors for developing diabetes down the road.  See amy links on Testosterone and Diabetes and Diabetes Prevention for more information.

Another proof of testosterone s relationship to insulin is the fact that supplemental testosterone, i.e. testosterone therapy, can be used to treat and sometimes cure insulin-related issues in the obese, who are one of the toughest populations to treat. [2][3] Obese, type II diabetic men with low testosterone have also has good success on Hormone Replacement Therapy. [4]

However, there is a much more important relationship between low testosterone and insulin that likely exists. First of all, insulin resitance is primarily related to the condition where energy in exceeds energy out, i.e. we eat more calories than we burn in exercise.  When this occurs, there is a very significant oxidative (free radical) load put on our mitochondria.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

In a rather involved metabolic adjustment, the body compensates for this increased oxidative load by adjusting a chemical pathway that results in insulin resistance. [5]  In other words, insulin resistance simply results from our body’s desire to protect our mitochondria from a modern sedentary, high caloric lifestyle.

Low testosterone, of course, only makes this worse, because we begin to lose muscle and this can easily lead to increased weight gain, i.e. a viscious cycle. However, even before this occurs, significant damage is likely occurring to our Leydig cells.  Why?  Because the same oxidative load and  mitochondrial damage that is leading to insulin resistance has been shown to be responsible for accelerating andropause, the age-related loss in testosterone. [6] And, as our testosterone declines at an accelerated rate, we find ourselves more prone to insulin resistance.

Now there are many other ways to control insulin by the way.  Here are just a few that you should be managing actively on a day-to-day basis:

1.  Obesity. Yes, being overweight is strongly associated with insulin resistance and most middle-aged and senior men in the U.S. need to drop significant weight.  Losing weight can also boost long term testosterone very significantly and greatly improve erectile strength as well.

2.  Exercise. Nothing improves insulin resistance like exercise.  30 minutes of exercise once a day if you have a desk job just “ain’t gonna cut it”.   You’ve got to keep moving to lower your insulin resistance throughout the day.  If you’ve got a desk job, get up and walk somehow, someway and make sure you are on a regular exercise regimen (without Overtraining).

3.  Low or Medium Fat Diets. Researchers use higher fat diets to induce insulin resistance in lab animals. Modern higher fat diets will do the same thing to you.  The highest  you want to go generally are the fat levels in a standard Mediterranean Diet, about 30-35%.  Low Fat Diets, in spite of the fact that they are higher carbohydrate are better yet for many men.

4.  High Glycemic Loads. Refined carbohydrates, sugars and corn syrup will lead to nasty cycling of blood glucose and insulin levels.  Researchers now believe that high post-meal glucose spikes kill off your beta cells (in the pancreas) leading, ultimately, to type II diabetes when enough of these cells die off.  Regardless, eating low sugar carbs is absolutely critical.  Also, many men do not know that high glycemic meals can hammer their testosterone for several hours as well.  See this link on Testosterone and Glucose for more information.

There are many other critical issues relating to blood sugar and insulin.  Again, read these links on Metabolic Syndrome and Diabetes Prevention for additional details.

Of course, the bottom line message is this:  get moving and, of course, don’t overeat!

1) Androgens, Insulin Resistance and Vascular Disease in Men: Testosterone and Insulin Resistance”, https://www.medscape.com/viewarticle/512077_4; Table 1

2) Obes Res, 1993, 1:245 251, “Androgen treatment of abdominally obese men”

3) Diabetes Care, 2001, 24:2149 2151, “Androgen therapy improves insulin sensitivity and decreases leptin level in healthy adult men with low plasma total testosterone: a 3-month randomized placebo-controlled trial”

4) Seattle Pi, SHAYA TAYEFE MOHAJER, Associated Press, Updated 07:06 p.m., Sunday, May 29, 2011, “Man celebrates 85 years of living with diabetes”

5) Arterioscler Thromb Vasc Biol, 2004, 24:816-823, “Is Oxidative Stress the Pathogenic Mechanism Underlying Insulin Resistance, Diabetes, and Cardiovascular Disease? The Common Soil Hypothesis Revisited”

6) Diabetes Care, July 2005, 28(7):1636-1642, “Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men”

Low Carb Diets: How It Potentially Be Sabotaging Your Sex Life

Low Carb (or Ketogenic) Diets are incredibly popular right now here in the U.S. and I see men on that diet all the time on Peak Testosterone Forum. Altthough, Low Carb Diets have been around for decades with various names and in various forms, they have recently flourished as never before due to the fact that a significant number of doctors and researchers have become apostles of the movement. Weight loss is rapid, due to loss of water attached to glycogen stores, and lipids usually improve in some positive ways, such as rising HDL and falling triglycerides.  If you’re a meat and dairy lover, this diet seems like a dream-come-true.

But behind the scenes, ugly side effects and research have been surfacing and literally tens of millions have jumped aboard.  I see over and over men that show up on The Forum with standard symptoms that they assume are testosterone or estradiol related.  In fact, I find that they are likely experiencing one or more of the common side effects of Low Carb Diets. Some men even get incredibly ill, and I did an interview with one of them here:  A Low Carb Diet Made Me Sick.

To be clear,  I am NOT saying that all of these side effects occur in all men on a Low Carb Diet. I am just saying that they occur often enough that men should be aware and monitoring themselves.  Plus, many men on a Low Carb Diet are feeling terrible and do not know why.  For all these reasons, I urge you to read for yourselves The Top Twelve (Dirty Dozen) Potential Dangers of a Low Carb Diet:

1. Heart Palpitations and Arrhythmias. Perhaps the most dangerous aspect of a low carb diet are the ketones.  What?!?  That’s not what you heard, right?  Low carb bloggers love to go on and on about the benefits of ketones – and there are some – but there is also a dark side.  (Low carb diets are labelled ketogenic, becausse ketone levels in the blood are elevated.)  What you are not going to hear about is the fact that high ketone levels can disturb the heart nodes responsible for your heart beat.  There is actually a growing body of research on the subject and I discuss it in page on Low Carb Diets and Arrhymias.

6) Clin Biochem,2004 Sep,37(9):830

7) J Nutr,Jun 2005,135:1339-1342

8) Nutr Metab (Lond),Nov 16 2005,2:31

9) Circulation, 2007, 116:II_819, “Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss”

10) J Clin Endocrinology Metabolism, published online Sep 4, 2007

11) New England J of Med, Nov 9 2006, 355(19):1991-2002

12) Diabetes, 2005, 54:1926-1933

13) Diabetes Care, 2005, 28:1636-1642

14) Angiology, 2000, 51(10):817-826

15) Amer J Clin Nutr, Received for publication February 3, 2009. Accepted for publication May 21, 2009; Emiliano Albanese, et al; “Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study”

16) Cell Metabolism, Aug 6 2009, 10(2):99-109, “Intestinal Cholecystokinin Controls Glucose Production through a Neuronal Network”, Grace W.C. Cheung, et. al.

17) Amer J Clin Nutr, Received for publication February 3, 2009. Accepted for publication May 21, 2009; Emiliano Albanese, et al; “Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study”

18) FASEB J, 2009 Aug 10. [Epub ahead of print], Murray, et. al., “Deterioration of physical performance and cognitive function in rats with short-term high-fat feeding”

19) “Vascular effects of a low-carbohydrate high-protein diet”, Proceedings of the National Academy of Science, Published online 25 August 2009, Foo S, Heller ER, W20) Prevention, Apr 2010, p. 45.

20) European journal of applied physiology, 2010 Apr, 108:1125-1131, “Influence of dietary carbohydrate intake on the free testosterone: cortisol ratio responses to short-term intensive exercise training.”

21) Journal of Exercise Physiology, 2009, 12(6): 33-39, “Dietary Carbohydrate and Protein Manipulation and Exercise Recovery in Novice Weight-Lifters”

22) https://news.temple.edu/news/2012-03-06/study-shows-how-high-fat-diets-increase-colon-cancer-risk

23) Environ Health Prev Med, 2002 Jul, 7(3):95 102, “Types and amount of dietary fat and colon cancer risk: Prevention by omega-3 fatty acid-rich diets”

24) Am. J. Epidemiol, 2007, 166(2):181-195, “Dietary Fatty Acids and Colorectal Cancer: A Case-Control Study”

25) https://www.diseaseproof.com/archives/cancer-highfat-foods-no-good-for-colon-cancer.html

26) https://www.livescience.com/36458-saturated-fats-diet-gut-diseases.html

27) Environ Health Prev Med, 2002 Jul, 7(3):95-102, “Types and amount of dietary fat and colon cancer risk: Prevention by omega-3 fatty acid-rich diets”

28) https://www.actscelerate.com/viewtopic.php?p=662918&sid=fa9a999b6c335d067ebf6bf316278e8f

29) Current Opinion in Gastroenterology, Jan 2008, 24(1):51-58, “Nutrition and colonic health: the critical role of the microbiota”

30) American Journal of Physiology, 1 Aug 2010, 299(2):G440-G448, “Propensity to high-fat diet-induced obesity in rats is associated with changes in the gut microbiota and gut inflammation”

On this page I explain that the researchers believe it is the ketones themselves causing these issues.  However, there no doubt that the increased cortsiol and other stress hormones that result from Low Carb Diets may contribute as well.  (See #2 below.)

2. Increased Cortisol and Adrenaline. Did you know that it is quite common for men on low carb diets to have elevated cortisol or adrenaline? This is actually how these type of diets work interestingly enough.

For example, some researchers have found that another danger of the Atkins (Low Carb) Diet is increased cortisol levels by allowing cortisol to stay in one’s system longer. [10] High cortisol levels are bad for many reasons, including the fact that they attack neurons, cause visceral fat depostion (“beer belly” or “pot belly”), lower testosterone and increase the risk of heart disease and disturb sleep. (Read this link on the Brain for more details.)  This was verified in a study on athletes were cortisol was increased by 17% on a low carb diet. [15]

What I have noticed is that it is always the younger guys pushing low carbohydrate diets.  The reason is simple:  young guys have enough buffer in their nitric oxide levels to withstand a high saturated fat meal usually.  But, as you age, you realize that all that fat is just going to sludge your blood and causes noticeable trouble.

>4. High Fasting Blood Sugar. Dr. Greger points out that there is an insulin-producing index that was created for a variety of foods. Counterintuitively for many, beef has a pretty high insulin index.  What?!?  How can a food with virtually no carbs produce an insulin spike?

The reason is simple:  modern beef is very fatty and these fats get broken down into fatty acids that end up stored in muscle and liver cells.  When these cells start getting packed with fat, insulin resistance sets in.  In fact, researchers use high fat diets all the time to induce insulin resistance in lab animals.

The irony in this is that many low carb men do not realize that they are actually quite insulin resistant in spite of the fact that they have consumed very few carbs.  Because of this, they often have high fasting blood glucose levels.  Now, if they are just a little high, it may not be much of an issue.  However, to play it safe, many physicians now urge low carb followers to pull their A1C also and make sure that average blood glucose levels are not too high.  Again, some men just do not do well with low carb and higher glucose levels will age tissues and potentially lead to chronic disease(s).

5. High Fasting Insulin Levels. Some low carb men – again, I am not saying all – have sky high fasting insulin levels.  I was just chatting with one whose numbers were 15+.  Of course, this is potentially dangerous for many reasons, including the fact that high insulin levels are pro-cancer and pro-inflammatory.  Again, the irony here is that a low carb person can have just as many blood insulin and glucose issues as men eating a lot of refined carbohydrates.

6. Decreased Exercise Performance (Higher Intensities). Have you had a low carb person tell you that their diet has been shown in the studies to increase exercise performance.  I have.  The person left out one little detail:  this is only true at lower exercise intensity levels!   And they also failed to mention was that still other research shows that at higher intensity levels, low carb or ketogenic diets actually lower exercise performance.

So, if you plan on slowly pedaling your say from New York to LA, a low carb diet may be a decent alternative.  But if you are doing almost any sport, or are weight lifting or strength training or doing more serious cycling or running, you’ll need carbs and you’ll need a decen tamount.  This has been shown over and over again. This is old news to anyone in the fitness business or athletics.  Just do a quick search on glycogen replacement and stores and you will see that loading yourself with carbs post-workout is critical.  In fact, some of you will be surprised to know that:

a) It is critical for athletes to consume a good amount of carbs post-workout in order to in order to activate their glycolytic enzymes sufficiently to handle the ensuing (and necessary) glycogen loading sequence.

b) Those interested in gaining muscle need to eat a good amount of carbs post-workout in order to insure adequate hypertrophy.  (Insulin is highly anabolic.)

NOTE:  Many of my readers are interested in enhancing their exercise performance, endurance, power and so on.  The above 2009 study on rats found that animals on a high fat diet could run only about half as far as those on a low fat diet.  [18] This is simple chemistry:  fat is an inefficient energy source for your muscles.  Just as bad is the fact that a recent study found that carbohydrates are just as essential as protein go muscle gains. [21]

7. Decreased Mood. A Low Carb diet has also been shown to be worse for your mood and outlook. Australian scientists placed participants on a Low Fat Diet or Low Carb Diet and, not surprisingly, found that both groups lost an equal amount of weight. However, the low carb group “felt more angry, depressed and confused” than the Low Fat cohort. [20]

8. High LDL Particle Counts. As I mentioned, low carb bloggers love to discuss how their HDL has gone up and their triglycerides have gone down..  There is even a study out there that shows that a Low Carb Diet can regress plaque.  (Keep in mnd that this study looked at 3 diets where the partipants losetweight and ALL 3 diets showed plaque regression simply due to the fact that their was weight loss.) What these bloggers never mention to their followers as far as I can tell is that low carb diets will astronomically raise LDL-P (LDL Particle Count) in about a third of men.  Interestingly enough, low carb blogger Jimmy Moore is one of those men and I posted his numbers in my page on Low Carb Diets and Heart Disease. His particle count number – and particle count is the #1 predictor of heart disease right now – was over three times the level that Dr. Davis recommends to regress plaque. It’s just simple chemistry: when the particle count is high, LDL will get pushed into the arterial wall. I find it very hard to believe that Low Carb men with this situation will somehow be magically protected from building up atherosclerotic plaque. And, once those penile arteries clog up, erectile function will go out the window.

49 Left Ventricular Dysfunction. One recent animal study found that a ketogenic diet negatively alterted the heart itself.  Of course, this would not be too surprising considered the changes that occur that lead at times to arrhythmias.  See my page on Low Carb Diets and heart disease for more information.

10. Gut Issues. Have you ever thought about what a carnivore’s colon has to do handle? It gets little to no fiber and is filled with a slow moving, decaying, fatty animal leftovers.  To adapt to this potentially toxic situation, carnivores have very short, straight colons.

Thank God we have short straight intestinal tracts, right?  Wrong!!  Nothing could be further than the truth.  Our intestines are very long with many convolutions.  We can pretend all we want, but we have the gut of an herbivore.  Yes, we can eat some meat and all virtually all cultures on planet earth eat at least some animal foods, but dumping the typical low carb meal into our GI tract is simply fighting against Mother Nature.  Your gut is cursing the darkness as this  rancidifing, decomposing, lardy mass slowly scrapes its way through the many twists and turns of the small intestine. Many low carbers consume lots of heme iron, which is pro-inflammatory just to complete the package.

If you wonder why low carbers often complain of gut-related issues,  it starts to make a lot of sense.  You’re throwing the diet of a wolf or bear and forcing it through the GI tract of essentially a gorilla or chimp.  Some day we will face this fact:  it is our brain that has put us at the top of the food chain, not our gut!  But mounds of meat is very ingrained in the American BBQ Culture.  It is often a part of our status and identity.  “Potatoes and rice are for those po’ folk – not us…”

Anyway, just do a search and you’ll see that low carb dieters are often complaining of gut issues – diarrhea, constipation and many of the above conditions.  For example, check out this poster:

“Rodney Mullins Just a warning about the Low Carb Diets… diverticulitis. It almost took my life and ended me in ICU for 7 days. The Doctors told me it was a direct result of the Low Carb Diet. After getting off the low carb diet I have never had another issue. If it is healthy and works for you that is great but for some people the need for carbs is life saving.” [28]

Now, as far as I know, there has been no direct study on Low Carb Diets and most issues surrounding gut health.  However, check out just a few of the studies that show how saturated and high fat meals, in particular, are likely a culprit:

““The increase in colitis stemmed from an uncontrolled growth of a certain type of bacteria, according to the researchers. These bacteria grow quickly in environments where saturated fats are broken down, and this overgrowth results in an immune response that leads to inflammation and colitis.” [26]”

“These results suggest that decreasing the intake of n-6 PUFAs and saturated fats and increasing that of n-3 PUFAs, particularly eicosapentaenoic acid and docosahexaenoic acid has the potential to be a major component of colon cancer control.” [27]

Unfortunately, the microbiota may also elaborate toxic products from food residues such as genotoxic hydrogen sulfide by sulfur-reducing bacteria in response to a high-meat diet.” [29]

“In conclusion, this study showed a strong link between gut inflammation and obesity, and the ensuing increase in plasma level of LPS seems to play an important role. Thus the sequence of events could be an increase in luminal LPS due to altered gut microbiota, a decrease in IAP activity, and an increase in TLR4 activation at the epithelium, leading to altered tight junction permeability and an increase in gut inflammation. An increase in gut permeability could increase passage of LPS from the lumen to the lamina propria, resulting in an increase in plasma levels of LPS, metabolic endotoxemia [30]

“Results from ecologic studies indicate that diets high in animal fat (rich in saturated fatty acids) are associated with increased risk of colorectal cancer in contrast to diets high in fish and fish products (rich in ?3 PUFAs), which are associated with reduced risk.” [24]

“Red meat is not the only problem. The consumption of chicken and fish are also linked to colon cancer. A large recent study examined the eating habits of 32,000 adults for six years and then watched the incidence of cancer for these subjects over the next six years. Those who avoided red meat but ate white meat regularly had a more than 300 percent increase in colon cancer incidence. The same study showed that eating beans, peas, or lentils, at least twice a week was associated with a 50 percent lower risk than never eating these foods.” [25]

11. Decreased Thyroid Function.  Many men struggle with hypothyroidism and do not realize that their low carb diet may very well be lowering their thyroid function.  Anthony Colpo did a nice job of summarizing the research and you can see his discussion here.

12. CCK Resistance. Finally, it has recently been found that rats fed a high fat diet developed cholecystokinin (CCK) resistance. [16] Cholecystokinin, or CCK, controls blood sugar production in the liver. A high fat diet limits CCK, leading to overly high CCK levels.  Being CCK resistant will very likely prove to be just as bad as insulin resistant and a high fat diet appears to lead to this condition.

CONCLUSION: Just as there are “good fats” and “bad fats,” there are good carbs and bad carbs.  Many men are now scared of carbs, but there is no need to be as long as you are consuming low glycemic load carbs.  In my opinion, many men out there will feel better and have better workout if they just add some of these good carbohydrates back into their diet.

REFERENCES:

The Zinc Taste Tests - Pros and Cons

REFERENCES:

1) Nature, Scientific Reports, 5, 2015, “Dietary calcium and zinc deficiency risks are decreasing but remain prevalent”

2) J Nutr, 1990 Nov, 120 Suppl 11:1474-9, “Assessment of zinc status”

3) Indian J Physiol Pharmacol, 1993 Oct, 37(4):318-22, “Zinc taste test in pregnant women and its correlation with serum zinc level”

4) European Journal of Clinical Nutrition, 2005, 59(Suppl 2):S31 S36, “Zinc status and taste acuity in older Europeans: the ZENITH study”

5) The Journal of Alternative and Complementary Medicine. , Jun 2012, 18(6): 541-550, “The Accuracy of the Zinc Taste Test Method”

The next obvious question is “how do I find out if I am zinc deficient?”  Unfortunately, as is so often the case, there is no perfect test out there available to physicians or patients.  There are essentially 3 traditional ways to test and using more than one is probably appropriate:

a) Plasma Zinc Levels. This is not considered a particularly accurate way to assess zinc status, because the body powerfully responds by conserving or releasing zinc stored in the bones, liver and plasma. [2] In other words, plasma levels can be acceptable even though the body is depleting its reserves.  This test can, of course, provide some information, especially if done over time.

b) Hair Testing. Hair testing can be useful when used as a complementary exam.  For example, Dr. Cutler states the following in his book Amalgam Illness: Diagnosis and Treatment:

“Hair zinc does provide useful information about body zinc levels but interpretation can be complex since elevated hair zinc can indicate low body levels, and low zinc can too. Low hair zinc does correlate well with low red blood cell and total body zinc. Substantially elevated hair zinc is usually a sign of zinc wasting and consequent LOW body zinc levels (and low blood zinc levels). That is, people with high hair zinc usually have low red blood cell zinc and low tissue levels of zinc. Rarely will high hair zinc be due to elevated body levels of zinc. Plasma and serum zinc are reduced in acute illness and are not reliable indicators of body inventory.”

(For more information, see my page on Hair Testing Summary Page.

c) Zinc Taste Test. This exam also can provide excellent information and is popular with health bloggers.  However, it is far from perfect and proponents usually do not mention some of the issues.  Below I give a summary of the pros and cons:

PRO:  The zinc taste test is inexpensive, can be ordered online and done in the privacy of your own home.

PRO – STUDY on Pregnant Women. A study on pregnant found the zinc taste test to be 70+% accurate and the authors concluded that “on the whole, zinc taste test was well correlated with serum zinc level, and provides a fair idea of zinc deficiency..” [3] Pregnant women were used, because they tend to have decreased zinc status as the pregnancy matures.

CON – TASTERS versus NON. One research summary basically brought up a very critical aspect of the zinc taste test:  your native ability to taste.  As you may know, there are people who are “Super Tasters,” and they tend to be the picky eaters.  And then you have the other extreme, the Non-Tasters, who usually will eat just about anything and everything.  The problem is that this builds a certain bias into the zinc taste test.  A Super Tester may test positive for zinc, but is actually okay.  This is potentially the most dangerous false read, because one does not want to oversupplement with zinc – more on that below.  By the same token, a Non-Taster may be zinc deficient and yet not know it simply because he does not taste the zinc solution as strongly as he should.

The authors covered this situation with the following comments:

“Although depletion of zinc leads to decreased taste acuity, it does not explain all cases of hypogeusia. Various other influences on taste perception are discussed in relation to the validity of the ZTT. Stringent exclusion criteria are therefore mandatory to increase specificity. Large variations from the original test design have been identified..” [5]

CONCLUSION: The zinc taste test is actually fairly accurate according to a few small studies.  However, to be ready for prime time, it really needs to be used along with a screening for one’s ability to taste food.  For those who wish to try it, here is one used successfully by one of our forum posters: Designs for Health Zinc Challenge Liquid.

HOW IS THE ZINC TASTE TEST DONE?  The steps are simple:

a) You consume a zinc sulfate solution after not consuming anything for a specified period of time, usually an hour.

b) You keep the solution in your mouth for (usually) 10-15 seconds.

c) You spit it out and then note if you tasted nothing, got a delayed taste reaction, got a mild taste reaction or ended up with a powerful and immediate taste reactions.

The gyst of it is that tasting nothing means that you are very zinc deficient and having a powerful and immediate nasty taste is a sign that you need no supplemental zinc.

TREATMENT DOSAGE:  In my opinion, one has to be careful not to take more than about an RDA of zinc per day in my opinion. I outline why I believe this in my page on The Potential Dangers of Zinc.  Some men with digestive issues probably need more, but the less risky solution is to fix the digestive issues of course.  Vegetarians and flexitarians can boost their zinc status by consuming zinc rich plant foods, such as pumpkin seeds, even though some of the zinc will be bound to phytates.

NOTE:  There is also study out there that shows that seniors have better abilities to taste sour and salt flavors if their zinc status is good. [4] These kind of observations are the reason that the zinc taste test was developed in the first place.

Arterial Plaque Regression Through Weight Loss Dieting

Below I will discuss a study that shows that a wide variety of diets from lower carb to lower fat can be used to regress plaque in most men as long as one is losing weight.  The clear message, assuming you have extra bodyfat to lose, that I am presenting is this:  get started! Lose weight gradually over an extended period of time so as to not negatively alter hormone levels and you should see your atherosclerosis improve.

Of course, I’ll say the obvious:  it is always best to work with a physician that has considerable experience reversing plaque.  Much of the subject is actually common sense coupled with recent research, much of which I have summarized in these Pages on Arterial Plaque Regression. However, there are definitely “gotchas,” i.e. things that can trip you up, and so I encourage you to keep looking for a doctor that knows that he is doing and doesn’t just throw you immediately on a statin.

CAUTION:  From what I have seen on the Peak Testosterone Forum, you can’t usually count on cardiologists unfortunately.  Most of them seem to actually discourage plaque regression!  This is a big mistake according to the research, because Erectile Dysfunction is Associated with Arterial Plaque and heart attacks as well.  I hate to be jaded, but keep in mind that they make much more money via angioplasties and stents than by spending time consulting with you on plaque regression.

“Eligible participants were aged 40 to 65 years with body mass index (BMI) 27 kg/m2 ; individuals with type 2 diabetes mellitus or coronary heart disease were eligible regardless of age or BMI. Pregnant or lactating women and participants with a serum creatinine 2 mg/dL (176 mol/L), liver dysfunction (2-fold higher than the upper limit of normal in alanine aminotransferase or aspartate aminotransferase), intestinal problems that would prevent adherence to any of the test diets, or active cancer were excluded.” [1] Note that 88% of the those in the study were male.  There is a very good chance that the solid majority of men reading this article would fit within these guidelines.

What were the results?  Before the study, the average IMT reading was 0.817+/-0.17 mm. IMT stands “intima media thickness” and is measures  the thickness of the tunica intima and tunica media, the innermost two layers of the wall of an artery, thus taking into account any plaque lining the neck (carotid) artery.  However, what the researchers actually monitored primarily was VWV (carotid vessel wall volume) in order to determine if atherosclerosis had receded or not.

They then divided the groups into a) (quasi) low fat, b) Mediterranean and c) low carb groups and, of course, compared them to controls.What the results showed would be counterintuitive to many:  ALL three groups showed a decrease in VWV of about 5%. Low(er) fat, low carb, Mediterranean – it didn’t matter – all regressed plaque almost exactly the same.  IMT was also examined and “over the two years of diet intervention, regardless of diet group, vessel-wall volumes diminished by 4.9%  while mean IMT improved by 1.1%” [2]

How much weight did these participants lose in the two years?  The original authors stated the following:

“The mean weight loss was 2.9 kg [6.4 lb] for the low-fat group, 4.4 kg [9.7 lb] for the Mediterranean-diet group, and 4.7 kg [10.3 lb] for the low-carbohydrate group; among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg [7.3 lb], 4.6 kg [10.1 lb], and 5.5 kg [12.1 lb], respectively.” [3]

Note that this is modest weight loss.  If you look at those who who actually finished the study, weight loss was between about a quarter pound and a half pound per month.  Most people who lose weight do so much more quickly. However, there is considerable wisdom generally in doing so gradually:  hormone levels are preserved; compliance is easier and plaque regression is extended.

Of course, this is great news and is yet another study that shows that plaque can indeed be regressed and it can be regressed in those that need it the most.  Monitoring of your plaque levels before and after via IMT or Calcium Score is essential in my opinion.

1) Circulation. 2010 Mar 16;121(10):1200-8, “Dietary Intervention to Reverse Carotid Atherosclerosis”

2) Medscape, Steve Stiles, Mar 02 2010, “Weight Loss, Regardless of Diet Intervention, Can Reverse Carotid Disease”

3) NEJM, Jul 17 2008, 359(3), “Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet”

Natural Ways to Lower Estradiol with Food - Peak Testosterone

Assuming my estradiol is high, how can I lower it naturally?

One of the questions that frequently comes up on The Peak Testosterone Forum is the subject of natural estrogen blockers or, usually more correctly, aromatase inhibitors. The reasons are generally due to concerns such as:

So the patient wants to take matters into his own hands.  Now, before one considers this option, let me mention that I have written a couple of pages that discuss the best natural ways to lower estradiol and, in my opinion, these should be your first line of defense:  Estradiol and Weight Loss and Lowering Estradiol by Adjusting Dosage and Frequency.  CAUTION:  Any pharmaceutical or supplemental method of lowering estradiol is potentially dangerous, because, if you happen to lower your estradiol too low, you could end up with bone loss (osteoporosis).  Best to work with a (knowledgeable) doctor on this.

If you look at my page on “Normal” or Youthful Estradiol levels, you’ll see that most men are in the 20-35 pg/ml range throughout their life. And, from what I have seen, most docs (who care) try to keep their male patients in the 20 to 35 pg/ml range and the reason is that going either too high or too low can lead to cardiovascular, erectile, mood and other general health issues if it continues for long enough.  See my pages on High Estradiol and the Link with Prostate Cancer / Enlarged Prostate and High Estradiol Increases Arterial Plaque.  (High estradiol also likely puts some men at risk for clotting issues.)

But remember that around two thirds of men in the U.S. are either overweight or obese.  The extra aromatase in fatty tissue will generally raise baseline estradiol – the “bad” estrogen – levels and lower baseline testosterone levels (if you are not on TRT).  And many men can dramatically lower their estradiol levels simply by losing weight. In other words, looking for any kind of an estrogen blocker can in some cases just be masking the fact that a man has too much body fat.  It’s always better to treat the root cause, eh?

So, that said, is there a legitimate use for natural ways to lower estradiol?  Yes, I believe so, assuming, of course, one is monitored by a physician, and that is simply for this simple reason:  virtually all men in modern societies are inundated with estrogen.  Bisphenol-A is on receipts and in plastics.  Phthalates are in many plastics.  Pesticides and many household chemicals as well as food additives can all increase a man’s estrogen load.  Unfortunately, rarely are men exposed to things that increase their T levels to balance things out. And this is undoubtedly one of the big reasons that we see fertility and testosterone levels falling worldwide.

However, as you will see below, the natural estradiol blockers used by HRT clinics and sold by supplement companies have some major issues associated with them in my opinion. If you are considering of the standard methods, I highly recommend what you read below.  men on HRT are particularly concerned with this, because their estradiol levels climb with the boost in testosterone.  Clinics and doctors will sometimes suggest dubious solutions, such as DIM, zinc, zinc/copper and chrysin, that may put their guys at risk long term.  I got my estradiol in line by getting my body fat down to 12% and by going to subQ cypionate injections and lowering my dose a little.  I believe most men can control their estradiol much  more safely by using that strategy as opposed to the supplements below.

1. Calcium D-Glucarate.  This has become the most widely used estradiol-lowerer on the Peak Testosterone Forum. And for good reason: it has a good side effect profile – nothing is perfect of course – and also can help the body detoxify and lower cholesterol / LDL-C. I actually covered this popular supplement on a separate page: Calcium D-Glucarate Lowers Estradiol.

2.  CAUTION: DIM. DIM (diindolylmethane) is a well-known estrogen controller and a phytochemical in a number of plant foods including cruciferous vegetables and kale.  Of course, researchers noticed these properties and a number of studies have shown promising results. DIM is known for switching the estrogen profile from the “bad” metabolites to the “good” metabolites.

However, DIM aficionados have gone one step beyond the studies and swear by Indolplex DIM, a DIM that is supposedly better absorbed than regular DIM and actually lowers estradiol levels.. I believe both iHerb and the parent company sell it.

WARNING and NEWS FLASH:  I recommend staying away from DIM and I3C.  One researcher has found a link between DIM / I3C and liver cancer in animal studies and wrote that “we performed a tumor study in trout to examine the effects of DIM on cancer development compared to 17β-estradiol. Feeding the trout either DIM (24 mg/kg/day) or estradiol in the diet long-term following acute exposure to a liver carcinogen resulted in more tumors compared to control animals. Concentrations of DIM lower than 24 mg/kg/day did not significantly increase the number of tumors. We confirmed that DIM was promoting cancer by acting like an estrogen by comparing gene expression in the liver samples over the course of cancer development.” [5]

For the record I have no affiliation with this product.  However, it has a good reputation in the steroid community for lowering estradiol levels and so I am just passing along information.  However, there are two things to be aware of:  a) although Indolplex DIM is fairly widely used in the alternative and steroid communities, there are no studies that I know of and, therefore, very little data on side effects and b) it is fairly expensive costing around $31 as of this writing for 60 capsules.

And how do you determine dosage?  Well, you’re forced to go by word of mouth.  One of our posters on this thread of the Peak Testosterone Forum, basically got into a hypogonadism user group and found a word of mouth dosage and stuck with that. This is a big disadvantage in my mind as Arimidex dosing is fairly well known.  An experienced doctor can fairly well look at your estradiol levels along with a couple of other factors and determine a reasonable starting dosage for Arimidex.  Indoplex DIM seems much more art than science.

Sure DIM is in food, but once you megadose, is it really “natural” any more?  I’ll leave it up to you and your doctor to determine if this is a more natural solution.

CAUTION:  This one is powerful enough that you should be under a physicians guidance and have your estradiol monitored regularly for the reason mentioned above. Again, you can hurt yourself if you drive your estrogen levels too low for too long. We had one user on the forum who claimed that his estradiol levels never recovered after months of taking too high of dosage on Arimidex for example and potentially the same thing could occur with DIM. [1]

HRT USERS: Some men on HRT may find that they only need to control estradiol with a supplement or medication for six to twelve months, because often the body’s testosterone and estrogen levels are stabilizing.  You may be able to get away with lowering estradiol for six months while your a) estradiol levels stabilize or b) you lose weight.

3. Zinc. Although the studies have been somewhat mixed, many experts feel that zinc supplementation will likely raise testosterone in zinc deficient men. And zinc deficiency is probably not too unusual. As you can see in My Page on Sleep Aids, a combination of zinc, magnesium and melatonin greatly improves insomnia and some users on the forum have reported that just simple ZMA greatly helps with sleep. (Anything that helps with sleep will likely give a little boost to testosterone.)

Zinc is also known for its ability to limit the activity of aromatase.  I don’t think anyone has any doubt that it works to a certain extent and probably most powerfully if you are zinc deficient.  However, I don’t know of any studies that actually show zinc being used to clinically lower male estrogen/estradiol levels.  (If you know of one, please post it on The Forum!)  Furthermore, I do not read of the steroid guys reporting zinc as a silver bullet in this area.

WARNING: I suspect the reason is that, to get a significant E2-lowering effect, one would have to consume a lot of zinc and this is probably risky based on the opinion of many experts.  I cover this in my issue article on Zinc Dangers where I discuss how zinc supplementation could easily lead to increased risk for prediabetes, prostate cancer, dementia and other chronic diseases.  Too little zinc and too much are both potentially huge issues.

So the bottom line is that taking a reasonable dosage (1-3 RDA’s) of supplemental zinc, especially vegetarians and plant-based eaters, is not a bad idea.  You may get a little bump downward in estradiol levels and many other benefits from taking zinc.  However, but don’t expect it to solve elevated estradiol levels.

CAUTION: My HRT clinic, in guys whose estradiol is not too high, will use a combination of zinc (15-30 mg) and copper (2-4 mg) per day to pull down E2 (estradiol) levels a little.  Zinc and copper compete and so many experts worry that giving supplemental could lead to copper depletion and inflammation.  However, I have some concerns with this, because copper has been implicated in a number of neurological diseases and excesses are hard on neurons. These same experts believe that we are slowly poisoning ourselves in many cases with copper pipes. You’ll have to do your own research and decide where you stand on the issue.

4. Chrysin. This is an old and well-known aromatase inhibitor. It has a spotty reputation for a number of reasons, including poor absorption.  However, a few years ago, Life Extension release a turbo-charged version that basically included piperine.  Piperine increases the absorption rates of many herbals and supplements and it seems to work well with chrysin.  For example, two of the anti-aging physicians, Drs. Smith and Whitcomb, that have answered the Peak Testosterone Questionnaires have mentioned (unprompted) chrysin as a regularly-used estrogen controller. And the fact that Life Extension, which is a well-respected supplement company, backs it is also a sign of its efficacy.

WARNING: Are there concerns with chrysin?  One side effect that has been reported is the slowing down of thyroid function.  Obviously, you don’t want to solve your estradiol problems just to create a new thyroid issue.  See my link on Controlling Estrogen for a study that shows this as well.  That said, I do see a number of alternative and even mainstream physicians on the Peak Testosterone Forum utilitizing it with their patients.  Perhaps taking a before and after snapshot of the thyroid would be a good idea?  You can see most of the standard tests for hypothyroidism in my page on Testosterone and the Thyroid.

5.  Grape Seed Extract. Many studies have shown Grape Seed Extract to be an aromatase inhibitor [3].  It also, in vitro at least, gives Vitamin C a longer shelf life. However, Grape Seed Extract has a couple of cautions that need to go along with it:  1) in combination with Vitamin C it apparently raises blood pressure [2] and 2) it may slightly decrease free testosterone because it can raise SHBG, the protein that binds to testosterone.  It also is known for improving venous insufficiency. That said, Grape Seed Extract has many properties that will very likely help with erectile dysfunction and perhaps serve as a cheap substitute for Pynogenol. For more information, read about it on my page covering Grape Seed Extract and Erectile Dysfunction.

However, there is one problem in using Grape Seed Extract as an aromatase inhibitor:  you would simply have to take too much.  For this reason, I have read of very few men actually using it for this purpose.

6.  I3C (Indole-3-Carbinol) + Calcium-D-Glucarate. One of our members, who had his estradiol slammed down too low by Arimidex, used these two supplements to successfully manage his estradiol.  He said these brought him into the lower 20’s and was very stable, i.e. he did not have any significant swings in estradiol. His dosage was:  “Source Naturals 500mg. Morning and Evening, and Indole-3-Carbinol 200mg. with lunch..” [4] Again, you’ll have to do your own research and find out if you think that these supplements are more safe than low dose Arimidex (anastrazole).  Long term effects are poorly understood in both.  WARNING:  The researcher above that tied increased liver cancer to DIM also tied it to I3C.

7. White Button Mushrooms.  I make the case in my page on Mushrooms: A Natural Aromatase Inhibitor, that some research suggests that white button mushrooms, eaten in sufficient quantity, may actually lower estradiol levels a bit.  And one of our senior posters found that his estradiol jumped from 25 pg/ml to 79 pg/ml when he stopped eating white button mushrooms. [6] Now, admittedly, he ate a lot of them, but this is a pretty big effect as well.  Again, read the page above to see the evidence that he may have been spot on.

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=894.0

2) J Hypertensm 2005 Feb, 23(2):427-34

3) Cancer Res. 2006 Jun 1;66(11):5960-7

4) https://peaktestosterone.com/forum/index.php?topic=3145.msg27519#msg27519

5) https://lpi.oregonstate.edu/ss06/indole.html

6) https://www.peaktestosterone.com/forum/index.php?topic=7661.0

Testosterone Abuse: Why Should Not Go High With it

I get guys on the Peak Testosterone Forum every so often, who I am pretty sure are taking non-physiological testosterone dosages. 1200 ng/dl is the level that I have seen accepted as a youthful maximum and some guys want to push that upper limit and abuse or game the system a little. Of course, that’s not a good idea for many reasons and I am going to share a near death experience that one of our posters confessed to me. He gave me permission to share his story and you’ll see why below:

So I started experimenting with higher doses of T to see if I could get bigger gains in the gym. I am currently prescribed 150mg/week. But believe it or not I discovered that with getting the 10ml vials the pharmacy wasn’t really policing how often I refilled it. So I worked up to a whopping 300mg/week for about 3 months. I doubled up my Anistrozole to keep the E2 in check. Can’t say I ever really saw any gains above my prescribed dosage. But there was a little something that was happening in the background that I and you know about, but I underestimated how bad it could get.

My RBC/hemoglobin started sky rocketing. Now I knew about this and had given blood in the past even when I was on normal doses. Never really got above about 17.5 at worst. So while I was planning on my next blood letting to align just prior to my vacation, because I wanted to squeeze out every bit of gains I could get before vacation, I noticed that I was getting a little short on breath over nothing. I realized I better get that blood out of me. I was stupid and in denial and did not want to check my blood pressure, even though I had a damn machine at home. Figured I would look at it after I gave blood. Well then the day of my appointment, the place I donate with makes you schedule it about 4 weeks in advance, they called and cancelled! UGH! I was pissed. Now I had to go to on vacation feeling this high hypertension.

So I get to our resort where it is 92 degrees and 90% humidity and I feel like I’m 400 pounds walking around. As you know, your circulatory system is mainly responsible for regulating your cooling. If your system is taxed to the limit, it has little ability to cool you down. I couldn’t be cool outside unless I was constantly in the pool or in the nice air conditioned room. Looking back now I’m sure my BP was sky high. I had constant beet red eyes to indicate it as well. So after I survived the $7500 vacation that I had looked so forward to I decided upon getting home to immediately find somewhere to get all that damn blood out of me. This started the next adventure!

So now I started researching medications that lower your heart rate and was sitting next to my wife on the couch. I mentioned to her that beta blockers will lower my heart rate 10 to 20 bpm. To my surprise she chimes in with “oh, I have some of those” What? She explained her dr prescribed them for her performances.

So I decided to self prescribe for 2 days and try ONE MORE TIME. Success!!! RELIEF! I finally made it far enough through the checks that they checked my hemoglobin. Mine was 19.4. Wholly Crap. That is high. They told me that is the highest they have seen. At 20 they said they wouldn’t take my blood. Just made that one. Interesting observation was that when I looked down at the blood bag for the guy next to me his looked like a nice dark red. Mine was nearly black!! They were calling me Iron Man! Here is the scariest thing I learned from dr after following up with him:

Since all of this happened I have given blood one more time only a month later. My hemo was down to 17.3 from the first one and now is likely in the normal middle of the range. I will find out in a few days. I just had my lab blood drawn. I am now off of the beta blockers, back to my simple 20mg/day of lisinipril and my my BP is running around 128/75. Resting heart rate has come back down to around 70 but I suspect this will drop further with more time.

So basically I learned a huge lesson about test, bone marrow blood production, and procrastination. The 3 together can become very dangerous pretty quickly.

So, in closing, I am really trying to get across three major points that I have learned from this whole experience:

1) Upping your dosage does not seem to really buy you anything in terms of gym gains. I suppose that the serious abusers that do 500mg/week or more get something. But I will never know. I will not try this as it is not worth the bigger health risk.

2) It is important to know for people that need to control their RBC from TRT by giving blood that you can get caught in this terrible catch-22 where they won’t take your blood. So don’t procrastinate on your scheduled blood draining if you are one of us who’s RBC is senstive to T-levels.

3) Letting things go without taking action can be fatal. If I hadn’t known what was causing my symptoms and taken action when I did my outcome could have quickly become much worse. Stay on top of your BP and lab results if you are on TRT.

:Interview with Dr. Barnard's , Joseph Gonzales.

One of the most well-known of all the Low Fat experts is Dr. Neal Barnard. I recently contacted his organization and asked them some of the questions that I get asked on The Peak Testosterone Forum from time to time. Dr. Barnard’s dietician, Joseph Gonzales, was nice enough to answer us and his very interesting and timely responses are included below. One of the huge assumptions of the Cholesterol-Doesn’t-Matter Movement is that cholesterol is good for the brain. Below you’ll read a study that should make any such person pause and reflect. You don’t need to consume a bunch of saturated fat – wild game generally has relatively little by the way! – to artificially ramp up your cholesterol production and Mr. Gonzales explain just why below.

Q1. I want to start by asking about PCRM, the Physicians Committee for Responsible Medicine. Can you give everyone a brief introduction as to what you and your organization are all about and hope to achieve?

A. Our nonprofit organization, founded by clinical researcher Neal Barnard, M.D., in 1982, advocates for preventive medicine, advanced research methods, and encourages higher standards for ethics and effectiveness in research. Endless research shows that low-fat, plant-based diets can prevent and reverse chronic diseases, including diabetes, heart disease, and cancer. Throughout our clinical research at the Physicians Committee, we ve helped hundreds of people transform their lives by making simple dietary changes.

To this effect, the Physicians Committee created the Power Plate, a visual tool to show consumers how to follow a healthful plant-based diet. A year later, the USDA launched My Plate, which bears a striking resemblance to the four food groups on PCRM s Power Plate: vegetables, whole grains, fruits, and legumes. We re happy to provide resources that influence federal legislation, shape dietary guidelines, and provide people with information that can save their lives.

Q2. Power Foods for the Brain is very timely, because a common claim that I receive on the forum and in emails is that a Low Fat Diet is hard on the brain because the brain is “the largest repository of cholesterol”. Can you give us a quick synopsis as to why a Low Fat is actually incredibly GOOD for the brain?

A. Studies show that diets high in saturated fats can more than double your risk for Alzheimer s disease. In the American diet, the biggest source of saturated fat is from dairy products cheese, ice cream, butter, and milk. Meats chicken, sausage, burgers, and roast beef are a close second.

Researchers from the Chicago Health and Aging Project find that over a four-year period, people who got around 25 grams of saturated fat each day had at least twice the risk of developing Alzheimer s disease compared with those who got only about half that much.

Saturated and trans fats cause your body to make more cholesterol, which, in turn, clogs your arteries and limits blood flow to your brain, putting you at risk for stroke.

Cholesterol also increases the production of beta-amyloid and plays a role in the formation of beta-amyloid plaques in your brain, which can lead to Alzheimer s disease. People who carry the APOE4 gene absorb cholesterol more easily from their digestive tracks compared with people who do not have this allele. As a result, APOE4 carriers tend to have a higher risk of both heart disease and stroke. The good news? Genes do not determine our destiny; they merely act as committees and suggest orders.

Q3.  Of course, a low glycemic Low Fat Diet can largely or completely reverse both (adult onset type II) diabetes and heart disease as your book describes in great detail. What other chronic disease conditions does a Low Fat Diet target extremely well?

A. A low-fat, plant-based diet is shown to alleviate chronic pain, including arthritis and migraines; prevent certain forms of cancer, especially colorectal and breast cancers; and can stave of Alzheimer s disease and dementia.

NOTE: My wife battled with migraines and got rid of them when she went to lowish fat, raw foods type diet.

We continue to hear about people who improve all other aspects of their life ranging from curing allergies to reversing Crohn s disease by making simple dietary changes. One of my favorite stories is from Randy Hale, an Oklahoma man, who thought a low-fat vegan diet was a bacon diet. He overhead a PBS interview about Dr. Barnard s 21-Day Kickstart program and decided to give it a try. He soon found no meat was allowed but went all out for 21 days. For three weeks he ate a diet rich in vegetables, fruits, whole grains, spices, and legumes. It s been a year and Randy hasn t looked back since. The result? He lost more than 40 pounds in six months, reversed type 2 diabetes, went off all medications, and has influenced several residents in Oklahoma City to test-drive a healthful plant-based diet. Randy no longer worries about living long enough to enjoy the company of his children; he now hikes 100 miles each month and can easily keep up with his energetic granddaughter.

Q4. One of the big objections to whole grains that I hear is that some of the most accessible and familiar grains (wheat, corn and soy) are heavily GMO’d. I avoid the issue by eating a lot of quinoa, beans and fruit/vegetable smoothies. Do you feel these GMO concerns are overblown? And, if not, how do you recommend men interested in Low Fat living circumvent this issue?

A. There remains a lot of controversy about GMO s but research consistently shows the health benefits of simple plant-based foods, including whole grains. I advise complex carbohydrates and prefer ancient grains, including brown rice, oats, barley, quinoa, spelt, and whole-wheat linguine. I start my day with a big bowl of oatmeal and top it with berries, a handful of nuts, and serve it with a green smoothie. Complex carbohydrates provide nourishment and certain grains, including oats and barley, provide soluble fiber, which lowers cholesterol levels.

About one in ten people do have a gluten sensitivity. If you suspect you fall into this category, eliminate wheat from your diet for three weeks and see if you notice a difference.

Q5. Would you like to fill us in on any new recent studies, projects or books? And do you have a home site where men can keep track of your latest advice and recommendations?

A. You can follow the advice of some of the best athletes in the world NBA champion John Salley, ultra marathoner Scott Jurek, and Ironman Brendan Brazier at 21 Day Kick Start, a free online program that goes live the first day of each month. We have a community forum where you can get direct feedback from our team of registered dietitians. You can also download healthful meal plans, find restaurants in your area, and liaise with fellow Kickstart participants. Better yet? You can create your own success story, whether you re aiming to build muscle or shed a few pounds.

You can follow the latest research at Dr. Bernard’s Web Site and access additional nutrition information at Nutrition MD.

Hemp Protein and Bodybuilding - Peak Testosterone

Can you believe the marijuana plant is the latest rage in proteins for bodybuilding?  Well, that’s a slight exagerration, but it is true that hemp protein is a growing segment of the market and there are many good reason for it.

First of all, the hemp used to make hemp protein has a very low THC content and THC, of course, is the psychoactive phytochemical that does what marijuana is famous for.  And, for the unitiated, the hemp plant has been widely used for centuries for food, clothing and various other commerical materials and processes.

Hemp’s popularity with muscle building was an outgrowth of the recent search for healthy, clean proteins.  As I’ve mentioned elsewhere on the site, the old days of raw egg shakes and sucking down a couple of pounds of grilled meat are long gone for everyone except NFL lineman.  Unless you are exercising like a professional athlete, all the arachidonic acid and saturated fat in these proteins is going to take you out of commission relatively quickly.

This is where a plant-based protein such as hemp comes in.  Each 30 gram serving is packed with heart-healthy magnesium (180 mg or 45% RDA), potassium (330 mg or 10% RDA) and omega-3’s (630 mg or 39% RDA).  So instead of taking out your artery (and erections) with a bunch of artery-clogging inflammatory and plaque-building foods, hemp will do quite the opposite.

In fact, hemp will also likely help with the “pump” that weight lifters crave. Anything that helps with blood flow will likely help in this way and hemp is packed with both L-Arginine (1.6 grams) and L-Glutamic Acid (2.2 grams). These will boost Nitric Oxide, lower blood pressure and other good things for your health and muscle. [1]

What about amino acid balance?  Unfortunately, hemp scores has a rather low PCAAS score, which is the metric used now to measure a protein’s digestability and general ability to be used by the body.  Eggs, casein (the primary milk protein) and, interestingly enough, soy all have the highest PCAAS score possible:  1.0.  Hemp’s PCAAS rating is significantly lower:  0.46. [2]  The reason for this is that it has  proportionally low values for about five of the eseential amino acids.  What this means is that you have to eat substantially more hemp protein in order for the amino acids to actually be able to incorporated into your muscle tissues.  In other words, some of the protein in hemp will be “left over” and unused because it is in an incorrect proportion.

This leads to another problem with hemp:  it is relatively expensive.  For example, I have purchased this hemp protein,  Mantioba Harvest Hemp Protein Powder, with success and it is about $15-16 on Amazon (and about the same in my local vitamin store).  This container has 15 servings, but the servings contain only 11 grams of protein.  In other words, you are going to pay about a $1 per 11 gram serving of protein versus about 25 grams for some of the other classic proteins such as whey.  When you consider it’s low PCAAS score, it is a hard sell from the bodybuilding standpoint.

NOTE:  I have also used Living Harvest Organic Hemp Protein and it is a little cheaper (~$11), but my point is still valid.

Does this mean one should not consume hemp for muscle building purposes?  I wouldn’t go that far:  hemp does have some L-Leucine (.84 grams), the key , and so can only help.  However, I would look at hemp more as a fantastic food that has some supplemental protein to help in your efforts.

One last thing I should mention:  hemp has a rather strong taste.  In fact, when you first put it up to take a drink, it smells like grass clippings.  After awhile, you get used to it, but it’s a far cry from some of the tastier whey products out there.  Also, hemp protein comes from hemp seeds and these have the consistnecy of groundup bark.

Is it worth it?  Again, it has many excellent properties that will help with long term health and bodybuilding, but it simply cannot be a core component of your protein regimen.

REFERENCES:

1) https://www.webmd.com/hypertension-high-blood-pressure/news/20090706/vegetable-protein-lowers-blood-pressure

2) https://nutiva.com/articles/fitness-trainer-picks-hemp-as-best-protein-for-building-muscle/

Propecia: The Risks - Peak Testosterone

Imagine a drug that shuts off androgen receptivity and production in the male body, literally castrating its users. Some might say this would be a perfect drug for repeat and violent sex offenders. However, someone got a better idea and decided to sell it to the general male public and all without mentioning any of the potential risks:  Propecia in its hey day generated a little over $400 million per year in revenue!

Yes, indeed, this castrating drug is called Propecia (generic name:  finasteride) and you can buy it over the counter in countless stores for hair loss. As I cover in my link on Hair Loss, Propecia (finasteride) is rife with sexual side effects.  Around one in ten men will experience significant erectile and sexual dysfunction after starting this nasty drug.

CAUTION: This drug is also sold under the trade name Proscar.  Regardless of the name, finasteride is sometimes used for prostate issues, such as enlarged prostate.  Talk with your doctor before going off of any medication for prostate or other medical reasons.

Just what does Propecia do?  Just about everyone knows that Propecia works on 5-alpha reductase, the enzyme that converts testosterone to DHT. In the short term, researchers have found that it also lowers a downstream metabolite called 3-alpha-diol, which in turn controls a critical brain neurotransmitter called GABA.  Researchers actually used finasteride (Propecia) to study its anti-seizure properties in mice.  They wrote:  “The 5alpha-reductase inhibitor finasteride significantly reduced 3alpha-Diol levels and also blocked letrozole’s ability to inhibit the proconvulsant effects of testosterone.” [2]

And post-finasteride victims often report that their 3-alpha-diol levels are low, which, of course, is going to affect the brain and sexual function due to the impact on GABA.  This is verifed by the fact post-finasteride victims have taken drugs such as Alprazolam or Bromazepam to stimulate GABA receptors with some positive results.  (These drugs can be potentially addictive and misused.)  However, there is a study on men that showed that finasteride lowered 3-alpha-diol, but “only” by about 22%. [4] This was an average, though, and undoutedly some men experience a much greater reduction.  It is probably these men that experience Post Finasteride Syndrome.

The good news is that the industry is just now admitting the problem and a recent study in the Journal of Sexual Medicine admitted that permanent erectile damage did seem to be occurring with Propecia usage. [1] They even encouraged doctors to discuss these risks with their patients.  Imagine that – discussing the potential risk of being chemically castrated before beginning a drug for prostate enlargement or hair loss!  And the FDA is now requiring a black box warning, so that is a start as well.

SOME GOOD NEWS: Reading about the after effects of Propecia and its potential medium and long term effects can be overwhelming.  In spite of the seriousness of the condition, we have had a few men on Peak Testosterone Forum who have largely recovered and I document just how they did it in my page on Propecia_Cures.

Below are two emails from a man who describes classic Post Finasteride Syndrome, with loss of erections, numbness in the penis and so on.

Here is his first email:

“I found your website very interesting. I wonder if you have ever heard of the condition “Post Finasteride Syndrome?” Finasteride is more commonly called “Propecia,” which is a hair loss drug that prevents the conversion of testosterone into DHT. I took this horrible drug for several years, and now I have a great deal of sexual side effects that I don’t think are going to go away. I’m curious if you have heard of the disorder, and whether you know if it is curable?”

Here is his 2nd email after I requested him to write down his symptoms and what he has been dealing with since beginning Propecia:

“Symptoms are varying. The main two which have not gone away at all since stopping the drug are complete numbness of the penis, and impotence. The numbness is to the point that I could stab it with a needle and not feel it. It is the most frightening of all my symptoms because I’m thinking there was permanent nerve damage.”

“Additionally, I am able to get an erection if I try hard enough, but it goes away very quickly without constant stimulus; coupled with the numbness this makes sex impossible without viagra — though that has recently stopped working as well.”

“Two other rather frequency side effects are prostate pain which goes from slight burning to sharp random pains; a lot of men with this condition seem to get prostate infections often, so that could explain these. In addition to the above, I get “brain fog” which is a strange feeling in the front part of my head and behind the eyes that makes concentrating and absorbing new information much more difficult.”

“The brain fog went away initially after stopping the drug, but it seems to be coming back, which is really terrible news and has me pretty severely depressed. My sleep pattern is also totally messed up, I wake up every night multiple times, and I very rarely dream. When I was on Propecia, I had almost no dreams; I have started getting some dreams back of late, so I’m hoping that is a positive sign.”

“Finally, when I really feel bad (which seems to come and go in cycles) there is a horrible feeling like my penis is VERY cold; it is not cold to the touch, but for some reason it feels like it’s extremely cold “mentally,” and it hangs very shriveled and looks wrinkly. This has happened to me twice since quitting. I believe these are the times when penile fibrosis (a symptom other men complain about) is setting in.”

“Sadly, all of the above symptoms are very common for other men who have quit this drug. I was taking approximately 0.8 mg of finasteride (which is under the standard recommended dosage) for 3.5 years for hair loss reasons. Before this, I was an otherwise totally healthy 20 something year old. Several men on a forum I visit complain about muscle loss and inability to gain muscle by working out, and I have read other accounts of men growing breasts from Propecia.”

“I believe the muscle loss is related to a loss of testosterone, and the breasts are from a spike in estrogen. I do not have any breast growth, and I don’t seem to have the muscle loss issue, but I am still concerned about my testosterone, and have begun working out in an attempt to raise it.”

“Thanks very much for the advice! I have been off the drug for approximately 8 months, with little to no improvement (in fact, I seem to be getting worse), so I will be going to see a doctor as soon as possible.”

It should be noted that the mental side effects from Propecia are easily as severe as the physical, because 5 alpha reductase is key to production of certain androgen-related neurotransmitters.  Some experts believe that this loss in brain function is what actually causes much of the sexual dysfunction. Thus, the risk is not just to the penis, but to the brain as well.

What has Merck’s response been?  As far as I have been able to document:  nothing.  Every year that they can stall and procrastinate hundreds of millions keep rolling in. Of course, class action lawsuits have started and so, as always, attorneys will be the only ones who will get the attention of these executives.

The prognosis currently for many men with Post Finasteride Syndrome from taking Propecia now appears to be grim.  However, I urge you not to give up and, if you have any symptoms after taking Propecia, read up on it, do your research and try to find a doctor that specializes in recovery from this medicaiton as soon as possible.  There is some chance that high testosterone or HCG therapy may help, but talk to a medical professional with considerable expertise in this area.  Currently the medical industry has not owned up to this major health issue, much less come up with treatment protocols.

In the meantime, spread the word about the risks of this dangerous drug.  It is simply not fair that someone would take Propecia for hair loss without realizing that he was potentially putting all he held dear as a male on the line.

REFERENCES:

1)  J Sex Med, 2011 Mar, 8(3):872-84. “Adverse side effects of 5?-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients”

2) Neuroscience, 2004, 129(1):195-207, “Testosterone modulation of seizure susceptibility is mediated by neurosteroids 3alpha-androstanediol and 17beta-estradiol”

3) PNAS, 98(14), “Excitatory versus inhibitory GABA as a divergence point in steroid-mediated sexual differentiation of the brain”

4) The Journal of Steroid Biochemistry and Molecular Biology, Nov 2013, 138:10-16, “Effect of finasteride on serum levels of androstenedione, testosterone and their 5α-reduced metabolites in men at risk for prostate cancer”

Visceral Fat and Erections - Peak Testosterone

For you middle-aged and beyond guys, this page is one of my most imporant and can save both you and your erections.  “You don’t know the power of the dark side” until you start looking at what fat can do to you. Sure, it can keep you warm in the winter, but it all goes downhill from there.

Visceral fat, i.e. fat in the stomach area that raps around your internal organs, is what is particularly nasty for us guys, because it is the fat that leads to insulin resistance and decreased blood flow.  FMD (Flow Mediated Dilation) is the medical term for decreased blood flow from your precious endothelium and researchers have found that even 10 pounds of extra fat is associated with substantially decreased FMD. [1] That means less blood flow and into your arteries and your penis when you’re trying to do your solemn bedroom duty.  The title of this study was “Modest Visceral Fat Gain Causes Endothelial Dysfunction in Healthy Humans” and, if you’ve read this site much, you know that life for any male is dependent on the all-important endothelium.

Visceral fat also leads to insulin resistance and Metabolic Syndrome (and eventually diabetes, heart disease and so on).  It is very correlated with the inflammatory marker TNF-alpha and, more directly, with raising FFA (Free Fatty Acid) levels in the liver and blood.  It is these elevated FFA’s that will lead you to the land of insulin resistance. [2] Furthermore, animal studies have shown that if you remove visceral fat you actually get rid of insulin resistance. One prominent theory to explain this is that visceral fat may release fatty acids that uniquely trigger changes in liver metabolism. [11] In other words, this is something that subcutaneous (normal) fat does not do and further proof of this is the fact that, in animals at least, if you remove visceral fat it actually gets rid of insulin resistance. [12]

REFERENCES:

1) J Am Coll Cardiol, 2010; 56:662-666, “Modest Visceral Fat Gain Causes Endothelial Dysfunction in Healthy Humans”

2) Diabetes Metab Rev, 5:83 109, “Biology of regional body fat distribution: relationship to non-insulin-dependent diabetes mellitus”; Lancet, 1963, “The glucose-fatty acid cycle: its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus”

3) Psychosomatic Medicine 62:623-632, 2000, “Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat”

4) Obes Res. 1996 May;4(3):245-52, “Mental distress, obesity and body fat distribution in middle-aged men”

5) J Appl Physiol. 1994;77:614 620, “Effects of strength training on total and regional body composition in older men”

6) Int J Obes (Lond), 2007 Dec;31(12):1786-97. Epub 2007 Jul 17, “A dose-response relation between aerobic exercise and visceral fat reduction: systematic review of clinical trials”

7) https://www.sciencedaily.com/releases/2010/03/100301091302.htm

8) Ladies Home Journal, “The Over-40 Factor”, Dec 10/Jan 11 issue, p. 133.

9) Journal of Medicinal Food, 2009, 12(5):935-42, “Regular tart cherry intake alters abdominal adiposity, adipose gene transcription, and inflammation in obesity-prone rats fed a high fat diet”

10) The Journal of Clinical Endocrinology & Metabolism, Aug 1 2001, 86(8):3845-3852, “Abdominal Visceral Fat and Fasting Insulin Are Important Predictors of 24-Hour GH Release Independent of Age, Gender, and Other Physiological Factors”

11) Diabetes Care, 2002, 25:1631 1636, “Unique Effect of Visceral Fat on Insulin Sensitivity in One Hispanic Children With a Family History of Type 2 Diabetes”

12) Diabetes, Oct 2002, 51(10):2951-2958, “Removal of Visceral Fat Prevents Insulin Resistance and Glucose Intolerance of Aging An Adipokine-Mediated Process?”

13) J Nutr, Aug 1 2003, 133(8):2655-266, “Alcohol Drinking Patterns Differentially Affect Central Adiposity as Measured by Abdominal Height in Women and Men”

14) International Journal of Obesity, 2003, 27:238 246, “Waist circumference in relation to history of amount and type of alcohol: results from the Copenhagen City Heart Study”

15) Expert Rev. Cardiovasc. Ther, 2008, 6(3):343 368, “Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity”

16)

However, scientists have discovered that the primary issue is something called ‘lipotoxicity’.  Basically, what occurs is that first fat begins accumulating in our normal adipose tissue.  Once the adipose, or subcutaneous fat, is “full”, then the fatty tissue begins “resistant” to any more fat storage and induces insulin resistance. This is when the river changes course and now the fatty acids begin deposting around your organs, such as the liver. [15] The trigger point for lipotoxicity is different for everyone, but the signs are insulin resistance and belly fat to be sure.

Researchers have also found that, as you gain weight, your adiponectin levels fall and inflammation rises, and this signals the liver to begin to store fat.  As the liver stores fat, all of the above occurs, something I discuss in my page on Inflammation and the Liver.

All of this leads to the viscious cycle that so many of us struggle with in middle age, because visceral fat and cortisol are good buddies.  Studies show that visceral fat has four times the cortisol receptors that subcutaneous fat has. [3]  Also, remember those cortisone injections that some athletes receive for joint issues? Cortisone is converted in the body to cortisol by an enzyme that is stored in fat tissues. So the fatter you are, the more cortisol, in general, that you will have. Furthermore, visceral fat has been shown to have higher concentrations of this enzyme!  Elevated cortisol levels increase appetite and, again, you have yet another make-you-fatter-and-fatter factor working against you. Finally, “Relative to subcutaneous fat, visceral fat deposits are mobilized at a higer rate to produce fatty acids…” [16]

Here is where the vicious cycle kicks in as well:  many studies have shown that stress and cortisol are associated with visceral fat accumulation. [4]  Yes, cortisol increases visceral fat and cortisol decreases testosterone and lowered testosterone leads to muscle loss which will also make you fatter still.

1.  Strength and/or Weight Training. This should be number one in your visceral fat fighting strategies. Strength training builds muscle and that has been shown to directly fight visceral fat and insulin resistance. [5]

2.  Testosterone. If you have low testosterone, testosterone therapy can literally melt away a significant amount of visceral fat with no other changes according to a number of studies.  I discuss the reasons in my link on Testosterone and Visceral Fat.

3.  Aerobic training. A recent metanalysis showed that aerobic exercise decreased visceral fat in a dose-dependent manner (for those w/o metabolic disorders). Another interesting thing: the study found that just exercise with no accompanying weight loss led to decreased visceral fat. In other words, you can slowly lose visceral fat just by exercising even without trying to lose weight.  And when weight loss was added, visceral fat melted off rapidly. [6]

4.  Sleep.  Watch your sleep.  One recent study showed that those getting less than five hours of sleep had significantly accumulated visceral fat deposits. [7]

5.  Medications. A number of pharmaceuticals increase visceral fat, including Paxil (and other antidepressants), lithium, Depo-Provera – tell your woman if she’s on it. [8]

6. Stress. The stress hormone cortisol is a known visceral fat booster. See my link on Stress Management for ways to decrease cortisol and stress.

7. Tart Cherry Juice. In animal studies, tart cherry juice reduced visceral fat. [9]  This is interesting, because Tart Cherry Juice reduced TNF-alpha (and IL-6) levels in this animal study.

8. Alcohol. It is no secret that alcohol increases overall fat levels by virtue of simply adding extra calories.  However, what is not as well known is that several studies have shown that alcohol is also associated with visceral fat accumulation. [13][14] Yes, “beer belly” is a good name after all.

NOTE:  Visceral fat and fasting insulin levels are also associated with decreased growth hormone. [10] And, of course, decreased growth hormone levels will also pack on the pounds.  Researchers have not found that growth hormone therapy particularly impacts visceral obesity.  What this may very well mean, then, is that visceral fat affects growth hormone levels in and of itself.

Sure, there are other things like green tea that will give you a boost in losing visceral fat, but the above three itens are your Big Three Gut Busters. As always, the bottom line is about lifestyle. There’s no way to melt away that Beer Gut, except to pay the price and do what you need to do in the gym or on the road, track, court and then sleep it off at night. Well, and lay off the beer…

Testosterone Cypionate Injections - self-injecting testosterone

Many men are now self-injecting testosterone cypionate as part of their HRT program and find themselves, for one reason or another, with expired vials.  And they wonder if it is safe to use this “old” testosterone cypionate.  Of course, I encourage men to play it safe and go by the expiration date for a variety of reasons:

1. Lack of Preservatives. Cypionate from one of the bigger pharmaceutical manfacturers will tend to have a pretty long expiration date.  However, some of the compounding pharmacies’ expiration will be much shorter and this is for a variety of reasons.  One of them is that, at times, they deliberately do not put preservatives in their preparations.  Regardless, it is best to play it safe and respect their judgement as to how long they think their preservative, or lack thereof, will last.

2. Oil Breakdown.  Testosterone cypionate is in an oil base and, while the ester itself is very stable, the oil itself can break down even more quickly.  Only the manufacturer knows the shelf life of their oil preparation and so it is best to heed their analysis.  For example, some will be stored in sesame or cottonseed oil.  And castor oil will, I believe, last even longer. [1] Again, only the manufacturer knows all the details of their oil product.

1)  Clin Interv Aging, 2007 December, 2(4):577 590, “Testosterone depot injection in male hypogonadism: a critical appraisal”

NOTE: It is possible, although rare, to have an allergic reaction to the oil itself.  Discuss with your doctor if you think this an issue for you.

I know everyone is trying to save a few dollars and manage their money wisely.  But, when it comes to medications, this is not a good idea.  I have read stories of men injecting from old vials and finding that it actually hurt.  Cypionate is just not that expensive.  Why risk it?  Just get a new prescription and play it safe.

Tests for Erectile Dysfunction

This is why you must be patient. All of this will take some time. Work with your doctors and test things out for yourself. Find out what works for you and what is the underlying cause.

Plus, as I discuss elsewhere on my site, an erection is a surprisingly complex physical process that involves the nervous, neurotransmitter, endocrine (hormonal), circulatory and muscular systems. Most middle-aged and senior males usually have more than one problem occurring simultaneously and so just throwing a medication after the problem only helps so much (and does not deal with the root of the problem).

The bottom line is that you need to find a good doctor, of course, and perhaps try a few things yourself.  Below are some tests that you can do yourself to try to learn more about any loss of erectile strength.

CAUTION:  Even though it is uncomfortable, you should always go to your doctor with erectile dysfunction, since it is a medical condition and can be a sign of heart disease or other significant issues.

Interval Training - The Many Advantages - Peak Testosterone

Want to boost your Growth Hormone response?  Want to build muscle and burn fat like never before?  Want to actually rebuild your brain?  Then Interval Training is just the thing for you.

NOTE:  You can also read more in my link about HIIT (High-Intensity Interval Training) as well.

The reason is that Interval Training is a proven, and natural of course, method to increase your body’s Growth Hormone output.  Growth Hormone was shown in a recent study to literally burn almost 10%body fat off middle aged male participants as well as reduce their baseline metabolic rate by about 200 calories. [6] These are incredible numbers.  So what doesn’t every doctor prescrible growth hormone for those middle aged and beyond?  Primarily cost.  The price of hormone has come down, but it is for the time being the stuff of Hollywood stars, ex-athletes and the rich and famous.

Well, that was until Interval Training came along:  now even the poorest of the poor can enjoy many nice bursts of Growth Hormone throughout the day by employing some very simple scientific exercise strategies that we will outline below.

Interval Training is nothing complex:  it’s basically exercising the way you did when you were a kid.  Watch kids play:  they don’t run at a slow, steady pace for an hour.  They sprint over somewhere, then rest, the sprint somewhere else and so on.  Going fast and hard followed by slow and relaxed is Interval Training at its core.ts core.

For example, classic Interval Training is doing some form of exercise at a very intense level for 30 to 60 seconds and then resting for a few minutes and repeating for several cycles.  The research studies have usually been done using sprinting, but the form of exercise really doesn’t matter much:  the key is to do something where you get out of breath and start sweating. Intensity in your Interval Training is what you are aiming for.

But it’s actually not as bad as it sounds:  you can do anything for 30-60 seconds, right?  A stationary bike, stair stepper or even weights [3] – anything can be used.  For example, with weight training, as long as you rachet up the resistance or weight significantly for a minute or two so that you’re wheezing and puffing, then that is Interval Training.  So it’s basically push yourself, then relax and repeat.  And I think most people will find this actually more enjoyable than just straight and steady endurance/aerobic exercising.  (Note:  Remember to build up slowly into this if you haven’t exercised in a while and consult your doctor.)

So what’s the advantage?  Many studies have shown that even one or two cycles of Interval Training churn out Growth Hormone into your system for several hours afterward.  And Growth Hormone is one of your truest friends:  it improves mental abilities – actually, it allows you to rebuild your brain even past youth – and burns fat and builds muscle while it’s at it.

So how much Growth Hormone can you churn out using Interval Training?  Well, one famous study [1] looked at nine males doing either one 6 second or one 30 second sprint.  The 30 second sprint gave a peak Growth Hormone response 450% higher than the 6 second sprint and elevated Growth Hormone levels for 90-120 minutes in total. That shows the magnitude of the Growth Hormone response from Interval Training exercise for only one cycle.  Even the 6 second sprint eleveated Growth Hormone for about 60 minutes afterward.  So even minimal time and cycles of Interval Training will still produce significant Growth Hormone output.

The bottom line is that you don’t have to train like an olympic athlete to get a powerful Growth Hormone response. In fact, you want to be careful, because if you do too many sprints during your Interval Training, you will have to take a break from training the next day due to muscle soreness, etc.  Plus, you’ll have to be careful not to overtrain which can decrease testosterone, raise cortisol and decrease immunity, all of these being Exercise-Session  Killers.

Therefore, you have to listen to your body.  One key study [2] found that “Total IGHC (Growth Hormone Response) increased linearly with increasing exercise intensity”.  In other words, the more intensity and the longer the intensity, the greater your body’s output of Growth Hormone.  So find that balance between intensity and being able to do Interval Training the next day.  Remember that even one or two cycles of Interval Training will get you a nice Growth Hormone response.

Also, don’t get too hung up on the exact times that you must do for each.  The basic idea behind interval training is this:  you go fast and then you go slow and then you repeat. Does it really matter whether you get a Growth Hormone response of 44% or 64%?  No, what really matters is that your workout is enjoyable enough that you’re back doing it the next day!  If you are a beginner, don’t try to sprint like a wild man for ten minutes straight. Just do what you can do and build up slowly and gradually.

Note:  Is there a way to boost Growth Hormone using much less weight during weight lifting?  Well, it turns out the answer may be yes.  Scientists recently found [4] that doing 40% of your one rep max at a slow pace – three seconds up and three seconds back – to exhaustion gave greater growth hormone response than traditional weight lifting techniques.  This has left the researchers scratching their heads.  These results should be considered preliminary, but maybe slowing down your reps is just what the Endocrinologist ordered.  Don’t forget to look at my Volume link to see a new way to put on muscle that is easier on the joints.

Most of the studies on Interval Training have been done on younger individuals (20-35 years).  Can the middle aged and beyond athlete expect a Growth Hormone (GH) benefit?  One study [3] examined just this question and here is their summary:  “The magnitude of GH release is greater in young women than in young men and is reduced by 4-7-fold in older individuals compared with younger individuals.”  At first, this sounds discouraging, but it’s not.  You can still get a significant Growth Hormone response even though it is not as large as a young person’s.  Imagine how much you would pay for a supplement that would increase your Growth Hormone response significantly for several hours.  Well, there is no such supplement:  instead you can just do a little exercise and achieve the same results!   .

By the way, one Hormone that goes hand in hand with Growth Hormone is IGF-1 and a 2008 study found that weight training increased IGF-1 levels in muscle tissue by 54%! [5] Adding creatine to weight training produced an even greater IGF-1 response.

I should also mention that one theory postulates that what you really want to aim for is brief Interval Training 2-3 times/day.  Of course, most of us have busy lives and so that is probably not possible.  But such a regimen of Interval Training would create a elevated Growth Hormone response throughout the day.  The study [3] cited above aimed to do just that and wrote “as a result, 24-hour integrated Growth Hormone concentrations are not usually elevated by a single bout of exercise. However, repeated bouts of aerobic exercise within a 24-hour period result in increased 24-hour integrated Growth Hormone concentrations”. This study, in young women, created a 24 hour Growth Hormone response twice the normal!  And, when coupled with long, quality Sleep in the night, Interval Training would dramatically elevate Growth Hormone for you night and day.

CAUTION: If you find your performance dropping off after a period of Interval Training, then you may need to take a week or two off.  You are probably experience a type of Overtraining which can lead to decreased testosterone output and immune function.

Remember:  exercise like a kid and have fun rebuilding your body and brain.

REFERENCES:

1) J Sports Sci, Jun 2002,20(6):487-94

2) J Appl Physiol,May 2002,92(5):2053-60:2053-60

3) Sports Med,2002,32(15):987-1004

4) J Physiological Sciences,2008,58(1):7-14

5) J Sports Nutr, 2008, 18:389-398

6) J Clin Endocrinology Metabolism, in press Sep. 4, 2007

Zinc, ZMA and Testosterone - Peaktestosterone

Scientists have for decades known that a zinc deficiency is associated with decreased testosterone production and other medical conditions.  However, lately zinc has been considered a big disappointment by researchers.  Studies have shown, for example, that it does not generally increase testosterone significantly or protect from colds as originally thought.

But does that mean you should give up on this mineral altogether?  No way!  Some guys, like Casanova, have reported near miraculous powers from supplemental zinc.  Could there by something to it?  Below are five reasons that zinc may in some cases dramatically boost testosterone and substantially improve your sex life:

NOTE:  ZMA is a special formulation of zinc and magnesium.  The Magnesium is a nice side benefit of ZMA and will likely help you sleep better and avoid Metabolic Syndrome and heart disease. An alternative way of getting your zinc is through oysters, although I certainly wouldn’t recommend doing that every day.  But we had one poster write in the following:

“On the subject of shellfish, here’s another anomaly: one night recently I ate a large plate of raw oysters for dinner, and later experienced very firm nocturnal erections and very sexual dreams (practically to the point of nocturnal emission). This, when it’s very rare for me to have a nocturnal erection at all, and never a firm one. I never put much stock in oysters’ reputation as an aphrodisiac, but I am now convinced there is something to it.” [13] Casanova himself ate several dozen oysters every day for its supposed aphrodisiacal super powers and oysters do have a lot of zinc.

1.  Testosterone.  Some research has shown that zinc can increase testosterone.  It all started when an absorbable form of Zinc called ZMA (which also contains Magnesium), was created by Victor Conte of Barry Bonds fame.  Mr. Conte backed a study that shows a nice increase (34%) in testotserone in young athletes taking ZMA. [1] Sounds good, eh? Unfortunately, subsequent research has cast doubt on Mr. Conte’s work and showed no testosterone increase with ZMA. [2]  One theory is that supplemention does not boost testosterone except perhaps in individuals who are zinc-depleted.  Furthermore, it is tough to determine who is really depleted in zinc and who is not.  Some experts recommed, for example, the zinc taste test to determine this.  Regardless, it seems that normal, healthy individuals receive little to no benefit as far as testosterone.

However, there is also another interesting explanation.  One study on infertile men showed that zinc increased testosterone only in men who were lower in testosterone (less than 480 ng/dl). [15] Therefore, if you have low testosterone, it may be worth it to try some zinc and see if you can get a little boost. To test your DHT, check out these links:  Reasonable Testosterone Labs and The Cheapest Lab Tests for men for some ideas. I have not used most of the labs, so do your own due diligence and am just passing along information that I have picked up on the Peak Testosteorne Forum.

NOTE:  Zinc may also boost DHT in some men, which could be good or bad depending on your situation.  See my link on Zinc and DHT for more information.

So who might be zinc depleted?  One misconception is that, if you happen to be having a lot of sex – you lucky dog! – that you may be making yourself zinc depeleted.  However, one study shows that only about 0.3 to 0.45 mg of Zinc, or 2-3% of your body’s RDA, is lost during ejaculation. [16] I also frequently get emails from heavy porn users who have lost their sexual desire and/or erectile strength.  (I am talking about guys clearly addicted and spending hours per day and ejaculating 3+ times in a 24 hour period.)  There are probably a variety of reasons for their sexual dysfunctions, but low grade zinc depletion does not appear to be one of them.  (There is also now evidence that are “numbing” their dopamine receptors as well.)

5. Depression. Zinc is a proven depression fighter. Several studies have shown that zinc levels tend to be lower in certain types of patients with depression and, furthermore, supplemental zinc has even been shown to help in treatment (25 mg along with an SSRI). [6] And, recently, researchers created depression (in animals) by inducing a zinc deficiency.

Of course, there is now a strong link established between Depression and Your Sex Life.

BONUS: Zinc can also significantly increase semen volume, something that some men are concernd about.  For other factors, see my link Naturay Ways to Increase Your Semen Volume.

Zinc – Dosage and Dangers

Zinc has some powerful properties that can really help us males. Because of this, it is very easy for to get overly enthusiastic. Zinc is extremely powerful and has a definite clinical range, i.e. you can hurt yourself if you overdo it in the ways listed below.  Again, stick to the 1-2 RDA range for zinc.

CAUTIONS: Copper Deficincy: Some experts caution about taking zinc supplementation, because it can lead to a copper deficiency. Copper is critical for the health of your heart and your collagen among other things. It doesn’t take much zinc to have a negative effect on your copper metabolism, because the two compete in the intestine for absorption. Researchers have found that it is the zinc to copper ratio that is critical and obviously taking zinc supplementation will affect this ratio significantly.

As an example, the RDA of zinc for an adult male is 11 mg and most zinc supplements have 2-3 times that, i.e. 20-35 mg or so. This is troublesome, because there is a disease (Wilson’s Syndrome) where copper accumulates in various tissues. Researchers will actually give supplemental zinc in order to reverse this condition. How much zinc do they give? One study found that only 75 mg daily will quickly start depleting copper. [4] Remember that this 75 mg is intended to yield results in just 10 days.

Now imagine a guy taking 35 mg of zinc for testosterone for months or years. It is certainly possible that he could experience lowered copper levels and this could potentially lead to elevated inflammation and the steadily increasing hypertension associated with copper deficiency. Again, there is no study showing that this is occurring, but it is certainly possilble.

CAUTION: My HRT clinic, in guys whose estradiol is not too high, will use a combination of zinc (15-30 mg) and copper (2-4 mg) per day to pull down E2 (estradiol) levels a little.  Zinc and copper compete and so many experts worry that giving supplemental could lead to copper depletion and inflammation.  However, I have some concerns with this, because copper has been implicated in a number of neurological diseases and excesses are hard on neurons. These same experts believe that we are slowly poisoning ourselves in many cases with copper pipes. You’ll have to do your own research and decide where you stand on the issue.

CAUTION #2: Neuron Damage. Before you go popping zinc like breath mints, keep in mind that some studies indicate that too much zinc is just as hard on your brain and neurons as too little.  Most minerals have a rather tight range and zinc appears to be no exception.

CAUTION #3: Heart Disease. There was a whole theory of heart disease that centered around the correct balance of copper to zinc. [10] Admittedly, this theory is outdated, but we can still learn something from it:  too much zinc can elevate cholesterol levels and possibly contribute to hyperlipidemia. (You do not want too much copper either:  it is very hard on the brain. When it comes to essential minerals, moderation and balance are definite keys.)

OTHER CAUTIONS:   There are other potential risks in taking too much zinc, from neurotoxicity to cancer to metabolic issues and I summarize some of the latest research in my page on The Potential Dangers of Zinc Supplementation.

1) Med and Sci in Sports & Exerc,1999, 31:483

2) European J of Clin Nutr, 2009, 63:65-70

3) Intl J Sports Med,2001,22(7)537-543

4) Am J Med Sci, 1993 Apr, 305(4):199-202, “Treatment of Wilson’s disease with zinc XII: dose regimen requirements”

5) J Nutr, 1996 Apr, 126(4):842-8, “Dietary zinc deficiency alters 5 alpha-reduction and aromatization of testosterone and androgen and estrogen receptors in rat liver”

6) Neuropharmacology, 2009, 56:531 540, “Zinc regulates the dopamine transporter in a membrane potential and chloride dependent manner”

7) Pol J Pharmacol, 2003, 55:1143 1147, “EFFECT OF ZINC SUPPLEMENTATION ON ANTIDEPRESSANT THERAPY IN UNIPOLAR DEPRESSION: A PRELIMINARY PLACEBO-CONTROLLED STUDY”

8) Journal of Neuroscience Research, 1 April 2005, 80(1):145-149, “Zinc modulation of serotonin uptake in the adult rat corpus callosum”

9) Physiol Behav, 2008 Oct 20, 95(3):365-9, “Zinc deficiency induces depression-like symptoms in adult rats”

10) Am J Clin Nutr July, 1975, 28(7):764-774, “Coronary heart disease: the zinc/copper hypothesis”

11) Biol Psychiatry. 1982 Apr;17(4):513-32, “Zinc, the brain and behavior”

12) Am J Clin Nutr July 1992 vol. 56 no. 1 148-157, “Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men”

13) https://peaktestosterone.com/forum/index.php?topic=628.msg5816#msg5816

14) https://peaktestosterone.com/forum/index.php?topic=758.msg7141#msg7141

15) 1) Systems Biology in Reproductive Medicine, 1981, 7(1):69-73, “Effect of Zinc Administration on Plasma Testosterone, Dihydrotestosterone, and Sperm Count”

16) J Hum Reprod Sci. 2010 Sep-Dec; 3(3): 124 128, “Relationship between seminal plasma zinc and semen quality in a subfertile population”

Can Probiotics & Gut Health Eliminate Age Loss in Testosterone

One of our Peak Testosterone Forum members posted a link to an incredible study from 2014 that somehow escaped the attention of the health world showing a strong link between probiotics and testosterone. Although the study was on mice, it probably has far-reaching implications for us human males and verifies some past research that I will discuss below.

The study tied into the fact that “Inflammation is the Root of All Evil.” (There is a research review entitled this, and it is VERY true.)  Inflammation is a root cause for cancer, heart disease, autoimmune disease and now it looks like for andropause.  Yes, inflammation may actually be the main reason that you lose your testosterone as you age!

To show this, researchers gave mice a well-known and well-studied strain of probiotics called L. Reuteri.  This is not one of the common strains in yogurt, which are usually acidophilis, bulgaricus and casei.  Nevertheless, L. reuteri is in many probiotic supplements already and researchers love it as a strain, because it is known for lowering inflammation.  For example, L. reuteri inhibits TNF alpha, the inflammatory messenger “bad boy” that has been tied into so many different aspects of chronic disease from Alzheimers to arterial plaque. [1][2] And it is so powerful that it is currently being studied in the treatment of colitis, an inflammatory-based gut disorder.

“‘A decline in testosterone levels as men grow older is likely the result — not the cause — of deteriorating general health’, say Australian scientists, whose new study finds that age, in itself, has no effect on testosterone level in healthy older men.  Handelsman and his team, however, found that serum (blood) testosterone levels did not decline with increasing age in older men who reported being in excellent health with no symptoms to complain of. ‘We had originally expected age to have an effect on serum testosterone, so the findings were a bit of a surprise,’ Handelsman said.”

Thus losing your testosterone does not appear to be inevitable and may easily be controllable and perhaps inflammation levels is simply the major lifestyle factor involved.

2. The Okinawans.  More evidence of this comes from the Okinawans, who experienced the highest known senior age testosterone levels of any recorded culture. Essentially, Okinawan men lost their testosterone levels much more slowly than the typical Westerner, something I discuss in my page on How to Avoid Andropause.

What was the Okinawans secret?  Well, they had many positive aspects to their lifestyle, including relatively low calories levels.  However, it should be noted that they ate a largely plant-based, whole foods lower fat diet.  (They were not super low fat, but somewhere between what we term low fat and Mediterranean.)  This kind of diet is very good for gut health.  They were also known for eating “probiotic foods.”  One of them was called Gobo or Burdock root and scientists noted that “Burdock root is low in caloric density and is high in two kinds of fiber: inulin and a spongy fiber called mucilage, which is a thick, glutinous substance related to the natural gums and used in medicine as an emollient. Inulin extracted from edible burdock has also shown probiotic properties that could promote health by increasing beneficial bacteria in the gut.” [5]

CONCLUSION:  One of the huge questions that plague any health conscious male is “where has all the testosterone gone?” First of all, there is the age-related decline in testosterone that we all know about, which is often termed “andropause.” Secondly, recent studies show DRAMATIC reductions in testosterone levels and fertility parameters among even young men. I was not able to locate the study, but a few years ago researcher found that young men had average testosterone in the upper 300’s (ng/dl)!  This is very low testosterone compared to historical levels, something I discuss in my page on  Normal Male Testosterone Levels by Age. What is causing this issue and how can it be reversed?  One of the issues may be gut health and inflammation, and, perhaps, falling testosterone levels can be slowed down by focusing on certain probiotic strains and gut-healthy lifestyles.

REFERENCES:

1)   BMC Microbiology, “Probiotic Lactobacillus reuteri biofilms produce antimicrobial and anti-inflammatory factors”

2) Infect Immun, 2004 Sep, 72(9): 5308 5314, “Live Lactobacillus reuteri Is Essential for the Inhibitory Effect on Tumor Necrosis Factor Alpha-Induced Interleukin-8 Expression”

3) PLoS One, 2014 Jan 2, 9(1):e84877, “Probiotic microbes sustain youthful serum testosterone levels and testicular size in aging mice”

4) https://www.sciencedaily.com/releases/2011/06/110607121129.htm

So what happened the researchers have L. reuteri to these mice?  The results were nothing short of astonishing:  both Leydig cell counts and sperm cell-producing tissue mass were increased when compared to controls. [3] Essentially, L. reuteri slowed down testicular aging. The researchers stated that “this showed that criteria of gonadal aging were reduced after routinely consuming a purified microbe such as L. reuteri.”  The authors then tested this by giving the mice an anti-inflammatory therapy and found that this was indeed the source of L. reuteri’s anti-aging magic.

Now does this mean that probiotics can increase your Leydig cell count and restore youthful testosterone levels?  (The Leydig cells produce about 95% of our T as men.)  There is no indication of that in the study – this isn’t magic after all.  However, what it does show is that you can likely slow down the age-related decline in testosterone by focusing on gut health and proper probiotic strains.  And it may even mean that andropause is not inevitable!

Do you think that’s crazy talk?  Well, let me give you two lines of evidence that it may not be as crazy as you think.  Young men in particular should check this out:

1. The “Healthy Man” Study. There was a recent study that showed that a significant percentage of men never experienced andropause. [4] In fact, what researchers found was that senior men who felt good were associated with youthful levels of testosterone.  These men were NOT rare oddities either:

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

Weight Loss Surgeries: Heaven and Hell - Peaktestosterone

Weight Loss (Bariatric) Surgery has done the unimaginable and miraculous:  cure people of diabetes within a week. Between half and three fourths of all patients who undergo these surgeries find that their diabetes disappears almost overnight.  Of course, this is extremely desireable, because even well-controlled diabetes contains sinister swings in blood sugar and that accelerate aging of many tissues throughout the body.  (See my link on Diabetes and Erectile Dysfunction for example.)

How does weight loss surgery do its magic?  Scientist are not completely sure, but one of the answers seems to lie in the fact that these surgeries permanently increase GLP-1, glucagon-like-peptide-1, which increases insulin and decreases blood glucose, both critical for diabetics. However, one study showed that GLP-1 is certainly not the only explanation. [1]

Regardless, this permanent increase in GLP-1 is one of the reasons that Weight Loss Surgery can permanently decrease appetite. [2]  Many patients are delighted to find that they suddenly no longer have those binge cravings that plague them.  Bariatric surgery also affects gherlin, a major appetite hormone, in a positive way as well.  Again, this is another miracle of Weight Loss Surgery for many patients:  instant appetite control.

Of course, Weight Loss Surgery generally helps miraculously with its #1 goal:  weight loss.  Patients usually lose a good 50 pounds and it is, of course, easier to keep those pounds off when your stomach, one way or the other, because the size of a walnut!  Of course, you can also pack back on the pounds even with the smaller eating are provided by the three big bariatric surgers, Adjustable Lap Band , Gastric Bypass (Roux-en-Y) or Vertical Sleeve Gastrectomy.  However, most of these surgeries leave your stomach with about an ounce of space, which ain’t much.

So why would anyone somewhat overweight not have one of these surgeries done?  Simple – they are just as much Hell as they are Heaven.  These surgeries seem to permanently alter digestion – and scientist don’t know why yet – such that the body aborbs much more poorly vitamins and minerals.

This is bad.  Very bad.

Surgeons know about this and most patients are advised to take a multivitamin.  However, even with a multivitamin, a big block of patients end up having to be treated for malnutrition. And, by the way, this cannot be explained by just the smaller size of the stomach and eating less:  researchers have determined that it stems from phyiological alterations in the body itself.

Now think about this:  if many are experiencing short term malnutrition, imagine what a lifetime of poorly absorbed vitamins and minerals does to their systems?  We do not yet know the damage that will occur in people decades after bariatric surgery, but it will likely not be pretty.  Many people already struggle with enzyme deficiencies, atrophic gastritis and other problems that results in malabsorption of vitamin and minerals.  Throw in aging and the poor nutritional quality of our modern crops and you’ve got major issues for these men and women even if they eat very well.

Potential signs of this nutritional malabsorption show up short term post-urgery with such common symptoms as major depression,  thinning hair and bone loss. This is very dangerous stuff indeed and we emphasize the good old-fashioned weight loss techniques that have no side effects, unless your Overtrain, of exercise and cutting back on calories.

Yes, these are work.  Yes, for some people these aren’t fun.  But these are the only reliable way to do long term weight loss without side effects and they are both incredibly good for your health, fitness and sex life.

And let’s be honest:  most people have accululated their extra weight through years or even decades of sedentary living and/or overeating. Any natural method is going to take a considerable amount of time to reverse the process.  For example, losing weight too fast can whack testosterone as I often mention.

ADVICE:  Get back your life without going under the knife…

REFERENCES:

1) OBESITY SURGERY, 2006, 16(12):1594-1601, “GLP-1 and Changes in Glucose Tolerance following Gastric Bypass Surgery in Morbidly Obese Subjects”

2) The Journal of Clinical Endocrinology & Metabolism, 2006, 91(5):1735-1740, “Glucagon-Like Peptide-1, Peptide YY, Hunger, and Satiety after Gastric Bypass Surgery in Morbidly Obese Subjects”

A PSA of 5.0!  The usual jump-up-and-down prostate cancer

It is 12/27/2013 and would you believe I have been off of HRT for almost 3 weeks?!?  Well, I can’t believe it either.

If you have poked around my site much, you know that HRT was a life-changing experience for me and cleared out mental fog, anxiety, fatigue and gave me morning erections for the first time in my life.  So I was not happy when my HRT clinic director told me I had to stop.

What happened?  Well, I had a high PSA reading of 6.3. I was absolutely shocked, because my PSA readings have always been below 1.5, which is pretty good for a guy in his early 50’s on HRT. Ideally, it would be below 1.0, but HRT bumps it up a bit as does exercise, intercourse, etc.  My lasting reading was 1.4, so this was a quadrupling of my PSA.

Actually, my clinic director did not take me off immediately but asked me to retest the following week with abstinence and minimal exericse.  The result?  A PSA of 5.0!  The usual jump-up-and-down prostate cancer screening level is around 2.5-3.0, so this did not look good.  They said, “Don’t come back until you have urological clearance” and sent me on my way.

The next couple of weeks were very stressful.  The urologist felt my prostate and it was quite small (30 mm?), i.e. I did not have an enlarged prostate.  An enlarged prostate can cause an increase in PSA, so this was good and bad news.  My urologist pointed out that it just eliminated another non-cancer possibility and he highly recommended that I get a biopsy, because he said it could definitely be cancer.

For those of you who have never had a prostate biopsy, it’s a relatively benign procedure.  You have about a 1 in 50 chance of getting a nasty go-to-the-E.R. prostate infection from it, but, overall, it’s not too bad.  But let me tell you what is bad:  waiting the 7-10 days for the pathologists report!  This is agonizing as you and your loved ones wait to see if you have prostate cancer or not.

Managing prostate cancer, if you have it, is ugly and controversial at this point.  If it’s bad enough, urologists can remove the prostate, but you can end up with medium term incontinence and erectile dysfunction as the nerves heal.  There’s also radiation treatment, but that is risky:  the prostate ends up so scarred that urologists can not do a prostectomy, which leaves you potentially at the mercy of a future advanced stage prostate cancer.  Yes, there is a new ultrasound treatment for handling prostate cancer, but it’s only available in Mexico, so it’s still quite a mess and not a road that I wanted to go down!

The story has a happy ending however:  I got the biopsy results back today and they found no cancer in any of the 12 samples.  Furthermore, there were no precancerous (PIN) samples either.  They also found that a couple of the samples had signs of inflammation, which is actually a good thing – relatively speaking – as I’ll explain below.

So I asked my urologist his take on the results and he said that the good news was it was extremely unlikely that I had cancer at this point. The biopsy does not sample everwhere on the prostate, but he said that it was still very unlikely that I had cancer at this point.  He went on to say that the root cause was likely inflammation based on the pathologist’s report and he sees fairly often a spike in PSA that will go away after a few months.  Of course, I tried to pin him down on what would cause the inflammation and he had virtually nothing to say on the subject.  Basically, he said, “We don’t know.”

NOTE: I was tested twice for bacteria and both came back negative.  So it appears I have some kind of mild abacterial prostatitis.  This was a complete surprise to me, since I do not really have any symptoms.  Many men suffer quite a bit with this type of chronic prostatitis, but I would not have even noticed if it was not for the high PSA reading.

I then asked him if the plan could be for me to try to lower my PSA through natural means and test it monthly in order to get my urological clearance back for HRT as soon as possible.  He then shocked me by saying that

1.  He would give me urological clearance for HRT effective immediately, because it was extremely unlikely that I had a prostate cancer.  (And, I assume, even if I did, it would show itself by a rising PSA on an ongoing basis.)

2.  I should NOT test my PSA monthly, because my prostate is now inflamed from the biopsy and likely would give me high reads for a couple of months.

Of course, I was overjoyed to get permission to go back on HRT and even more excited to know I very likely did not have PC.  However, the whole experience was very sobering and I realized that my ability to stay on HRT depends on keeping my prostate extremely healthy.  I have to guard against an enlarged prostate, inflammation of the prostate, precancerous growth and, of course, cancer itself.

Now this is no small task as one of the men on The Peak Testosterone Forum pointed out. He struggled with chronic, abacterial prostatitis and said that he has noticed that the key is to keep good blood flow and nitric oxide to the prostate, because the prostate does not have particularly good vascularization. Let me actually quote some of his commentary: [1]

“Naw, I do not believe that I have CPPS. My main symptom especially during flare ups is I feel I cannot empty my bladder completely. CPPS symptoms seem to be more severe. Pain in the genitals or anal area, very painful urination, and painful ejaculation.

The prostate gets very little blood flow. So it is extremely difficult to “flush” any irritants from it. That is why I try to limit the toxins I take into my body. I try to limit my ingestion of chemicals and pesticides. So, if one eats foods high in pesticides, for instance, these poisons eventually end up in the prostate. It takes I long time for the prostate to eliminate these things. Also, in my case, I believe Kegels increase oxygenation and blood flow to the pelvic area. Moreover, Kegels sorta give the prostate a massage.

So, I will try to anything that helps blood flow. Exercise, reduce systemic inflammation, beetroot juice, etc. I am hoping that by improving my arteries and blood flow it will in turn help with my prostate issues. I do feel much better than a year ago…certainly my eating and exercise habits have helped more than the antibiotics and Advil that the uro’s prescribed me.”

This is a case, I believe, of the patient have much better ideas and knowledge than the docs!

When you look at the big picture, I have to guard against inflammation and prostate cancer primarily and this caused me to implement some important changes to my lifestyle:

I know that to many of you, some of the above measures will seem extreme. However, they are all research-backed as I how in my pages on How to Lower Your PSA, Flaxseed and Prostate Cancer and A Potential Prostate Cancer Cure.  Plus, I never want to go through the stress again of wondering if I am going to leave my family in a tough situation, since I provide the great majority of our income. And who wants to die a grisly death from cancer? I knew a man once who died of prostate cancer that metastasized and it’s fugly – that’s not the way I want to go and if I can do anything in my power to avoid it, I am going to do it.

Finally, I do NOT want to ever be off of HRT again. I’m a believer in the Replacement Philosophy (in general) and I think having youthful testosterone levels is healthy for most men. However, this whole experience made me realize just how fragile HRT is: one high PSA reading could take me off of HRT for months and that’s not something I want to deal with again.

If I can get my PSA down by doing the above, I may go off of a strict vegan diet and then monitor my PSA after eating some Low Fat Meats. One thing at a time though. I am just glad not to have cancer…

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=2865.msg25432#msg25432

Kwikmed: A Unique Online Pharmacy -Viagra, Cialis

Question: How many legitimate, licensed online pharmacies (in the U.S.) are there that can prescribe and mail PDE5 inhibitors (Viagra, Levitra and Cialis) without you having to visit a doctor’s office?

REFERENCES:

1) Mayo Clinic Proceedings, Aug 2008, 83(8):890-896, “Safety of Prescribing PDE-5 Inhibitors via e-Medicine vs Traditional Medicine”

2)

3) https://www.kwikmed.com/cialis.asp

Answer:  One.  Kwikmed.

Yes, you read that right.  You can get a prescription for Viagra without ever going into a doctor’s office. However, you do have to answer an online questionnaire for about 20 minutes that will step you through 20-100 diagnostic questions, depending on what you answer.  Of course, this is critical to make sure that these drugs are not misprescribed such that  it could endanger one’s health.  Viagra and Co. should not be taken, for example, with nitrates as they can cause a life-threatening drop in blood pressure.

At first the Kwikmed way of doing things might seem a bit scary.  However, both experience and research have shown the opposite:  one large study showed the Kwikmed online process is actually more reliable than visiting a doctor when it comes to these specific medications. [1] (Kwikmed only prescribes a total of six medications that lend themselves well to online protocols.  For details, see the Kwikmed Home Page. [4]) In fact, Mayo Clinic did a press release explaining that “over the past nine years, KwikMed has treated more than 300,000 patients without a single adverse medical result“. [2]  Not a bad record, eh?  Kwikmed’s track records argue that, for these six medications, their methodology is much more safe, private and efficient for customers.

So what’s to keep kiddies and “Viagra junkies” from abusing the system?  Simple – price.  Kwikmed doesn’t give their Viagra and Cialis away.  In fact, the price is about a third more than you would pay at a standard online retailer.  For example, Cialis is about $23-24 for three 20 mg tablets at a retail pharmacy but at Kwikmed, you will pay as of this writing $33. [3] That’s just too expensive for most kids, or even college students, to abuse.

However, many adult males enjoy the privacy and convenience and are willing to pay the slight premium.  That’s why Kwikmed keeps the online customers rolling in.  Customers also have faith in Kwikmed, because Kwikmed is actually licensed by the state of Utah as a legitimate pharmacy. (Utah is one of the ideal spots for this, being Silicon Valley Lite if you will.)

To get that certification, Kwikmed had to allow access to their records for scrutiny and review by the state.  Furthermore, they had to allow submission of their online questionnaires and protocols to examination by the state’s medical board. So this is not a fly-by-night, pharmacy, but rather a legitimate online business of almost a decade trying to work its way up in the medical and retail community.

They have come a long way since their owners were handcuffed and prosecuted in 2001.  That’s right – Kwikmed was gutted by federal authorities and then take over by venture capitalist Peter Ax. (Why couldn’t I have a cool name like that?”)  Mr. Ax was a former Lehman executive who took over Kwikmed and built it from the ground up.

So move over Linus Torvalds and Shawn Fanning – there’s a new online superhero in town who is putting more guys back in the saddle…

Inflammation: How Certain Juices Can Help - Peaktestosterone

Can you juice your way to lower inflammation?  Could it be that simple?  The answer  is a resounding ‘yes’, within reason of course, and we’ll show you two or three common juices that can do just that.

Now, before I write anything else, let me just make the comment that it is very unlikely that you can “live like hell” and get away with just drinking some juice and counteracting the ill inflammatory effects.  For example, in my link on How to Lower Inflammation, I cover how high-glycemic meals, Atkins diets, a sedentary lifestyle, extra salt and lack of sleep can all lead to elevated levels of inflammation.

However, assuming you live a reasonably healthy lifestyle, you may be able to juice away one of your arch-enemies as a male.  Remember that inflammation is a natural process, but runaway inflammation – the curse of men in modern, industrialized societies – is the root of almost every ill that you can conceive of.  Inflammation has been implicated as one of the major root causes in cardiovascular disease, Alzheimer’s, erectile dysfunction, cancer and autoimmune disorders. Yes, elevated inflammtion is pure evil.

Furthermore, it’s going to be a very long time before they come up with a nice, brightly colored pill that you can pop to magically overcome its ill effects.  The good news is that you don’t need to!  You can dramatically lower your inflammation levels through diet (and exercise).  In fact, below we will show you how combining two to three different types of fruit juice each day are just like taking an “anti-inflammatory pill” and all without the nasty side effects!

REFERENCES:

1) Scand J Med Sci Sports, 2010 Dec, 20(6):843-52. “Influence of tart cherry juice on indices of recovery following marathon running”

2) Nitric Oxide, 2007 Aug, 17(1):50-4, “The influence of pomegranate fruit extract in comparison to regular pomegranate juice and seed oil on nitric oxide and arterial function in obese Zucker rats”

3) J Agric Food Chem, 2006, 54:980-985, “Pomegranate juice, total pomegranate ellagitannins, and punicalagin suppress inflammatory cell signaling in colon cancer cells”

4) Clin Rheumatol, 2007 Oct, 26(10):1709-10, “Pomegranate juice may be a potential addition to anti-Behçet armamentarium: a hypothesis”

5) Am J Clin Nutr, Apr 2010, 91(4):940-949, “Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin increase and Toll-like receptor expression”

6) Diabetes Care, 2010 May, 33(5):991-7, “Differential effects of cream, glucose, and orange juice on inflammation, endotoxin, and the expression of Toll-like receptor-4 and suppressor of cytokine signaling-3”

7) Am J Clin Nutr, 2006 Oct, 84(4):756-61, “Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers”

8) The Journal of Nutritional Biochemistry, May 2002,  13(5):282–288, “Potential role of dietary flavonoids in reducing microvascular endothelium vulnerability to oxidative and inflammatory insults”

There are likely many more fruit juices that would qualify, but here are a few of the heavy hitters and just how they lower inflam

1.  Tart Cherry Juice. This juice made the news in the sports and fitness world when researchers found that it reduced muscle soreness and recovery time for marathon runners.  What is not as well known is that reduced two of the biggest inflammatory markers, IL-6 and C-Reactive protein at the same time. [1]

2.  Pomegranate Juice.  This powerhouse has decreased the vascular inflammation markers, thrombospondin (TSP) and cytokine TGFbeta1. [2]  It also has, at least in cancer cells, decreased TNF-alpha COX-2 expression. [3]  Pomegranate Juice is so powerful in this area, especially in at risk men, that researchers have contemplated using it to treat Behcet’s Syndrome, a nasty condition that results in dramatically increased arterial inflammation. [4]  (Pomegrante juice can be a big help in the bedroom as well.  See my link on https://www.peaktestosterone.com/pomegranate for more information.

3)  Orange Juice. Researchers recently found that 300 calories of orange juice offered significant protection to men and women from the typical pro-inflammatory response that results after with a nasty, fast food meal. These were normal, healthy subjects who ate 900 calories of items such as sausage muffins, hash browns and so on. [5]  Of course, we don’t advise having orange juice just so you can eat “like hell”, but this does show the power of fruit juice to limit inflammation.  A similar study in the same year showed that orange juice mutes the rise in the deadly TNF-alpha cytokine as well. [6]

4. Cranberry Juice. Cranberry juice appears to help control inflammation by working downstream from the inflammatory cytokines, i.e. it “reduced TNFα induced up-regulation of various inflammatory mediators (IL-8, MCP-1 and ICAM-1) involved in the recruitment of leukocytes to sites of damage or inflammation along the endothelium.”  Translated it means that cranberry juice will likely protect the lining of your arteries from the inflammatory agents brought about by TNF-alpha. [8] And that will be good for erections of course.

NOTE:  It doesn’t take a lot of juice to do some magic.  Most of the pomegranate juice studies are with 8 oz and one study of orange juice showed that low calorie, i.e. less concentrated, orange juice lowered C-Reactive protein levels. [7]  This is very significant, because it shows that just a little juice can “go a long way”:  C-Reactive protein is correlated with a host of nasty conditions including cardiovascular disease and colon cancer.

CAUTION: More is not necessarily better when it comes to fruit juices.  The experts recommend keeping your total fructose for the day less than about 50 grams.

Flaxseed's Benefits: Lowering Blood ,Cancer and Inflammation.

One of the guys on The Peak Testosterone Forum essentially asked the question, “Why would any man take flaxseed?”  I would actually ask it the other way around:  why would any man NOT consume flaxseed?  Flaxseed is that good and arguably the most powerful superfood on the planet right now.  (One could make a great case for spinach, broccoli and berries however.)  I simply do not know any food that can do as much for men as flaxseed. As you’ll see below, it does literally everything a guy could possibly want a food to do, including clear benefits for the bedroom.

Tragically, it is currently in vogue to attack plant foods (at least here in the U.S.).  Flaxseed comes under fire from those who have not bothered to read the research, because it has a fairly high phytoestrogen content. In fact, it is obvious that the above poster had read material from these blogs:

“Okay guys, Cronos, Peak T, anyone… sort me out with a quick answer, you’re all well informed on here. Remind me again…why should we be taking flaxseed oil or flaxseed in general, when we know it to be a ‘gazillion’ times more estrogenic to the male body than (processed) soy? Thank you…” [5]

1. Protecting Against and Possibly Clearing Out Penile Arterial Plaque.  I know of only one other food – Pomegranate Juice – that has research showing that it can single-handedly help with arterial plaque.  However, we have another recent addition to the family:  flaxseed.  (See my page on  Pomegranate Juice: Your Best Bedroom Buddy for more details on this powerhouse.)  For example, an animal study showed greatly decreased plaque progession in flaxseed fed animals versus controls:

“Dietary flax-supplementation resulted in a significant ≈40% reduction in plaque formation (P = 0.033). Both Group II and III animals displayed improved contraction and endothelial-dependent vessel relaxation. Dietary flaxseed is a valuable strategy to accelerate the regression of atherosclerotic plaques; however, the flaxseed intervention did not demonstrate a clear beneficial effect on vessel contractile response and endothelial-dependent vasorelaxation.” [1]

Will it actually help you regress the plaque you already have?  My guess is ‘yes’ – and you’ll see later why I say this – but suffice it to say that flaxseed has many CVD marker and atheroclerotic studies under its belt. And keep in mind that almost every man growing up with a Western lifestyle has signficant plaque if they are over the age of about 30 – sometimes younger! – and so flaxseed is clearly a fantastic tool in their arsenal.  Also remember that it only takes a little bit of plaque in your penile arteries to really make a difference in erectile strength.

2.  Powerfully Lowering Blood Pressure.  Many men have hypertension and the added pressure on arterial walls is a risk factor for erectile dysfunction and atherosclerosis (and stroke, etc.).  Many men do not realize that a recent study showed that flaxseed lowered blood pressure in a study on men and women with hypertension by an average of 15 points (mm) systolic and 7 points (mm) diastolic. [2] This is a huge drop and rivals that of most of the phamaceutical solutions out there!  Now the study in #1 did not show a signficant increase in endothelial function.  However, this will undoubtedly occur in most of those with high blood pressure per the above

3.  Protecting You From Prostate Cancer.  I point out everwhere I can that research shows that about half of all men by middle age have small prostate cancer nodules growing within their prostate. Now this is no reason to panic, because prostate cancer typically grows slowly.  But, given the right environment, those nodules can grow and raise your PSA value.  Then the ugly stuff starts to happen:

a) Your urologist may want to biopsy you.  This means a painkilling shot into where the sun don’t shine and ejaculating blood for a few weeks while your prostate heals from the samples they clipped out of it.

b) If you are on HRT, you will probably be pulled off of HRT while you are evaluated with a biopsy.  See my story High PSA But No Cancer for a very personal example of this.

c) Unfortunately, these nodules can metastisize.  Once this happens, it is very hard to treat and, well, you know the story.

And, by the way, try to have an active sex life after you’ve had a biopsy and your wife or girlfriend is worried over your rising PSA and if you’re gonna be there next Christmas…

4.  Decreases in LDL, Triglycerides and Lp(a)l.  Many studies have shown flaxseed’s incredible ability to lower cardiovascular disease markers. Again, flaxseed potency in this arena is similar to Pomegranate Juice in terms of it’s sweeping potency and long term arterial protective powers.  I plan on doing a more detailed page on the subject, but let’s just look at the conclusions of one study here (on men and women with high cholesterol):

“Flaxseed supplementation was associated with significant reductions in TC (-17.2%), LDL-C (-3.9%), TG (-36.3%) and TC/HDL-C ratio (-33.5%). There were no significant differences in absolute change in BMI nor in percentage change in TC, HDL-C, LDL-C, TC/HDL-C ratio between flaxseed and statin groups. Dietary flaxseed significantly improves lipid profile in hyperlipidemic patients and may favorably modify cardiovascular risk factors.”  [3]

First of all, notice that the authors compared its powers to the pharmaceutical statins.  And notice that it powerfully dropped triglycerides and total cholesterol (and its modest reduction LDL).  If you’ve read my page on  How to Clear Your Arteries of Plaque or my page on HDL, LDL and Triglycerides, then you’ve got some starter info as to how these markers can reasonably reliably help you actually regress plaque (or maintain zero plaque if you are one of the “lucky” individuals). Another study (on women) shows that flaxseed can reduce Lp(a). [4] This is another risk factor for arterial plaque and it can bite people with good lipid numbers otherwise.

5.  Improving Your Omega-3/Omega-6 Ratio.  Many of you know that some of our standard plant-based oils, such as sunflower, are high in omega-6’s and can lead to inflammation.  Flaxseed is completely different, however, as it is packed with alpha-linolenic acid, which your body converts into the all-important omega-3’s DHA and EPA.  Many guys feel noticably better when consuming flaxseed and this is probably the reason why.  Our bodies were meant to consume a very low omega-6 to omega-3 ratio – Dr. Greger says 4:1 is probably the safe maximum – and flaxseed can help you greatly improve this ratio.

Vegetarians and vegans – and I am 95% plus vegan – interestingly enough, get themselves quite frequently into trouble with their omega-6 to omega-3 ratio.  The reason?  It is probably because in the U.S. there are now so many packaged and processed plant-based foods.  Cooking and food preparation is a lot of work and even the health-conscious can be foiled by food manufacturers who, quite frankly, are thinking of convenience, price and shelf-life before the health of their customers.

REFERENCES:

1)   Am J Physiol Heart Circ Physiol (April 12, 2013), “The Effects of Dietary Flaxseed on Atherosclerotic Plaque”

2) https://www.reuters.com/article/2013/11/01/us-flaxseed-bp-idUSBRE9A00R520131101

3) Revista Medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi, 2005, 109(3):502-506, “Flaxseed supplementation in hyperlipidemic patients”

4) Nutrition Research, Jul 1998, 18(7):1203–1214, “Whole flaxseed consumption lowers serum LDL-cholesterol and lipoprotein(a) concentrations in postmenopausal women”

5) https://www.peaktestosterone.com/forum/index.php?topic=5969.0

-Supplements - Five Erectile Supplements with a Solid Track Records

One thing that I find rather shocking is that most guys experiencing a decline in bedroom performance generally have no idea that there are erectile supplements with solid research behind them and a good safety profile as well. Most males turn immediately to the PDE5 Inhibitors, Cialis, Levitra and Viagra, without even considering that there are much less expensive alternatives available that, in some cases, have been used by men effectively for decades or even centuries.

The potential tragedy of this is that PDE5 Inhibitors such as Cialis and Levitra are full of side effects and it is highly questionable that these can be used for decades without some sort of negative lasting effects.  (See my link on The Side Effects of PDE5 Inhibitors for more details, especially regarding how PDE5 inhibitors often effect the eyes, ears and stomach.)

Science has shown us many inexpensive supplements that can help improve erectile dysfunction and significantly eliminate impotence very quickly, within a matter of a week or two in some cases. Furthermore, some of these supplements increase libido and my give a little boost to testosterone as well.

NOTE: If you have any medical condition or are on any medication, check with a doctor before taking a supplement.  Also, for potential side effect, please go to any links mentioned below which have a more detailed information page. I also recommend implementing one new supplement per two weeks and not all at once.

1) L-Citrulline. Citrulline is the new wonder supplement on the block. The beauty of Citrulline is that even small amounts will increase baseline nitric oxide levels, especially in men with endothelial dysfunction. This is absolutely critical, because most middle-aged and beyond men with erection-related issues are in this catgory. Viagra and Cialis often will not work for them, because they simply do not have enough nitric oxide produced by their arteries and vessels for these medications to act upon.

For this reason many men seem to be finding Citrulline downright miraculous, restoring morning and/or daytime erections. Furthermore, there is now a study showing that this supplement significantly increases hardness factor for many men with erectile dysfunction. L-Citrulline is typically sold in 1 gram tablets and men will take 1-2 grams daily: Source Naturals L-Citrulline 1000mg. (I would not take more than that.) For more information, see this link on The Benefits of L-Citrulline.

REFERENCES:

4) Phytotherapy Research 2002,16:1-5; Nutrition Research,2001,21:1251-1260;Nutrition Research, 2003,23: 1189-1198;Life Sciences,2004,74:855-862

5) J Urol 2002; 168:2070-3

6) Asian J Androl 2007;9(2):241-4

7) Intl Journ Cardio 2005 Feb 28, 98(3):413-9

8) Eur Heart Journ 2007 28(18):2249-2255

9) Urology 2004 Apr,63(4):641-646

10) Curr Med Res Opin, 2004 Sep,20(9):1377-1384

11) Amer Jour Clin Nutr, 2007 Sep,86(3):610-7

12) Amer Jour Cardio,2007 Aug 1,100(3):455-8

13) Am Jour Clin Nutr, Apr 2007, 85(4):1068-74

15) J Cardiovasc Pharmacol,1998,32:509-515

16) Hum Psychopharmacol,2002,17:279-284

17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin 17) Gen Pharmacol,1982,13:169-171;Gen Pharmacol,1982,13:225-230;Gen Pharmacol,1983,14:277-280

18) J Clin Endocrinol Metab,1991,73:4-7

19) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

20) Journal of Andrology, Sep/Oct 2008,(29):5

21) JAMA,2007,297:2351-2359932-40

24) Circulation, 1998 Jun 9, 97(22):2222-9

25) Intl J Impotence Res, 2008, 20:173-180

24) Circulation, 1998 Jun 9, 97(22):2222-9

225) Intl J Impotence Res, 2008, 20:173-180

26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementa26) Eur J Clin Nutr, 2008 Dec, 62(12):1426-31, Epub 2007, “Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients”, Wang, et. al.

27) Journal of Chromatography A, 17 June 2005, 1078(1-2):196-200, “Determination of citrulline in watermelon rind”

28) Brit J Sports Med, Oct 2003, 37: 464–70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

29) https://www.prelox.com/pdf/prelox_research.pdf

2) Pycnogenol. Pycnogenol is a proprietary extract of a French maritime pine bark extract, whose remarkable powers have been known for over a century.  Pycnogenol has been shown to stimulate the enzyme nitric oxide synthase (NOS) [15] which in turn stimulates Nitric Oxide production. Furthermore, research shows, which I document in my link on Pycnogenol and Erectile Dysfunction, that it is a supplement, when coupled with L-Arginine, that improves erectile strength and heals erectile dysfunction in around 75% of guys!

This is an incredible track record if you stop and think about it and, furthermore, the studies show no side effects.  What a contrast with Viagra and Cialis!

You can do what was done in the studies by taking between about 50-150 mg of Pycnogenol, such as TwinLabs Pycnogenol Capsules, 50 Mg, 60-Count Bottle, along with about 1.5 grams daily of L-Arginine per L-Arginine (500mg).  This is much less expensive than any of the PDE5 inhibitors and, again, there have been no reported side effects in any of the studies. [29]

Research has shown that pycnogenol also lowers bad cholesterol (LDL), raises good cholesterol (HDL), decreases inflammation and lowers blood pressure, which will very likely protect a guy from future erectile dysfunction as well. (High blood pressure and inflammation are both major risk factors for erectile dysfunction.) [4]

3) Korean Ginseng. Ginseng has been one of the big guns in erectile research and has a fairly established track record.  In facit, it has been used literally for centuries. It’s (generally) potent sexual powers come from its abilities to directly boost nitric oxide, a fact that has been verified in multiple animal and human studies. Furthermore, several studies have showed that it actually helps with erectile dysfunction.  And, as I document in my link on Ginseng and Erectile Strength, it improved the sex life of almost two thirds of men directly.  It is also a libido booster and in some cases may boost testosterone as well.  Some Ginseng brands are careless and have been found to be contaminated with lead and/or pesticides. Solgar, however, sells a Korean Ginseng that passed on all accounts in recent Consumer Labs testing: Solgar – Korean Ginseng Root Extract, 60 veggie caps. (It can thin the blood a little: discuss with your doctor.)

4) Maca. Maca is not actually a direct erectile supplement, but I mention it here, because it has many studies (animal and human) that show it is agood, old fashioned – and legitimate – aphrodisiac. It probably doesn’t directly improve erectile dysfunction or cure impotence, but is a good bedroom buddy nonetheless. Many guys struggle with passion and desire and this is where Maca excels.  It also has the advantage of being consumed as a food for decades in South America and thus has a strong safety record.  The “gold standard” brand is Navitas Organic “Gelatinized” Maca. Find out more detail in my Maca Link as well.

Research has shown that pycnogenol also lowers bad cholesterol (LDL), raises good cholesterol (HDL), decreases inflammation and lowers blood pressure, which will very likely protect a guy from future erectile dysfunction as well. (High blood pressure and inflammation are both major risk factors for erectile dysfunction.) [4]

5) Neo40. One of the new kids on the block is Neo-40, the creation of one of the top nitric oxide researchers in the world.  The approach of Neo40 [Daily 30 Lozenges] – Nitric Oxide Supplement is really fairly simple and is based on utilizing two different metabolic pathways via L-Citrulline and a Hawthorn Berry Extract for nitrate/nitrite production. You can read more about here in my Interview with Neo40 Founder Nathan Bryan.

Beetroot Extract has also done very well in the studies, particularly in the area of fighting cancer interestingly enough. The good news is that jt is dirt cheap and should boost nitric oxide a little as well for beleaguered middle-aged and senior men everywhere: Nature’s Way Beet Root Powder Capsules.

7) Icariin Extact. Icariin, the chief phytochemical in Horny Goat Weed, gives this herb its erectile superpowers.  Viagra and Cialis are PDE5 Inhibitors and Icariin is one as well.  It is significantly less powerful than Viagra and Cialis but the 10+% extracts give a significant dosage and generally with many less side effects.  Icariin also has antioxidant and other properties that seem to give it actual healing properties. Many men have had excellent results with products such as Source Naturals Horny Goat Weed Extract (Epimedium) 1000mg, which has 10% Icariin. For additional information, see this link on Icariin for more information.

8) CoQ10. CoQ10 has many excellent properties and has been extensively studied.  It is well-known for its mitochondrial protective powers and is used in alternative medicine for a variety of conditions, including gum disease.  But what few men know is that it helps the body preserve nitric oxide and, yes, that has been shown in several studies to increase blood flow. The benefit is mostly for those men 40 and older and especially those with endothelial dysfunction.

9) Fish Oil. Fish Oil is not directly an erectile supplement, but I mention it here becuase one European study found that it helped endothelial function and nitric oxide output (in diabetic patients) and that is just what the doctor ordered. [14] Yet another study found that fish oil increased the elasticity of arteries, i.e. their “expandability”. [26] Yes, we males want nice expandable blood vessels that allow blood to flow into the penis. Fish oil also protects against inflammation, a huge erection-fighter, and triglycerides, which will clog up penile arteries faster than you can say, “Pass the bacon.”  It may even optimize free testosterone while it’s at it!  For more information about fish and fish oil and how it benefits the heart and penis, please read The Many Benefits of Fish and Fish Oil here. CAUTION.: It’s very easy to buy rancid fish oil, which will do more harm than good, and fish can have mercury and PCB’s. Read my link on Fish and Fish Oil for how to consume your omega-3’s safely.

CAUTION: Gingko. Gingko, like Pycnogenol, strengthens the activity of Nitric Oxide Synthase (NOS), making it a viable erectile dysfunction supplement. [16] Furthermore, animal studies have shown that Gingko relaxes in a dose-dependent fashion arteries, including those all-important ones supplying blood to the penis.[17] Direct evidence that Gingko improves erectile dysfunction and impotence in a significant way is still lacking, but any herb that increases Nitric Oxide will help males struggling in this area. (This is an herb can be purchased inexpensively even in places like Wal Mart.)  NOTE:  Gingko Biloba is often tauted as improving erections in men with erectile dysfunction that had resulted from taking antidepressants.  However, the studies have actually shown mixed results in this area.  CAUTION:  Care should be exercised with this supplement as Gingko thins the blood and has several drug interactions including NSAIDs and anticoagulants.

Depression and Erectile Dysfunction - Peak Testosterone

If you’ve ever been around someone clinically depressed, it becomes painfully obvious how debilitating this condition is on friends, family and career.  But, what few people realized until recently, is the incredibly negative physical consequences that depression carries along with it.  Depression is definitely not all in someone’s head.

NOTE:  Read about some of the Not-So-Common Symptoms of Depression.

For example, researchers have long known that there is a connection between testosterone and depression. Men in the lowest 20% of free testosterone, after controlling for other common factors, were found to have three times the rate of depression. [9]  Depression stresses the body – as in a real, tangible stress reaction – and anything that stresses the body can lower testosterone.

Similarly, it is not too surprising to anyone that depression would lead to erectile dysfunction. One would expect to be less sexually stimulated if one was feeling down after all, right?  But actually there is a less obvious reason that depression leads so easily to erectile dysfunction:  depression is a major contributor to heart disease.  One recent study found that the reason for this was simply inactivity. [1] And that makes sense:  if you’re depressed, the last thing you feel like doing is going to the gym or out for a jog.  What does it matter, right? Other factors in that same study were also that the depressed were less likely to take their medications and also smoked twice as much.

So with depression directly leading to heart disease and undoubtedly lowering of libido and physical activity, no one has been suprised to find that depression leads to erectile dysfunction as well.  One excellent study surveyed men before and after a five year period, which allowed the researchers to examine causations.  They found that depression can cause erectile dysfunction and erectile dysfunction can cause depression, or is, in their own words, bidirectional. [2]

Even more astonishing is the fact that a previous study, the Massachusetts Male Aging Study [3], had discovered that the problem of either moderate or complete erectile dysfunction was nearly 90% versus 25% in the highest to lowest cohort of depressed patients.  A 90% rate of ANY condition is scary indeed.

I have to mention that depression is INCREDIBLY hard on the brain.  It literally destroys neurons and whack neurotransmitter levels.  How does it do this?  Around 50 percent of people with significant depression have elevated corisol levels and elevated cortisol levels literally shred the brain. [7] One study from Washington University School of Medicine that those who had been depresses at ANY time of their life had a 12-15% shrinkage in their hippocampus.  Again, depression destroys brain cells and must be dealt with.  On top of that, elevated cortisol levels increase the risk of getting diabetes which also accelerates aging throughout the body including the brain. (Some researchers have speculated that low testosterone often plays a role in depressed individuals developing diabetes. [8])  Because of this, it is absolutely critical to get any and all depression under control as soon as possible.

By the way, an item of interest is the question, “When in life does depression generally lead to erectile dysfunction?”  One study looked at this and found that, in general, this bridge occurred in the late 40s and early 50s. [4] In other words, the freight train of depression will usually result in erectile dysfunction during these two decades of middle age.

Because of the heavy consequences to your brain and body, I emphasize getting professional help for your depression.  I have also prepared a page that discusses Natural Cures for Depression. Depression can be complex and difficult to completely overcome, but I believe you or someone you care about will find considerable help from this link.

Antidepressants are also a common cause of erectile dysfunction for guys. However, there is one potential solution:  Gingko Biloba.  See my link on Gingko Biloba and Antidepressants if applicable.

REFERENCES:

1) JAMA, 2008, 300(20):2379-2388

2) J of Urol, 2007, 177(2):669-673

3) J of Urol, 1997, 15(1):54-61

4) Sex Med, May 2005, 2(3):390-396

5) J of clin Psychopharmacology, 2007, 27(1):62-66

6) Amer J of Psychiatry, Oct 2001, p.1623

7) Saving the Brain, Jeff Victoroff, 2003, p. 85.

8) Endocr Rev, Oct 1, 2005, 26(6): 833 – 876

9) Arch Gen Psychiatry, 2008, 65[3]:283-289

HCG Daily: As Powerful As HRT? - Peak Testosterone

REFERENCES:

1)  Hum. Reprod, 2003, 18(11):2294-2297

2) https://www.peaktestosterone.com/forum/index.php?topic=6760.0

Many men that go on standard HRT (TRT) have excellent experiences and I am an example of that.  Once I got dialed in with a good protocol, I have found boosting testosterone has tremendously helped my libido, mood, erectile strength, etc.  Now this certainly does not happen with all men, but it’s a pretty decent percentage of men, assuming they have a good protocol to start with.  However, what I have not seen on The Peak Testosterone Forum is men that have that kind of stellar, “wow” experience with HCG Monotherapy.  Part of the reason may be that HCG Monotherapy can produce higher levels of estradiol for a given testosterone level, but that doesn’t seem to explain all of it.  Men usually say things like, “Well, I feel a somewhat better but still not that great…”  In fact, what is interesting is that adding low dose HCG to standard HRT actually produces that wow effect for many men, but not really HCG by itself.  (You can read more about it here on this page:  HCG Monotherapy.)

A typical protocol from some of the savvy online HRT physicians is 500 IU of HCG three times per week. Sometimes they will go a bit higher, which is something I discuss in my page on  HCG Dosage. Again, although these 3 times a week  protocols work reasonably well, they often don’t seem to get the men back to feeling really good again.

So what is wrong?  It turns out that it may have to do with the relatively short half life of HCG, which is around 24 hours according to most of the sources I have looked at.  There is a study on women that says it is around 33 hours. [2] Regardless, the point is that after 48 hours, you have significantly less HCG in your system and so it probably results in quite the roller coaster ride.  So what if one injected more frequently, i.e. daily?  What would happen?

Anecdotally, results sound very positivie, or at least worthy of an attempt.  Here is what one of the senior posters – thanks Just Askin! – on our site wrote about his experiment with daily HCG:

“After 10 days of doing small everyday dosing, I now wake with erections every morning and have vivid sex dreams like in my 20’s, and my testes have increased in size significantly. Don’t know if it will help anyone else or even me long term, but so far so good, though you do have to inject daily.” [2]

And results seem to just keep better for him.  At the two week point he wrote that “I keep getting better, my testes are the size of when in my 30’s, still erections every morning, easier stimulated, larger loads.” [2]

That is the kind of description that I see with men on HRT that have a good experience:   they are actually enthusiastic and ready to evangelize and take over the world.

Why will daily HCG work so well for some men?   Remember that HCG activates the enzyme that converts cholesterol to pregnenalone.  This may be part of the reason that HCG stimulates libido and improves mood for some men.  Men on HRT are actually often put on low dose HCG to stimulate libido just for this reason (at the HRT clinics anyway) and the fact that HCG will increase the volume of the testicles back to normal.

So the big advantage of smaller, more frequent shots appear to be

a) Continous and even conversion of cholesterol into pregnenalone

b) Less ups and down in HCG levels and, therefore, testosterone and estradiol levels.

c) The fact that it can be given subQ (subcutaneously) since it is usually a small volume injection. This makes it a perfect candidate for daily shots if one has the time and patience.

Whatever the reason, a couple of sites are reporting good results for some men and so this may be a protocol to discuss with your doctor or clinic and try.  I would guess that most doctors that allow HCG would be open to the idea, since it is clearly more physiological.  A healhty male pulses out LH – and HCG is an LH mimic – in the early morning hours on a daily bases.  Thus, daily HCG (or LH actually) is what the male human body is used to.

WHEN SHOULD YOU TEST? JustAskin said that he heard that you normally stabilize within two weeks on this protocol.  I know this is true with topicals and so, considering the fact that this also is a daily protocol, this makes a lot of sense.

CAUTION:  You may not want to inject in the late afternoon or evening.  Some men report difficult in falling asleep with this protocol or even disturbed sleep.

Pro-inflammation and a Dangerous Part of Most Modern Diets

Right now many health-conscious men are consuming incredibly amounts of Arachidonic Acid (AA) in their diet. The reason for this is primarily the rise of the Atkins and Low Carb Diets: it is now popular to consume significants amounts of chicken and turkey in the belief that this natural living and a “Paleo lifestyle” that mimics what mankind has done for millenia before our Western, industrial lifestyles. However, what most of these men do not realize is that modern poultry is unnaturally high in Arachidonic Acid, significantly higher than beef actually. (Farm raised salmon is as well, because they corn feed the salmon!)

Furthermore, many men also consume multiple whole eggs per day, not realizing that an egg yolk is higher still in AA.  Some men now are also taking Arachidonic Acid supplements in order to build muscle!  (You can build lots of muscle without any AA:  see my link on Safe Muscle Building.)

So what’s wrong with consuming all this extra arachidonic acid?  In a word:  inflammation. Arachadonic Acid has been shown in many studies to increase systemic inflammation, the kind that is so deadly.  Hopefully, you have read enough to know that Inflammation is the Root of All Evil.

NOTE:  Arachidonic Acid is both necessary and essential.  Again, it is TOO MUCH dietary AA that causes problems.

REFERENCES:

1)   https://blog.zonediet.com/drsears

2) RHEUMATOLOGY INTERNATIONAL, 2003, 23(10):27-36, “Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis”

3) British Journal of Nutrition, Sep 2007, 98(03), “Dietary arachidonic acid: harmful, harmless or helpful?“

4) Ann Nutr Metab 1997;41:203–234, “n-3 Polyunsaturated Fatty Acids and Cytokine Production in Health and Disease”

5) Infect. Immun, May 2000, 68(5):2808-2818, “The Cytotoxic Enterotoxin of Aeromonas hydrophila Induces Proinflammatory Cytokine Production and Activates Arachidonic Acid Metabolism in Macrophages”

6) Cardiovasc Res, 2009 Oct 1, 84(1):33-41. Epub 2009 May 27. “omega-3 polyunsaturated fatty acid supplementation for the treatment of heart failure: mechanisms and clinical potential”

Yes, some inflammation is good and helps you to fight infections. And, yes, some inflammation is necessary to build muscle.  But the problem is that

a) Modern grain fed animals are unnaturally high in AA.

b) Our modern, Western lifestyle raises inflammation levels, through. low omega-3’s, refined carbs, etc.

The key thing is that researchers have implicated chronically raised inflammation as a root cause in almost everything you fear: heart disease, autoimmune disease (arthritis, diabetes, Crohn’s, etc.), many cancers and, yes, erectile dysfunction. For example, in heart disease one of your body’s inflammatory molecules, TNF alpha, plays a key role in fighting damage to your arterial wall and does so by triggering the plaque building process that advances arteriosclerosis and hardens your arteries. (See my link on TNF Alpha Inhibitors for some additional information.)

The concerns over the dangers of arachidonic acid started with Dr. Barry Sears.  If you’ll recall from his famous Sears dietary plan, he brought to the public’s attention the research that showed how diet can greatly influence inflammation.  If you read his blog, he states “It has been known for nearly 20 years that https://www.peaktestosterone.com/ are the only drug that increase the levels of arachidonic acid (AA) by stimulating the enzyme delta 5-desaturase (2-4). This means greater cellular inflammation that leads to insulin resistance (thus increasing diabetes) and disturbances in signaling mechanisms in nerve cells (thus decreasing memory).” [1]

And Dr. Sears was certainly not the only one:  Dr. David Chilton documented his success in clinical practice by attacking inflammation in his bestseller Inflammation Nation.  One of the pillars of his program was lowering dietary arachidonic acid.

And it’s not just a few doctors stating this.  One study on rheumatoid arthritis patients found that participants were helped by fish oil along with lowering arachidonic acid. [2] The authors made it clear that “a diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.”  In other words, lowering AA helps omega-3’s.  This is an important point as you’ll see below.

What is the controversy about then?  Well, it goes back to a well-known Paleo blog that cites a study where the researchers concluded that “Taken together with the studies on blood lipids, platelet reactivity and bleeding time, including this latest study, it seems appropriate to conclude that a significant increase in arachidonic acid intake by healthy adults, up to an intake of, say, 1·5 g/d appears unlikely to have any adverse effect.”  [3]

Now this is a very curious conclusion to me.  The author actually cites several studies that supposedly show that AA exhibits no real dangers.  Yet notice what one of the cited studies says in its summary:

“The mechanisms for these potential benefits are complex and not well defined. It is well established that fish oil supplementation lowers plasma triglyceride levels, and more recent work demonstrates anti-inflammatory effects, including reduced circulating levels of inflammatory cytokines and arachidonic acid-derived eicosanoids, and elevated plasma adiponectin.” [6]

In other words, fish oil works by dampening the effects of arachidonic acid, which are clearly pro-inflammatory.  And the conclusion of this Paleo author, by the way, was basically that if you consumed enough fish oil, you were safe.

Personally, I think this is premature and risky.  And I am not just saying that because of doctors such as Sears and Chilton along with the rheumatoid arthritis study. Many studies recognize the fact that arachidonic acid is a pro-inflammatory compound.  Here are just a few:

“Arachidonic-acid-derived eicosanoids modulate the production of pro-inflammatory and immunoregulatory cytokines. Overproduction of these cytokines is associated with both septic shock and chronic inflammatory diseases. The n-3 polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid, which are found in fish oils, suppress the production of arachidonic-acid-derived eicosanoids and EPA is a substrate for the synthesis of an alternative family of eicosanoids” [4]

“The cytotoxic Enterotoxin of Aeromonas hydrophila induces proinflammatory cytokine production and activates arachidonic acid metabolism in macrophages”. [5]

The bottom line is that, if you read the research at all, you quickly come to the conclusion that AA increases inflammation and fish oil (omega-3’s) dampen its effects.  So are you going to eat a bunch of arachidonic acid just to prove that fish oil can save your life as the Paleo sites suggest?

This just not seem logical.  It seems clear that if you want to decrease inflammation, you must simply increase omega-3’s and lower arachidoic acid.  And this is exactly what the above doctors are stating works in real life.

In fact, did you know that the ibuprofen, Advil, Alleve and other NSAIDs are merely nullifying the actions of arachidonic acid in your body? That’s right – when arachidonic acid is released from membranes in your body, it triggers the COX enzyme which ramps up inflammation.  All these NSAIDs do is inhibit this COX enzyme, thus lowering your body’s inflammatory response and reaction to AA.

Lets cover just a few facts regarding AA::

1) Men can put on lots of muscle without eating any extra poultry, egg yolks or AA supplements.  Many vegetarian and vegan bodybuilders are examples of this with huge physiques and yet consuming very little extra arachidonic acid in their diet.

2) The research on any dangers of arachidonic acid are still in the early stages.  We simply do not all that we should about this complex subject.

3) We do know that in many cases Arachidonic Acid will significantly raise inflammation levels.

4)  We know elevated inflammation is a huge risk factor for heart disease, autoimmune disease, cancer and erectile dysfunction.

Now, if you put 1 through 4 together, the answer is clear in my mind:  play it safe and avoid much extra arachidonic acid.  It is simply too dangerous at this time and just not worth the small muscle gains that you might get from consuming it.  Seriously, are you going to risk blowing out your arteries or getting Crohn’s or arthritis or cancer just to put on 42 pounds of muscle instead of 40?

Let me tell you what makes sense:  put on 40 pounds of muscle and keep those arteries nice and clean and low in inflammation so you can do well in the bedroom.  No woman is going to care about those extra two pounds of muscle, but she WILL care if you cannot get an erection because you have advanced arteriosclerosis and hardening of the arteries.

Yes, in twenty years, they may have figured out ways that you can consume AA without raising inflammation.  Maybe if you exercise enough, you will not be harmed. Maybe if you consume enough fish oil and omega-3s you will be safe. In the meantime, why risk life and limb for very low benefits?.

Protocol to Rapidly Lose Weight Yet Maintain Muscle - Best for Men

Most men that want to lose weight want to do it rapidly and “get it over with.”  I seem to be unusual, because I hate rapid weight loss – I’d rather suffer litte bits of pain every day than experience “Hell Week” so to speak.  Regardless, one of the problems with rapid weight loss is that typically a lot of muscle is lost along with the fat. This leaves one with both less fat AND less muscle, which effectively skews one’s metabolism to put on weight on again after the post-dieting stage. What you ideally want to do is lose just the fat.  But how you do that is the question.

Well, a recent study in the American Journal of Clinical Nutrition came up with a protocol that did the job for the study participants (who were young overweight males in their early 20’s) quite nicely.  Here is the formula they used: [1]

a) Cut calories by 40% from baseline (including exercise calories).

b) Intense exercise training (six days per week)

c) Consume high protein levels (2.4 grams per kilogram of body weight or 1.1 grams per pound of body weight).

WHAT I LOVE ABOUT THIS PROTOCOL – IT’S JUST SO DEAD ON: This study came out of McMaster’s University, where they have been doing some fascinating and impotrant anti-aging research, and it shows.

First of all, they used a wide variety of exercise routines.  Particpants had to walk at least 10,000 steps per day on top of their exercise. (I’m proud to say I try to do 13,000 including my exercise as of this writing.)  They also did intense exercise six days per week, including a) resistance, whole body circuit training, b) HIIT, c) plyometric circuits and more.  (If you want to know the exact details, see Reference #1 below and check out the full study.)  Now you don’t want to do intense exercise 365 days per year, but I loved to see them doing a wide variety and types of exercise .

Secondly, if you add up the calories, the particpants actually were eating around 2,500 calories per day. This is a far cry from the starvation diets in the 1,200 calorie range that are often advocated.  In other words, this diet was not a Biggest Loser, go-through-hell-while-I-yell-you-through-it kind of diet.  They calculated baseline calories and included the calories needed for all the exercise that they were doing.  This is why the participants lost so much weight even though their calorie levels were fairly high.

NOTE: Middle-aged and senior men who want to try this will generally need to consume less calories, because our metabolism decreases generally as we age.  If you have any signs of heart disease or other medical conditions, get clearance from your doctor first.

Third, I like the fact that the protein they consumed came from lean protein sources.  Now they used whey protein drinks, and I personally don’t think that that much whey is a good idea for many reasons, but the point is that they were trying to come up with protein sources that didn’t involve ingesting a bunch of industrial meat and dairy, so hats off to them.

Lastly, they put the men on a low fat, high protein, medium carb diet. This is exactly how I eat, except that I am careful to consume only “good carbs,” i.e. low glycemic, whole food carbohydrates.  Basically, I eat a lower fat flexitarian kind of diet and believe that this style of eating will really catch on in the coming decades.  Check out the accompanying graph to get a picture of their macronutrient levels.

Most men will find that their lipid levels dramatically improve on this kind of a diet, and it is used by Dr. Gould, one of the physicians regressing arterial plaque.  (See this page if you are interested:  A Review of Heal Your Heart. I would also add that it is this kind of a diet that and exercise lifestyle that helped Nathan Pritikin (likely) clear out his arteries and also the Tarahumara to be one of the longest-lived and healthiest peoples on the planet

NOTE: I think the following is the best and safest approach for longer term weight loss, a program designed by Clarence Bass, the king of being cut and musclar well into his senior years: Clarence Bass’ Challenge Yourself Program.

REFERENCES:

1)  Am J Clin Nutr March, 2016, 103(3):738-746, “Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial”

d) Do this for 4 weeks

The results were very impressive.  In fact, it is hard to imagine better numbers, especially considering that it was done naturally without pharmaceutical or supplements of any kind:

1.  Participants lost 11 pounds of fat on average

2.  Participants gained 2.5 pounds of lean body mass.

Now keep in mind that the 2.5 pounds of lean body mass likely mostly reflects a loss of water.  That said, it is pretty clear that those in the study did not lose muscle and may have even gained some, making this a short term routine worth considering for rapid weight loss.  (

CAUTION: You probably wouldn’t want to do it forever due to its reliance on intense exercise so many times per week.  As evidence of this, consider that these were young men and their testosterone levels dropped from 507 to 126 ng/dl! The controls also had testosterone levels drop off this much in T and so that indicates that it was the intense exercise causing testosterone to plummet.  Or, another to look at this, is that this sort of protocol may only be appropriate for men on HRT where they are propped up with exogenous hormones.

A Low Carb Diet Made This Man Sick - Peak Testosterone

I find Low Carb Diets just fascinating. To me it is remarkable that they are as popular as they are. I eat what I would call a high protein, medium carb, low fat diet and love it. I love fruit in particular, beer, dark chocolate, quinoa and a lot of things that have carbs.  I simply cannot imagine going with vegetables only. However, I recognize that Low Carb Diets are very popular with men, especially those losing weight. Low Carb Diets may even have some interesting applications, such as controlling certain types of cancer. [1]

That said, I have had concerns that some men – I’m not saying all – could hurt themselves with these types of diet.  And I have raised up some of the negative studywork in my links on Low Carb Diets and Inflammation and The Potential Dangers of Low Carb Diets. And, anecdotally, some men seem do seem to be getting hurt from these types of dietary regimens. Below is a horror story from the Peak Testosterone Forum members as to how a Low Carb Diet made him just plain sick. So, if you’re on a Low Fat Diet, and feel good, then no attack is intended.

But some of you could very well be experiencing some of the negative consequences of Low Carb Diets as this man did, including insulin resistance, inflammation and high cholesterol:

GUEST AUTHOR: DdR

Q. You mentioned that you got down to 10% bodyfat on a Low Carb Diet. That’ s quite impressive, of course, and so can you explain how you did that? In particular, can you give an overview of your diet?

A. Well, I say 10%, but it could’ve been 12%. I definitely had a six-pack. I lost three inches off my waist and could’ve worn size 30 pants no problem. I’m 5’11”, 35 years old, athletic build.

I achieved this by using a combination of the programs from Bulletproof Exec, Lean Gains, and Carb-Backloading. In essence I would wake up and drink a cup of Bulletproof Coffee with 10 grams of whey protein mixed in (prevents catabolism of the muscle). That would keep me satiated until 2 p.m., when I would have my first meal, which would consist of animal protein (let’s say tuna fish with mayonaise) and a vegetable (let’s say steamed broccoli with sauteed garlic). I would eschew all carbs. My second meal would echo the first meal, i.e., protein and vegetables, little carbs. I would eat nuts too and allow myself red wine.

On workout days (workout = heavy weightlifting) I would follow the same program, but after hitting the gym in the afternoon, I would slam carbs together with protein until bedtime. It didn’t really matter the amount of carbs, because I could only eat so much before getting sick. The theory is that carbs are being channelled towards the muscle cells to restore glycogen stores in lieu of going to fat cells.

Q. You mentioned that you were eating a lot of protein and fat? Was most of this coming from meat? Or were you also ingesting supplemental proteins and various oils?

A. Meat consisted of grass-fed beef, wild-caught salmon or other fish, pastured chicken, and eggs. Maybe tuna fish now and then. Whey protein every morning in my coffee. I also had salads quite a bit with EVOO and took cod-liver oil daily.

Q. You mentioned that you felt this diet led to some serious health issues. Can you describe those?

A. After a few months my cognition began declining, and in fact I started getting brain fog. My performance at work was slipping and I could barely tread above water.

I got blood work done. My cholesterol shot up by 70 points in three months. The other thing that was disturbing was that my inflammation marker (c-rp) was way above normal. This corroborated with how I was feeling, which was achy a lot. I was 34 and thought that this is what happens when you get older, but man I was shocked how quickly I was aging.

The thing that did it for me was that I started witnessing shortness of breath. Like I was about to pass out from shortness of breath. I first noticed it skiing (which I do a ton of and never had an issue), but then it began translating into normal everyday routines, like climbing stairs or riding a bike at a leisurely pace. When I would go to the gym and do squats and kettlebell swings, I would have to concentrate on breathing otherwise everything would go white.

I obviously was really concerned I had a heart defect, so I went to multiple specialists. Pissed away lots of money. They also said that I was normal. But I just felt awful and basically felt I couldn’t do strenuous activity anymore, otherwise I’d die. I thought that this was going to become my new life or non-strenuous activity.

Q. And you can’t think of anything else that might have caused these issues?

A. See answer above. PCP and cardiologist cleared me of any health problems. Once I ceased the above-described diet and starting ingesting normal foods, especially carbs, my shortness of breath went away. I had been suffering from insulin resistance since June of last year, but that has slowly been going away as well. I’ve noticed that my thinking the last few months has become much clearer.

Q. What made you finally pull out of that style of eating? And how did you know “it was time.”

A. Thinking that I was going to die. I’m not kidding. When you can’t even climb a flight of stairs without everything turning white and your heart’s pounding in your chest, you know something’s seriously wrong.

Q. How are you eating now and how improved are you? Some of the guys would probably be interested in knowing how long it took you to recover.

I eat a normal breakfast now, at least normal to me: a few eggs, lentils and some sauerkraut with tea. Or a smoothie with 40g Hi-Maize resistant starch, berries, flax seed, pea protein, and almond milk. I won’t hesitate to eat pancakes or Muesli.

I generally eat salads during lunch, but won’t hesitate to ingest some carbs, but clean carbs like quinoa, rice, legumes, or buckwheat. Dinner I usually let go and will eat pasta or a cooked potato. I’m eating fruit again! I love fruit. I eat a lot less meat and a lot more vegetables given that I’m basically substituting clean carbs for animal protein.

My bf% is now probably 16%. I don’t love what I see in the mirror, but my girlfriend doesn’t care, and frankly, I just want to feel good.

I still have not recovered 100%, even though I stopped this diet almost a year ago, although I’ve improved quite a bit. My cognition and memory have improved a lot, but I had to tackle the insulin resistance that had developed first. I believe my thyroid got screwed up from that diet because I’ve been suffering from libido, erection and insulin issues over the last year. I had a hemorrhoid for over eight months, which finally went away once I began jogging again and drinking pomegranate juice on a regular basis.

The biggest thing is the breathing. I think this diet really hammered my vascular system. I skied my butt off this past season w/o any issues. I’ve been climbing mountains the last few months, and no scary moments! I jog regularly for 30 minutes.

I’m still not great at the gym and do get dizzy when I do squats. It’s like I’ve still maintained my strength, but my lungs/vascular system is lagging behind, and I get close to passing out. I hesitate going to the gym sometimes now (like today!) because I’m fearful of passing out, even though it hasn’t happened (yet). I’m thinking of drinking beet juice before hitting the gym to ensure that I have adequate oxygen until this problem goes away.

Hope this helps everyone out there. I would really steer clear of low-carbing given what happened to me.

REFERENCES:

1)  Nutr Metab (Lond), 2011, 8:75, “Is there a role for carbohydrate restriction in the treatment and prevention of cancer?”

My sleep would be atrocious that night after carb backloading.

At any event, I put on muscle while simultaneously losing weight. It was stupidly simple to maintain that body-fat percentage as long as I got used to it.

Q. How did you feel on this diet in the beginning? Were you actually feeling good at the start of this program? And how long did you stay on this type of diet?

A. I felt fine in the beginning. I don’t want to say I felt great, but I felt normal. Energy levels were ok, but I would often suffer low blood-sugar levels and feel like utter crap. Didn’t notice any big difference from consuming BP coffee (unlike Joe Rogan, who said he “wanted to kick an alligator in the dick” after drinking BP coffee).

I stayed on the diet from August 2012 to May 2013.

Measure Your Testosterone - Peak Testosterone

STEP 1.  Pull Your Testosterone. The first step in evaluating your testosterone status should start with pulling your total testosterone.  In my opinion, evey guy should just pull this number periodically, symptoms or not, in order to have a good baseline.  As you’ll see below, it’s about $25 now here in the U.S.  It is fast, cheap and very important to your health.

One of the things that I have discovered as I have begun to research and monitor my own health is that my physicians – God love ’em – do not always test everything they should test nor monitor as frequently as is necessary. This is nothing against them, of course, as they have limited time and are under obligation to insurance companies and fellow physicians to minimize costs as much as reasonably possible. I know that in my own life I was low testosterone for years before I convinced my PCP to finally pull my T.  And it was years after that that anyone pulled my prolactin, estradiol and TSH. These all should have been looked at, but it simply never happened. And I could have probably avoided a great deal of heartache and suffering if I had simply had done these tests myself and shown them the results.

I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.  Think of this: your body and mind are an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional.

This is the reason that I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can and can/cannot be used for. I am NOT suggesting that you become your own doctor, but in the U.S. and many other countries, there is considerable medical freedom and one has the right to monitor one’s health.

NOTE: There are four states that will not let you pull your own labs. Yes, you read that right.  Even if you PAY CASH, you cannot pull your own labs.  Now please tell me that America is a free country when many of its citizens cannot even monitor their OWN health when they pay for service with their OWN money.

Think of this: your body and mind is an incredibly complex and highly tuned machine. It makes a combustion engine look like a play toy. Does your doctor really have the time to see if you need a tune up? 99% of the time your doctor is too busy just trying to keep patients alive and semi-functional? Consider my situation:

–I have never had homocysteine pulled by any doctor.

–I have had ferritin pulled only once.

–I have never had any thyroid hormones pulled except TSH and total T4.

–I have had CRP pulled maybe twice.

–I never had LH, FSH or prolactin pulled in my hypogonadal days.

Is my situation unusual? Certainly not. There just aren’t the financial and time resources available for decent testing in the great majority of insurance-backed systems. The bottom line is that you are probably going to have to do some yourself, or perhaps find a doctor or naturopath on a cash basis that can help you do the same.

For all these reasons I compiled a list of testosterone labs that pull various hormones for men based on Peak Testosterone Forum posts that I have received over the years. I have also included some commentary about what some of these specialize in and what they can/cannot be used for. Almost all of these labs are U.S. only, but there are a couple of exceptions as you will see:

CAUTION: I do not have any personal knowledge or affiliation with any of these labs. You must do your own research, i.e. “caveat emptor”.

1. DiscountedLabs.com.  If you are looking for the best prices for self-testing with the biggest, most respected lab (Lab Corp) in the country, then Discounted Labs is a good starting point. Nelson Vergel started Discounted Labs, and many of you will recognized his name as one of the most established names in the TRT/HRT community. He sent me an email where he promised to beat anyone else’s prices, and it sure seems to be the case! NOTE:  I have used Discounted Labs and had a good experience. Again, one big advantage is that the use Lab Corp, which is the largest lab here in the U.S. (NOTE: Discounted Labs is a site sponsor.)

2 Health Tests Direct.  I first found out about this lab company, because one of our longtime posters used them with great success.  They were unique for a long time, because they offered not only LabCorp pricing but also Sonora Quest. NOTE:  I have used them and had a good experience.

3.  Life Extension Foundation. One of the older and more respected supplement companies, LEF is known for its in depth articles and good support staff.  One very interesting thing that you can get, through them, a wide variety of lab panels at some of the big labs.  They have for example an Inflammation Panel and a Cardiac Panel that I have wanted to get myself that includes many of the key heart disease risk factors such as “Chemistry Profile (Complete metabolic panel with lipids) Complete Blood Count (CBC), C-Reactive Protein (high sensitivity), Fibrinogen, Homocysteine Vitamin D 25-OH.”  They also have some more specific blood draws for things like CoQ10, anemia and cortisol. The prices are quite reasonable and, of course, it’s nice to deal with a well-established company. NOTE:  I have used them and had a good experience.

One of the panels many men would be interested in is the Male Panel, which includes the “Chemistry panel (complete metabolic panel with lipids), CBC, DHEA-S, DHT, Estradiol, PSA, Pregnenolone, Total and Free Testosterone, Sex Hormone Binding Globulin (SHBG), TSH, Free T3.”  So in one shot you’ve got a lot of questions answered dealing with male hormones, especially the ones that can directly impact your sexual health.  The cost as of this writing was about $224 for members and $399 for nonmembers where a one year membership cost $75.

NOTE: You’ll want to check out that the above test uses the correct estradiol test for males. If you happen to be low estradiol, then the standard test will often not give you correct results based on what I have seen. Talk to the lab and make sure you are getting the correct test.

Also, they use LabCorp, which is I believe the biggest general lab in the U.S. and most states are available to LEF members.  For general information, see these LEF FAQ’s and LEF Blood Test Descriptions.

NOTE: I have purchased a number of items from LEF with good success and been quite impressed with their support staff.  However, I have never ordered lab work through them.

4.  ZRT Labs. This is another reasonably priced lab.  The offer both saliva and blood spot testing. One of our senior posters used them several times to examine some standard male hormones as well as adrenal and thyroid function. One intriguing panel is called the Female/Male Saliva Profile I and includes the following: “five (5) tests: Estradiol (E2), Progesterone (Pg), Testosterone (T), DHEA-S, and morning Cortisol (C1)” for $170 as of this writing. [1] Blood spot testing tends to be a little more but is still (relatively) inexpensive.

5 Canary Club.  The same poster mentioned in #3 above wrote that “If you can afford $255 bucks, join canaryclub.org(its free) and use their discount to order the HIS saliva/blood spot panel from ZRT labs. I did this and between the questionnaire and 7 page response from them on my test results it helped me get a sense of where I was at.” [2] Of course, a 7 page report accompanying lab results is impressive and reveals the fact that Canary Club has very thorough commentaries and analysis on your hormone results.

6. (U.K. Testing) Private Blood Tests.  U.K. guys, from what I have seen on the Peak Testosterone Forum, have a notoriously difficult time getting treatment and testing.   “I’ve found a useful website here in the UK, www.privatebloodtests.co.uk , this allows you to run bloods at a local hospital without going through your GP, which is useful for tracking things like Clomid.” [5] Again, I do not know anything about them, other than what was mentioned in this post, so do your own research.

7.  (U.K. Testing) Blood Tests London. One of our posters also recommended bloodtestslondon.com.  His comments were that “the prices were very competitive, and they turned my thyroid blood work around in less than 1 working day. If any of the blood results are out of range then they get a doctor to comment on them (included in the price).” Again, I do not know anything about them, so do your own research.

8.  PrivateMDLabs.  This lab, according to one of our veteran posters, uses blood draws through LabCorp.  This one has been used by a couple of men and the only negative comment was that “they have a male panel that is not as comprehensive as I’d like, but includes some things that are worth monitoring.” [7]

9.  Genova.  One of our posters that has been around awhile used Genova labs for a metabolic and digestive panel. [8] One of the established Paleo media personalities has used them.

10.  Rhein Labs. This lab specializes in testosterone and estrogen-related metabolites and can really help you diagnose the root cause of your hormonal issues.  Check out this thread for sample results and costs from one of the senior posters on the Peak Testosterone Forum.

11.  Direct Labs.  I have used this lab for hair testing.  However, they have many other tests available as well.

REFERENCES:

1) https://store.zrtlab.com/index.php?option=com_content&view=article&id=106&Itemid=612

2) https://peaktestosterone.com/forum/index.php?topic=1250.15

3) https://www.saveonlabs.com/Dr-Mark-Hyman-Saveonlabs-com-s/1889.htm

4) https://www.saveonlabs.com/product-p/361648.htm

5) https://peaktestosterone.com/forum/index.php?topic=571.msg5346#msg5346

6) https://peaktestosterone.com/forum/index.php?topic=456.30

7) https://peaktestosterone.com/forum/index.php?topic=1453.0

8) https://peaktestosterone.com/forum/index.php?topic=1431.0

Why Doesnt My Viagra or Cialis Work Any More? - Peak Testosterone

Viagra is a miracle pill, right? Actually, it is suprising how often Viagra and the other PDE5 Inhibitors do not work for men with erectile dysfunction. Many guys are left asking, “Why doesn’t Viagra work for me?”

Just how common is this issue?  PDE5 Inhibitors, such as Viagra, Levitra and/or Cialis, are unsuccessful in about a fourth of all men with erectile dysfunction.  Furthermore, in certain at-risk subpopulations, there is an even greater chance for failure.  For example, only about half of all diabetics are able to use one of these medications successfully. [2]

So why, pray tell, would a powerful drug such as Viagra and Cialis, not work?  Well, the research has uncovered some interesting and not-necessarily-obvious reasons for this stressful phenomenon:

4.  Psychology (Fear, Anxiety, etc.). Some guys have normal erectile strength, yet have erectile dysfunction during intercourse.  This is termed psychogenic (psychological) erectile dysfunction and can be very difficult to overcome.  Interestingly enough, Viagra and other PDE5 Inhibitors can be used as partial or even complete treatment as I document in my link on Psychogenic Erectile Dysfunction.  However, for those who experience failure, obviosly no amount of these medications will help.

5.  Major Medical. Certain major medical conditions such as prostate procedures, pelvic surgeries, back injuries and advanced cardiovascular disease can negate all normal drug-related attempts to acheive an erection.

REFERENCES:

1) Current Vascular Pharmacology, 2006, 4:89-93, “The Management of Phosphodiesterase-5 (PDE5) Inhibitor Failure”

2) J Urol, 2001 Sep, 166(3):927-31, “Long-term efficacy of sildenafil and tachyphylaxis effect”

1.  Resistance. You can actually become resistant to PDE5 Inhibitors over time. [2] Of course, that means you must up the dosage to get the same effect and this is problematic because Viagra, Cialis and Levitra have so many side effects.  See my link on Viagra and Cialis Resistance for more details. (In addition, you may want to read on The Side Effects of PDE5 Inhibitors and The Dangers of Cialis for more information.)

2. Low Testosterone/Venous Leakage. Some guys actually have atrophy of various peniles tissues, including nerve, connective and muscular. This most often occurs in a low testosterone environment and I have covered in detail in my link on Venous Leakage.  This can usually be greatly improved through Testosterone Therapy.

3.  Lack of Baseline Nitric Oxide.  One major reason, and I cover solutions for this condition in my link on Viagra Failure, is the lack of baseline nitric oxide.  Many men with endothelial dysfunction simply do not supply enough raw materials into this biochemical pathway to make up for the age-related loss in this compound, a term called “nitric oxide insufficiency.”  You can’t “squeeze blood out of a turnip” as they say.

NOTE: One way to solve this lack of baseline nitric oxide is through the consumption of high nitrate foods. See my links on Beetroot Juice and A Review of Beet the Odds for more information.

Estrogen: Control (of the Age-Related Rise) - Peak Testosterone

So what can you do to slow down the endocrinological avalanche caused by estrogen?  It’s simple:  read over my link on Estrogen Increasers and then consider these Estrogen Controllers as well:

1) Alcohol.  I document in my links on Beer and Testosterone and Alcohol and Testosterone just how ethanol is tied to lower testosterone levels.  It does this by negatively affecting the testes, but it also does it by altering liver function. And it is this alteration in the P450 cytochrome enzymes that allow plasma estrogen levels to persist for a longer time. This is why even one drink per day has been shown to increase a woman’s risk of breast cancer through elevated estrogen levels.

Does alcohol increase a man’s estradiol levels?  The answer is that for moderate consumption (1-2 drinks/day), there is little evidence that alcohol has a significant effect. A couple of studies have found just that, i.e. a negligible impact. [10] However, if you go past moderate consumption, the signs of elevated estrogen are everywhere.  For example, male alcoholics are known for developing gynocomastia, whose root cause is usually estrogen-related. There is much less evidence of that for moderate drinkers. Nevertheless, it is worth mentioning, because many men are fairly heavy drinkers.

2) Lose Weight. The major contributor to an increase in aromatase is, you might have guessed it, that extra weight around your midsection. Fat cells are known for storing the aromatase enzyme and many studies have shown its ill effects on testosterone. Is it any wonder?  Those extra pounds actually slowly biochemically neuter the middle aged and beyond male. Even worse, fat cells lead to the creation of, actually conversion to more estrogen which displaces testosterone throughout the body. How many of us have seen overweight males with “man boobs” that are the result of just this phenomenon?

And those love handles on the side of your gut: they should really be called loveless handles. One study looked at 64 severely obese men and their average testosterone was 340 even though the average age was only 48! [7] Furthermore, the authors found that weight was associated with an increase in estrogen and a decrease in testosterone. They then looked at these men when given a certain kind of bypass surgery that lowered their weight and BMI.  You guessed it:  estrogen decreased and testosterone increased significantly! By the way, fat cells are also known for spitting out chemicals that cause inflammation throughout your body leading to damaged heart and erectile tissues. Being overweight is strongly correlated to erectile issues for this and several other reasons. (I discuss the many problems of being overweight here.) So if you won’t drop the pounds for the wife or your health, at least do it for the Little Gipper.

3) BANNED: 6-OXO.  This supplement, also called 4-AT, appears to be the “real deal”, a legitimate estrogen blocker. Estrogen is a huge issue for aging males for many reasons, but one of the nastiest is that increasing estrogen actually decreases testosterone.  (See this link on How to Limit Estrogen for more information.) Some estrogen is important for brain and bone health but that is not an issue for most aging males.  Many 55 year olds have close to or more estrogen than their wives!

In 2007 6-OXO was studied definitely and the results look excellent:  resistance-trained males saw “FT [free testosterone] and DHT underwent overall increases of 90% and 192% for 300 mg 6-OXO and 84% and 265% for 600 mg, respectively, while T/E increased 53% and 67% for 300 mg and 600 mg 6-OXO, respectively”. [7]  Notice the substantial boosts in free testosterone and the testosterone to estrogen ratio.  In fact, 6-OXO was so good that the FDA, decided to ban this supplement in August of 2009. [13] This goes back to what I always say, “If it’s a legitimate testosterone booster, the FDA will ban it”.  However, in this case, the FDA was spot on:  6-OXO turned out to be a nightmare supplement.

First of all, one study [7] also showed substantial increases in DHT and estrone.  But, eventually, the news broke that 6-OXO was a “irreversible aromatase inhibitor“, i.e. 6-OXO actually permanently bonds to some of your aromatase in fatty tissue and actually destroys the enzyme.  (You can, however, usually rebuild your enzymes in a few weeks.  However, we have had one report on the The Peak Testosterone Forum where it seemed to be permanent.)  In addition, 6-OXO has led to clotting. [9] There are other irreversible aromatase inhibitors out there, such as Aromasin or Extemesane, but I think caution is definitely in order as these are relatively new and poorly understood in my opinion.

NOTE: Broccoli (and other cruciferous vegetables such as cauliflower and cabbage) are powerful estradiol “shifters.” While you’d be hard-pressed to eat enough broccoli to actually lower your estradiol, you can definitely shift your estradiol metabolites from bad to good quite easy. This is one of the reasons that men can achieve powerful Prostate Cancer Protection.  NOTE: Broccoli is easy to fix:  just put raw florets in a coffee cup with a half inch of water on the bottom and heat for around two minutes in a microwave.  The steam for the bottom of the cup will cook the broccoli soft and tender.  Then just add a little salt and it is ready to eat.

4) Certain Supplements such as Chrysin, Zinc, Calcium Glucarate and Grape Seed Extract. Chrysin has had meager results in some studies. [3] However, Life Extension Foundation seem to have overcome these underlying issues by including piperine in their formulation for greater absorbability. See my Review on Super Miraforte and my Natural Estrogen Blockers for more information.  CAUTION: Supermiraforte has been around quite awhile.  However, it should be noted that one study showed Chrysin inhibiting the conversion of T4 to T3 and thus negatively impacting thyroid function. [4] This could potentially lead to weight gain (and other issues), which would sabotage estrogen control. (For more information on Grape Seed Extract, see my link on Natural Estrogen Blockers, where I cover some of the pros and cons of using grape seed extract. The summary is that grape seed extract definitely has some desireable and positive properites but will not likely solve one’s E2-related issues.)

5) Progesterone.  Hey, men need progesterone too – or at least they need adequate levels. See this link on Progesterone and Men, but progesterone can help men out in many key areas and one of them is bone mass.  I see very differing opinions on just how to raise progesterone.  Some experts say you should “backfill” using pregnenalone.  Others say that generally is ineffective.  Some say most middle-aged men need some progesterone and there is now an evidence that Progesterone Can Help with Erectile Dysfunction. Still other experts say that progesterone is “estrogenic” and fights against “maleness” and should rarely if ever be given. Nevertheless, I post it here, because it is an interesting solutions.

Again, I encourage you to also look over my link on Estrogen Increasers to avoid those things that can negatively boost estrogen levels in our everyday life.

6)  Zinc. My HRT clinic once proposed that I take supplemental zinc to control estrogen, because Zinc is also known for its ability to limit the activity of aromatase. The way my clinic explained it is that it is a way to fine tune or tweak estradiol, i.e. it has a relatively small effect. However, I do want to point out that there many risks in taking too much zinc, from neurotoxicity to cancer to metabolic issues, something I outline in my page on The Potential Dangers of Zinc Supplementation.

REFERENCES:

1) Agents Actions, Jun 1987,21(1-2):223-8

2) Medical Hypotheses, Jun 2001, 56(6):702-708

3) J Steroid Biochem Mol Biol,Sep 2001,78(3):231-9Biol,Sep 2001,78(3):231-9

4) Prog Clin Biol Res, 1986, 213:359-71, “Iodothyronine deiodinase is inhibited by plant flavonoids”

5) J Int Soc Sports Nutr,Oct 19 2007,4:13

6) Med and Sci in Sports & Exerc,1999, 31:483

7) Journal of Clinical Endocrinology & Metabolism, published online on January 27, 2009, Submitted on July 24, 2008, Accepted on January 15, 2009, “Effect of Roux-en-Y Gastric Bypass Surgery on the Sex Steroids and Quality of Life in Obese Men”, Ahmad Hammoud MD, MPH*, et. al.

8) Cancer Res, Jun 1 2006, 66:5960-5967

9) https://en.wikipedia.org/wiki/4-Androstene-3,6,17-trione

10) Alcoholism: Clinical and Experimental Research, May 2004, 28(5):780-785, “Effect of Moderate Alcohol Consumption on Plasma Dehydroepiandrosterone Sulfate, Testosterone, and Estradiol Levels in Middle-Aged Men and Postmenopausal Women: A Diet-Controlled Intervention Study”

12) J Clin Endocrin Metab, 1993, 77: 375-381, “Effect of aging on endogenous levels of 5-alpha-dihydrotestosterone, testosterone, estradiol and estrone in epithelium and stroma of normal and hyperplastic human prostate”

13) https://www.fda.gov/NewsEvents/Newsroom/ PressAnnouncements/ucm152358.htm

14) https://www.prnewswire.com/news-releases/consumer- reports-tests-find-wide-range- of-bisphenol-a-in-canned-soups-juice-and-more-68723862.html

Cholesterol and Longevity - Peak Testosterone

Want to live a healthy life and increase your longevity?  Then get your total cholesterol below 150, right?

One piece of evidence that is true is that the healthiest and longest-lived societies on planet earth, as documented in John Robbin’s Healthy at 100, all have cholesterol below 150.  These cultures have virtually no heart disease or cancer.  Contrasted with the typical modern, industrialized society where both cholesterol and mortality rates are much higher, one can’t help but wonder if cholesterol is causative.

Unfortunately, examining whole cultures is not really a good proof, since after all, there are many lifestyle factors that are significant health-determining factors.  For example, all of the above cultures exercise for many hours of the day and all of these cultures also tend to be low stress and low calorie as well.  It is difficult to separate out one variable from another.  The famed China Study attempted to do this and offered additional evidence for those interested.

Complicating matters were several earlier studies that showed that all cause and cancer mortality tended to go up with lower cholesterol levels below about 150. In other words, some studies seemed to show the very opposite of what the above supercultures showed.  The Paleo and Low Carb diet crowds took advantage of the situation and a tidal wave of internet articles and pages presented the idea that a low chosterol diet was actually dangerous.

Some researchers have even jumped on the bandwagon.  One Japanese scientist recently went so far as to state that “cholesterol is an essential component for the creation of cell membranes and hormones. It’s not recommended to lower LDL figures by means of dietary intake and medication.” [1] In other words, the argument was that one could not get enough cholesterol on a low fat diet to adequately supply the body with needed fatty acids.

The burning question, of course, remained though, “Why did the studies show that low cholesterol led to decreased longevity and increased mortality?”  Well, researchers had long ago answered this question.  One study from 1981, for example, showed that

What they found was both important and interesting:  low cholesterol did not increase overall cancer rates significantly IF you took out those with “preexisting conditions”.  They did this by removing those with known cancer and those who died within the first two years. Let’s face it:  most of those who die within two years from cancer likely had it at the time of the study and this will lower cholesterol levels unnaturally. [2]  (NOTE:  The researchers did find that colon cancer had a higher risk factor with low cholesterol once these other factors were taken into account, but this is the lone outlier.)

A 1995 British Medical Journal study found an additional explanation that verified this conclusion:  they found that if you looked far enough into the future, all cancer risks were eliminated. [3] Again, this shows that a number of individuals had lower cholesterol levels due to prexisting cancer and, when eliminated, becomes irrelevant. A similar study of Finnish men reached the exact same conclusion. [4]

Thus, the studies show the following:  lowering cholesterol dramatically and linearly decreases heart disease and is largely neutral with respect to cancer.  This results in an impressive overall decrease in mortality and increase in longevity when all factors are combined.

REFERENCES:

1) https://www.physorg.com/news203844242.html

2) Am. J. Epidemiol, 1981, 114(1):11-20, “SERUM CHOLESTEROL AND MORTALITY IN A JAPANESE-AMERICAN POPULATION THE HONOLULU HEART PROGRAM”

3) BMJ, 1995 Aug 12, 311(7002): 409 413, “Low serum total cholesterol concentrations and mortality in middle aged British men”

4) Am. J. Epidemiol, 1992, 135(11):1251-1258, “Short- and Long-term Association of Serum Cholesterol with Mortality The 25-year Follow-up of the Finnish Cohorts of the Seven Countries Study”

HCG Mono-therapy:Most Natural Way to Boost Testosterone ?

6) Can you tell us what dosage you are currently taking and give us some of the practical details such as needle gauge(s), needle length, self or office injections, frequency, etc.? Also, is the shot painful at all?

A.  My legs are muscular with no fat on them so I use a 1/2″ 27 ga needle. Most people should probably use at least an inch long needle to start off with and adjust down if its feasible. I was injecting 3x/week but i have recently gone to daily injections of 250 IU to see if that will reduce estrogen. I haven’t had labs done since I made the change.

7) Have you been satisifed with HCG Monotherapy – has it met your goals and been what you had hoped for?

A.  I have been happy with HCG monotherapy. The effects are subtle and gradual but very real. If you go in expecting a monster libido increase like you may get with a test injection that takes you up to 1200, you’ll be disappointed. But there have been numerous benefits that have happened over time once I got my estrogen down a bit.

8) My understanding is that the side effects of going on HCG are basically those of having standard testosterone therapy and/or elevated estradiol? Have you personally had any side effects from taking the HCG?

A.  I have experienced no side effects whatsoever other than spiked estrogen. My dr monitors red blood cell count in my labs as for trt but theres been no increase there. I do not believe HCG will produce that side effect which test injections can, but i dont mind that he’s monitoring it anyway just to be sure.

9) Has HCG helped you in the typical areas that men get relief from HRT, i.e. improved libido, increased morning erections and erectile strength, decreased mental fog, anxiety and depression?

A.  The positive effects I can report are: daily morning erections (but only once I started taking Arimidex) where they were rare before, increased penile sensitivity, much harder erection quality, and constant feeling of good mood and contentment. I was not depressed before going on it, but since going on it I feel like I am always in a good humor no matter what. The other thing is body composition has gradually changed. I am the same 6’3 205lbs I was a year ago, and I was muscular then and I lift weights regularly. But there has been a noticeable composition change with less fat and more muscle. I have not been tested for body fat, but looking at pictures and descriptions online I would estimate I have gone from around 20% body fat to around 15%. Libido has improved but it is subtle and dont expect miracles there:  the difference in erectile function is much greater than the improvement in desire.

10) What about Arimidex? Have you had to take anything to control estradiol? I have read many times that in some men HCG can really ramp up estradiol. Has that been the case for you?

A.  I am not aware of anyone who has successfully pursued HCG mono and not needed to control estrogen. HCG produces much more estrogen than exogenous test does. I would advise anyone who tries this route to not even start it unless their doctor is monitoring their estradiol and is willing to prescribe Arimidex if estrogen gets high. Because I can almost guarantee it will and you will not get any benefits without controlling it. All of the erectile function benefits did not occur for me until about a week and a half after I started taking Arimidex, as my estradiol had gone up to 49 from half the HCG dosage I currently take.

11) What do you think the future holds for you? Will you just stay on HCG Monotherapy as long as you can? Or will you switch to standard testosterone therapy once you are longer concerned about fertility?

A.  At some point I am sure I will move to more of a testosterone protocol, perhaps combined with HCG to prevent testicular atrophy. My sense is you get the best of both worlds this way, and get the mood and contentment benefits of HCG with the stronger libido benefits of testosterone. I also generally think it is more safe to not allow your testicles to atrophy, even if you dont need them for fertility, but that’s just my opinion/bias.

In summary, I think HCG Monotherapy is a good option for a small subset of people with low testosterone which I fall into, that of younger people who are in shape and otherwise healthy. This is a small minority of people with low t, so my guess is it will never be commonly prescribed or studied in detail. I think if someone is significantly overweight they should not pursue this route, as it will be even harder to control estrogen and getting it up high may do more harm than good.

Now since HCG can also increase testosterone in many men with secondary hypogonadism, it was just a matter of time before someone got the idea that maybe some men would do just fine with HCG alone and just skip the testosterone cypionate altogether. This treatment strategy is called “HCG Monotherapy” and seems to be growing in popularity.

What is interesting is that, because HCG is extremely similar to Leutinizing Hormone, some doctors and patients consider this a more natural solution than giving a man testosterone replacement therapy, because it stimulates the body’s own production of testosterone.  Of course, the practical side of administering HCG is that it really ramps up estradiol in most men, at least from what I have seen.  So, as you’ll see below, one often has to take more Arimidex than one would with just standard testosterone therapy, making this seem less natural perhaps when one considers the pharmaceutical involvement.

A couple of our Peak Testosterone Forum members have gone this route and one of them graciously agreed to answer some questions about his experience, which I have published below:

1) So you’re on HCG Monotherapy, i.e. you not taking Clomid or receiving testosterone therapy? Can you give us a little background and let us know what made you decide to go with this decision? Fertility I assume?

A.  Yes HCG Mono. I am concerned about fertility. Also, my endocrinologist was not comfortable putting someone as young as me (37 at the time) on exogenous test as he viewed it as a lifelong commitment I could never quit, presumably due to testicular atrophy. So in contrast to most he was more comfortable putting me on NCG or Clomid than exogenous T, and I didnt want clomid.

2) Can you let us know your testosterone numbers before and after starting the HCG Monotherapy? How much of a testosterone boost can the typical secondary hypogonadal male get in your opinion?

A.  I had been tested by my gp for several years in the 320-330 range. I have increased the dosage over time and am now at 500iu 3x/week and my last testosterone reading was 610. Others I have seen have gotten as high as 700.

3) How long have you been on HCG Monotherapy and were you on Clomid or testosterone prior to this?

A.  It’s been about a year now and was my first HRT experience.

4) How did you find a physician that knew how to handle this kind of treatment protocol? Are you currently satisfied with his or her level of expertise? My impression is that it is mostly fertility docs who handle this. Is that what you have seen?

A.  I looked on this endocrinologist’s website and he mentioned different forms of trt, ie gels, pellets, etc and he was fairly young, so I figured he might be more open minded. I am his first HCG patient clearly:  he does not seem to have any experience with it. He told me he has people on Clomid, but it won’t raise libido. He tried to get me to try Wellbutrin which acts on dopamine, but i was not comfortable with that. I have been leading the charge here if you will.

5) What I have heard is that HCG will not hurt fertility parameters and will often help men in this area. Is this what you understand as well?

A.  Thats what I understand and it is prescribed at higher dosages as a short term fertility aid.

HDL: Increase It with Estradiol - Peak Testosterone

One interesting protocol change that I have observed on the Peak Testosterone Forum of late is that some of the guys on HRT are saying that their doctors want their estradiol quite high. “More is better” seems to be the philosophy with these physicians. Now I am very skeptical of that position for many reasons:

In spite of all these negatives, these doctors wanting higher estradiol levels do have an interesting point: estradiol is incredibly important according to recent research for arterial health. In fact, one study showed that IMT (intima media thickness) scores, i.e. arterial plaque levels, were tied to estradiol levels. The authors concluded:

“Circulating E2 is a predictor of progression of carotid artery intima-media thickness in middle-aged men. Further studies are needed to investigate the role of endogenous E2 for incident cardiovascular disease events.” [1]

1)  JCEM, 91(11), Received: May 02, 2006, Accepted: August 17, 2006, Published Online: July 02, 2013, “Circulating Estradiol Is an Independent Predictor of Progression of Carotid Artery Intima-Media Thickness in Middle-Aged

2) JCEM, Published Online: July 01, 2013, “Physiological levels of estradiol stimulate plasma high density lipoprotein2 cholesterol levels in normal men”

3) Arteriosclerosis, Thrombosis, and Vascular Biology, 2004, 24: 1741-1742, “Estrogen and HDL: All that Glitters Is not Gold”

4) JAMA, 2009 May 13, 301(18):1892-901, “Circulating estradiol and mortality in men with systolic chronic heart failure”

5) J CARDIOVASC PHARMACOL THER, May 2014, 19(3):256-268, “Regulation of Endothelial Nitric Oxide Synthase and High-Density Lipoprotein Quality by Estradiol in Cardiovascular Pathology”

Men have the idea that estradiol, being the chief estrogen is “bad,”  because it is the “female hormone.”  Well, the truth is that you desperately need a certain amount of estradiol in order for arteries to be healthy and on this page we are going to look at one reason why:  estradiol is a stimulator of HDL, the good cholesterol that shuttles cholesterol out of foam cells.  Researchers have long known that women, who have higher estradiol levels than men of course, enjoy improved and increased HDL levels.  So the question is whether or not the same effect would be seen in men as well.

NOTE: Again, you do not want to be “deficient” in estradiol.  For the many reasons, see my page Do Men Really Need Estrogen, Especially Estradiol? for more information.

“Plasma HDL cholesterol, particularly, the HDL2 fraction, decreased significantly in response to the low serum E2 level…Only a small decrease in HDL2 cholesterol was seen in these men. There were no hormonal or lipid changes in the placebo group. We conclude that in men, physiological levels of E2 [estradiol] are important in maintaining plasma levels of HDL cholesterol, especially the HDL2 fraction. ” [2]

So this study directly confirmed the idea that estradiol increase HDL.  However, one concern that researchers have is that you don’t want to increase HDL unless the quality also increases.  It turns out that you can increase HDL and actually make it pro-oxidant to where it does not do it’s cholesterol transporting job.  One study showed that this was indeed the case: estradiol lead to the incorporation of serum amyloid A (SAA) into the HDL, which actually turns your good cholesterol from friend into foe. This ugly turn of events can create a “franken-HDL” that would increase plaque instead of decrease it. [3] Indications of these issues were shown in a study on men with chronic heart failure, where participants with estradiol greater than 37 pg/ml had more than double the risk of dying. [4]

There is yet another “cardiovascular dark side” to estradiol increases:  estradiol generally raises CRP (C-Reactive Protein) and other inflammatory markers. [3] This may negate any cardiovascular benefit when artificially elevated.  Many women, for example, are not allowed estradiol creams (for post-menopause, etc.) over clotting concerns.  Although men have much lower levels of estradiol, the concerns still remain.

All of this means that, while estradiol does increase HDL, it is highly debatable as to whether or not it is wise to just let estradiol go overly high.  This is a real issue for men on HRT, whose estradiol often goes very high due to the increase in testosterone coupled with being overweight.  (Fat contains aromatase, the enzyme that convert testosterone to estradiol.)

NOTE:  Does testosterone affect HDL?  Read my page on Testosterone and HDL for additional information.

Hypogonadism, Testosterone and Your Sex Life.

One of the reasons I find this study so fascinating is that there are SO many doctors out there who still think that low testosterone makes little difference. I get letters all the time with horror stories from guys who have struggled for years while their doctor completely ignored (or didn’t know how to handle) their problem.

This means that low testosterone should simply be called The Great Sex Life Killer: it removes sexual desire, makes you limp and destroys the long term health of your penis by reducing morning erections.  What’s left, eh?  And, if you’ve read my site at all, you know that Sex is Very, Very Good for Males, regardless of age.

So here’s the bottom line, at least according to the study:  if you have the above symptoms, you should ask to get tested for low testosterone since these are by far the most strongly correlated.  Of course, I cover some of the other studies in my link on Low Testosterone Symptoms, but according to the NEJM, your sex life is the best indicator.

Furthermore, realize that doctors are often reluctant to identify and treat low testosterone.  Consider this fairly recent 2007 study where the researchers 1) defined low testosterone as total below 300 ng/dl and free below 5 ng/dl. [2]  These are very low numbers and guys will very often experience problems in the 300’s and even 400’s in some cases.

This is also what I find disturbing about the study.  The researchers had a Clinical Practice Guideline from the Endocrine Society that had the following very rigorous guideline for treating low testosterone or hypogonadism:

Low total and free testosterone plus the presence of

plus two or more of the following symptoms:

This seems much too conservative to me.  I mean you might as well just say that you don’t want to treat hypoganadism, because you’ve set the testosterone level astronomically low, required osteoporosis and other questionable and ill-defined symptoms before you treat.  I ask the question:

If a guy has a couple of low testosterone readings, what else do you need, especially considering the many dangers of low testosterone, including increased risk of Metabolic Disorder, heart disease and Diabetes?

REFERENCES:

1) “NEJM, 2010; 363:123-135, “Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men”

2) https://www.sciencedaily.com/releases/2007/09/070907233610.htm

Decide Target, Normal Estradiol Level with Physician.

Decide on a target estradiol level with your physician.  Going too low will likely lead to osteoporosis and going too high may increase risk of arterial plaque, cancer, enlarged prostate and possibly prostatitis.  I have a lot of pages on these subjects and I cover them here:  Summary Page on Estradiol and Estrogen, so you can read more in depth there.

There is no magic “normal level” for any hormone from what I have seen that will work for every guy in every situation. That said, you don’t want to go to the opposite extreme and decide that there is no such thing as high or low estradiol. The savvy physicians from what I have seen use a combination of symptoms and comparing your blood draw to a “normal,” youthful level, which is what I am to discuss below.

Actually, I should also mention that the solid majority of physicians currently do not even pull estradiol in men.  In general, this is due to ignorance.  Unfortunately, doctors incorrectly think that estradiol is a “woman’s hormone” and has little impact on us guys.  This could not be more wrong and estradiol is every bit as powerful as testosterone.  Sure, estradiol in us guys comes from testosterone, but that does not mean it is not important, and, fortunately, a couple of recent studies have highlighted this fact and brought it to the forefront of the medical community.

Most men, though, instinctively know that estradiol does actually matter, which is why the two most common questions that I get asked on the Peak Testosterone Forum are probably:

There is a lot of good data on #1, but very little on #2. As I have often discussed with other guys, men’s issues seem to take a back seat in the research quite often!

However, the great majority of physicians have absolutely no idea that estradiol has such a powerful effect on men.  For example, look at the story of this man, whose estradiol was actually above the lab range and yet his doctor would do nothing about it:

“This summer a test showed I had slightly elevated E2 (estradiol), my result was 181 pmol/l [49.3 pg/ml] and range 50-162 and nothing happened, no doctor seems to think this is an issue and so far refuse to even consider my problems to have anything with E2 to do…This autumn I meet a new doctor and he quickly changed from 12 week to 8 week injections and, well im not going to describe how it made me fell since i would need to curse in roughly 32 different languages to even get close. No erections at all not even soft, achieving orgasm was borderline impossible and orgasm didn’t feel good at all, increased pain from toes to head, sleeping less good and some other problems. ” [2]

And, while I am not a big fan of Arimidex (which lowers estradiol (E2), look at what happened to him when he started taking it:

“Then I made a request for Arimidex and thankfully my request was handled by a doctor either knowing what she did or more likely, didn’t know what she did, either way I got a recipe for ~400 pills and supposed to take one a day. I noticed a change the first day but the second day, WOW my little weiner was alive again and the feeling was amazing, it was so hard it was almost painfull, i can honestly say it felt like I had forgotten how good it feels.”

In any event, let’s start with the assertion of my old HRT clinic.  They claimed that generally men feel better when their estradiol levels fall between 20 to 30 pg/ml. The implication, of course, was that this range was the normal, healthy, youthful ranges for estradiol in men.  I tend to believe them, because I have so often seen men on HRT end up higher than 30, then take Arimidex to get their level between 20 and 30 only to feel dramatically better.  Of course, I disagree with this policy of my old clinic, because I do not think the vast majority of men should take Arimidex.   I believe is risky for two reasons:  a) it is easy to knock your estradiol down so low that you could end up with bone loss and b) it is a pharmaceutical that some experts believe, even in low doses, could increase the risk of clotting.

CAUTION: 20-30 pg/ml comes from the old way of measuring estradiol in men, which the labs are no longer using. More research needs to be done to correlate the old versus the new tests.

Nevertheless, I think the philosophy of not going too high or too low with estradiol is good.  And I think this is shown in studies of estradiol in men by age.  Just what are normal, youthful and healthy levels of estradiol in a male?  Check out this data:

To answer these questions, we can go back to a 2000 Clinical Endocrinology study where they summarized a variety of hormone levels by age, including estradiol:

The above are in international units and not the standard pg/ml, so let me do that conversion for everyone reading this in the U.S.  (The appropriate conversion factor is 3.671.)

Many of us would guess that estradiol levels would rise as we put on weight with aging, right?  However, the data above shows that that is decidedly not the case and estradiol levels to tend to fall as the decades roll by. This is part of the reason that so many men end up with osteoporosis.  And making the matter worse is that our SHBG levels climb, leaving us with less free estradiol as we age as well.  (SHBG binds to estradiol as well as testosterone.)

Most importantly, notice that youthful estradiol levels are 28 pg/ml for men in the 20’s and about 26 pg/ml for men in their 30’s according to this study.  This is a powerful argument that youthful estradiol levels fall right in the 20-30 range recommended by my old clinic.

Now someone might object and say, “But these included overweight and sick individual which would skew the results.”  Sorry, but the researchers were one step ahead of you and only “healthy, non-obese subjects” where allowed in the study.  Average BMI was actually 24.6+/-2.5 kg/m^2.  This means that the highest BMI man in the study was 27.1.  So the argument seems weak that normal weight men tend to be high in estradiol.  In fact, notice that at no age were natural average estradiol levels above 30 pg/ml.

It should be noted, though, that, just as testosterone symptoms can be variable from individual to individual, there is no doubt that estradiol symptoms and levels can fall in the same category.  For example, the standard deviation in estradiol values for the 20-29 year olds was 23.43 pmol/.  This means that the top threshold for “normal” estradiol, if we look at one standard deviation up from the mean, is 34.4 pg/ml. Thus, one could argue that youthful testosterone could be up to the mid 30’s for a significant block of men.  The point is not to come up with hard and fast rules but rather to point out that youthful estradiol levels are generally not overly high.

HUGE ISSUE:  So then we can just target 20 to 30 or maybe 35 pg/ml, right?  Unfortunately, the answer is probably no, and the reason is that the state of estradiol testing for men is in disarray.  The labs are now pushing the LC-MS/MS test, which is righteous and good, but this technology generally reads significantly lower than the old immunoassays from what I have seen.  This was shown in a study that compared the LC-MS/MS against 4 other immunoassays and the average results varied by up to 53%! [3] A number of the men have seen this on The Peak Testosterone Forum, i.e. a much lower estradiol score from the LC-MS/MS tests. Basically, the only worthwhile test is probably the LC-MS/MS, but we have no good research data showing what is high and low based on this test!

So we know we don’t want to go too low with estradiol or we could end up with brittle bones and hip fractures like a lot of 75 year old women struggle with.  Furthermore, common sense dictates that more is not better when it comes to estradiol.  Many men who go on HRT and end up with estradiol in the 40’s and 50’s very commonly have a certain suite of side effects:  gyno, water retention, lowered libido, loss of erectile strength, moodiness, poor sleep etc.  If you’ve been around Peak Testosterone Forum at all, you know this is actually quite common.  And many experts have concern about long term effects as well, because high estradiol may increase clotting risk, arterial plaque and prostate issues as I mentioned.

So what’s a fella to do?  Well, let me share my own story here. I am testosterone cypionate and my last testosterone read was 700 ng/dl at one lab and 800 ng/dl at another.   So I’m somewhere around 750 ng/dl on a daily basis I inject my cypionate subQ every other day, so my levels should be quite constant and consistent.  Yet my last estradiol read was 27 pg/ml without any Arimidex.

I think most men would be happy with that read via only natural means.  So how did I do it?  I simply did the following 3 natural methods:

Now the point of that story is that one I got my testosterone levels to a more reasonable level and dropped my body fat down to what it was in college, – low and behold! – my estradiol levels dropped into the range that they should be. I am 54 and so don’t buy into the theory that, because you are a little older that you cannot control estradiol and, therefore, must to be on a pharmaceutical to control it.

So in my opinion the solid majority of guys on TRT can get their estradiol in line if they follow the above principals, and this is a far safer approach that just throwing Arimidex at the problem.

CAUTION: As I mentioned, there has been considerable debate about the best way to measure estradiol in men.  Of course, our estradiol levels are very low and so you cannot just use the standard test, which is designed for premenopausal women with abundant estradiol.  See my page on  Which Estradiol Test is the Best? for more information. In addition, there is a recent study that shows HIV+ men may need higher levels of estradiol to maintain bone mass. [4]

REFERENCES:

1)   Clin Endocrinol (Oxf), 2000 Dec, 53(6):689-95, “Age-related changes of serum sex hormones, insulin-like growth factor-1 and sex-hormone binding globulin levels in men: cross-sectional data from a healthy male cohort”

2) https://www.peaktestosterone.com/forum/index.php?topic=5726.0

3) Clinical Chemistry, 2014, 60:3, “Performance of Direct Estradiol Immunoassays with Human Male Serum Samples”

4) Osteoporos Int, 2015 Oct 28, “Serum total estradiol, but not testosterone is associated with reduced bone mineral density (BMD) in HIV-infected men: a cross-sectional, observational study”

How I Got Rid of My Atherosclerosis - Peak Testosterone

My scores were actually 0 across the board.  I was in such disbelief – they give your readout on the spot – that I asked the technician if there could be a mistake.  She said that she actually sees the imagines, or slices, from the CT scan.  She said plaque is incredibly obvious and shows up as white patches in the arteries and even a lay person could not miss it.  The computer then calculates your average arterial plaque based on the 64 slices, but, in my case, there was nothing to calculate!  For those interested, here are my actual Heart Scan Results . Hey, I may not be the best-looking or best built guy in the gym, but I may just have the best arteries!  (Statistically, my printout said that about 10 percent of men my age with have a calcium score of zero, so it’s actually not terribly unusual.)

No, I say humbly that I was very thankful and completely stunned and the reason is that, as I have explained elsewhere on the site, I have been low testosterone for probably decades and this can lead to hardening of the arteries. In addition, I have eaten a lot of fast food during for about 30 years as well. Growing up, I had meat for every lunch and dinner almost without exception.  So, what I am getting at, is that prior to the age of about 45, I ate a lot of fat and saturated fat and, undoubtedly had accumulated at least some arteriosclerosis.  Studies on soldiers show that almost all men on a Western Diet have acclerated arteriosclerosis.

NOTE:  I hope that no one will believe the myth that you cannot have zero arteriosclerosis. I have heart this stated a 100 different times from various authorities that fall in the Paleo/Low Carb crowd.  Essentially, the argument is that “arteriosclerosis is inevitable” and so you just have to learn how to manage it. Well, that is risky business.  It’s true that the Masai had significant arteriosclerosis, but they also exercise about 8 hours a day and had very low levels of stress.  The typical Westerner with arteriosclerosis is asking for very painful angina at a minimum and strokes and heart attacks eventually.

Anyway, let me explain why I am almost certain that a Low Fat Diet is the primary reason for me having these kind of arterial plaque results:

1.  Stress.  I do practice meditation and PMR but am very inconsistent.  Furthermore, I did not even know how to execute these until a couple of years ago.  And, to be very honest, I am a high anxiety person in general.

2.  Sleep. My sleep over the last five years has probably averaged 6 hours per night and, yes, I tend to be hypocritical.  However, a lot of it has to do with this site.

4.  Exercise.  I don’t think anyone is going to claim that exercise will remove arterial plaque.  Even so, I want to point out that I have been diligent in exercising for the last five years almost every day.  However, the majority of my exercise time is weight lifting and low intensity cardio.

5.  Sitting.  Having a desk job and working on this site have me sitting a big percentage of the day.  This is very hard on the body.

6.  Fructose. I think it’s safe to say that I have quite often exceeded the 25-50 grams/day dosage of fructose that I mention on my site.  Fructose is very hard on the cardiovascular system.

7.  Supplements.  I have experimented briefly with a wide variety of supplements but eventually quit almost all of them.

Again, I am just trying to point out that I have definitely NOT lived perfectly and my lifestyle is anything but ideal for optimal health. Don’t get me wrong – I’m proud of the changes I have made.   But it would be a real stretch to claim that other lifestyle factors may have been responsible for may lack of arterial plaque.

However, I do want to mention some things that I have consistently done over the last five years that may have helped considerably:

1.  Vitamin C. For the majority of these years I have taken at least 3 doses of 500 mg Ester-C.  There is an entire “Pauling Theory” of Vitamin C protecting the collagen in one’s arteries and that Vitamin C lowers arterial oxidation and inflammation.  However, this is not well accepted in the medical community to say the least and I doubt anyone thinks that just taking Vitamin C will magically reverse arteriosclerosis.  Nevertheless, I suspect this may have helped somewhat.

2.  Fruit and Vegetables. The minute that I started on a Low Fat Diet, I increased my fruit and vegetable consumption.  I have eaten a lot of whole grains as well, including things like brown rice, wheat germ, quinoa, etc.  (I know shy away from wheat due to concern over the high GMO’d content.)  But I think it’s safe to say that I’ve averaged about 8 servings of fruit and vegetables daily and 1-2 of whole grains during the entire time period. I also am an avid black tea drinker, which is artery friendly.

3.  Exercise. Although I would strongly argue that exercise will not eliminate arterial plaque, it is interesting that Pritikin, who died with perfectly clean arteries, was religious about running a mile per day.  Exercise may play more of a role than we realize and I have been steady and consistent over the last five years.

Now let me say what really pumped me up about Low Fat Diets.  I have eaten a Low Fat Diet that is a little different from the standard:  I use a lot of protein from egg whites, undenatured rice and at time undenatured whey.  I have heard it argued and implied that this would sabotage my efforts, so, needless to say, I was VERY pleased that it had had no negative impact. (There is a chance that some proteins may increase cancer risks however, but that is a big subject.)

CAUTION: Before deciding on a Heart Scan, you have to decide if the radition is worth it. Keep in mind that it is the equivalent of about four chest xrays from what I have heard. I decided it was worth the risk, but you have to do your own research and make up your own mind as I always say…

Arterial Plaque Regression Through Weight Loss Dieting

Below I will discuss a study that shows that a wide variety of diets from lower carb to lower fat can be used to regress plaque in most men as long as one is losing weight.  The clear message, assuming you have extra bodyfat to lose, that I am presenting is this:  get started! Lose weight gradually over an extended period of time so as to not negatively alter hormone levels and you should see your atherosclerosis improve.

Of course, I’ll say the obvious:  it is always best to work with a physician that has considerable experience reversing plaque.  Much of the subject is actually common sense coupled with recent research, much of which I have summarized in these Pages on Arterial Plaque Regression. However, there are definitely “gotchas,” i.e. things that can trip you up, and so I encourage you to keep looking for a doctor that knows that he is doing and doesn’t just throw you immediately on a statin.

CAUTION:  From what I have seen on the Peak Testosterone Forum, you can’t usually count on cardiologists unfortunately.  Most of them seem to actually discourage plaque regression!  This is a big mistake according to the research, because Erectile Dysfunction is Associated with Arterial Plaque and heart attacks as well.  I hate to be jaded, but keep in mind that they make much more money via angioplasties and stents than by spending time consulting with you on plaque regression.

“Eligible participants were aged 40 to 65 years with body mass index (BMI) 27 kg/m2 ; individuals with type 2 diabetes mellitus or coronary heart disease were eligible regardless of age or BMI. Pregnant or lactating women and participants with a serum creatinine 2 mg/dL (176 mol/L), liver dysfunction (2-fold higher than the upper limit of normal in alanine aminotransferase or aspartate aminotransferase), intestinal problems that would prevent adherence to any of the test diets, or active cancer were excluded.” [1] Note that 88% of the those in the study were male.  There is a very good chance that the solid majority of men reading this article would fit within these guidelines.

What were the results?  Before the study, the average IMT reading was 0.817+/-0.17 mm. IMT stands “intima media thickness” and is measures  the thickness of the tunica intima and tunica media, the innermost two layers of the wall of an artery, thus taking into account any plaque lining the neck (carotid) artery.  However, what the researchers actually monitored primarily was VWV (carotid vessel wall volume) in order to determine if atherosclerosis had receded or not.

They then divided the groups into a) (quasi) low fat, b) Mediterranean and c) low carb groups and, of course, compared them to controls.What the results showed would be counterintuitive to many:  ALL three groups showed a decrease in VWV of about 5%. Low(er) fat, low carb, Mediterranean – it didn’t matter – all regressed plaque almost exactly the same.  IMT was also examined and “over the two years of diet intervention, regardless of diet group, vessel-wall volumes diminished by 4.9%  while mean IMT improved by 1.1%” [2]

How much weight did these participants lose in the two years?  The original authors stated the following:

“The mean weight loss was 2.9 kg [6.4 lb] for the low-fat group, 4.4 kg [9.7 lb] for the Mediterranean-diet group, and 4.7 kg [10.3 lb] for the low-carbohydrate group; among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg [7.3 lb], 4.6 kg [10.1 lb], and 5.5 kg [12.1 lb], respectively.” [3]

Note that this is modest weight loss.  If you look at those who who actually finished the study, weight loss was between about a quarter pound and a half pound per month.  Most people who lose weight do so much more quickly. However, there is considerable wisdom generally in doing so gradually:  hormone levels are preserved; compliance is easier and plaque regression is extended.

Of course, this is great news and is yet another study that shows that plaque can indeed be regressed and it can be regressed in those that need it the most.  Monitoring of your plaque levels before and after via IMT or Calcium Score is essential in my opinion.

1) Circulation. 2010 Mar 16;121(10):1200-8, “Dietary Intervention to Reverse Carotid Atherosclerosis”

2) Medscape, Steve Stiles, Mar 02 2010, “Weight Loss, Regardless of Diet Intervention, Can Reverse Carotid Disease”

3) NEJM, Jul 17 2008, 359(3), “Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet”

MSG Risks to Testosterone (and Thyroid) - Peak Testosterone

What would be the most subtle way of poisoning the general population? I would suggest that it would be giving them a perfect natural substance used by the body and found in many tissues and then putting it in food and labeling it as harmless and, well, natural . This is precisely what the food industry has done with MSG (monosodium glutamate). Glutamate is actually one of the primary neurotransmitters used by our neurons and so what could be more helpful than putting a little extra in our food, right? It s kind of like taking a vitamin, right?

Unfortunately, the research has shown that nothing could be further from the truth than this and that even small amounts of glutamates in food can have toxic effects. One thing that is indisputable from animal studies is that minute amounts can cross the placenta quite easily and damage permanently the developing fetus. Over time this may explain many reproductive abnormalities in modern societies and the overly rapid decline in testosterone levels.

However, the risks are not just for fetuses and infants but for adults as well and let me explain why: the hypothalamus. I explain this a little in my link on Excitotoxins and Testosterone. However, I can tell from the <a=href= testosterone_monosodium_glutamate_excitoxins=””>Peak Testosterone Forum that this point has simply not been explained adequately. Here is what so many men miss:</a=href=>

If you put these five facts together, one can clearly see that a huge risk of MSG consumption is that it can damage the hypothalamus, lower GnRH signaling and potentially lower testosterone. Now some of you may be thinking, Well, I don t need to worry I never eat Chinese food. Unfortunately, it s not that simple: MSG is EVERYWHERE. Many foods, processed, packaged and fast, contain MSG in one form or the other. For example, most wheys and protein shakes and powders that men consume for weight lifting are loaded with ungodly amounts of MSG. Many, many foods contain autholyzed yeast extract and/or various hydrolyzed proteins. And, furthermore, diet drinks almost always contain a sister excitotoxin (aspartates) that do just as much damage.

If you put this altogether, most people in industrial countries are eating hundreds of grams of excitotoxins, including MSG, on a yearly basis. And a bunch of it is going to get snatched up the neuronal tissue of the hypothalamus, where, if in sufficient quantities, will do significantly damage, especially over the years and decades.

So is there really any evidence for all that I am saying. Yes! One recent study shows that this is going with much more prevalence that scientists initially anticipated. Before we go into this study, though, I have to make the observation that many animal studies have shown that MSG consumption can lead to obesity later in life. [1] A 2011 study on a Chinese population verified this in adults: the more MSG consumed, the more weight gain experienced by the participants. [2] The authors of the study noted that influences energy balance through the disruption of the hypothalamic signaling cascade of leptin action. In other words, the researchers believed that MSG was negatively impacting hormonal leptin levels through the hypothalamus.

The reason that researchers were so sure that this could be an issue is that animals studies showed that there were leptin receptors in a region of the hypothalamus called the arcuate nucleus. Of course, the question is if MSG could reach and damage these receptors enough to make a negative impact. Several animal studies showed that this could definitely occur and that the arcuate nucleus could be damaged permanently by MSG. [3] And, so yes, one should be asking, Why on God s green earth would we put this in our food supply?

Common sense tells you that you do not want to damage a key endocrine gland for ANY reason and yet this is exactly what we are doing by consuming these kind of nasty excitotoxins. MSG literally overexcites thus the name excitotoxin neurons and can lead to synaptic miswiring and hormonal death.

A similar analogy could be Vitamin D. Vitamin D is good and used for a host of metabolic processes, because it controls calcium processing in the body. Calcium is used for many things, including neuronal signaling, bone building and many other functions. However, too much Vitamin D can actually lead to hypercalcemia, which, of course, too much calcium can lead to pain, fatigue and, ironically, bone damage. This is similar to consuming too many glutamates: it literally chokes one s neuronal systems with too much of a good thing.

Now the evidence is out that MSG from food likely effects one hormone (leptin) influenced by the hypothalamus. Is it really that much of a stretch to assume it does the same with testosterone through GnRH when there is abundant animal evidence of just such a phenomenon? Many animal studies have shown that MSG in relatively small dosages can lead to hypogonadism. [5] Is it really prudent to wait for another study to directly show this on humans?

By the way, it is important to remember that the hypothalamus is also involved in signaling the thyroid. Recent animal studies show that excitotoxins can take out the hypothalamus and lead to hypothyroidism. [4] What is the significance to us men? Remember: hypothyroidism is associated with low testosterone. This means that the risks to your testosterone from MSG are actually multiple: 1) by damaging GnRH signaling and 2) by inducing or exacerbating hypothyroidism.

The bottom line is that your poor hypothalamus is sitting vulnerable and exposed to MSG that you consume and that this is a huge risk to your testosterone and general endocrine function. Study after study is showing issues: read also my link on Excitotoxin Syndrome for another example. The bottom line is that there is simply no compelling reason to risk the negative impact and potential damage of MSG consumptions.

1) Neuroendocrinology, 1992, 56(3), “Monosodium Glutamate-lnduced Reductions in Hypothalamic Beta-Endorphin Content Result in Mu-Opioid Receptor Upregulation in the Medial Preoptic Area”

2) Am J Clin Nutr 2011 94: 958-960, “A lack of epidemiologic evidence to link consumption of monosodium L-glutamate and obesity in China”

3) AJP – Endo, July 1 1997, 273(1):E202-E206, “Attenuation of leptin-mediated effects by monosodium glutamate-induced arcuate nucleus damage”

4) Endocrinology, Jul 1 2010, 151(7):3267-3276, “Developmental Hypothyroidism Increases the Expression of Kainate Receptors in the Hippocampus and the Sensitivity to Kainic Acid-Induced Seizures in the Rat”

5) African Journal of Biotechnology, Jul 2009, 8(13):3031-3035, “Hepatotoxic effects of low dose oral administration of monosodium glutamate in male albino rats”

Endothelial Dysfunction - How to Get Your Nitric Oxide Back -

Blood flow. That’s what it’s all about for us guys. We need it for optimal brain function.  We need it for cardiovascular health and athletics.  And, most importantly some of us might argue, we need to for maximum bedroom performance. But it’s all dependent on our endothelium, that delicate lining of our arteries that pumps out nitric oxide.  Unfortunately, the endothelium is under attack by a Western lifestyle. Damage begins accumulating from a very young age due to inflammation, oxidation, skewed lipid profiles and toxins (especially smoking).

Most of us think of our arteries, including the ones in our penis, as a hose.  However, this is actually a poor analogy, because our arteries can expand (dilate) and contract (constrict).  When duilated, the arteries literally become wider and blood flow is increased.  This also drops blood pressure, because there is more space (or volume actually) for your heart to pump the blood.

So what controls endothelial function?  This is actually an involved subject, but there are three primary chemicals that can dilate/constrict your arteries:

1.  Nitric Oxide. Just about every male knows about this heavy hitter. Nitric oxide is what is increased (through action on an enzyme called NOS) by PDE5 Inhibitors such as Viagra and Cialis.

2.  Acetylcholine.  This is a less powerful, but nonetheless significant vasodilator. Interestingly enough, it is used in research labs to measure endothelial function.

3.  Noradrenaline (norepeniphrine).  This stress hormone will put the brakes on artery expansion and your erections. Some noradrenaline is actually a good thing and keeps you from destroying your penile tissues due to priapism, an erection that persists for hours.

These three are natural acclerators/decelerators of blood flow and endothelial function.  So what don’t they work in your middle-aged and senior years?  Why do so many 35+ men struggle with endothelial issues?

The problem lies with a modern  lifestyle that literally attacks the endothleium. This a very involved subject, but the Cliff Notes version is the following:

As you can imagine, every step in this process is hard on the delicate lining of the arteres, especially the inflammation, oxidation and plaque-raising stages.  All of these will tend to lower nitric oxide over time and decrease the flexibility of arteries to dilate.

Accelerating the process is the increased blood pressure that results from a decrease in nitric oxide and narrowing arteries due to arteriosclerosis.  See my link on 30+ Natural Ways to Lower High Blood Pressure for some additional information.

Measuring Endothelial Dysfunction

Can you measure endothelial function?  There are some excellent ways that are done in sophisticated research settings.  Unfortunately, for the Everyman like you and me, these are simply too expensive and, therefore, there is no perfect replacement methodology.  You can get a pretty idea, however, by using some of the less expensive, more available techniques listed below:

1) FMD (Flow Mediated Dilation). This is most common method used by doctors, but does have some potential inaccuracies associated with it and is expensive unless covered by insurance.

2) Nitric Oxide Test Strips.  Neogenis recently developed test strips that can quite accurately estimate your endothelial nitric oxide levels. The test strips seem to work quite well, but they do not give an actual numerical reading.  Instead, it is kind of “litmus” test where you have four color regions on a test strip that give you an idea of your NO. Of course, the big advantage is that they are relatively inexpensive and can be done in the privacy of your own home. For more information, see my link on Nitric Oxide Test Strips.

3) Blood Pressure. Blood pressure is not actually a direct measure of endothelial dysfunction. However, the two are definitely related. You can measure this at home with an inexpensive blood pressure monitor.  From what I have heard, it is important to get one that uses an arm band and not a wrist strap.  You also cannot trust the ones in big stores that are for public use with the unadjustable cuff. Again, arteries with endothelial dysfunction resulting from heavy plaque buildup and low nitric oxide levels will tend to have elevated blood pressure.  You want 120/80 or below.

4) IMT (Intima Media Thickness). This is actually a measure of arteriosclerosis. However, arterial plaque buildup and endothelial are definitely related. Arteriosclerosis is somewhat like A1C (glycated hemoglobin) in the sense that it is usually going to show the cumulative damage that has built up over the years. Lots of arterial plaque indicates lots of damage and hardened, stiffened arteries.

Natural Solutions for Endothelial Dysfunction

When you first realize you have endothelial dysfunction, it can be a “little bit scary” as my five year old would say.  What is very sobering is that you suddenly realize that you have years or even decades of heavy damage to your arteries. Suddenly, the whole picture seems hopeless.  The good news is that the body can remarkably recover and even heal itself as we will cover below.

CAUTION:  Talk to your doctor if you are on any heart or blood pressure medications before doing any of these. Some of these can alter absorption rates of certain medications for example.

Here are 10+ Ways to Get Back Your Endothelial Function:

1.  Nitrates. Foods that contain nitrates can boost your baseline nitric oxide. Beetroot juice, spinach, lettuce and any green leafy vegetable has ample nitrates to get your arteries moving again.

5.  Nitric Oxide Boosting Supplements. Most of the supplements that have studies behind them will boost nitric oxide through one pathway or another. There are lots of ideas here in my link on Erectile Supplements. (Always talk to your doctor first.)

3. Low Fat Diet. When it comes to beating endothelial dysfunction, it is hard to beat a Low Fat Diet. This diet, popularized by men such as Pritikin, Ornish and Esselstyn, has actually been shown to arrest and, according to some studies, even reverse arterial plaque buildup. It also boosts blood flow and lowers

4. William Davis Track Your Plaque. This cardiologist has a strategy to reduce plaque.  I don’t have personal experience with his approach, but he is well-known at this point and can be followed on the site “Track Your Plaque”.  You can also read my review of his book Wheat Belly here.

5.  Nitric Oxide Boosting Foods. I cover these in my book called The Peak Erectile Strength Diet.

6.  Exercise. There is a simple solution to boost your nitric oxide and improve blood flow and endthelial function avaialbe to virtually every man: walk, move and exercise throughout the day. Instead of a 30 minute, once per day workout, just walk every few hours. This is how our bodies were designed and how every superculture on planet earth lives. These walking or exercise sessions boost your nitric oxide for several hours afterward just like Mother Nature intended it.

7.  Pomegranate Juice. I cannot say enough good things about Pomegranate Juice. It can boost nitric oxide, lower blood pressure and one study even shows it clearing out arterial plaque. For more information, read my link on Pomegranate Juice.

8. Testosterone. Yes, testosterone builds muscle and raises libido, but it also does three things that can directly improve your endothelial function: a) boosts nitric oxide levels by acting on NOS, b) lowers inflammation and c) protects your arteries from arteriosclerosis. So, if you are low or lowish testosterone and boost your baseline T enough through either Testosterone Therapy or natural methods, it can definitely help the lining of your arteries in multiple ways. For more information, see my links on Testosterone and Inflammation and Natural Solutions for Hardening of the Arteries.

9. Mediterranean Diet. The Mediterrean Diet is protestosterone diet, based on fruit, vegetables, grains, wine and olive oil.  It has a nice benefit of being likely pro-testosterone in nature due to the 30-35% total fat levels and emphasis on monounsaturated fats. It has been shown in a number of studies – on men with elevated cholesterol or obese for example [1][2] – to improve flow mediated dilation.

10. Drop the Vices.  #1 through #9 are not going to work if you are significantly overweight, smoking, using (most) recreational drugs, drinking immoderately or prescribed to certain medications. (Do not go off of a medication without talking to your physician.) All of these are incredibly hard on the endothelium.

So get out of the cycle now and get your endothelium back. Remember: “Never Say Die!”

REFERENCES:

1) Am J Clin Nutr August 2009, 90(2):263-268, “Close adherence to a Mediterranean diet improves endothelial function in subjects with abdominal obesity”

2) Annals of Internal Medicine, 2001, 134(12):1115-1119, “Mediterranean and low-fat diets improve endothelial function in hypercholesterolemic men”

Vegan Men Have Highest Testosterone Levels : Vegetarianism

REFERENCES:

1) British Journal of Cancer, 2000, 83(1):95-97, Hormones and diet: low insulin-like growth factor-1 but normal bioavailable androgens in vegan men

The corollary to this formula is that vegetarians (and vegans especially) must have lower testosterone levels than their carnivore counterparts. This kind of thinking permeates most popular health blogs and forums out there, especially on Paleo Diet and bodybuilding sites. In addition, almost every major men’s health magazine, at least here in the U.S., have recipes and recommendations with meat front and center stage.  The message that guys get is clear:  if you want to be healthy and hormonal – you must eat meat.

The reasoning behind such thinking is fairly straightforward and goes something like this:

1.  Meat is full of saturated fat and the research shows that saturated fat is pro-testosterone.

2.  Vegetarian and vegan diets are higher fiber which also has been linked to low testosterone.

3.  Bodybuilding, a sport obviously highly dependent on testosterone, is completely dominated by carnivores.

I myself have discussed some these issues at length in my links on The Two F’s: Fat and Fiber and Testosterone and Diet.

So what do the studies show?  Well, first of all, saturated fat is definitely pro-testosterone and it is true that higher fiber diets have some linkage to lower testosterone. I myself have discussed some these issues at length in my links on The Two F’s: Fat and Fiber and Testosterone and Diet.

CAUTION: Saturated fat slows down blood flow, something always less than desireable for sexually active males, and can destroys arterial health under most circumstances: read my link on The Potential Dangers of Saturated Fat for more details.

However, what I also bring up, and this is generally ignored by the bodybuilding and Paleo communities, is that vegetarian diets tend to have ample pro-testosterone monounsaturated fats. Even more importantly, vegetarian (and vegan) diets are also high in certain phytochemicals, which have some evidence for increasing testosterone, as I document in my link on Antioxidants and Testosterone. Whole grains, fruits, vegetables, beans, legumes, nuts, seeds are the bulk of what most vegetarians eat and they are all packed with antioxidants, anti-inflammatories and other constituents that will protect and in some cases even stimulate those all-important Leydig cells.

So who is the winner?  Well, to date there has only been one study that directly examined this question.  The researchers were primarily interested in comparing IGF-1 levels in vegans, vegetarians and meat-eaters, but also monitored a variety of other androgen-related hormones, including testosterone, as well. What they found was that vegetarians and vegans had average testosterone 6% and 16% higher than the carnivores, respectively. This, by the way, was after adjusting for important variables such as age and smoking status.[1]

The one variable that the researchers did not adjust for was BMI (body mass index) and when they did that, the vegetarians and meat-eaters had virtually equal testosterone and vegans were higher than everyone by about 6%.  Again, this flies in the face of almost everything you read on the web:  supposedly vegans and vegetarians do everything backwards and are loading up on toxic grains, fiber and all the things that will their slam manliness. In fact, though, the truth is that their testosterone levels are perfectly health and may even be higher on average than carnivores.  Either way, there is no evidence that vegetarians are suffering from a lack of androgens.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs.

And this really is common sense.  Vegetarian diets have been studies extensively and there have been no signs that vegetarians have low testosterone whatsoever.  Furthermore, vegetarian (or very close) diets have been adopted by hundreds of millions of people around the globe and there are simply no signs of mass symptoms of low testosterone in these populations. In fact, one could actually argue quite the opposite:  cultures and societies that eat low quanitites of meat are known for their active sex lives later in life.  (See my book, the https://www.peaktestosterone.com/, for other reasons that many plant foods boost erectile strength.)

It should also be noted that those in the study were in early middle age, which means that had lived long enough to accumulate damage to the Leydig cells, the hypothalamus and other key tissues that control and govern testosterone.  Therefore, it is possible that younger meat-eating males may have slightly higher testosterone but build up damage from some of the pro-inflammatory or other aspects of a meat-based diet.  We just don’t know the answer to those kind of questions yet.

One very revealing aspect of the above study was that vegetarians and vegans both had very robust levels of SHBG, again significantly higher than the meat-eaters.  SHBG, Sex Hormone-Binding Globulin, is the protein tthat does just what its name implies:  it chemically bonds to most of the testosterone in your body.  Now that sounds bad, but researchers have noted that generally as SHBG increases so does total testosterone.

The Okinawans are another example that plant-based diets outperform meat-based diets in the long run.  The traditional Okinawans were actually not strict vegetarians, as they did eat some pork and fish.  However, the great bulk of their diet was always vegetarian and they ate relatively little fat, including saturated fat. Interestingly enough, they also consumed significant soy, which has fairly high levels of various phytoestrogens.

Yet, as I document in my link on https://www.peaktestosterone.com/, the average 70-year-old Okinawan has testosterone of 439 ng/dl, a very respectable number, and a direct contrast to the 346 ng/dl average level of the typical 70-year old American. [62] Just as remarkable is the fact that the typical Okinawan 100-year old has testosterone of 298, which is above the level considered hypogonadal. By any standards, Okinawans have delayed andropause by a couple of decades and are a further sign that the carnivore lifestyle is anything but superior when it comes to preserving and protecting one’s testosterone levels..

What about the fact that bodybuilding is dominated by the carnivore lifestyle?  Bill Pearl says that after going vegetarian, he had the same amount of muscle that he did when he won his Mr. Universe titles.  Kenneth Williams, a vegan bodybuilder, placed third in the 2004 Natural Olympia bodybuilding competition.  And, of course, Mike Mahler is long time vegetarian and strength coach extraordinaire. The fact is that, if you desire, one can easily build a massive physique while on a vegetarian or vegan diet.

Walking: An Easy and Simple Way to Improve Erections.

Walking and ErectionsSometimes the simplest and easiest things are the most powerful and walking is no exception. If you want to help get your erections back through exercise, probably the last thing you’d think of is walking.  After all, most guys look down on walking as boring, ineffective and something women do to lose weight.

However, nothing could be further from the truth. Walking is incredibly powerful and is a fantastic help in improving your erectile strength and increasing blood flow.  All of the superhealthy supercultures in the world do an abundance of walking.  This is what our heart, and as I will show below, penis was built for.  Walking is the easiest exercise to do and this is VERY important for many guys.

Many guys absolutely hate gyms, biking, jogging, competitive sports and all the “standard” forms of exercise that we’re used to. Think of the people you know:  what percentage of them are regulars in the gym or on the trails or streets?  I’ll bet it’s less than 10 percent.

There was recently an article by the pointy-headed leader of Life Extension, William Faloon, where he admitted that he never exercised, until a recent health issue surfaced and  that he “absolutely detest regular exercise of any kind and get no pleasure from it whatsoever.” [1]  Here is one of the most important health experts in the world who is just being honest and saying what most people won’t admit in public.

1) https://www.lef.org/magazine/mag2011/may2011_My-Recent-Life-Altering-Event_01.htm

2) Circulation, 1999;100:1194-1202, “Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive As Well As Hypertensive Subjects”

3) Hypertens Res, 2000 Nov, 23(6):573-80, “Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension”

4) Circulation, 2000;102:1351, “Regular Aerobic Exercise Prevents and Restores Age-Related Declines in Endothelium-Dependent Vasodilation in Healthy Men”

You don’t need equipment.  You don’t need to be around anyone.  You don’t need to sweat like a quarterhouse.

You just need to walk and here’s some great erection-boosting reasons:

1.  Miraculously Restore Endothelial Function.  The endothelium.  For most guys, that’s the most important tissue in the body, because it pumps out nitric oxide and allows arteries to expand and erections to occur.  And it is the endothelium that steadily gets damaged with a modern lifestyle, leaving many guys with erectile dysfunction and heart disease. I’ll let one set of study authors speak for themselves: “Our results indicate that regular aerobic exercise can prevent the age-associated loss in endothelium-dependent vasodilation and restore levels in previously sedentary middle aged and older healthy men.” [4]

2.  Nitric Oxide and Blood Flow.  One study of Japanese men and women found just what the doctor ordered:  walking 5-7 times per week briskly for 30 minutes significantly increased nitric oxide. [2]Yes, a simple 30 minute walk does the same thing Viagra does and, like Viagra, the study authors found that walking increased forearm blood flow.  In other words, more blood was moving and you can bet that’s better for erections. And one thing that is critical to note:  just 30 minutes per day provided excellent results.  Imagine what an hour a day will do…

3.  Blood Pressure.  One of the biggest enemies of erections is high blood pressure and research has shown that walking lowers blood pressure. For example, one study found that folks with mild hypertension who did 10,000 or more steps per day lowered their systolic blood pressure by an average of 10 points (from 149 to 139). [3]  Keep in mind that lowering blood pressure always means that your arteries, including the ones to your penis, are opening up and expanding and letting blood flow where it should.

The study authors were clear that it did not matter how long or how hard the individuals exercise:  they still got a dramatic lowering of blood pressure. In other words, you do not have to exercise hard to stay hard! You might want to read my link on Blood Pressure and Erectile Dysfunction for more details.

So the bottom line is that you don’t have to be gym rat like me and risk life and limb fighting gravity with heavy bars and steel plates.  Nor do you have to set up an elaborate marathon schedule.

Really you just need to open your front door and put one foot in front of the other.  It’s really that simple…

Excitotoxin Syndrome - Peak Testosterone

There’s a lot of you out there that feel like crap and you have no idea why or how or when it happened.  You’re tired all the time; you ache all over; your joints and muscles hurt; you feel like you are walking around in a fog. To your dismay you find that the doctors are little to no help and sometimes suggest that you’re “depressed” or “stressed” instead of offering any real solutions.  Well, I want you to know that these symptoms are a plague in Western societies and you are not alone.  Doctors, generally smart and well-intentioned, just can’t know everything.  And so I want to hopefully help a good percentage of you out there with these general Feel Like Crap symptoms.

First of all, all of the above symptoms can be caused by Low Testosterone or hypothyroidism as my well-rounded and well-read readers already know.  So if you hurt all over, can’t concentrate and are incredibly fatigued most of the day, then do your due diligence and get tested.  But some of you may have been tested for thyroid and testosterone and had fairly reasonable readings and so you are left without answers.

Well, there is another avenue that you may need to travel down as well:  Excitoxin Syndrome. I have told many people about Excitotoxins and the dangers of diet drinks such as Diet Coke and Diet Pepsi.  Most of the time their comment is something similar to this:

Interestingly enough, mild to moderately low dopamine levels have been found in CFS (Chronic Fatigue Syndrome) patients. [1]  This has not been supported yet by any epidemiological studies that I know of, but it is very likely Excitotoxin-induced damage to the hypothalamus can lead to low dopamine levels which in turn can lead to Fibromyalgia/CFS-like symptoms.  Excess glutamate depletes glutathione, which can lead to neuronal damage. And, sure enough, one study that clearly indicates this is a study where women who had been consuming excitoxins in the form of diet drinks were taken off of the diet drinks (and other excitotoxins) and had a complete recovery from their fibromyalgia! [2]

It is important to point out that the authors did not say that all fibromyalgia is caused by excitotoxins.  But they clearly stated in my opinion that a certain percentage of fibromyalgia was caused almost strictly by this excitotoxin syndrome and could be dramatically cured through removal of the dietary excitotoxins: “the elimination of MSG and other excitotoxins from the diets of patients with fibromyalgia offers a benign treatment option that has the potential for dramatic results in a subset of patients”.

The may also be a non-excitotoxin related reason for some of the standard symptoms as well:  one animal study shows that aspartame consumption by animals resulted in a dangerous build-up of formaldehyde.  Ingested aspartame, the artificial sweetener in diet Coke and Pepsi and Nutrasweet, breaks down into various nasty compounds such as methanol (“wood alcohol”) and the excitotoxin aspartic acid. Just as bad, the methanol then breakes down into formaldehyde, which is an extreme tissue irritant and is associated with retinal damage and birth defects. Another big concern with formaldehyde is that is not easily eliminated from the body and, sure enough, one animal study showed just such a dangerous build-up of formaldehyde in tissues. [3]

Regardless of whether it is hypothalamus damage, neurotoxicity or formaldehyde build-up, consumption of Excitotoxins can lead to the typical Excitotoxin Syndrome symptoms that are so closely related to Chronic Fatigue Syndrome and Fibromyalgia.

REFERENCES:

1)  J of Chronic Fatigue Syndrome, 1998, 4(2):3-22

2) The Annals of Pharmacotherapy, 2001, 35(6):702-706, Relief of fibromyalgia symptoms following discontinuation of dietary excitotoxins, JD Smith, CM Terpening, SO Schmidt, and JG Gums 1998

3) Life Sciences, 63(5):337f, “Formaldehyde Derived From Dietary Aspartame Binds to Tissue Components in vivo”

“But why would they do this to us knowingly?”

or

“The evidence can’t be that strong or they would allow it.”

Sorry, but this is one time where the world has gone crazy mad and dangerous.  Excitotoxins  wreak their havoc through a variety of pathways.  First of all, we have discussed how they go straight into the hypothalamus and alter negatively the hormonal factors that the hypothalamus secretes to the pituitary and thyroid.  And hypogonadalism (low testosterone) and hypothyroidism (low thyroid) will make you feel like Crap.

But there are several other key reasons that Excitoxins probably create the CFS/Fibromyalgia-like symptoms:  the hypothalamus is the dopamine manufacturer for your body.  Dopamine is the neurotransmitter most responsible for the highs and rushes that we as males so enjoy in life. Both sex, cocaine and other opiates lead to burst of dopamine flooding our brains with pleasure.

Dopamine and Testosterone - Peak Testosterone

Testosterone and dopamine are intimately connected in a bidirectional relationship. Testosterone regulates dopamine and dopamine testosterone. Because many of the men that show up to my site are low testosterone, I want to start with the research that shows that testosterone profoundly affects brain dopamine levels. Testosterone profoundly affects many other neurotransmitters as well, which I over in my link on Testosterone and the Brain.

Here are three keys ways that testosterone and dopamine influence each other:

1. MPOA (Medial Preoptic Area). This region of the brain sits near the hippocampus and is critical for the bedroom. If this area is injured, animal studies show that no copulation will occur. And one study in rats showed this by microinjecting dopamine stimulators into the MPOA, which increased mountings, and dopamine suppressors, which did the opposite. [1] Therefore, it is obviously dopamine in this region that is one of the key gatekeepers.

What testosterone have to do with this?  Research, again in animals, has shown that testosterone controls dopamine release in the MPOA. In fact, castrated animals show no interest in mounting and had no dopamine release in the MPOA.  Castrated animals given testosterone, however, would do their duty with a female AND had the necessary dopamine release. [2] The clear takeaway:  testosterone governs dopamine release in key areas of the brain.

2.  Low Testosterone Can Destroy Dopamine. So testosterone can stimulate release of brain dopamine and low testosterone can inhibit it.  However, preliminary evidence shows that low testosterone can have a much more nefarious side and may play a role in Parkinson’s Disease.  Of course, Parkinson’s is the well-known condition that afflicts over a million people and is characterized by muscle rigidity and tremors due to loss of brain dopamine levels.

What researchers at Rush University Medical School found out is that mice who suddenly lost their testosterone had a rapid rise in iNOS levels.  Many of you are familiar with eNOS, which is the endothelial nitric oxide synthase that Viagra and Cialis act on and which dilates your arteries.  iNOS, inducible nitric oxide synthase, is its less well-known cousin and is involved in immune and inflammation response.

1)  Physiology and Behavior, 2005, 86:356-368, “Dopamine, the medial preoptic area, and male s_xual behavior”

2) Hormones and Behavior, May 2001, 39(3):216-224, “Testosterone Restoration of Copulatory Behavior Correlates with Medial Preoptic Dopamine Release in Castrated Male Rats”

3) J Neurol Neurosurg Psychiatry, 2004 Apr;75(4):637-9, “Are men at greater risk for Parkinson’s disease than women?”

4) https://www.rush.edu/webapps/MEDREL/servlet/NewsRelease?id=1712, Rush University Medical Center press release, July 26, 2013,  “Sudden Decline in Testosterone May Cause Parkinson s Disease Symptoms in Men”

5) Arch Neurol, 2002, 59(5):807-811, “Refractory Nonmotor Symptoms in Male Patients With Parkinson Disease Due to Testosterone Deficiency”

6) Journal of Clinical Neuroscience, Jan 2006, 13(1):133 136, “Testosterone improves motor function in Parkinson s disease”

7) Endocrinology, 1992 Jul, 131(1):395-9, “Role of dopamine in the regulation of gonadotropin-releasing hormone in the male rat brain as studied by in situ hybridization”

iNOS is known for releasing large amounts of nitric oxide as a defensive tactic.  Nitric oxide is a free radical that can be used as a weapon and, therefore, sudden low testosterone essentially puts a huge oxidative load on the brain and may actually do some damage that leads to Parkinson’s. [4] A further verification of this is the fact that, according to one study, men are 1.5 times more likely to contract Parkinson’s and that low testosterone levels have been associated with Parkinson’s. [3][6] In addition, giving male Parkinson’s patients testosterone can help with tremors. [5]

NOTE:  It is important to point out that there have been other key factors identified in the progression of Parkinson’s, including copper and pesticides.  I cover the latter in my link on Pesticides and Parkinson’s.

It is also VERY important to note that testosterone’s impact on the male brain is extraordinarily profound.  I know that when I got my first testosterone cypionate injections, I felt like “fireworks” were going off in my brain.  Low testosterone is linked with depression, mood disturbances, fatiuge, anxiety, decreased working memory, mental fog and on and on the list goes.

Yes, testosterone is the Bedroom Hormone.  Yes, testosterone is the Muscle Hormone.  But, more than that, testosterone is the Brain Hormone.

Here are a few links that may be of interest:  Testosterone and Depression, Testosterone and Mood and . Finally, you may also want to check out my link on Natural Dopamine Increasers as well.

REFERENCES:

Libido and Testosterone - Peak Testosterone

When it comes to libido and sexual desire, you have no truer friend than testosterone. Study after study on rams, sheep, rats, mice and a lot of other animals have shown just how strongly testosterone and libido are related.  I quite often get letters from wives saying things like, “My hubbie is lethargic, anxious and has almost no libido.  Could that have to do with his low testosterone?”  The answer, of course, is a definite ‘yes’!

Many studies have shown that testosterone affects mood, cognition and mental function in men.  Sexual desire is no exception.  One urological journal summarized by saying that testosterone enhances libido, frequency of sexual acts and sleep-related erections. [1]  “Enhances” is an understatement if we’ve ever heard one and that’s especially true if you have low testosterone. Several studies have shown that low testosterone is a powerful desire-killer. [2]

Furthermore, several studies have also shown that testosterone therapy can have profound sexual desire-boosting powers in hypogonadal men.  In fact, one of the most interesting ones was a study of low T senior men with erectile dysfunction.  About half of them had their erectile dysfunction greatly improved through testosterone therapy. However, what is remarkable is that 100% of the men experienced dramatic improvements in libido from the testosterone.[3]

1)  WORLD JOURNAL OF UROLOGY, 15(1):21-26, “The effects of testosterone on the cavernous tissue and erectile function”

2) Am J Psychiatry, 155:1310-1318, Oct 1998, “Age-Associated Testosterone Decline in Men: Clinical Issues for Psychiatry”

3) The Journal of Sexual Medicine, Mar 2007, 4(2):497-501, “Improvement of Sexual Function in Men with Late-Onset Hypogonadism Treated with Testosterone Only”

4) The Aging Male, Jun 2003, 6(2):94-99, “Oral testosterone undecanoate reverses erectile dysfunction associated with diabetes mellitus in patients failing on sildenafil citrate therapy alone”

5) Int J STD AIDS, 1998, 9:41-44, “Testosterone therapy for clinical symptoms of hypogonadism in eugonadal men with AIDS”

6) Mayo Clinic Proceedings, Jan 2007,82(1):20-28, “Testosterone Use in Men With Sexual Dysfunction: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials”

7) The Journal of Clinical Endocrinology & Metabolism, Jul 1 2005 90(7)7:3838-3846, “Dose-Dependent Effects of Testosterone on Sexual Function, Mood, and Visuospatial Cognition in Older Men”

8) J Clin Endocrinol Metab, 2006 Jul, 91(7):2509-13. Epub 2006 May 2, “The relationship between libido and testosterone levels in aging men”

NOTE: This same study showed that a significant percentage of men took 12-24 weeks to experience the effects.  In other words, it takes time to rebuild receptors and tissues and if you “don’t feel anything right away,” that doesn’t mean that nothing is happening.

Does HRT help everyone?  Well, you can never say always.  However, it has helped some categories that most would consider very tough to treat or cure.  For example, diabetics who are non-responders to Viagra were helped significantly with sexual desire [4] as have HIV patients with normal testosterone. [5]

Other research, though, has shown a much more “linear” relationship between libido and testosterone.  For example, one study of senior men showed that libido followed a nearly linear progression across all ranges of testosterone. [7].  In this case, they took senior men between the ages of 60 and 75 and then reset their testosterone production almost to zero through a pharmaceutical GnRH agonist.  They then gave these men varying dosages of testosterone and found that, in men that were sexually active, the more the testosterone, the greater the libido.

This is called “dose dependency” and is a sign that there is a strong correlation between two variables, in this case testosterone and libido.  The study also found that waking erections and sexual function were also dose dependent.

Other studies have shown somewhat similar results.  A study of community-dwelling seniors ordered men by a 14-point scale on libido and found that “analyses indicated a 3.4 ng/dl (0.12 nmol/liter) increase in total T per unit increase in libido.” [8] So almost all men will find that their libido is influenced by testosterone, but those with low testosterone will likely have the most noticeable effect.

Hair Testing and Mercury (Example Provided) - Peak Testosterone

DISCOVERY and ANALYSIS: To actually find out if you are (probably) overloaded with mercury, you can start with a hair analysis test.  Strangely enough, you cannot just look at the hair test results and go by whether or not you are high in mercury or not.  The reason for this is simple:  high mercury individuals usually do not have high plasma levels of mercury.  The mercury is stored in various tissues, particularly the brain, where it often wreaks havoc for decades.

So how do you diagnose elevated tissue mercury then?  It turns out that you can look at something called “mineral transport.” Mercury attaches to many enzmymes and thus disrupts the body’s handling of minerals and metals and so you typically end up with numbers or patterns that do not fit the general populace.  Dr. Cutler’s claim to fame is that he came up with a way to estimate the extent of this disruption based on hair test results.

To show you how useful this can be, I’ve shown my wife’s hair test results below.  Note that the front end lab company that we used was Direct Labs, who mailed us out a hair test kit.  The name of the test was “Hair Toxic & Essential Elements-DD KIT” for those interested.  We cut samples of my wife’s hair and mailed it in the prepaid envelope. where it ends up in well-known hair analysis lab called Doctor’s Data.  Doctor’s Data then sends the lab results back to Direct Labs, who posts it on their web site for your or your practitioner’s review.  (I do not have any affiliation with Dr. Cutler, Direct Labs or Doctor’s Data.)

MY WIFE – MERCURY OVERLOAD? Doctor’s Data displays your hair test results in tabular and bar graph form as shown below.  It seems incredibly straightforward on the surface of it.  For example, check out my wife’s results below from July of 2015:

So all you have to do is look at what is low and what is high and you’re done, right? Unfortunately, it is not that easy.  Again, what you actually have to do is see if you have an unusual pattern of mineral and metal levels.  This then effectively tells you if you have dysfunctional mineral transport and likely are struggling with mercury overload.  Dr. Cutler goes into great detail in his book Hair Test Interpretation about how to do this and has basically has four rules that look for abnormally low / high values, abnormally “dead” values, and then a fifth one that covers the grey areas.  While it is true that his books are expensive, he also has made it available free online.

Of course, just a casual look at my wife’s results and it becomes apparent that she seems to have many extreme values, especially in the bottom section called “Essential and Other Elements.”  (This is actually the only section used for Cutler’s Five Rules for Deranged Mineral Transport.)  She has four values (calcium, magnesium, lithium and strontium) that are all in the red zone.  This violates Cutler’s Rule #3 and indicates mineral transport issues.

Does it makes sense that my wife could have a heavy mercury burden?  Absolutely and here is why:

a) She had a mouthful (five) of mercury fillings and had them removed about 10 years ago.

b) When they removed the fillings, they did not do anything special to protect her from the vapor.

c) Mercury that settles in brain tissue in particular can become trapped in neurons and cause issues for decades.  In other words, even though it had been ten years does not mean she was “out of the woods,” because she had never been chelated.

So are the results conclusive?  Are we going to talk someone about chelation or use Dr. Cutler’s protocol?  Unfortunately, two of her four extreme values (calcium and strontium) are, according to the inforation Doctor’s Data sends in their lab results, common in hair products.  Therefore, there is a chance that the hair samples were contaminated even after the washing that the lab does.  We decided that she would not do anything to her hair for several months and then we would retest, since it would not be at all surprising if she had high levels of stored mercury.

NOTE: I am NOT a doctor or a researcher.  This information is strictly to make men aware of the toxicity issues out there and to start investigating their own health as my wife and I have already started doing.  Your plan should be to a) get informed, b) get a good doctor (or naturopath) and c) work with him or her.

Ever wonder WHY your hormones are low and out of alignment?  Or you may have noticed a time when your health and energy seemed to inexplicably go downhill and you’re not sure why?  One of the grossly undertreated and surprisingly common reasons is undoubtedly related to  heavy metal overloads, particularly mercury.  This is something completely ignored by the vast majority of physicians here in the U.S.  I am 55, and I have never had a physician test for heavy metal exposure.

So why is it important to look for mercury overload?

Reason #1.  It is surprisingly common, mostly due to mercury (metal) fillings and thimerosol exposure.  Estimates range between 1% and 5% of men.

Reason #2.  Symptoms of mercury overload (and other heavy metals and nutritional deficiencies) can lead to symptoms very similar to low testosterone.

Reason #3.  High enough levels of mercury can actually lower testosterone levels and lead to hypothyroidism.  (See my page on Testosterone and Mercury for some examples.)

Reason #4. Mercury gets trapped in neurons behind the blood brain barrier and does not often come out easily unless “coaxed.”  Mercury overload thus affects millions of men for decades.

Even worse, until recently the general public simply did not have access to testing or inexpensive, non-invasive protocols.  Doctors will not test for it, except in rare and extreme cases, and costs for many of the standard lab tests are very expensive.  However, that all changed here in the U.S. when hair testing became publicly available and general knowledge about the subject began to spread.  Now you can get hair testing done at a top notch lab, check out your results and then bring it a practitioner. Furthermore, there are great lay textbooks out there which can give you an incredible background in mercury and how to deal with it.  Probably the most well-know of these books is Hair Test Interpretation and Amalgam Illness, Diagnosis and Treatment by Dr. Andrew Hall Cutler.  Be forewarned that these are not light reading however!  (His Ph.D. is in Chemistry.)

NOTE:  Many PCPs (primary care physicians) will criticize hair testing, even though they know next to nothing about it.  I will include many case studies, if I may use the term, in my link Hair Testing Summary Page that hopefully will convince you that hair testing can be both practical and potentially life (and hormone) saving.

Review of the Berkeley Nitric Oxide Test Strips

A. The underlying science for both strips is relatively the same. We touch upon it in detail in our FAQ section and provide scientific papers on clinical studies (see FAQ and Scientific Articles at Berkeley Test).

The patent pending strips by Berkeley Test is different in the following ways from that of Neogenis’:

* First, Berkeley Test is very affordable. This is relevant for those monitoring their own levels on a frequent basis, i.e., multi-daily testing, in order to make dietary adjustments. At present, the Amazon retail pricing is less than 70-cents compared to Neogenis , which is about three times as much, presently $2.10. In working with corporate wellness programs and educational organizations, Berkeley Test provide significant discount to encourage heart healthy meals enriched with leafy greens, vegetables, and fruits.

* Second, Berkeley Test is much easier to use. We have an absorption pad and test pad on the opposite sides for the strip; the absorption pad allows you to easily collect the saliva from your mouth and then you simply fold it over to make contact with the test pad. Feedback from elite athletes (see our   Berkeley Test All-stars) and senior residences at an independent living facility find the absorption pad was very important to them; they did not like using Neogenis because you have to use your finger to apply the saliva.

* Third, Berkeley Test provides packets of 50 and 10 strips per packets as well as individually sealed for corporate wellness and educational programs and other partners interested in validating nitric oxide potent foods. Surprisingly, we found it made a significant difference for different types of individuals. For example, some of the power users love the 50 packet because they use it 2-3 times a day, hence, the 50 packet per month makes economic sense. Whereas other simply want to check once to every other day, therefore, they like the 5-day packet of 10 strips. And now we are finding some of our partners want large orders of the individually sealed strips to give out to their employees to encourage health healthy lunches.

NOTE: For additional information, see my pages on Nitric Oxide Replacement Therapy.

Q. Can you please share what you were going to say about the sensitivity of the strips? I have gotten many questions about Neogenis products on the Forum and so it will be very helpful if I can explain some details about your strips?

A. The current sensitivity of both strips is relatively the same; in short, the underlying test is functionally the same. The Berkeley Test strip is reflective of total body status of nitric oxide derived from both endothelial nitric oxide synthesis and the bioconversion from dietary sources, ie, nitric oxide-potent beets, spinach, among other leafy greens.

Q. Can the Test Strips be used to test the effectiveness of dietary and supplement modifications that one has made in order to improve his nitric oxide status?

A. Philosophically, we are advocates of natural whole food approaches in elevating nitric oxide levels. We receive a lot of email of appreciation ranging from: Berkeley is an effective compliance tool to keep me on my DASH diet to Berkeley strips remind me to incorporate multiple leafy green servings into my meals to Berkeley strips are a great Game to get my kids to eat their salads and so on.

More recently, we are finding users are finding that Berkeley Test is effective at screening for nitric oxide supplements. We are not against nitric oxide supplements, but we receive a lot more emails from folks who tell us about nitric oxide supplements that are bogus or don’t come close to raising my levels compared to spinach and so on. We recommend that if you are unclear about the effectiveness of your nitric oxide supplements compare them to Mediterranean salad rich in arugula, beets, and spinach or an all-natural beet root juice from a reliable source 2 hrs afterwards. We continue to search for a high quality all-natural ingredient alternatives.

A. As a follow up to our previous response, in our opinion, which is reinforced by the current biomedical literature and scientific clinical correlates, a natural source delivered through vegetables and fruits is a very effective and safe way to elevate nitric oxide via the non-nitric oxide synthase pathway. Natural whole foods is both an effective and safe way to elevate nitric oxide as reviewed by Lundberg at the Karolinski Institute.

Q. Why do you emphasize the DASH Diet out of curiosity? There are many great diets out there – why specifically the DASH?

A. Your point is very good and your observation that we tend to selectively push DASH is correct; actually, there are a number of well-characterized heart healthy plant-based diets that are very effective at elevating nitric oxide in the body.

With that said, the reason for emphasizing DASH is because of how well characterized the diet is as it relates to potentiating nitric oxide levels in context of the underlying nitric oxide benefit to reduce hypertension.

From a practical standpoint, we see how effective the strips have been at influencing dietary lifestyle changes for the better, ie, DASH compliance. Based on a very large number of emails, we see the strips bringing heart healthy foods, repeatedly, into one’s daily meals.

Q. You (and Dr. Bryan) have mentioned that the best time to test your NO is really in the morning right when you wake up to get a baseline reading. However, can you really measure this with the strips as they stand now since they’re not really measuring true endothelial NO, just a correlate? Plus, if you ate some nitrates at 8 pm, aren’t they completely out of your system by the time you wake up the morning?

A. Berkeley Test strips are reflective of the total nitric oxide bioactivity and bioavailability. For the vast majority of users, early morning readings provides a relative baseline and then measuring at various time points after eating foods presumably rich in nitric oxide potency will give you feedback as to when your levels have peaked. Depending on the food source and amount as well as the frequency of eating will influence your levels throughout the day. And for some elite athletes versus sedentary individual, we find levels will vary dramatically. However, it is not usual to see peak levels within 2-3 hrs after eating a spinach-beet salad.

Q. You mentioned that nitrites can “build up” in your system I believe? In other words, a man might have to eat nitrate-based foods for a few days. I thought nitrites were short-lived or is that just NO itself? Or did you mean that one’s responsiveness to nitrites has to build up?

A. Nitric oxide is measured in milliseconds, and nitrite is in constant flux with nitrate, which is relatively stable. But keep in mind, the flux for both nitrate and nitrite is influenced by a number of factors, i.e., high intensity training causing pH changes which influences nitrite reduction, the amount of XOR in RBC, i.e., pre-hypertensive are higher in XOR, therefore may be more effective in reducing nitrate, frequency of eating nitric oxide-potent foods as well as the amount and type of nitrate rich foods, and so on.

However, I think a reasonable rule of thumb is that the current strips provide a snapshot of one’s nitric oxide bioavailablity and bioactivity within the body. Based on clinical correlates, saliva levels serve as a meaningful biomarker of the nitric oxide benefits derived from natural whole foods diet rich with nitric oxide-potent leafy greens and beets.

Q. How well do your test strips measure arterial (endothelial) nitric oxide?

A. The strips are effective at providing a gauge of total body status. More to your point, the strips are reflective of nitric oxide bioactivity and bioavailability derived from both endogenous, ie, nitric oxide synthase, and exogenous, ie, bioconversion of a dietary source.

From a practical standpoint, we see the strips as an effective means to reinforce the importance of plant-based diets rich in nitric-potent foods. I sense you would agree, especially, for the US, we as a society fall far short of the recommended servings of ‘heart healthy’ vegetables.

Q. Let’s say someone eats a meal that includes a significant amount of beet root juice, spinach or arugula and yet does not register much if any increase on your test strips. What would your reaction be? What could cause this?

If the individual is depleted a few hours after eating a nitrate-rich meal, here are some thoughts: first, antibiotics and/or mouthwash disrupted the microflora in the mouth, second, drug interference, i.e. proton pump antagonist, third, a systemic concern, i.e., poor GI absorption if so, see your doctor, third, you are unusually depleted possibly because of a poor diet if so, please consider seeing a nutritionist and reassess your vegetable and fruit intake and it may take some time to replenish your pools per se. And there are other considerations depending on the individual.

If you encounter such a problem with our strip and simply have a question, please feel free to contact us at info@berkeleytest.com and we will be more than happy to work with you.

Please check Scientific Articles at Berkeley Test.

Prostate and Testosterone - Peak Testosterone

Every male needs to take an aggressive approach to protect himself from prostate cancer. If you’ve grown up in a Western society, then you have spent decades eating beef (especially) and other meats cooked at high temperatures.  That delicious black residue on your meat is filled with various cancer causing agents such as HCA’s (heterocyclic amines) that head straight for your prostate. (The typical fast food burger, that we literally live and die for, is loaded with the stuff.)Many aspects of the Western lifestyle increase risk for prostate cancer and current lifetime estimates are 16%. [36]  

Many of you have also consumed huge amounts of dairy – another huge risk factor for prostate cancer. Again, to protect yourself from prostate cancer, you have to realize that you have no time to waste:  the “seeds of destruction” have already been planted through significant free radical and DNA destruction inside the delicate tissue of your prostate. In addition, many of you are overweight, which puts a significant and potentially deadly estrogen load on your prostate.

NOTE:  You should also check out my page How to Lower Your PSA, which shows the latest research on how to lower your PSA, and my page that discusses the research on Does Testosterone Therapy (TRT) Cause Prostate Cancer?.

But the good news is that research has shown us that you can drastically lower your odds of prostate cancer through simple dietary and lifestyle measures. I’ve listed below some of the most critical foods that you can eat (or avoid in some cases) to very significantly protect yourself from prostate cancer.

1) Men s Health 9/05 p 74

2) Science,Jan 23 1998,279:563-66

3) JAMA, 2004,291:1578-86

4)  PNAS, June 17, 2008,105(24):8369-8374

5) Cancer Epidemiol Biomarkers Prev,2006,15(2):203-10

6) Cancer Research, Jun 1 2008,68:438

7) Journal Nutrition, 136:2813-2819, 2006

8) Am J Clin Nutr, 2007 Nov, 86(5):1420-5

9) Amer Jour Epidemiology, 163:989-996, 2006

10) J Nat Canc Inst,2007,99:1200-1209

11) Cancer Res 2007 Mar1,67(5):2239-46;J Biol Canc,2005 Mar 11,280(10):8756-64

12) Cancer Causes Control,2002 Dec,13(10):947-55

13) Clin Cancer Res,Jul 1 2006,12(13):4018-26

14) Proc Natl Acad Sci USA. 2005 Oct 11;102(41):14813-8

15) Cancer Epidemiol Biomarkers Prev,2007,16:63-69

16) Jour Clin Invest 117(7):1866-1875, Jul 2 2007

17) Amer Jour Clin Nutr 2007,85:523-9

18) Cancer, Epidemiology, Biomarkers Preview, v.6, 1997, p967-9

19) Prostate, v.27, 1995, p. 25-31

20) Journal of Clinical Endocrinology and Metabolism, v82, 1997, p571-5

21) Int l Journal of Andrology, v.25,2002, p119-125

22) Cancer Research v.59,1999, p4161-4; Amer Journal of Clinical Oncology v20,1997,p605-8;Journal of urology, v163, 2000,p824-7; Prostate v47, 2001, p52-8; Journal of the American medical Assoc, v276, 1996, p1904-6

23) Am J Clin Nutr. 2007 Feb;85(2):523-9

24) UUrology,2007,70:672-676

25) Amer J of Epidem,2008,167(1):71-77

26) PLoS ONE, 2008, 3(7):e2568

27) Cancer Epidemiology, Biomarkers & Prev, Nov 1, 2007, 16:2213, “Cholesterol-Lowering Drugs and Advanced Prostate Cancer Incidence in a Large U.S. Cohort”

28) Cancer Epidemiol Biomarkers Prev 2009, 18:2807-2813, “Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the Prostate Cancer Prevention Trial”

29) Cancer Epidemiol Biomarkers Prev 2009; 18:2814-2821, “Prediagnostic total and high-density lipoprotein cholesterol and risk of cancer”

Cancer Epidemiol Biomarkers Prev, 2009;18:2805-2806, 2807-2813, 2814-2821

31) Harvard Men’s Health Watch, June 2007

32) CA Cancer J Clin, 2004, 54:68,”TOMATOES BEAT LYCOPENE ALONE FOR PROSTATE CANCER PROTECTION”, https://caonline.amcancersoc.org/cgi/content/full/54/2/68

33) https://www.northwestern.edu/ newscenter/stories/2010/11/soy-prostate-cancer.html, Northwestern University Newscenter, Nov 8 2010, “Soy May Stop Prostate Cancer Spread: Experimental soy-based drug shows benefits in men with localized prostate cancer”

34) The Lancet, 1 January 2011, 377(9759):31-41,”Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials”

35) https://www.dailymail.co.uk/health/article-2359466/Taking-omega-3-fish-oil-supplements-increase-risk-aggressive-prostate-cancer-70.html

36) JAMA, 2011, 306(14):1549-1556, “Vitamin E and the Risk of Prostate Cancer The Selenium and Vitamin E Cancer Prevention Trial (SELECT)”

37) J Natl Cancer Inst, 2000 Dec 20, 92(24):2018-23, “Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer”

38) https://www.medicalnewstoday.com/articles/260338.php

Another huge question in the minds of many males is “will HRT (testosterone supplementation) put me at risk for prostate cancer”?  Several large, well done studies – see below – have showed this not to be the case.  Talk to your doctor, of course, but the evidence looks very positive for testosterone therapy.

Below are several studies that show normal testosterone levels and supplementation are actually healthy for the prostate:

You may have a concern if you have heard or read that sometimes doctors will treat certain prostate cancers by decreasing androgens, i.e. signficantly lowering testosterone.  The reason that this is done is that testosterone actually suppresses t-lymphocyte immune response.  So some doctors feel that your body can more aggressively attack the prostate cancer with testosterone out of the way. As a side note, this may be why females more frequently develop autoimmune diseases:  their immune response in some cases may be too strong due to a lack of testosterone.

Benign Prostate Hypertrophy (BPH)

One other worthy subject with regards to the prostate is protecting yourself against prostate enlargement, which leads to difficulty urinating and a host of other problems.. Current research shows that vegetables, in particular, protect against BPH. One recent study [23] showed that vegetables rich in lutein, beta-carotene and Vitamin C were particularly protective.  (Note:  Fruit consumption did NOT correlate with increased protection from BPH. Furthermore, getting these nutrients from supplements did not correlate well either.) But most protective are actually onions and garlic.  In one 2007 study onions decreased the risk of BPH by 60% and garlic by 30%. [24]  For more information, please read this link on Protecting Your Prostate from BPH.

Appetite and Food

You know the old saying: “Life is a lot easier if you don’t fight your hormones”.  It’s like swimming upstream if you don’t cooperate these powerful chemical messengers.  This is nowhere better shown than in the weight loss and dieting arenas.  We have already covered how many people fail at dieting because they ignore How Neurotransmitters are Involved in Weight Loss.  The same holds true for hormones as well.

As with almost everything else health-related, it is much, much more easy if you are willing to learn a little of the science involved.  You don’t need a Ph. D. – you just need to take the time to hearn a few basic facts.

Of course, if you exercise hard enough and have steely discipline, you will lose weight no matter what you do.  But with our busy and stressful lives, who can exercise for hours or be masochistically ascetic about anything?

A more realistic route to weight loss is through moderate excercise and moderate reduction in calories coupled with some basic hormonal knowledge that will make your life much easier.  Here’s a few tips about your hormones that will make it much easier for you win the battle of the bulge:

1)  Gherlin.  One of the most important appetite-controllers is gherlin.  Lack of sleep will significantly increase your gherlin levels and increase your appetite, particularly for fatty foods.  Have you ever noticed that when you are tired you want to eat and eat in order to “comfort” yourself?  Well, you’re just obeying your own hormones.  So here is the key:  get enough sleep.

2)  Leptin. Another appetite-related hormone is leptin.  Leptin is significantly decreased by lack of sleep, a fact that will send you in your weakened state repeatedly to the refrigerator and snack machine.  Again, sleep is critical.  By the way, researchers have also found that sugar and corn syrup also whack leptin, so keep the sugars lean and low. CAUTION: Researchers have found that mild stress resulting from an “enriched social, physical and mental environment” ends up decreasing leptin levels, which of course could increase appetite. [13]   However, this same study found that leptin also causes cancer to thrive and grow and was linked to increased risk of colon and skin cancer.

3) Cortisol.  Lack of sleep can also increase cortisol, which will fight any fat loss you are attempting every step of the way.  “Work smarter, not harder” mean controlling this dietary bad boy.  Highcortisol causes you to crave both high fat and high sugar foods.  One way cortisol does this is by stimulating release of galanin, a neurotransmitter that triggers for fat in particular.  Even worse, you midsection has a very hgih level of cortisol receptors, which means that stress will actually cause you to deposit more fat right around your stomach.  One might call cortisol the Spare Tire Inflator, eh?

Of course, it’s not just lack of sleep that can increase cortisol.  As we cover in our page on Stress, many other factors such as depression or a nasty boss will do the same thing.  Again, see my link on Stress for some practical ways to lower cortisol.

I hope you noticed that all three of the above hormones are ALL affected by lack of sleep.  The bottom line is that will be very difficult for you to lose weight, unless you are a highly disciplined person, unless you are getting adequate sleep.

Remember:  hormones are your friends.  Don’t fight your friends…

Pesticides, Brain Damage, ADHD and Dopamine - Peak Testosterone

I just read an article describing how researchers have identified that the epidemic of ADHD in America is actually related to a lack of dopamine. [1] Kids who have low levels of dopamine in the brain, which is what this article is discussing, have difficulty concentrating, thus the ADHD diagnosis.  Yes, they can concentrate if you give them something particularly engaging, such as a computer game or something similar.  But a lack of concentration and focus is their struggle.

Dopamine is actually produced in two primary locations in the body:  the almond-sized hypothalamus, as a neurohormone, and the substantia nigra as a neurotransmitter. Dopamine cannot pass the blood brain barrier so the two are largely separate systems. Sadly, both sources of dopamine are under attack.  As we cover in other links, the hypothalamus is hit hard by excitotoxins, creating a host of maladies.

Here I want to cover how dopamine in the substantia nigra is under attack from a different set of substances:  pesticides.  Many studies have shown that pesticides are correlated to damage of the substantia negra and are a significant factor in Parkinson’s, the “Michael J. Fox” syndrome with tremors and muscle rigidity.

For example, one 2007 study found that Parkinson’s was correlated in individuals who reported pesticide exposure and to certain pesticides. [2]  Another Mayo Clinic study published shortly after found something similar:  Parkinson’s was significantly associated with pesticide/herbicide exposure. [3]  And, as I mentioned in another link, one recent meta-analysis found that Vietnam vets exposed to Agent Orange and other herbicides  had an increased rate of Parkinson’s (and ischemic heart disease). [4]

Scientists took this a step further and examined a specific pesticide called chlorpyriphos on inner city children. [5] Their results showed clearly that chlorphyriphos exposure was correlated to ADHD. In other words, just one pesticide was able to very likely damage the brain enough to decrease dopamine and lead to classic ADHD symptoms.  What are we doing to ourselves?

An even more toxic example is dieldrin, a DDT alternative, which has a study showing it increases oxidative stress, lowers dopamine levels and is likely a cause of Parkinson’s Disease. [6]  Furthermore, it has induced liver and hepatocellular cancers. [7]  Even worse, it is not biodegradable.  It has been banned for decades yet still persists in our food supply like radioactive waste.

NEWS FLASH:  Chemicals in the environment are also be sabotaging our neurons as well.  Researchers recently found that TCE (trichloroethylene), a very common chemical abundant in our environment (and in much of our drinking water supplies), is strongly linked to Parkinson’s. [8] It is almost impossible to get away from TCE as it is used in dry-cleaning, carpet cleaners, paints, glues and degreasing agents.

SOLUTIONS? Researchers are hoping a new “maintenance” drug called isadiprine can protect us from Parkinson’s and it should be in phase II trails as I write this. Parkinson’s is actually likely partly genetic – they have found gene(s) that are strongly correlated – and environmental, i.e. pesticides, herbicides and other chemicals that we do not know about yet. However, I would argue that eating organic as much as possible would be wise until we better understand just what we are doing to our bodies.

There is also a Russian antihistamine (latrepirdine) of all things, that is holding great promise in the treatment of both Alzheimers and Parkinsons. []

REFERENCES:

1) Nora D. Volkow, M.D., director, U.S. National Institute on Drug Abuse, Bethesda, Md.; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Schneider Children’s Hospital, New Hyde Park, N.Y.; Sept. 9, 2009, Journal of the American Medical Association

2) Amer J of Epidemiology, 2007, 165(4):364-374,”Pesticide Exposure and Self-reported Parkinson’s Disease in the Agricultural Health Study”

3) Neurology, 2008, 70:1461-1469, “Synuclein, pesticides, and Parkinson disease: A case control study”

4) National Acad of Sciences, July 24 2009, “LIMITED DATA SUGGEST POSSIBLE ASSOCIATION BETWEEN AGENT ORANGE EXPOSURE AND ISCHEMIC HEART DISEASE AND PARKINSON’S DISEASE IN VIETNAM VETERANS”, https://www8.nationalacademies.org/onpinews/newsitem?RecordID=12662

5) Pediatrics, Dec 2006, 118(6):e1845-e1859, “Impact of Prenatal Chlorpyrifos Exposure on Neurodevelopment in the First 3 Years of Life Among Inner-City Children”

6) Exp Neurol, Apr 2007, 204(2): 619 630, “Dieldrin exposure induces oxidative damage in the mouse nigrostriatal dopamine system”

7) Hayes WJ jr. and Laws ET jr. eds. (1991) Handbook of Pesticide Toxicology, Academic Press Inc., San Diego, 732-735, 741, 828, 832, 836-840

8) Annals of Neurology, Article first published online: 14 NOV 2011, “Solvent exposures and parkinson disease risk in twins”

9) https://en.wikipedia.org/wiki/Latrepirdine

Sexercise - Peak Testosterone

What will exercise do for you?  Well, here’s just a few things to think about:  exercise will boost your sex life, improve erectile strength, improve your memory and brain function, build new synapses in your brain, decrease your risk of cardiovascular disease and make your body look twenty plus years younger. Any other questions?!?

I can’t think of anything better for your sex life and erectile strength than exercise.  Other than a Low Fat Diet or possibly a Mediterrean Diet, you can’t beat exercise to boost your bedroom performance. Exercise boosts all the stuff you want for erections, testosterone and nitric oxide for starters, and lowers all the stuff that’s hard on erections – no pun intended – including blood pressure and triglycerides.  The list of benefits could go on and on and I’ve covered that extensively in my link on How Exercise Can Cure Erectile Dysfunction and Improve Your Sex Life.

4) Trends Neurosci,2002,25:295 301; Nature,1995,373:109;Pharmacol Biochem Behav,2004,77:209 220

5) J Appl Physiol,2007,103:1655-1661

6) Hypertension,1999,33:1385-91

7) Experimental Physiology,2005,90(4):645-651

8) Med Sci Sports Exer,2007,39:1714-19

9) Intl J Sports Med,2007,28:815-22

10) Diabetes,1983,32:408-11 Diabetes,1983,32:965-69

11) Am J Physiol Heart Circ Physiol,1997,273:H2186 H2191 Am J Physiol Heart Circ Physiol,2003,284:H970 H978

Archives Intern Med 167:999-1008,2007

14) J Neurosci,2001,21:5678 5684;J Neurosci,2001,21:1628 1634

15) Psychol Sci,2003,14:125 130

16) Kramer AF, Colcombe SJ, Erickson KI, and Paige P. Fitness Training and the Brain: From Molecules to Minds. Proceedings of the 2006 Cognitive Aging Conference, Georgia Institute of Technology, 2006

17) Ann Intern Med,2006,(144):73 81; Am J Epidemiol,2005,161:639 651; Arch Int Med,2001,161:1703 1708; J Am Med Assoc,2004,(292):1454 1461

18) New Engl J of Med,1998,338:94-9

19) JAMA,1998,279:440-4

20) JAMA,2007,298(21):2507-2516

21) Arch Neurol,2001,58:498-504

22) Fitness Rx, 9/08, p. 24.

23) Experimental Physiol, 2007, 93(2):296-302

24) Brit Med J, 2008, 337:a439

26) Psychological Bulletin, Nov 2006, 132(6):866-876, “Effects of Chronic Exercise on Feelings of Energy and Fatigue: A Quantitative Synthesis”

27) Journals of Adolescent Health, Received 3 February 2009; accepted 19 June 2009. published online 18 August 2009, “High Exercise Levels Are Related to Favorable Sleep Patterns and Psychological Functioning in Adolescents: A Comparison of Athletes and Controls”

28) Journal of Sound and Vibration, 28 August 1997, 205(4):393-403, “EFFECT OF DAYTIME EXERCISE ON SLEEP EEG AND SUBJECTIVE SLEEP”

29) Arch Intern Med, 1999 Oct 25, 159(19):2349-56, “Effects of exercise training on older patients with major depression”

30) Psychosom Med, 2000 Sep-Oct, 62(5):633-8, “Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months”

31) Generation Health, Sep 2009, p. 38.

Exercise and Sex

Straight aerobics is also fantastic for the brain:  multiple studies have shown that it raises levels of a brain chemical called BDNF, which can actually promote the formation of new neurons and synapses. [4]  And, by the way, this is NOT just for the young.  Remarkably, the studies show that both young and old can rebuild their brain.

Okay, so we can add new neurons to our brains.  Does that really translate to more brain power?  Can we actually make ourselves smarter through exercise?? The research says, “Yes!”  A large meta-analysis in 2003 showed that found that exercise actually improved many of the cognitive areas in seniors that are most likely to show age-related decline such as planning, scheduling, working memory, inhibitory processes, and multitasking . [15] Furthermore, one recent MRI study of older adults found that exercisers had significant increases in grey matter, i.e. these individuals actually increased their brains! Again, this is seniors we are talking about here. [16]

Anyone who exercises hard and consistently for any length of time can feel this. Endurance training “clears your mind” and makes you ready for action. Men s Health in the October 2005 issue covered this and described it as “the kind of smart that leads to faster and more accurate decision making, yields greater productivity and inspires innovation. If you want to be calculating about it, it s the kind of smart that makes you money.” This same article goes on to document an elite group of corporate executives that enter the CEO Challenge, which is an Ironman Triathlon. Most of these executives believe that exercise completely transformed their careersoup of co and that without it, they would not still be CEOs today.

Those CEOs, who have been doing this for quite awhile, were years ahead of their time:  research is pouring in showing almost unbelievable gains in mental capabilites from exercise.

All of this has been shown in multiple studies.  I cover this in my How to Raise Your Kid’s IQ page.  (See number 9.)

It should not be suprising that exercise is also one of the few proven preventors of Alzheimer’s and dementia.[17] One analysis of the Canadian Study of Health and Aging, for example, found that “Compared with no exercise, physical activity was associated with lower risks of cognitive impairment, Alzheimer disease, and dementia of any type. Significant trends for increased protection with greater physical activity were observed. High levels of physical activity were associated with educed risks of cognitive impairment, Alzheimer disease, dementia of any type”. [21] And this appears, by the way, to occur not just because of exercise’s neuron-building and neuron-promoting properties.  A study at the University of Chicago showed mice that exercised had 80% less Alzheimer’s plaque than mice that did not exercise.

Exercise – Looking Good Again

And don t leave out strength training. It is true that past 40 it’s harder to gain muscle and it takes longer to recover. Is that any shock? Your testosterone isn’t 800 any more, so that shouldn’t surprise you too much. But what you may not realize is that your nightmare is not the fact that you have trouble putting on muscle. Your nightmare is losing muscle.

Each pound of muscle literally burns the fat right off your body. Consider this:  if you add ten pounds of muscle somehow:  it will burn off 62 pounds of fat over the next year! And for anyone past middle age a more relevant comment:  if you let your body lose ten pounds of muscle, you are opening yourself up to potentially gaining 62 pounds of fat unless you drastically change your caloric intake (which requires nerves and discipline of steel).

Check this link out for details:

https://www.askmen.com/sports/bodybuilding_60/92_fitness_tip.html

The major point is that you definitely do not want to lose muscle.  If you do, you will inevitably begin to put on weight more easily because your “metabolism” shifts to where you keep those pounds more easily. For some of you this sounds VERY familiar. Have you ever felt like you just can t lose weight even when you cut back on calories? Well, if you ve lost a lot of your muscle mass, what do you expect? Muscle is your body s fat burner.

So, yes it s time to hit the iron. There are added bonuses by the way. Recent research shows that weight lifting burns off many more calories than previously thought. So not only does weight training burn fat while you’re lifting, it helps your body burn fat all day long after your training session.

Plus, Weight Lifting in particular has been shown in several studies to increase baseline testosterone. No wonder that exercise so completelky transforms the body.  Even those middle aged and beyond bodies out there can transform themselves. It s a fact that those who lift weights with even moderate intensely will turn back the clock dramatically. Someone who lifts weights will have the body of someone 15-20 years younger.

However, please don’t think that you have to become a bodybuilder to take a couple of decades off of your appearance. Looking twenty years younger requires only modest effort and even that level of training will boost your Self-Image and Mental Outlook, which in turn can directly boost your testosterone, which builds more muscle and improves your mental being which in turn burns more fat and so on.  I think you get the idea:  this all ties together and one discipline will help the other.

CAUTION:  New research shows that aerobics/cardio should always be done after weight training.  A recent study out of Japan [5] has potentially uncovered the fact that weight training actually stiffens arteries – and you don’t want stiff arteries if you want anything else to be stiff if you know what I mean – unless followed by cardio or aerobics. Furthermore, weight training without cardiovascular training leads to decreased Nitric Oxide production from the endothelium, which is bad – very bad.  Intense weight training leads to very high, albeit brief, blood pressure levels. [6] These pressures may “stun” the lining of our blood vessels and arteries and possibly even do long term damage.  Again, do NOT do aerobics before your weight workout – do it after. This will nullify any negative effects on the endothelium of the weight training.  (Note:  Some studies have not shown weight training in a negative fashion, but it is best to play it safe. [7])  News Flash: A recent study showed that intense weight training hardened the arteries but did not seem to damage the endothelium.  To test this, they immersed the weight lifters foot in icy water and then measured artery expansion in the neck. [23]

CAUTION #2: Be careful with the heavy, Olympic-type lifts that is advocated by most body building magazines.  It is very easy to injure yourself.  Fitness Rx is one of the few that is honest with its readers and cites a recent journal article that reports that almost all lifters who do regular and heavy bench pressing experience shoulder injuries. [22]  By the way, I have put on mass using much-easier-on-the-joints  Isolation and Volume Techniques.  These lifts will not as significantly raise your blood pressure as high either and you will find yourself.

Exercise and Your Heart

For heart health, nothing beats exercise (and a Low Fat Diet). How exercise works its magic is somewhat of a mystery.  Scientists have discovered that it does some rather suprising and near miraculous things such as increase the secretion of enzymes that extract cholesterol and fatty acids from the blood. [31] This may be the reason that exercise lowers inflammation [8], decreases blood pressure [9], improves insulin sensitivity [10], decreases arterial stiffness [11] and raises HDL, the good cholesterol. [12] The HDL-improving aspect of exercise was re-verified in a recent meta-analysis, which is a study of previous studies, showing significant increases in HDL for anyone who exercised over 120 minutes per week and/or burned over 900 calories per week.  [13] One could say truthfully that exercise improves significantly almost every know risk factor for heart disease (and therefore erectile dysfunction and brain/cognitive/memory issues). The bottom line is that there is no discipline more important to your sex life, your health, your mental capabilites and even your survival than exercise.  Find an exercise program that you enjoy and get started. If you haven’t exercised in years, go easy at first.  (If you have health issues, check with your doctor of course!)  But get started:  there is nothing more important that you can do to enjoy the next decades of your life.

Exercise and Energy Levels

Several studies have shown that sedentary people have less energy than exercisers.  It might seem that sitting around and “resting up” would give you more energy, but the research shows that the opposite is actually the case. You middle aged and beyond guys out there:  you can have the energy of someone in their 20’s if you’ll start exercising. The transformation will shock you.

Exercise and Sleep

Exercise, as long as you don’t do it right before bed, is a powerful sleep-inducer.  In one study, researchers reported that exercisers experienced “better sleep patterns including higher sleep quality, shortened sleep onset latency, and fewer awakenings after sleep onset, as well as less tiredness and increased concentration during the day”. [27] Another study found similar results and went a step further to find that it improved brain wave patterns including prolonged (and restorative) slow-wave sleep. [28] Read here about Sleep Increases Testosterone and Growth Hormone.

Exercise and Mortality

What if I told you I could give you a way to reduce your risk of dying by 50% or more?  Well, I can and you can probably guess what I am going to say:  exercise is your best life insurance policy.  Exercise has been shown in numerous studies to reduce your risk of dying by heart disease, cancer and all causes. One study, the Honolulu Heart Program, grouped Japanese non-smoking males aged 61 to 81 according to whether they walked < 1 mile/day, 1 – 2 miles/day or 2+ miles/day.  As might be expected, the 1-2 miles/day group beat out the death rates of the < 1 mile/day group in cancer, heart disease and all causes.  Similary, the 2+ miles/day group beat out the death rates of the 1 – 2 mile/day group in every category. [18]  And if you compare the 2+ group to the < 1 mile group, the death rates in cancer, heart disease and all causes is approximately half!

Another study of Finnish middle and senior aged twins found much the same result:  the group doing the most exercise had about half – actually in this case about 60% less – the death rate of the cohort doing the least exercise.  [19]  There are numerous other studies that show similar results.  One interesting one showed that exercise was an even better predictor, or perhaps a better way to put it is an even stronger factor, than waist circumference. And we all know that extra body fat is deadly. [20]

One 2008 study in the British Medical Journal had an interesting twist:  it showed that those with greater strength compared to those with weakest had a 32% reduced death rate from all causes. [24] This is an incredible reduction, especially considering they are just looking at one factor isolated by itself.  Even more remarkable is the fact that the results showed that there was a 50% reduction in heart deaths and 32% from cancer.

I don’t know what else to say except that there is nothing more important that you can do to enjoy the next decades of your life than exercise.  Exercise not only gives life, but it increases your ability to process and enjoy it.

REFERENCES:

Beets and Nitric Oxide - Peak Testosterone

Every man wants to boost nitric oxide. I mean what’s not too like? It increases blood flow, relaxes arteries, lowers blood pressure and, most importantly for most of us guys, makes an erection possible. But there is a big problem that Dr. Nathan and his co-author Carolyn Pierini lay out clearly in this book: not of all us can make our own nitric oxide via the normal route. Viagra, Cialis and Levitra all work on the enzyme (NOS) in our endothelium, the lining of our arteries, to allow nitric oxide to last longer or “build up”. So what happens when we get arteriosclerosis?

Well, most of us in the developed world know darn well what happens: we lose much of our ability to produce nitric oxide and our blood pressure and erections suffer because of it. How can the lining of the arteries pump out nitric oxide when they are injured and covered with layers of plaque from decades of abuse? That’s a good question and the answer is that they can’t.  In fact, when it gets bad enough, the blockbuster PDE5 Inhibitors do not work. (There are other reasons:  see my link on Viagra Failure for more information.

So what’s a fella to do? Nathan Bryan points out the answer: high nitrate foods and supplements. Yes, Mother Nature left an escape route for us middle-aged and beyond guys. These high nitrate foods bypass the normal pathway and can supply us older guys with a nice dose of nitric oxide even with damaged arteries.

Let me say that again in case you didn’t catch it:  you can have significant arteriosclerosis and still give yourself a decent dose of nitric oxide with beets and other high-nitrate foods. Beets can improve blood flow and lower blood pressure in such men as well. This is very good news and Dr. Bryan calls it nature’s backup plan for arterial health.

Now I do want to say that, realistically, this is not going to produce a “Viagra-like” effect for most men.  Nitrate foods are potent but not that potent.  However, I have observed that they seem to have a healing effects when used over the days and weeks that the PDE5 Inhibitors just do not have.  Remember:  even though nitric oxide is a free radical, Beet the Odds goes into great detail about how beets have incredible antioxidant and anti-inflammatory powers. In other words, beets can actually slowly heal your arteries.

NOTE:  I also have previously given some coverage to the studies involved in my link on The Power of Beetroot Juice.  And I cover the importance of nitrates (and many other phytochemicals) to blood flow in my book The Peak Erectile Strength Diet but Beet the Odds discusses just how powerful nitrates are on their own.

For example, how fast can you expect a boost in NO coming from beetroot juice or any other high nitrate food? It lowers blood pressure within an hour and continued up to 24 hours afterward! Yes, pour out those testosterone-lowering beers and and drink a true Love Potion made from beets (along with some Pomegranate Juice while you’re at it).

CAUTION: If you have any medical conditions or medications, discuss with your doctor before taking high nitrate foods (or any major lifestyle change).

Dr. Bryan also describes in detail the pathway for creation of nitric oxide through the stomach and tongue and lists the foods with the highest nitrate content. The way it works is that after you eat some nitrate-laden food, the nitrates make into the blood stream and back up into the saliva.  Bacteria on the top of the tongue actually convert the nitrates in the saliva into nitrites, which in turn gets converted into nitrities.

Now I mention this specifically, because this is SO critical for many of you middle-aged guys.  I have always eaten a lot of high-nitrate foods (spinach, celery, carrots) but haven’t really focused on this as an actual major strategy to get my nitric oxide levels up.  I noticed immediately the impact.  For example, my blood pressure has been a solid to about 115/70 after adding beets into my diet. For some additional details, see my link on How I Lowered My Blood Pressure to Teenager Levels.

Again, I highly recommend this book.  Beets also have strong potential to help with athletic performance as well and Dr. Bryan discusses this at length. Again, this is a book that can make a huge difference for men struggling with erectile or blood pressure issues.  For details, see Beet the Odds by Nathan Bryan on Amazon for more information.

Medicine and Drugs Kill You and Your Sex Life - Peak Testosterone

Research is pouring out of laboratories around the globe that can transform the lives of men all over the planet, giving them added decades of health and longevity. However, a cancer has spread into the system that is destroying the reputation of Western medicine. What am I talking about? I’m talking about the fact that our medicines are killing us.

Medicine, by definition, heals and restores, right? Wrong!  Nothing could be further from the truth when it comes to the modern pharmaceutical industry.  Yes, some drugs, such as antibiotics, are no brainers. But, recently, one medication after another has been found to be a major killer.

I am pro-doctor and pro-research, but the pharmaceutical industry is completely out of control and simply does not have our best interests at heart. Every drug should be tested for the basics:  how it impacts the cardiovascular system, clotting, hormones, brain function and other obvious major health issues.  Yet, as shown below, this clearly is not occurring.  I know that drug companies spend tens of millions researching a drug.  But what good is all that research if you don’t study how it affects our most basic physiology??  “Just what are they testing?”, one could ask

4. Asthma Drugs: Symbicort, Advair Diskus, Serevent Diskus, Dulera and Foradil. As unbelievable as it may seem, these anti-asthma drugs are strongly suspected of causing deaths and, actually, many more deaths than result from asthma itself each year. [6] Even worse, the primary population dying from these drugs are children. Why aren’t they pulled off the market? Money at lots of it – these drugs are huge cash cows for the pharmaceutical giants behind them.

5.  Meridia. This weight loss drug worked by turning you into a zombie.  That’s right – it worked by blocking reuptake of seratonin and dopamine, sort of a lobotomy in pill form, eh? So this drug should be good for the heart, since losing weight is always good for cardiovascular outcomes, right?  Unfortunately, Meridia was a heart-stopper very frequently and was shown to increase both the risk of heart attack and stroke. [7] Yes, the cure can be worse than the disease and the company, Abbott, recalled the drug.

6.  Vioxx.  This COX-2 inhibitor, supposedly a miraculous improvement over standard NSAIDs such as ibuprofen and aspirin, just had one little problem:  it doubled your risk of heart attack [8] This led Merck to make the biggest recall of a medicine in history.  Good riddance is all we can say.

7.  Chantix. This drug utilized a simple strategy for smoking cessation:  it stopped the heart from beating. Indeed, one hardly desires a puff when you are fighting for your last breath, eh? Well, this bad boy increased the risk of heart attack by 72% in smokers. [9]

8. Calcium Channel Blockers. Ironically, some hypertension medications can signficantly increase the risk of heart attack and stroke. [10] Just how did that little fact slip by the FDA?

9. Propecia (Finasteride). This hair loss drug has been found to permanently castrate (at least partially) a significant percentage of men. For more information, read my link about The Risks of Propecia.

10. PDE5 Inhibitors (Cialis, Levitra and Viagra). These drugs can cause temporary and sometimes permanent loss of hearing, tinnitus and dyspepsia (upset stomach).  Perhaps worst of all, they can often cause loss of vision.  Researchers have recently found out why:  they tend to cross over and affect other PDE enzymes including those in the eye.  And they found this means in many cases decreased blood flow to the optic nerve. [11] So, ironically, these drugs may increase blood flow to the penis and yet decrease it to the eye. Who knows if this is causing long term damage, but it is likely in my opinion as decreased blood flow is rarely a good thing in the body.

11.  Sleeping Pills. These have been found to greatly increase the risk of dying. Researchers discovered, for example, that even those taking low doses, 4-18 per year, increased their risk of deat by 3.6 times! [13] Yes, the cure can be worse than the disease!

12. Celexa (Citalopram). What about an antidepressant that increases your risk of death from sudden cardiac issues?  A recent study showed that that is just what Celexa does. [14] This drug, which is very popular, actually changes one’s heart beat and increases the risk of fatal arrythmias.

This list could go on and on. I have not even discussed the drugs that lower testosterone, Drugs Associated with Erectile Dysfunction or the Problems with Statins. (Nor have I discussed the 100,000 plus deaths every year in America from drug interactions, Tylenol liver poisoning and so on.)  The bottom line is that we need a champion, someone in the medical community who is willing to take on the FDA and the pharmaceutical lobbying machine.  Until then, “let the consumer beware.” And let the consumer exercise and eat a Mediterranean or Low Fat Diet!

And, hopefully, someone has alerted intelligence agencies around the globe that they can stop using primitive tools such as strichnine, cyanide and arsenic to do their dirty work. Almost every home in America has a whole medicine chest full of pills that will do a much less messy job.

REFERENCES:

1) N Engl J Med, 2007, 356:2457-2471, “Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes”

2) Medications Found to Cause Long Term Cognitive Impairment of Aging Brain, Study Finds ScienceDaily (July 13, 2010)

3) https://www.telegraph.co.uk article

4) https://blogs.scientificamerican.com/ article

5) https://www.alternet.org/health/alterticle

7) N Engl J Med, 2010 363:905-917, “Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects”

8) https://www.vioxxnews.com/

9) https://health.msn.com/ article

10) https://www.nytimes.com/ article

11) https://www.drugs.com/viagra.html

12) Drugs Today 2005, 41(8):547, “Drugs of Today”

13) https://www.dailymail.co.uk/health/article-2107390/Sleeping-pill-users-times-likely-die-early.html?ito=feeds-newsxml

14) https://www.telegraph.co.uk/health/9367001/ Safety-warning-over-Britains-most-common-antidepressant.html

Consider the medicines below that have been released to the general public and do incredible damage, even leading to thousands and thousands of deaths and untold physical and mental damage annually:

CAUTION: Do not cease any medication without talking to your doctor first.  Sometimes the risk of some drugs may be the best alternative depending on the severity of your medical condition.

1.  Avandia.  This diabetes drug was a disaster from day one.  It increases the risk of heart attack, stroke and congestive heart failure just for starters. [1] Nice, huh?  The company made millions and lawyers now will too.

2.  Anticholinergics. Ever heard of Benadryl? I’ll bet you have. These old line antihistamines (that I used to take like candy) are called anticholinergics, because they block acetylcholine receptors in the brain. Turns out this is a very bad idea and researchers have found that it can accelerate congitive impairment. [2][3] NOTE:  Some disease conditions, such as glaucoma, can require anticholinergics and there may not be a good alternative in some cases.  Talk to your doctor.

3.  Antidepressants. These drugs, which Americans drink like water, are now suspected of being relationship killers. [4] Yes, they can sometimes help with depression – although some studies have shown them on average little better than placebo – but they also can hammer the dopamine system.  This leads to decreased feelins of romance and often sexual dysfunction in women and erectile dysfunction in men. Maybe these should be called Cold Shower In a Capsule? And, yes, one major PLOS study concluded that the SSRI’s (Paxil, Prozac, etc.) are no better than placebo except for the most severaly depressed patients. [5]

Antidepressants are also now known to often be a major source of weight gain. Many studies have verifed this fact across a broad range of antidepreassants and one journal summarized by saying that “antidepressants such as amitriptyline, mirtazapine and some serotonin reuptake inhibitors (SSRIs) also may promote appreciable weight gain that cannot be explained solely by improvement in depressive symptoms. The same phenomenon is observed with mood stabilizers such as lithium, valproic acid and carbamazepine.” [12]

DHEA: Just What Hormones Does It Change? - Peak Testosterone

There are clearly some significant misconceptions about the hormonal changes that DHEA supplementation actually brings about. The common wisdom out there is that DHEA can “choose a pathway,” either testosterone and estradiol and you never know which one it will be. Some men will get a boost in testosterone and some men will get a boost in estradiol. Now there aren’t a lot of studies on DHEA and hormones in men, but, after I discuss the research, I think that you will agree with me that the above testosterone-or-estradiol-pathway theory is simply not true. Yes, occasionally a man may get a small boost in estradiol, but this is the uncommon exception.

So am I saying that DHEA does nothing?  Actually, I am saying the opposite:  DHEA does profoundly affect certain hormones – just not the ones that most men think about. Let’s start with a study where they gave HIV-positive men a large dose of DHEA (usually 400 mg / day) and monitored the key hormonal changes that occured:

1. Total Testosterone. This did not change at all from week 1 to week 8 (600 ng/dl).  This has been echoed in a couple of other studies:  DHEA simply does not change total testosterone significantly with either moderate or, as in this case, massive doses. Need one more example? Here are couple of more:

a) 50 mg in Men Aged 40-70. According to this study, some change in IGF-1 occurred, but none in testosterone. [3] This dosage is kind of the standard dosage that I see most men taking on The Peak Testosterone Forum with 25-100 mg being the range.

b) 100 mg in Men Aged 55-70.  A followup study by the lead author of the above study for a longer period (6 months) and double the dose again found no difference in testosterone (or DHT) in men. [4]

CAUTION: In my opinion, no one should consider taking DHEA without first testing to see if he is low.  For labs that will do this reasonably, see my page Testosterone Labs. I always recommend working with a doctor, naturopath, or an organization like Life Extension Foundation if you are dealing with hormones to make sure adequate testing is done and that you have no contraindications. DHEA falls off with aging, so many men over 40 will have low levels of DHEA

2. Estradiol. This changed minimally from 37 pg/ml to 35 from week 1 to week 8.  This is less than a 10% change and probably within the lab error range.  Notice, by the way, that not only did estradiol not increase, it dropped! The second study mentioned in #1 also found no change in estradiol with a 100 mg daily dose. [3] Again, I know of no evidence that DHEA increases estradiol in most men.  If you want to play it safe, you can test before and after.  See my page Which Estradiol Test is Best? for more information.

3. Cortisol. DHEA has a yin and yang relationship with cortisol, so, obviously, giving this large of a DHEA lowered cortisol significantly right?  Again, the answer is ‘no:’  14 ug/dl before and 13 after, again less than 10% change.

So the hormones that were supposed to be flying into orbit or imploding scarcely budged.  Yes, you have to watch out for that “bro science.”

Clearly, though, DHEA is affecting something right?  As I describe in my page on The Benefits of DHEA, it has likely restored morning erections in a couple of our posters at relatively small doses. Keep in mind that the study was using LARGE doses of DHEA (400 mg) that should be taken by most men and so the hormonal changes are likely MUCH larger than one would achieve at smaller doses.

To give you an idea, post-supplementation plasma DHEA-S levels went from 875 to 17,775 ng/ml. Most low DHEA men are in the 100-250 range and the usual target with normal DHEA supplementation is 350 to 500 from what I have seen. So these men actually had respectable DHEA levels and supplementation sent them through the roof. But this is an important study, because it shows what hormones actually can be altered through with DHEA usage:

So let’s look at just what hormones were changed by DHEA.

1. Free Testosterone. This rose significantly just as expected from 17 to 29 pg/ml from weeks 1 to 8.  I say expected, because there is a well-known study out there that echoes these results.  In fact, this study showed that, when combined with HIIT, it doubled free testosterone levels.  See my page on How to Increase your Testosterone Levels Naturally for the specific study involved.

2. SHBG. It is no secret that DHEA drops SHBG, but what is not as well known is that it does not lower it by all that much.  In this study, and keep in mind that this with a large dose, SHBG only dropped from 55 to 49 nmol/l from weeks 1 to 8.  This is just a little over 10%.  Nevertheless, it did go down as expected.

3.  DHT. Dihydrotestosterone (DHT) is a major male androgen that has significant effects on libido.  It can also negatively impact the prostate and the hair line in some sensitive men.  In this study DHT jumped from 640 to 3,392  pg/ml from week 1 to 8.  (Remember this was with a very large dose of DHEA.)

4.  Estrone. This estrogen tripled from 163 to 498 pg/ml from weeks 1 to 8. Of course, this is odd, because estradiol scarely changed, but this estrogen changed dramatically. This estrogen is much less studied in men. If you are diabetic, it may not be good to increase your estrone for example. [2]

5.  Androstenedione. This skyrocketed from 2 to 13 ng/ml from weeks 1 to 8.

6. IGF-1. A few studies show changes in IGF-1, which is potentially dangerous, although I would argue that the changes are pretty small for lower dosage.  See my page on  DHEA and IGF-1 for more information.

The DHT may scare some of you.  Again, keep in mind that most men are taking much smaller doses that these HIV men, who have a clinical need for higher doses of DHEA.  The typical doses for us guys that I see out there are either 25 mg or 50 mg daily.  The former is 1/16th of the typical dose in this study.  So I recommend monitoring before and after with one of these Testosterone Labs.

Notice the profound hormonal changes that occur from week 1 to week 8.  Several men on the Peak Testosterone Forum have successfully, tried DHEA supplements only to find that the effect fades after a few weeks.  Could this be the reason? (There are also transdermal / topical DHEA products out there as well now and these bypass the liver. Some men do better on these.)

Testosterone Replacement - Peak Testosterone

One philosophy that I think holds up well in the research is the concept of replacement. By that I mean, there are hormones and key enzymes and antioxidants that should be replaced to youthful levels if missing in order to optimize general physicial and mental health.  Examples abound and include many hormones, antioxidants such as CoQ10 and digestive enzymes as well. Again, the idea of replacement means, by definition, to youthful levels and not to the supraphysiological levels of steroid users or supplement megadosers.

One reason that I am a big believer in replacment as a general health philosophy is that HRT (testosterone therapy) has been a transforming life experience for me:  when I got on testosterone cypionate injections which took my testosterone up into the 900-1000 ng/dl average range I noticed that for the first time in my life I had morning erections!  I also noticed that the mild depression that I had struggled with my entire adult life vanished overnight.  (You can read My Personal Health and HRT Story for the many bumps in my journey.)

Now you and your doctor will have to decide if you subscribe to this kind of replacement philosophy, but, if so, then this leads to the first step of what I call My Peak Testosterone Program:

1)  https://www.massgeneral.org/about/pressrelease?id=1617

a) Assess Your Symptoms. The first step of my personal program is to examine your testosterone symptoms.  Let’s look at the very common symptoms of low testosterone:

Now there are many other what I would call more “minor”symptoms, such as poor workout recovery, decreased facial hair, poor sleep, “hot flashes”, etc.  But the above list are the most common and the most debilitating from what I have seen. (There are some dangerous side effects of low testosterone such as anemia and bone loss, but most men have not been tested for these initially.) In my case, I had ALL of the above symptoms when I hit my late 40’s, but you may have only one or two.  I finally asked my doctor about this and got tested after years of suffering.

CAUTION: Notice that all of these seven of the signs of low T can have many other causes.  There is no guarantee that testosterone is the root cause.

b)  Testosterone and Estradiol Testing.  If you have any of the above symptoms, get your testosterone and estradiol (ultrasensitive) pulled.  It’s inexpensive and, even if you are not low T, you’ve got a nice baseline for the future.  If you can afford it, pull free testosterone and/or SHBG as well.

d)  Choose an Estradiol Range. Most of the HRT clinics and anti-aging physicians try to get their patients in the 20-30 pg/ml range from what I have seen.  And the reason is simple:  generally their patients feel better in that area.  The other reason is that there is evidence that this is the safest area based on some research summarized in this Life Extension article.

Now I have seen some doctors go down to about 15 and some up to 35 pg/ml.  But the concept is this:  low and high estradiol can affect sexual and mental function just as much as low testosterone and are likely also dangerous to your long term health just like low testosterone.  (A recent study confirmed the former. [1])

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

What If My Physician Will Not Even Test Me? Most regular doctors have limited knowledge of testosterone and very few understand the importance of estradiol.  Because of this, sometimes a man cannot even get the basic testing that he needs which is a grave injustice in my opinion.  Been there!  Remember:  most physicians are good-hearted people, but they are constrained by insurance companies and their physician partners to hold down costs, and so you will generally receive very limited lab work under managed care.  However, the good news is that, at least here in the U.S., the medical establishment has not been able to override our ability to do some basic testing on our own and I have some of the options that Peak Testosterone Forum members have used in this link on Testosterone Labs. (I have no affiliation with any of them.)

e) Testosterone Treatment. If your total testosterone is below the hypogonadism threshold above, then you and your doctor must come up with a treatment plan.  Here are the basic categories that I know of to boost your testosterone:

i) Go Natural.  Almost everyone can boost their testosterone a little through lifestyle changes.  There are many ideas for this on my site and they include such things as competition, correcting sleep disorders and depression, weight lifting, certain supplements, getting more sleep and so on.  From what I have seen, these will only raise a hypogonadal man’s testosterone a little.  But these need to be corrected anyway for your general health and so many men will want to try this route first assuming that their low testosterone is not causing major health issues. [FOR MORE INFO: How to Increase Your Testosterone Naturally.]

There is one potential exception:  Weight Loss. If you are 50+ pounds overweight – and most American men over the age of 40 are – then you can very likely greatly increase your testosterone levels and drop estradiol as well.  It is even possible to double your testosterone levels in some cases:  see my link on Testosterone and Weight Loss for more information.

CAUTION: Low testosterone can lead to many nasty health conditions including anemia, osteopenia/osteoporosis, elevated insulin with prediabetes and/or diabetes, etc.  If you have one of these conditions, going natural may not be a good option.

ii) HRT (Testosterone Replacement Therapy).  There are many options available here:  testosterone patches, injections (cypionate, enanthate and undecanoate depending on your country), pellets, compounded creams, brand name topicals (Androgel, Testim, Fortesta, Axiron).  Each of these have their advantages and disadvantages. [FOR MORE INFO: Testosterone Therapies.]

NOTE: Very often Armidex (anastrazole) is given along with HRT, because the elevated testosterone will increase estradiol along with it.

iii) HCG Monotherapy.  HCG is an “LH (leutening hormone) analogue”, meaning it is almost identical in structure and function to LH.  Of course, LH is what stimulates the testes to produce testosterone and so, as long as one’s testes are functioning correctly, HCG can give a substantial boost in testosterone.  [Arimidex is often given with it, because the increase in testosterone will increase estradiol as well.] This option often works in men wishing to maintain fertility. [FOR MORE INFO: HCG Monotherapy.]

iv) Clomid.  Clomid is a pharmaceutical in the SERM family that acts on the hypothalamus and stimulates testosterone production in men with a functioning pituitary and testes.  Unfortunately, many men experience no increase in libido on Clomid and often have other estrogenic symptoms. (Clomid is composed of two drugs actually, and one of those is estrogenic.) [FOR MORE INFO: Testosterone and Clomid.]

NOTE: It is uncommon, but a few savvy doctors will try to diagnose whether or not you have primary or secondary hypogonadism. However, few urologists, PCPs or endocrinologists will do this simply because their solution for both conditions is HRT.

f) Prolactin. If your testosterone is low, then imo you shoud have your prolactin pulled and the reason is that elevated prolactin is quite common and will lower libido and total testosterone.  [FOR MORE INFO: Testosterone and Prolactin.]

g) Estradiol Management. If you and your doctor decide that your estradiol (using the ultrasensitive test) is too high, then one can consider a) losing weight which can dramatically lower estradiol and/or b) low dose Arimidex (anastrazole). Typical dosages for men on HRT are .25 mg – .50 mg twice per week. [FOR MORE INFO: Testosterone and Arimidex; the Testosterone-to-Estradiol Ratio.]

Ways to Get Out of HRT? - Peak Testosterone

And I see the same thing on the Peak Testosterone Forum more often than not.  Most men are simply not thoroughly evaluated but just immediately put on HRT.  (Many docs do not even ask the man if he wants to have kids or not!) If you ask doctors why they don’t check root causes of low testosterone, their response will likely be, “Well, the cause doesn’t really matter, because the solution (HRT) is always the same.”  As you will see below, this is often going to be a poor assumption and that at times testosterone can be restored with proper diagnostics and research into the underlying problem. And therein lies the problem:  the docs simply do not feel that they have the time or expertise to research an unlikely problem.

However, I think that view is short-sighted, because we are learning more and more about what can cause low testosterone.  I cover a number of prominent reasons in my page on Common Causes of Very Low Testosterone for those interested.  And this is not just theoretical but practical:  correcting the underlying problem can lead to a doubling or tripling of baseline testosterone levels.  I love Hormone Replacement Therapy with Testosterone Cypionate: it has been a very positive experience for me. However, I have to admit that it is a fair amount of expense and time (and, for some men, potentially has some side effects and risks). So why not avoid all that time and expense and correct the underlying problem instead? Well, I guess that would make too much sense!

One would think endocrinologists would be the ideal type of physician to research the root cause of your low testosterone.  However, from what I have seen, endocrinologists will not even consider you low testosterone unless you are VERY low, i.e. below about 200 ng/dl.  They will usually not treat you unless you push them, even in the 200’s where most urologists will immedietaly give you treatment.

The end result is that, if you want to get to the bottom of your low T, you will probably have to be the prime mover and find the necessary docs and possibly do some self-testing yourself.  See my links on Inexpensive Labs

You also have to realize that you may never find the root cause.  We are still in our infancy in understanding metabolism and hormones.  If I had it to do over again, I would attempt to find the underlying cause.  You’ll see why below when you check out these Ways to Double or More Your Low Testosterone without HRT:

1. Zinc Deficiency. Zinc and magnesium are involved in 100’s of enzyme systems. Deficiencies in either one can lead to decreased testosterone levels, but zinc is particularly critical in this regard. If you are zinc deficient – and you can buy a simple and inexpensive zinc taste test on Amazon – then it is possible to double or triple your testosterone levels simply by correcting the zinc deficiency. I cannot help but wonder how many men have suffered needlessly and are on HRT because of this easy-to-fix problem. For more information and to see the studies, see my page on Zinc Deficiencies and Low Testosterone.

Think how many of your friends and family have some sort of autoimmune issues, such as rheumatoid arthritis, Crohn’s, Hashimoto’s, Graves, etc. These sort of diseases are at epidemic proportions and this is LDN’s sweet spot.  As an example, one of our regular posters had autoimmune thyroid issues (Hashimoto’s) and went on LDN and said that he more than doubled his testosterone from it. (Hashimoto’s is very common.) Now, granted, this is just one story out there, but I have little doubt that LDN can do this for some men.  Look at what he wrote: [1]

“I have had Hashimotos with my antibodies being around 2500… just after a few months of using LDN my antibodies were 500 and my testosterone went from 400 to 1000….. I did read small amount of other users saying how LDN boosts the pituitary LH similiar to HCG … but theres only a small amount of research out there on it for testosterone.”

3. Lose Weight. If you lose 50+ pounds, it is definitely possible to double or more your testosterone.  The extra aromatase in fat cells can convert so much of a man’s testosterone into estradiol that he develops a kind of secondary hypogonadism.  Check out the studies in this page on Testosteorne and Weight Loss.

4. Thyroid. If you are both hypothyroid and hypogonadal, it may be possible to double your free testosterone simply by correcting the underlying hypothyroidism. For the study, please my page on Testosterone and Your Thyroid Hormones.

5. Eliminate a Parasite. One of the Peak Testosterone Forum member shared a story about how his LH (leutinizing hormone) climbed up to primary hypogonadal levels.  Of course, this is a sign of primary hypogonadism.  After years of suffering, he finally figured out that he had a specific type of tapeworm and took some medication to eradicate it.  It took six months, but his testosterone almost doubled from 350 ng/dl to 670.  What better example of the necessity of getting to the root cause than a tapeworm that can grow to 10 feet!

6. Clomid Restart. Clomid, in my opinion, is a pretty nasty drug with lots of side effects and a debatable effect on the male brain. I talk about all of this in my page on Clomid and Testosterone. However, steroid men use it all the time as part of their PCT (Post Cycle Therapy) to restart their testosterone levels. Basically, steroids can actually shut down hard a man’s androgen production and also shut down all the feedback loops that would normaly trigger the body to naturally restore baseline testosterone. By going on Clomid for a few months, steroid men can essentially force the hypothalamus to signal the testes to fire up once again.

This strategy works quite well in steroid users, because they are usually young men with a healthy HPT axis.  I mention this, because some low testosterone men that have never touched a steroid can restart their testosterone.  Unfortunately, it is not very common, but it does happen occasionally.  Obviously, if this were to occur, it would make the risk of taking Clomid well worth it, because one’s testosterone production would be restarted completely on its own.  For more information, see my page on Testosterone Restarts.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

OTHER ALTERNATIVES TO HRT: One does not even have to go on standart HRT (TRT) to significantly raise testosterone in most cases.  From what I have seen on the Peak Testosterone Forum, most men respond quite well to either Clomid or HCG Monotherapy.  For most men, these are indefinite solutions, i.e. they will not restart you.  However, in the case of Clomid, it keeps the pituitary and testes activated and HCG keeps the testes alive and kicking (but will atrophy the pituitary a little).  See my pages on Clomid and Testosterone and HCG Monotherapy for more information.   [It should be noted as well that Androxal will come out in the next year or two.  See my page on Testosterone and Androxal for more information.]

1) https://peaktestosterone.com/forum/index.php?topic=2723.0

Injections Research/Studies to Show a Reluctant Doctor

One question that I get from time to time on the Peak Testosterone Forum is “do you have any subq (subcutaneous) studies that I can show my physician to prove that this is a legitimate protocol?” And the answer is ‘yes,’ although there is not as much out there as one might hope for. This is a topic that is near and dear to my heart, because it took me over a year to find a doctor that a) knew about subQ and b) was willing to let me use it.

In my case, I stumbled upon a doctor – my primary care in this case – who did not need a lot of persuading:  she felt comfortable with it just from a common sense standpoint. And you may find that this is the case with your doctor as well, because many physicians are comfortable with subQ injections since their diabetic patients utilize them on a daily basis with a hormone (insulin).

Why did I want to go on subQ injections?  The primary answer is that it easily allows a man to inject 2 or more times per week, which allows for a much more physiological HRT (TRT).  Weekly cypionate injections tend to give you a fairly big spike in the first day to three days.  SubQ is rumored to lead to lower estradiol levels and I found that to be the case.  It was one of the things that helped me get my estradiol levels down.  For details, see my page on SubQ Cypionate, the Best HRT Protocol?

SubQ is also incredibly convenient.  The shots are almost painless, easy to give yourself and there is no need for aspiration.  In addition, if you are going to self-administer an intramuscular shot, it is usually in the quad and this sometimes can be uncomfortable and requires a little larger needle than subcutaneous.

However, for those of you who do not have any such good fortune, here is some research-backed evidence that you can show your physician:

1. Antares Quick Shot.  There is currently a patent on a subQ “pen” that actually capitalizes on a subQ protocol.  The ester will actually be enanthate in this case, but that has a very similar profile to cypionate.  As of this writing, it had not been FDA approved, but they are already pushing for standard dosages:

“Testosterone enanthate administered subcutaneously once each week with possible titration to a higher or lower dose at scheduled intervals during study. Three dose strengths are available: 100 mg, 75 mg, and 50 mg.” [2]

2. Hypogonadal Males. This Canadian study looked at subQ because “the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients.” [6] Basically, the study concluded that it was a “no brainer” that got 100% of the males in the study within acceptable ranges.

3.  Fifth World Congress on the Aging Male Study. The authors were clearly positive in a paper presented at this World Congress and concluded that “patients tolerated this therapy with no adverse effects…A once-week SC injection of 50-100 mg of TD appears to achieve sustainable and stable levels of phiologiccal T. This technique offers fewer physician visits and the use of smaller quantity of medication, thus lowering costs.” [7]

4. Drs. Crisler and Shippen. There are two very well-known HRT physicians, Dr. Crisler and Shippen, that have been doing subQ testosterone cypionate injections for years with many of their patients. According to one of our senior posters, Dr. Shippen actually pioneered the technique:

“FYI…Dr Shippen was the one who pioneered the sub-q T injection method. When I was in his office, he told me that after I mentioned the Dr Crisler video demonstrating how to inject using that technique. He mentioned it modestly though…he’s a very humble guy and isn’t the kind of doctor who is into self-promotion.” [1]

Dr. Crisler must have jumped on board soon thereafter and became an apostle of the technique.  I know he has had actual training materials on his site for at least five years using this protocol.

5. Small Study on Hypogonadal and Transgender Men. One conference paper noted that two of the physicians had been using subQ injections with their transgender patients. Their protocol is very similar to the one that I see most often being utilized by men now: “T enanthate or cypionate was administered at a dose of 50-60 mg sc once weekly using 5/8″ 23g or 25g needles.” [3] The only difference is that most men use 27 or 29 gauge needles and are injecting 2-3 times per week for a total of about 100 mg of cypionate per week.  (I am currently injecting 40 mg twice a week for example.)

6. Transgender Men. This study looked at  female-to-male individuals and was significant because it a) was fairly long term (6 months), recent (2014) and used the cypionate ester.  The authors noted that “subcutaneous delivery of testosterone for masculinization of transgender youth seems to be effective and well tolerated over short treatment times.” [4]

7. Peak Testosterone Poll. For what it’s worth, 18% of the members doing standard HRT in a Peak Testosterone Forum Poll were using subQ cypionate injections.  That’s basically one out of five and clearly represents a significant percentage of those doing testosterone therapies.  Most doctors tend to feel more comfortable with the Big Pharma topicals and it should be noted that, as of this writing, there were as many men using subQ cypionate as all the topicals put together. [5]

CONCLUSION: There are now multiple studies on hypogondal and transgender males with subcutaneous testosterone cypionate protocols as well as widespread clinical experience. SubQ has now been widely used for years and so interested doctors should be able to find meaningful data from which to pull from.

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=3182.0

2) “A Recent Antares Pharma Patent Confirms The QuickShot Testosterone Product Will Debut Vibex Needle-Free Jet Injector Design And Novel Ethanol Formulation For Needle-Free Subcutaneous Injection”, https://seekingalpha.com/instablog/2421271-lokodude/3464615-a-recent-antares-pharma-patent-confirms-the-quickshot-testosterone-product-will-debut-vibex-needle-free-jet-injector-design-and-novel-ethanol-formulation-for-needle-free-subcutaneous-injection

3) San Francisco Endo 2013 Conference, Monday, June 17, 2013: 1:45 PM-3:45 PM, “Evaluation of the efficacy of subcutaneous administration of testosterone in female to male transexuals and hypogonadal males Program: Abstracts – Orals, Featured Poster Presentations, and Posters Session: MON 586-595-Reproductive Axis Determination, Development & Transgender Medicine, Basic/Clinical

4) LGBT Health, Sep 2014, 1(3): 165-167, “Subcutaneous Testosterone: An Effective Delivery Mechanism for Masculinizing Young Transgender Men”

5) https://www.peaktestosterone.com/forum/index.php?topic=4794.0

6) Saudi Med J, 2006 Dec, 27(12):1843-6, “Subcutaneous administration of testosterone. A pilot study report”

7) The Aging Male, March 2006, 9(1): 1 70, “Men s Health and Aging: The 5th World Congress on the Aging Male”, https://www.hormonebalance.org/ images/documents/ Lunenfeld%205th %20World%20Congress%20on%20the%20Aging%20Male%2006.pdf

Testosterone Lowerers - Peak Testosterone

REFERENCES:

1) Intl J of Impotence Res, 2009, 21:89 98, “Obesity, low testosterone levels and erectile dysfunction”

2) Francis Hayes, The results were presented at The Endocrine Society s 91st Annual Meeting in Washington, D.C. This was not published even online at the time of writing but was covered extensively in the health and medical press.

3) Natl Inst on Alcohol Abuse and Alcoholism, “Alcohol and the Male Reproductive System”, Mary Ann Emanuele, M.D., and Nicholas Emanuele, M.D.

4) Reproduction, 2002, 124:173-180, “Regulation and Perturbation of Testicular Functions by Vitamin A” (Review)

5) Clin Endocrinol (Oxf), 2009 Dec 29, [Epub ahead of print], “Association of vitamin D status with serum androgen levels in men”

6) European journal of applied physiology, 2010 Apr, 108:1125-1131, “Influence of dietary carbohydrate intake on the free testosterone: cortisol ratio responses to short-term intensive exercise training.”

7) Contraception, 73(3):301-306, “Evaluation of the potential antifertility effect of fenugreek seeds in male and female rabbits”

8) Phytotherapy Research, Mar/Apr 1993, 7(2):134-138, “Efficacy of the steroidal fraction of fenugreek seed extract on fertility of male albino rats”

Research has shown that every one of these items can lead to very signficantly lowered testosterone (and libido). I call them the Dirty Dozen.

NOTE:  You may also want to read my link on Common Chemicals That Lower Testosterone as well.

1) Overweight.  Those extra pounds are strongly correlated with lower testosterone [1] and a Lot of Other Bad Stuff as well.

2) Metabolic Syndrome (insulin resistance) and diabetes are both equate to decreased testosterone levels. [1]

3) Chronic and Non-Moderate Alcohol Consumption.  Animal studies clearly show heavy drinking for an extended period of time will lead to lower testosterone. [3]  Always play it safe with Alcohol and limit yourself to one or two drinks per day.

4) Stress.  We males can intuitively feel how hard stress is on our body and mind and the reason is, among other things, simple chemistry:  stress increases cortisol and cortisol has been shown repeatedly to be associated with lowered testosterone levels.  I cover this extensively in my link on Stress, Testosterone and Your Brain.

5) Lack of Sleep.  This actually follows – and many guys don’t know this – as really a subcategory of #4.  Lowering sleep quantiy or quality will leads to increased cortisol and a corresponding testosterone decrease and I cover that extensive in my link on the Nasty Effects of Lack of Sleep.  Sleep can also lead to calcification, or hardening, of the arteries and blood sugar management issues as well.

6) Depression.  Depression is also actually a subcategory of #4 and leads to increased cortisol and inevitably lowered testosterone levels. Depression also can lead to erectile dysfunction and literal brain damage as well. Read my link on Depression for more details.

7) Vitamin A Deficiency.  Being deficient in Vitamin A has nasty results on both sperm and testosterone.  In fact, animal studies show that in Vitamin A-deficient animals, lower testosterone is followed by atrophy of the testes. [4] Don’t forget that you don’t have to directly consume Vitamin A to get your what your body needs:  your body can also build it from betacarotene, the orange phytochemical in yams and carrots.

Did you know you can inexpensively do your own testing for most hormones? The industry leader is Discounted Labs..

8) Vitamin D.  Vitamin D has been correlated with higher total and free testosterone. [5] Vitamin D deficiency is incredibly common, as I cover in this link on Vitamin D, and can result from being indoors, skin color, the seasons and so on.  The solution, of course, is to take Vitamin D as a supplement in order to avoid lower testosterone.  (Read my link on Vitamin D for more information.)

9) Overtraining. If a little exercise is good, then a lot has to be better, right?  Unfortunately, that doesn’t apply when it comes to our hormones.  Overtraining lowers many of our most precious hormones, such as testosterone, and raises still others that ought not to be raised.  You must build up slowly in your training endurance and strength and make sure you have sufficient rest.  Read more in my link about Overtraining’s Powerful Testosterone Lowering Abilities.

10) Toxins.  There’s a lot of what I call “Socially Acceptable Chemicals” that will give you lower testosterone.  In fact, it’s nearly impossible for a modern urban dweller to escape at least some exposure to these nasty hormone killers, which include Pesticides, Excitotoxins and Marijuana.  Read these links:  no one but you can protect your testosterone.

11) Varicocele.  These are nasty distended and/or tangled systems of veins near the testicle that can affect testosterone and fertility. I had one young reader write in who knew exactly when this occurred:  during a squat at the gym. (See my link on Fertility for details.)

12) NEWS FLASH: This is hot off the press:  rapidly increasing blood sugar levels lead to significantly decreased testosterone. [2] In fact, blood sugar elevation can whack testosterone by as much as 25%!  Over 95% of the men in the above study, both with normal glucose clearance and diabetic, had their testosterone significantly lowered for hours by a glucose drink.   Again, you must manage the Glycemic Load of your foods. Read this link on How Sugar Lowers Your Testosterone and Assaults Your Sex Life.

13) NEWS FLASH #2:  The Atkins (or Low Carb Diet) received yet another black eye from scholars at the University of North Carolina.  Researchers there found that a low carb (30%) diet lowered testosterone by about a third and increased cortisol by about a seventh (15%) when compared to a high carb (60%) diet after some intense training. [6] The testosterone to cortisol ratio is incredibly important to male long term health and this hammered it from both ends.

14) Fenugreek.  Watch out for this herb (at least the seeds) that hail from India, China and other parts of Asia.  Several animal studies show a decrease in both testosterone and fertility. [7][8]

Mercury will also lower your androgens, but unless you are eating a lot of fish, this shouldn’t be an issue for you.  Also, I highly encourage you to read about my link regarding Excitotoxins as, unlike Mercury, this is so prevalent in our foods and supermarkets thanks to the FDA and Food Industry and will take out both your Brain AND your hormones.

NOTE:  You should also read my section on Free Testosterone as there I discuss several things that can uniquely lead to lower Free Testosterone as well.  Remember that Free Testosterone  is the bio-available serum testosterone that can actually “do work” in your tissues.

Remember that this is not a cumulative list.  However, it only takes ONE of these to severely reduce your T-levels 30% or more.  Remember that low testosterone is associated with heart disease, diabetes, Metabolic Disorder, depression and osteoporosis in males.

NOTE:  Please read this link on How Marijuana Can Destroy Your Hormones, Fertility and Lead to Impotence.

Fructose and Erectile Dysfunction - Peak Testosterone

Fructose also raises uric acid levels in the body, another risk factor for heart disease and cardiovascular issues. Some researchers do not consider uric acid to be an independent risk factor for heart disease.  But there are many, many studies which show uric acid is linked to heart disease:  science just cannot decide if it is a chicken or egg sort of thing.  This had been established by so many studies that I recommend you simply look up this Medscape Link on Uric Acid and Heart Disease. This summary clearly states that “raised serum uric acid in both men and women was associated with significantly higher risk of all-cause, CV disease, and ischemic heart disease mortality”. One well-known JAMA study concluded “Our data suggest that increased serum uric acid levels are independently and significantly associated with risk of cardiovascular mortality.” [2] In other words, uric acid is a Natural Born Killer.  (NOTE:  One large study did not find uric acid to be related to heart disease was an examination of the famed Framington data. [3])

But I ask the question, “Does it really matter how fructose is going to maim, kill and destroy?”  The important thing is that it does and then to avoid it.  Consider this experiment [4] where they took 40 sexually mature rats and fed them a 10% fructose solution in order to induce hyperlipidemia.  That’s a fancy word for the nasty condition that plagues those in modern societies where they’re lipid profile, i.e. the various cholesterol readings, are completely out of whack.  In other words, researcher know that fructose is a great way to induce the nastiest of all cardiovascular environments and yet so many of us consume fructose in great quantities with no fear?

I think a better name for fructose would be Pure Penis Poison:  it is simply that bad.  Of course, if you just have the small amount that is in fruits, you are very unlikely to have an issue.  But if you are consuming significantly quantities through table sugar and corn syrup, half of which is digested into fructose, you will undoubtedly greatly increase your likelihood of Metabolic Syndrome, a common risk factor tied into the epidemics of cardiovascular disease and erectile dysfunction that affect so many men middle aged and beyond. [5]

Part of reason for fructose’s destructive force is that it is almost entirely metabolized in the liver, where it is easily converted to artery-killing triglycerides.  Just as bad, the liver requires large amounts to Nitric Oxide to form the uric acid and so the body can easily become depleted of Nitric Oxide.  And I don’t need to tell Peak Testosterone readers that Nitric Oxide is the stuff of erections:  you don’t want to do anything that will tamper with this all-important chemical.

And that’s why I say fructose is Pure Penis Poison:  it simultaneously helps clog your arteries, thus leading to long term impotence, all the while it is robbing your tissues of Nitric Oxide, potentially leading to an immediate loss of erectile strength.

Does it get any uglier than that for your sex life?

WARNING: Fructose has been linked with pancreatic cancer and researchers recently discovered the likely reason why: cancer cells feed off of fructose in order to spread and multiply. Glucose is used by cancer cells for survival but fructose to proliferate. [6]

REFERENCES:

1) Am J Clin Nutr, 2007, 86:1174-1178; Nutr Rev, 2005, 63:133-137

2) JAMA, 2000, 283:2404-2410

3) Annals of Internal Medicine, Jul 1999, 131(1):7-13

4) Uruology, 67(3):642-646

5) Am J Physiol Renal Physio, 2006, 290:F625-F631

6) Cancer Research, Published Online First July 20, 2010, “Fructose Induces Transketolase Flux to Promote Pancreatic Cancer Growth”

DHT (Dihydrotestosterone): How to Lower It - Peak Testosterone

Every man’s hormonal situation is different and some men want to lower their DHT (dihydrotestosterone). There can be many reasons for this including

Whatever the reason, I see concern for these issues on the Peak Testosterone Forum quite often. Compounding the problem is the fact that the big pharmaceutical inhibitors of DHT (Propecia or finasteride) are rife with side effects and so men are often reluctant to touch them. A number of experts believe in something called “Post-finasteride Syndrome” and believe it can cause permanent sexual side effects. I cover some of this in my page on The Risks of Propecia Use.

Regardless, men are often looking for more natural ways to manage the problem and, below, I include several herbal and dietary ways that may lower DHT without using a synthetic pharmaceutical solution:  (Always discuss everything first with your physician if you have any medical issue or are on any medication.)

5. Green Tea. Green tea has two powerful catechins, ECG and EGCG, the latter being responsible for most of the anti-aging and superfood characteristics exhibited by green tea.  Black tea does have some of these compounds, but not nearly as much.  (Black tea can lower your blood pressure and boost blood flow though!) But green tea has enough ECG and EGCG to where some believe your DHT could be lowered enough to notice. [1]

We had one forum member claim that black tea probably lowered his libido and that rodent studies showed that DHT could be lowered with black tea.  I could never find the evidence for that and am skeptical, but here is what he wrote:

“I’m British and drink a lot of black tea (with milk), there was a few studies claiming black tea lowered dht in rodents by 72%, more than finasteride (hair loss drug) that reduced dht by 70%. I know people say this isn’t related to humans because it was done on mice, but mice were found to to have 70% lower dht on finasteride, exactly the same as humans. I drink about 8 to 10 cups a day, I know, a bit excessive!” [3]

Now, while green tea may lower DHT a little, it is truly an incredible superfood and even displays anti-aging superpowers.  I have a glass every day.  That said, I wouldn’t “go crazy.”

6. Quercetin. I took quercetin for awhile when I had a high PSA.  It is an anti-inflammatory and some polyphenols are also 5-alpha reductase inhibitors.  There are indications that quercetin may lower DHT as well. [3] Is this safe long term?  Again, taking megadoses of quercetin is a relatively new phenomenon – no one knows the answer for sure.

WHAT ABOUT ZINC?  I have read in many places that zinc acts as an 5-alpha reductase inhibitor.  However, as you’ll see in my page on Zinc and DHT, there is a well-done study that shows men actually increasing their DHT with zinc supplementation. Also, you may want to scan through my Zinc Dangers page.

CAUTION: Remember that DHT is responsible for a significant part of a male’s libido.  So reducing it too much could have a negative impact in the bedroom.

1)   Carcinogenesis Advance Access published February 12, 2004, Hung-Hsiao Lee1, Chi-Tang Ho2 and Jen-Kun Lin1,* , “Theaflavin-3,3’-digallate and Penta-O-galloyl-β-D-glucose inhibit rat liver microsomal 5α-reductase activity and the expression of androgen receptor in LNCaP prostate cancer cells”, https://watermark.silverchair.com/bgh106.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApYwggKSBgkqhkiG9w0BBwagggKDMIICfwIBADCCAngGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM4wvpm1JhT6IC5854AgEQgIICSZ09SbOiyc20GVEJdeQLuBlW1jcCn3WQ48RoVcbVsR2QPP0a6OPlvXb20mVPQHWvqysE95alZZdJZTk8QOaxqhcbc6aB3pvemVJ4_qW4hrKmRhoA9Uph5OMJMOtbN6e7dKGRwyM6B1jmk6HsRkQ6s_egV0ZgPYEt0CoyTWU1EO83yBFOhnkwq5kUKgnidrq8JB6E5rr4f2Aad-msMTi9pVMCPJSXFBep2-KD23L3aLluvbo25eRfBxoMEvYFKDWt6sDl9J4_vY_sGUIFaaMUv0TbPDl9EAYYp1b0a8jhbraaDDNsTd_iyfnMPhdJuDyT1teitMJe1cewmMcFj-NQTxy4iXVd9-BMVb4zebeJkUbfwhxhYbCTJKwTfzf0ACGr5WZlGqYvxu8L1jMDvyhQieRlmmHmtYOPhq9FrE0pavoYNvUrxMB9nWoJOoMSH1mUPNQjy6o3lsDW0a4UZKz8XcoeP4g_5BHCXhkuUaF5zNKZE2LhHJi4_2i0Hi_lMDh41BAS7BBQz_457zbxjtzriDj1KFdd1jxSKP92CJSrFZfIEjxdvd96WUgGod63Kq-Bu2zAHKO_Yx4Bv7XVVUZsjev_ADI6mCrgrs6_bX6c_c35yRzuCB8ugluTPKDb9ozUxSEVKmhUklxbwSofR3XMxljSztQY_hWH7pEKGIr0Gm-AbxkFOpfwQnjeVU3AzJ1OFjIZyxo4do6brbmY6hge80P0Ytv3wzWaS6ZJ72NffBk_Csy1HZ5jrPoUlx2ugCHUmFPJmxIQaWhHVQ

2) https://inhumanexperiment.blogspot.com/2009/01/caffeine-and-polyphenol-contents-of.html

3) J Endocrinol, Jun 1 2004, 181″493-507, “Reduction of rat prostate weight by combined quercetin-finasteride treatment is associated with cell cycle deregulation”

4) The Journal of Antibiotics, 1990, 43(12):1615-1616, “Riboflavin, a testosterone 5 alpha-reductase inhibitor”

5) Am J Chin Med, 2004, 32(3):331-8, “Saw palmetto and benign prostatic hyperplasia”

6) Aging Male, 2004 Jun, 7(2):155-69, “Preventing diseases of the prostate in the elderly using hormones and nutriceuticals”

7) https://articles.mercola.com/sites/articles/archive/2008/01/02/natural-progesterone

1. Saw Palmetto. This is the most well-known of the herbal 5-alpha reductase inhibitors and has many studies showing its powers. How effective is it in real life?  Well, it actually has a couple of significant studies showing that it improves BPH (enlarged prostate) for example. [5][6]

2. Stinging Nettle and Pygeum. These are widley used in herbal prostate supplements and research shows them to be 5-alpha reductase inhibitors, especially when used in combination. [6]

CAUTION:  Saw Palmetto, Stinging Nettle and Pygeum have a better track record that Propecia.  However, some men on the post-finasteride boards report that these herbs caused them trouble.

3. Progesterone.  Progesterone is the new men’s health hormonal kid on the block and some research has shown that it can even improve erections.  In fact, I have a whole page on the subject:  Pregesterone and Erectile Dysfunction. Progesterone has an interesting property: it is widely reported to lower DHT in men. Is it safe for men in the long term? Dr. Mercola has stated that the cream version can accumulate in tissues in some cases. [7] Some say it is safe and prostate protective, but very little research comparatively has been done.

4. Riboflavin (Vitamin B2).  One Japanese study found this to inhibit the 5-alpha reductase enzyme. [4] Unfortunately, dosage is not well-known.

Fructose and High Blood Pressure - Peak Testosterone

So what’s a little high blood pressure (hypertension) among friends? Nothing if you don’t expect to have a sex life:  nearly 70% of men with high blood pressure have erectile dysfunction. [1]  This is particularly scary because it is estimated that nearly 25 percent of Americans have high blood pressure.  That means a heck of a lot of guys struggling with erectile dysfunction and other problems associated with high blood pressure, including stroke and some of the items I cover below.

Elevated blood pressure (hypertension) usually comes with a suite of symptoms called Metabolic Syndrome which, besides robbing you of all your bedroom glory and erectile strength, leads to heart disease and stroke:  having high blood pressure even slightly above youthful 120/80 values leads to greatly increased risk of heart disease. In fact, one 2006 study found that readings of 120-129/80-84 led to a 180% greater heart disease risk probability. [6] And, as I emphasize on this site, heart dysfunction means erectile dysfunction.

High blood pressure is also associated with “brain damage” and that is largely because it is a huge risk factor for strokes. Not all strokes are the kind that leave you drooling and incoherent:  your brain can suffer microstrokes that do month-by-month damage to your precious grey matter.  Microstrokes and microscopic brain damage are yet another reason you MUST lower your high blood pressure:  one large study of 999 men found that “cross-sectional measurements at age 70 showed that high 24-hour BP, nondipping, insulin resistance, and diabetes all were related to low cognitive function”. [10] Other researchers quantified this and found that for each 10 point rise in the last blood pressure number (diastolic), there was a 7% greater risk of cognitive decline. [24] In other words, high blood pressure destroys your ability to learn and remember.

REFERENCES:1) Intl Journ Impot Res, (19)296-302, 2007

2) Clin Nutr 2004;23(3):423-33

3) Nutrition Research, 2001, 21: 1251-1260

4) Jour Nutrition 137:84-87, 2007

5) Amer Journ Clin Nutr 2006; 83:780-787, 2006

6) Am Journ Med 2006(Feb);199(2):133-141

7) Magnesium Res,1989,2:229;PNAS,Oct 15 1984,81(20):6511-15

8) J of Andrology, May/June 2006,27(3)

9) J Nutr,Nov 2007,137(11):2405-2411

10) Hypertension,1998;31:780-786

11) Arch Intern Med,2008,168(7):713-720

12) NEJM,April 17, 1997,16(336):1117-1124

13) https://findarticles.com/p/articles/mi_hb4365/is_/ai_n29180324

14) British Med J, 2008 Jul,15(337):a258

15) Hypertension, 2005, 45:28

16) Biofactors, 2004,22[1-4]

17) European Heart Journal Advance Access published online on June 7, 2007; “The red wine hypothesis: from concepts to protective signalling molecules”

18) J of Clin Hypertension, May 9 2007, 9(4):249-255

19) J Nutr. 2005 Feb;135(2):212-7

20) Am J Cardiol, 2004 Apr 1, 93(7):933-5

21) Circulation, Submitted on Nov 27 2008, Accepted May 15 2009, “Glutamic Acid, the Main Dietary Amino Acid, and Blood Pressure. The INTERMAP Study (International Collaborative Study of Macronutrients, Micronutrients and Blood Pressure”

22) Hypertension, Published Online on Feb 4 2008, Andrew J. Webb, et. al., “Acute Blood Pressure Lowering, Vasoprotective, and Antiplatelet Properties of Dietary Nitrate via Bioconversion to Nitrite”

23) Sleep, Jun 1 2009, 32(6):760-766, “Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk”

24) Neurology, 2009, 73:589-595, “Association of higher diastolic blood pressure levels with cognitive impairment”

25) Amer J of Clin Nutr, March 2005, 81(3):611-614, “Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons”

26) Perez-Pozo S, et al “Excessive fructose intake raises blood pressure in humans” AHA BPRC 2009; Abstract P127

27) Webmd, “Daily Glass of OJ is Heart Smart”

28) Phytotherapy Research, Received: 13 November 2008; Revised: 3 March 2009; Accepted: 11 March 2009, “Hesperidin suppressed proliferations of both Human breast cancer and androgen-dependent prostate cancer cells”, Choong Jae Lee, et. al.

29) Biological Psychology, Feb 2006, 71(2):214-222, “Blood pressure reactivity to stress is better for people who recently had penile vaginal intercourse than for people who had other or no sexual activity”

30) BMC Cardiovascular Disorders,2008, 8:13, “Effect of garlic on blood pressure: a systematic review and meta-analysis”

31) Modesti PA, et al “Daily sessions of music can reduce 24-hour ambulatory blood pressure in mild hypertension” ASH Meeting 2008; Abstract 230.

32) Consumer Reports on Health, Oct 2009, p. 2

33) Prevention, Jan 2010, p. 98.

34) Intl J of Epidemiology, 24(6):1117-1123, 1995, “Dietary Calcium, Potassium, Magnesium and Blood Pressure in the Netherlands”

35) Journal of Hypertension, Jan 2009, 27(1):92-101, “Antihypertensive effect of French maritime pine bark extract (Flavangenol): possible involvement of endothelial nitric oxide-dependent vasorelaxation”

36) American Journal of Clinical Nutrition, Feb 2008, Vol. 87(2):323-331, “Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol”

37) The Lancet Oncology, Jul 2010, 11(7):627-636, “Angiotensin-receptor blockade and risk of cancer: meta-analysis of randomised controlled trials”

38) Am J Clin Nutr, 2009, 90:493-498, “Whole grains and incident hypertension in men”

39) Curr Hypertens Rep, 2007 Dec, 9(6):520-8, “Stress reduction programs in patients with elevated blood pressure: a systematic review and meta-analysis”

40) https://en.wikipedia.org/wiki/Transcendental_Meditation

41) J. Nutr, First published December 16, 2009; “Hibiscus Sabdariffa L. Tea (Tisane) Lowers Blood Pressure in Prehypertensive and Mildly Hypertensive Adults”

42) Am J Hypertens, 2012, 25(6):640-643, “Watermelon extract supplementation reduces ankle blood pressure and carotid augmentation index in obese adults with prehypertension or hypertension”

43) Nutrition Research, Feb 2007, 27(2):119 123, “Cellular effects of garlic supplements and antioxidant vitamins in lowering marginally high blood pressure in humans: pilot study”

44) https://www.dailymail.co.uk/health/article-2110806/Zona-Plus-Can-squeezing-ball-help-cut-blood-pressure.html , “Can squeezing a computerised stress ball help cut your blood pressure?”, by PAT HAGAN

WARNING: High blood pressure medications have recently been implicated as cancer-causing. [37]  The specific class of drugs involved are the ARB’s (Angiotensin Receptor Blockers).  Talk with your doctor about possibly using some of the more natural approaches given below if applicable.

Fortunately, modern research has found many strategies to lower your  blood pressure back down to normal and thus decrease your risk of erectile dysfunction.  What is “normal” blood pressure?  120/80.  Those are the magic numbers. Do not settle for anything over that.  Keep working and working and working – with your doctor of course – at lowering your high blood pressure until you get it below 120/80.

Here are 35 Natural and Research-Backed Solutions to Lower Your Blood Pressure based on the lastest research, of course, in order to keep you out of the land of stroke, heart disease and erectile dysfunction.  Note that the items designated “HEAVY HITTER” lower blood pressure as much as most pharmaceutical blood pressure medications.

CAUTION:  Do NOT make any changes to your blood pressure medications without consulting first with your doctor.  And, if you have high blood pressure, stroke-related issues or heart disease, it is always a good idea to check with your doctor first.

1. HEAVY HITTER: DASH Diet .  This diet is a clinically proven lowerer of high blood pressure .  It is somewhat similar to the Ornish Diet and Mediterranean Diet that I write about in many links on this site in the sense that whole grains, fruits and vegetables are emphasized and saturated fats are avoided. But there are many key differences.  For example, the DASH Diet allows fish, non-fat dairy and nuts (including peanut butter). Furthermore, the DASH Diet does even allow some meat but you have to trim away the fat, buy lean cuts, etc.  Furthermore, there is a kind of ‘pyramid’ where a certain number of servings of different types of food is laid out.

Here is the standard daily eating pattern on this diet:  a) 8 servings of grains, b) 5 servings of vegetables, c) 5 servings of fruit, d) 2-3 servings of skim or low-fat milk, e) yogurt or cheese, f) 5 servings per week of nuts, seeds or beans, g) 1-2 servings of meat, poultry or fish and h) restrict sweets and fats.

But all the effort is well worth diet:  the DASH Diet is also fast at producing results:  in the clinical study it began working within 14 days. Average blood pressures in the original study were 131/85 and the DASH Diet reduced this by 5.5/3.0 (although bigger gains were achieved by those with higher than average pressures). [12] So the DASH Diet almost took the study participants back to normal pressure. Even greater results were achieved in a follow up study that limited sodium as well.

A recent study, which studied 88,000+ nurses found that stroke and heart attacks were significantly reduced as well.  Those whose diets most closely resembled DASH were 24 percent less likely to develop heart disease and 18 percent less likely to have a stroke than those women whose diets strayed most from DASH. [11] Other studies have shown that the DASH Diet lowers bad cholesterol and homocyteine, both strong risk factors for heart disease, as an added bonus.   (The Ornish Diet is still King at heart protection.  But the Ornish Diet is significantly harder to follow for the typical Westerner than the DASH Diet since it is low fat and does not allow meat of any kind.)

<pCAUTION: If you have a medical condition or are on any medications, please discuss any changes with your doctor first. Certain supplements, foods and even juices can alter absorption rates of certain medications for example. Play it safe.2. HEAVY HITTER: Vitamin C and Garlic. A 2013 study came out showing that the combination of Vitamin C (2 grams/day) and garlic (2.5 grams/day)  greatly lowered blood pressure in marginally high hypertensive patients, which means right on the border of 140/90. [43] Neither supplement by itself did much of anything, but, in combination, it took blood pressure down to below 120/80 and increased nitric oxide by three times! Now it would be nice if they did some followup study work, but these two supplements are very well tolerated and appear to be as powerful as any medication that I have read about.  (I would recommend also reading my links on Why Take Vitamin C and Increase Your Nitric Oxide with Vitamin C for some additional information.)

3) HEAVY HITTER: Citrulline. A couple of studies that use a combination of Citrulline + Arginine have shown very substantial decreases in blood pressure. One study gave obese adults with hypertension or prehypertension 6 grams daily of Citrulline with Arginine, which I believe would be 4 grams of Citrulline with 2 grams of Arginine. This led to ankle and brachial reductions in systolic blood pressure of 11.5 and 15.1 mm, respectively! [42]

4. HEAVY HITTER: Ornish Diet.  The Ornish Diet dramatically lowers blood pressure and also cleans out your arteries while it’s at it. In fact, it’s an understatement to say that the Ornish Diet lowers high blood pressure:  it drops it like a rock.  One study of diabetics (half with heart disease) found that their average blood pressure was a high 136/79 and fell to an average of 124/72 on the Ornish Diet.  This is a huge drop and put people with very serious medical condition(s) just a hair above normal! Similar results were found with ‘1,245 participants who had coronary heart disease (55%), diabetes, and/or at least three other risk factors (hypertension, hyperlipidemia, and obesity)’. [13]

5. Sex. That’s right – researchers found that penile-vaginal intercourse (PVI) improved stress reactivity, i.e. arterial blood pressure response to stress. [29]  And you thought research was dry and boring? Now it’s important to note that only PVI and not other sexual activity had this effect. I have already written to the department chair asking if they need volunteers for any follow-up study work.  Also, remember that sex also improves overall mortality and erectile dysfunction!

6. HEAVY HITTER: Dark Chocolate (Cacao). A little known fact is that dark chocolate lowers blood pressure almost as much as the much more well-known DASH Diet mentioned above.  A recent study found that average systolic blood pressure in healthy subjects went from 113.9 to 107.5, a very healthy drop indeed. [25] This is one of the secrets of the ultra heart healthy Kuna peoples. You can bet these folks have lower rates of impotence and erectile dysfunction to go along with it.

7. HEAVY HITTER: Quercetin. A 2007 study showed that supplementation with about 700 mg of quercetin lowed blood pressure by an average of 7 and 5.  [9]  Quercetin is commonly found in various fruits and vegetables. (This is large amount of quercetin.)

8. HEAVY HITTER: Pomegranate Juice .  Heart patients with significant artherosclerosis were given an ounce of pomegranate juice daily and blood pressure lowered on average by 20% .  [2]

9. HEAVY HITTER: Grape Juice. One study on Korean men with mild hypertension who took Grape Juice decreased their systolic blood pr9sure by 7.2 mm on average and their diastolic by 6.2 mm.  [16] This is a very significant decrease. Don’t go crazy with grape juice, however, as it is relatively high in fructose and high fructose consumption is increasingly associated with a host of health issues. CAUTION:  Red wine and Alcohol should, theoretically, lower blood pressure but, in fact, are associated with a small increase in blood pressure. [17] Alcohol is very cardioprotective overall, but if you are hyptertensive, this is definitely a factor to consider.

10. HEAVY HITTER: Juvenon.  This is a supplement that is basically a combination of Acetyl-L-Carnitine, the mitochondria booster, and ALA (Alpha Lipoic Acid), the powerful antioxidant. One study showed a nice reduction in blood pressure in those with Metabolic Syndrome (139 to 130) and hypertension (151 to 142). [18]

11. HEAVY HITTER: Music and Breathing. One study showed that “rhythmically homogenous” music combined with breathing exercises for a half hour a day reduced systolic and diastolic blood pressure in mildly hypertensive patient by 4 and 3, respectively. [31] Furthermore, the results persisted for one month. A variety of music was allowed, including classical, Celtic and Indian, but rhythmic consistency was required.

12. Nitrates in Plant Foods. Researchers have also been discovering that the nitrate content of many plants gets converted to nitrities by the saliva which then raises Nitric Oxide levels in the body and relaxes arteries.  (Yes, that will be good for erections.  One study showed that beetroot juice was particular powerful in this regard, but many other vegetables and grains have nitrates, especially green leafy vegetables. [22] See my link on Beetroot Juice for more details.

13. Pycnogenol. Pycnogenol lowered blood pressure in a randomized, double-blind, placebo-controlled study performed in mildly hypertensive patients. [3][35]  This is just one of the many reasons that Pycnogenol Helps with Erectile Dysfunction.

14. Orange Juice.  One 2009 study showed that the flavinoid hesperidin, found in citrus fruits, lowered blood pressure in adults. [27] The good news is that the amount of hesperidin in the study was the equivalent amount in one (500 ml) glass of orange juice.  Hesperidin also has anti-cancer qualities as well. [28]

15. Grains, Legumes and Beans. Researchers recently found out that the high glutamic acid content in plant products, such as grains in particular, led to a drop in blood pressure. [21]  Glutamic acid is the primary amino acid in plant protein.  Later research uncovered the fact that those who ate whole grains daily, over about 46 grams/day, were 19% less likely to develop hypertension. [38]  All of this may explain some of the powers of the Ornish and DASH Diets to lower blood pressure.

16. Excess Weight.  Lose the Excess Weight. Studies show that as weight increases so does blood pressure (and blood pressure is a huge risk factor for erectile dysfunction [8] and heart disease).  You cannot expect to lower your blood pressure with that spare tire strapped to the middle of your body!  And, not too suprisingly, those excess pounds are directly associated with erectile dysfunction and lowered testosterone as well.

17. Heme Iron. There are two types of iron:  iron from meat (heme) and iron from plants (non-heme).  Heme iron is much more readily absorbed and a recent study found that it is significantly correlated with high blood pressure. [14] This was a large study involving almost 5,000 men and women from Asia, the UK and the US.

18. Fructose.  Watch your fructose consumption.  Fructose is contained in corn syrup, fruits and table sugar and studies show that high blood pressure is significantly correlated with high uric acid levels and – you guessed it – fructose consumption leads to elevated uric levels. [15] One 2009 study found that men put on a high-fructose (200 g/day) diet raised their blood pressure by 6 mm and 3 mm, respectively.  In addition, putting them on a uric acid blocker almost eliminated the increase. [26] You don’t need to worry about the small amount of fructose in fruit:  200 g is a LOT of fructose.  But you should definitely limit sweets and cokes and anything with a substantial amount of sugar or corn syrup.

19. Exercise.  Exercise increases nitric oxide output, which relaxes the vessels and lowers blood pressure. Exercise also leads to lower body inflammation levels which lowers the plaque buildup in your arteries.  Exercise has also been shown to greatly improve erectile dysfunction.

20. Olive Oil.  One recent study showed that olive oil was associated with a 3% drop in systolic blood pressure. [4] (You probably have to have high polyphenol olive oil for this effect, however.)

21. Cutting Carbs.  One recent study found that replacing high glycemic carbs, such as white bread, pasta and sugars, with lean read meats decreased blood pressure by four points. [5] Note:  High levels of cheap carbs are associated with Metabolic Syndrome and insulin resistance, which is in turn associated with hypertension.

22. Magnesium, Calcium and Potassium.  Is sodium the only mineral that affects blood pressure?  Definitely not – researchers have found a trinity of other minerals that are probably more important.  Magnesium, calcium and potassium were found in one British journal, for example, to be associated with lower blood pressure. [7]  Of course, whole grains and veges are loaded with potassium and magnesium. Don’t go crazy with calcium as it’s associated with an increased risk of prostate cancer.

23. L-Arginine. Men with high cholesterol were given 12 g of Arginine per day, which is a lot in my opinion, but did achieve decreased blood pressure and significantly decreased homocysteine, a leading heart disease risk factor. [19] Another study gave 6 g/day of L-Arginine and also found a decrease in blood pressure and an increase in blood flow. [20] Read my link on Arginine. There is study with pycnogenol and Arginine that shows an improvement in erectile dysfunction as well. CAUTION: Do not take L-Arginine if you have had a heart attack recently and read all side effects on the above link as well as discussing with your doctor.

24. Salt Intake .  Be very careful of your salt intake. Time was when the prevailing wisdom was that salt only affected the blood pressure of “salt sensitive” individuals.  However, salt draws water into the arteries increasing the burden on the heart and often increasing blood pressure.  One study published in Sep. of 2009 showed a significant reduction in blood pressure for patients with existing hypertension by decreasing salt to 1, 150 mg per day. [32]

25. Vinegar.  Vinegar probably lowers blood pressure.  It also does a host of other semi-miraculous things as well.  Please read How Vinegar Lowers Blood Pressue and Keeps the Weight Off.

26. Nicotine and Alchohol.  1-2 drinks of alchohol per day is likely heart healthy: studies of light drinking show that it raises HDL (good cholesterol) and decreases cardiovascular risk.  However, the studies show that 3+ drinks per day of alchohol actually leads to increased blood pressure and that means potential erectile dysfunction.  And, as if you didn’t need another reason to quit smoking, nicotine actually constricts blood vessels which of course can lead to increased blood pressure.

27. Insomnia.  Insomnia is correlated with both heart disease and heart failure.  Researchers in one study have found one reason why:  it raises nighttime blood pressures which could be deadly. [23]

28. Eggs. Believe it or not, eggs may actually lower blood pressure.  See my link on Beef and Eggs for details.

29. Nostril Breathing. Did you know that the olfactory nerves connect to the hypothalamus and the hypothalamus helps regulate blood pressure?  Researchers tested a breathing technique involving alternating breathing through each nostril back and forth for about 7 minutes.  This led to a 1 mg drop in blood pressure.  This is a small drop but shows how little we understand the body.

30. Garlic. Supplemental garlic (600-900 mg/day of Kwai powder) lowers blood pressure very significantly.  A meta-analysis found a decrease of about 8 and 7 points in systolic and diastolic pressure for hypertensive patients and the researchers noted that the results are similar to standard high blood pressure medications. [30] Again, anything that lowers high blood pressure is likely to help and improve erectile dysfunction and impotence.

31. Mineral Water. I have covered elsewhere the many problems in tap water, and it may be no surprise that natural water confers some surprising health benefits. For example, Pelligrino – not the seltzers – has 56 mg of magnesium and 208 mg of calcium and in one study significantly lower blood pressure in individuals with mild hypertension. [33] CAUTION:  This may lower stomach acid a bit, which is critical for digesting certain nutrients and vitamins.

32. Berries. A 2008 study showed that moderate berry consumption resulted in decreased blood pressure levels (and increased HDL) in a group of middle subjects. [36]

33. Transcendental Meditation and Progressive Muscle Relaxation. Both of these techniques decreased blood pressure according to one recent meta-analysis. [39]  Forgetting about some of Transcendental Mediation’s strange spiritual connections may be difficult for some [40], but it was the most powerful stress reducing technique when examined just based on the physical evidence.

34. Hibiscus Tea. Hibiscus Tea is a favorite of mine.  It is much-loved in Mexico and known there as Jamaica. I live in the southwest and you can buy it in most of the supermarkets in the Mexican herbal section.  Just throw it in some boiling water for several minutes and pour it over ice (with maybe a half teaspoon of sugar) and – voila! – you’ve got an excellenet ice tea with some bite to it.  In fact, Hibiscus Tea is very popular in a variety of cultures around the world and is a common long-standing ingredient in many herbal tea preparations even here in stodgy, non-exotic America.  Researchers have found that Hibiscus tea has many many excellent properties iincluding ample Vitamin C and the lowering of cholesterol. Perhaps best of all, a 2009 study discovered that the equivalent of about 3 cups of hibiscus tea per day can significantly lower blood pressure. [41]  If you can’t find it locally for some reason, you can order it off of Amazon: Hibiscus Tea – Certified Organic – 24 Teabags.

35. Hand Grip Devices. Using a hand grip device for 10 minutes was recently shown to lower blood pressure several points. This is not a bad reduction for such a simple procedure. It may not produce the same results in those who are already exercising regularly. However, it may be way for someone working a desk job to get some downward motion in this blood pressure during the day? [44]

Black Tea: Good for Erections, Bad for the Brain.

Green tea is remarkable:  it reduces heart disease risk, cancer risk and overall mortality.  But what about the more common, at least to us Americans, black tea?  Does black tea help or hurt the heart?  brain?  erections?

The answer to that is not as simple as it sounds.  Black tea is known to be loaded with polyphenols and phytochemicals that promote health.  Unfortunately, the fermentation process that black tea goes through converts almost all of the EGCG (contained in green tea) to other less effective compounds.

Nevertheless, black tea is powerful stuff with significant superpowers and one meta-analysis found solid evidence that if three or more cups were consumed per day cardiovascular risk would be significantly reduced. [1]  Furthermore, it likely provides protection against a host of ills due to its blood glucose-controlling powers. [4]

What about erections? Will black tea help your sex life? This has never been directly studied as far as I know, but the answer is undoubtedly ‘yes’.  The reasons are:

1.  Caffeine.  Caffeine is a mild PDE5 inhibitor, i.e. is Viagra or Cialis Lite.

REFERENCES:

1) European Journal of Clinical Nutrition, 2007, 61:3 18, “Black tea helpful or harmful? A review of the evidence”

2) Circulation, 2001, 104:151 156, “Short- and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease”

3) Am J Cardiol, Jun 1 2004, 93:1384 1388, “Black tea increases coronary flow rate velocity reserve in healthy male subjects”

4) “Alpha-Glucosidase Inhibitors for Type 2 Diabetes.” Chen, H., Journal of Food Science, published online June 30, 2009

5) Toxicology, Jul 17 2007, 236(3):208-216, “Effects of fluoride on the expression of NCAM, oxidative stress, and apoptosis in primary cultured hippocampal neurons”

6) Archives of Physiology and Biochemistry, 1999, 107(1):15-21, “Fluoride Enhances the Effect of Aluminium Chloride on Interconnections Between Aggregates of Hippocampal Neurons”

6) https://www.redorbit.com/news/health/1891847/ black_tea_has_more_fluoride_than_thought/index.html

2. Endothelial Function.  Erections are all about the endothelium, the delicate lining of your blood vessels and arteries that pumps out that precious nitric oxide for erectile strength.  Black tea has been shown to improve endothelial dysfunction in heart disease patients and even improved blood flow. [2]  Almost everyone in a modern society will have a certain amount of  heart disease.

3.  Blood Flow.  The same study above [2] found that “flow mediated dilation” was significantly improved as well.  Translated, this means improved blood flow and improved blood flow will almost always translate to a more powerful erection. And lest you think this applies only to those plagued with major cardiovascular issues, another study found improved blood flow in healthy male volunteers. [3]

Now I love black tea – it’s probably my favorite day-to-day beverage, yet I am very cautious about it.  Why? The reason has nothing to do with the heart or penis but rather the brain.  Scientists have always know that flouride tends to accumulate in black tea and believe that this is the reason that it likely has not done very well in cognition and brain-related studies.

Fluoride, as it turns out, is very hard on the brain and caused increased oxidation and cell death. [5]  It also worsens the effects of aluminum in the brain [6], another very common dementia-related element.

Of course, the question, when it comes to flouride, is dosage.  Does black tea have enough flouride to merit concern.  It has long been known that instant tea accumulates enough flouride to even cause troubles in the short term, but scientists did not know what to think about regular black tea over long time periods.

A recent study raised even higher levels of concern when researchers found that black tea contained much higher levels of flouride than previously thought.  Previous studies had shown 1 to 5 mg/liter of fluoride in black tea but the level was actually found to be about 9 mg/liter. [6] This level is high enough to cause concern because it could lead to bone and skeletal issues, another issue with fluoride consumption, for heavy tea drinkers.  And if it is causing bone issues, it will simultaneously be wreaking havoc with your neurons as well.

So, for the sake of  your brain, black tea is definitely a drink that should be consumed in moderation and some researchers might even argue sparingly.  Green tea is much safer and more powerful alternative.

Vitamin D: The Dangers of High Levels

It is now fairly well-known in the men’s health community that correcting a Vitamin D deficiency can increase testosterone, something I cover in my page on Testosterone and Vitamin D.  I have seen men on the Peak Testosterone Forum increase their testosterone with the simple supplement.  However, I have also seen other men jump on this and assume, therefore, that the more Vitamin D taken, the better. Below I make the case that this is likely an unwise assumption and even show potential risks of driving your Vitamin D levels too high.

Measuring your Vitamin D levels is a simple, inexpensive test that you can do yourself (here in the U.S.) at any one of these Inexpensive Testosterone Self-Testing Labs. The test is called “25-Hydroxy.”  This is a good idea, because abundant research shows that a Vitamin D deficiency is likely NOT a good thing and has been tied to literally dozens of chronic and autoimmune diseases and conditions.  A deficiency is usually defined as 25-hydroxy levels below 30 ng/ml. (25-hydroxy is just the name of the test for Vitamin D). And, as mentioned above, low Vitamin D can in turn lower testosterone levels . I take Vitamin D every day and am personally targeting 40-50 ng/ml 25-hydroxy levels, but you’ll have to study the research and talk to a good doc and decide for yourself of course.

I would also recommend that you look at the 6 Potential Dangers of Increasing Your Vitamin D Levels Above ~50 ng/ml that I have listed below:

1. Decreased Fertility.  When I first started understanding the importance of Vitamin D, I listened to a Vitamin D supplement representative claiming that 25-hydroxy levels above 140 are common in some indigenous cultures exposed to direct sunlight.  He was clearly arruging for supplementation to very high plasma levels. Like many men, I assumed that I need to really boost my Vitamin D levels to achieve maximum benefits.  However, one of the first clues that there was more to the story came from hearing about the fact that high Vitamin D levels actually lowered male fertility.  One study found that “Sperm concentration, sperm progressive motility, sperm morphology, and total progressively motile sperm count were lower in men with ’25OHD=50 ng ml(-1)’ when compared to men with ’20 ng ml(-1)=25OHD<50 ng ml(-1)’.” [1]

This showed the obvious:  all hormones have a range and Vitamin D was no exception.  (Vitamin D is a considered a hormone by many experts, because it affects so many tissues and systems.)  CAUTION: One study showed that lower levels of Vitamin D likely lower fertility and stated that “the pregnancy rates per patient and per cycle and delivery rates per patient and per cycle were all significantly higher in couples with normal Vit D levels.” [4]  This argued again for a “sweet spot.”

2. Increased Estradiol. While it is true that some hypogonadal men are low in estradiol, the high prevalence of overweight and obese men often leads to unnecessarily high estradiol levels and “estrogen dominance” if you will.  Men in this category do not need more estradiol, and it turns out that Vitamin D is one of the controllers of estradiol levels in both males and females.  Men get their estradiol via the aromatase enzyme conversion of testosterone and Vitamin D governs the aromatase enzyme. One study on mice with deficient Vitamin D levels found greatly reduced aromatase enzyme levels. Estradiol levels were reduced correspondingly by almost 40%. [2][3] Going back to #1, this may explain the decreased fertility in men who take too much Vitamin D:  higher levels of estradiol actually worsen sperm parameters.

3. Poor Study Outcomes. There have been literally dozens of studies giving patients Vitamin D supplementation.  If raising Vitamin D to higher levels was beneficial, it can be (easily) argued that it would have shown up in the research by this point.  However, the studies have actually shown the opposite, i.e. that going above 50 ng/ml either provides no additional benefits or, in some cases, even makes things worse.  This journal summary says it all:

“Even if 25(OH)D values above 50 ng/mL, or even above 100 ng/mL, are unlikely to cause acute toxicity, achieving 25(OH)D values above 50 ng/mL has not been found to be beneficial, especially for the general population.” [6]

4. Increased Mortality Rates. One study showed that death rates increased at either low or high values of Vitamin D.  The authors wrote that “analysis of 24,094 adult patients showed that 25(OH)D levels less than 20 ng/mL and 60 ng/mL or greater before hospitalization were associated with an increased odds of 90-day mortality. Although previous reports have suggested an association between low vitamin D status and mortality, these data raise the issue of potential harm from high serum 25(OH)D levels, provide a rationale for an upper limit to supplementation, and emphasize the need for caution in the use of extremely high doses of vitamin D among patients.” [5]

By the way, this verified what an earlier study had found:

“In this study from the general practice sector, a reverse J-shaped relation between the serum level of 25(OH)D and all-cause mortality was observed, indicating not only a lower limit but also an upper limit. The lowest mortality risk was at 50-60 nmol/liter. The study did not allow inference of causality, and further studies are needed to elucidate a possible causal relationship between 25(OH)D levels, especially higher levels, and mortality.” [7]

5. Higher Cardiovascular Disease Rates. A 2009 study found that non-institutionalized seniors had an inverse association with cardiovascular disease risk.  In other words, basically the lower the Vitamin D levels, the lower the risk of heart disease! [8] It is hard to know the cause for this but remember that Vitamin D controls the body’s calcium levels and, therefore, potentially Vitamin D could push calcium into soft tissues.  Yes, arterial plaque is calcium, so perhaps this is the mechanism.

6.  Increased Pancreatic Cancer Risk. There is a recent study that shows 5000 IU of Vitamin D regressed prostate cancer.  However, yet another study found that going too high seemed to increase risk:

“No significant associations were observed for participants with lower 25(OH)D status. However, a high 25(OH)D concentration (> or =100 nmol/L) was associated with a statistically significant 2-fold increase in pancreatic cancer risk overall (odds ratio = 2.12, 95% confidence interval: 1.23, 3.64). Given this result, recommendations to increase vitamin D concentrations in healthy persons for the prevention of cancer should be carefully considered..” [9]

CONCLUSION: We now have several studies, some even large and recent, that show that raising 25-hydroxy levels above 50 (or perhaps 60) ng/dl is risky and associated with increased risk of chronic disease.  Results seem to indicate that there is an optimal zone for Vitamin D.

REFERENCES:

1)  Asian J Androl, 2012 Nov, 14(6):855-9, “Association of 25-hydroxy-vitamin D levels with semen and hormonal parameters”

2) Endocrinology, 2000 Apr, 141(4):1317-24, “Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads”

3) https://press.endocrine.org/doi/10.1210/endo.141.4.7403?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed (Full study of #2)

4)  Reprod Biol Endocrinol, 2015, 13: 127, “Males with low serum levels of vitamin D have lower pregnancy rates when ovulation induction and timed intercourse are used as a treatment for infertile couples: results from a pilot study”

5) J Clin Endocrinol Metab. 2014 Apr;99(4):1461-9, “Evidence for a U-shaped relationship between prehospital vitamin D status and mortality: a cohort study”

6) Mayo Clinic Proceedings, May 2015, 90(5):577 586, “Changing Incidence of Serum 25-Hydroxyvitamin D Values Above 50 ng/mL: A 10-Year Population-Based Study”

7) J Clin Endocrinol Metab, 2012 Aug, 97(8):2644-52, “A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study.

8) J Am Geriatr Soc, 2009 Sep, 57(9):1595-603,Epub 2009 Jun 22, “Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults”

9) Am J Epidemiol, 2010 Jul 1, 172(1):81-93, “Circulating 25-hydroxyvitamin D and risk of pancreatic cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers.

Dr. Esselstyn's Method for Plaque Reversal - Peak Testosterone

The book Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn is now a classic. Dr. Esselstyn was one of the early pioneers of plaque reversal and enjoyed considerable success at the well-known and respected Cleveland Clinic. What is particularly remarkable is that he achieved recognition in spite of the fact that he was a surgeon and not a cardiologist. Not only is he not a cardiologist, but he is a rare individual among M.D.’s, because he has devoted his time and energy to disease prevention and disease reversal through lifestyle means. What a concept!

Seriously, how many physicians do you know that believe lifestyle changes can cure medical conditions and discuss the same in any detail with their patients?  From what I have seen, the great majority of physicians are almost completely ignorant of this kind of preventative medicine and much prefer and respect pharmaceutical and surgical solutions. So kudos to Dr. Esselstyn for going against the current.

So just how does Dr. Esselstyn reverse plaque? Basially, the game plan is simple: eat a low fat vegan diet composed of legumes, fruit, vegetables and whole grains with the goal of dropping your total cholesterol below 150 and LDL less than 80. If you can’t achieve these numbers through diet alone, he will give a statin. But, in his case, a statin is a last resort and I have the impression used a relatively low percentage of the time with patients.

Again, the point is that Dr. Esselstyn believes that plaque reversal has been made too complex and summarized his philosophy nicely here:

“If you follow a plant-based nutrition program to reduce your total cholesterol to below 150 mg/dl and the LDL levels to less than 80 mg/dl, you cannot deposit fat and cholesterol into your coronary arteries. Period.” [1]

1)   Prevent and Reverse Heart Disease, by Caldwell Esselstyn, Jr., M.D., p. 33.

Sound too good to be true?  Well, Esselstyn states that his patients have cleared out between 10-30% of their arterial plaque just through following his dietary advice.  And thus leads to big improvements in blood flow.   He insists that his patients follow a strictly plant-based diet. Again, his rules are simple, but many would find them hard to follow, and include whole plant foods without nuts, oils or avocados. So he is very strict: no animal products, oils, fats, margarines, etc.

Again, this is so simple:  you eat four kinds of food – nothing more and nothing less.  Dr. Esselstyn does not emphasize stress management or exercise and believes those do not affect plaque reversal.  I also do not see any mention of triglycerides or HDL.  Again, his strategy relies on bringing LDL way down below the concentration at which it can be deposited in the arterial walls.

The reasoning here is based on the principles some of us learned in high school chemistry:  the concentration on one side of a membrane must be high enough to move molecules across that membrane.  In this case the membrane is the endothelium and the concentration at which LDL can be pushed into the arterial walls is right at 80 mg/dl according to a variety of research. So basically if you lower the concentration below 80, then atherosclerosis cannot progress.

He also is a big believer in plant-based nutrition, because it a) is so powerfully anti-inflammatory and b) promotes endothelial function.  I don’t remember him directly saying this in the book, but low fat plant foods tend to increase nitric oxide and nitric oxide is a powerful anti-inflammatory. Furthermore, low fat plant foods tend to lower blood pressure, which is critical, because even mildly increased blood pressure above 120/80 is very hard on arterial walls.  All of this is the subject of my book, The Peak Erectile Strength Diet, for example.

b) Drs. Gould and Davis allow for some meat consumption and Dr. Gould for the consumption of dairy.  (Dr. Esselstyn started out allowing low fat dairy, but stopped that recommendation, because he believe that dairy may fuel some types of cancer.)

c) Drs. Gould and Davis do not exactly emphasize exercise but insist that you do some.  Dr. Esselstyn does not even make exercise part of his program.

This list could go on, but let me stop there and say also that the packed with lots of excellent information.  He has lots of practical tips, such as how to eat low fat when travelling and with family, recipes, case studies and on and on.  Again, this is another book that should be on your nightstand and read every night – it’s that important.

NOTE:  For those unfamiliar, I have discussed the other plaque-reversing strategies here:   A Review of Heal Your Heart by Dr. K. Lance Gould and A Review of Track Your Plaque by Dr. William Davis.

Propecia Syndrome Cures - Peak Testosterone

I took Propecia (finasteride) briefly for male pattern baldness and sometimes I wonder if it put the accelerator on issues I was already experiencing from low testosterone. (More on that below.) And I’m not alone as many men experience issues after this DHT-lowering medication. Experts estimate that between 5-20% of men that use Propecia will experience significant sexual side effects, including erectile dysfunction and lowered libido.  As I discuss in my page on Propecia and Depression, long term psychological side effects are probably much more prevalent due to finasteride’s negative effect on brain GABA levels. Common complaints of “Post-Finasteride Syndrome (PFS)” as it is termed includies things like brain fog, testicular/prostate pain, “lifeless” gonads (eunich-like) and low androgen hormone levels.

If you read about the experiences of those coming off of Propecia, it can be overwhelming and even discouraging.  As I document in my link on The Risks of Propecia, the effects can not only affect the gonads but also the brain and can easily become a life-changing event. One can quickly lose hope.  The good news is that I can say that I have seen a few things that have worked for those with PFS and I discuss those cases below:

1. Case #1. HRT (Testosterone Therapy). HRT does not always help victims of Propecia, but sometimes it works very well. From what I have read, PFS sufferers tend to have lower testosterone levels.  However, it is my belief that this is not because Propecia causes low testosterone but rather because low testosterone men are very vulnerable to the negative brain effects of Propecia.  The reason for that is simple:  low testosterone can cause depression (and anxiety) and I show the research evidence in my page on Testosterone and Depression. Many men on the Peak Testosterone Forum can attest to the fact that HRT has greatly helped them in this area.

So clearly the last thing a low testosterone man needs is Propecia, which will likely then lower his GABA levels significantly. GABA, along with serotonin, are the “relaxing / peace-and-harmony” neurotransmitters.  Low GABA levels are associated with – you guessed it – increased depression and anxiety.  Therefore, one would think that restoring testosterone levels in a PFS hypogonadal man would at least partially reverse these negative psychological symptoms.

3.  Case #3 (Weights, Running, Fish + Lifestyle). This was another young man who took it for 8 years starting at age 18! He was able to largely recover in just six months by doing the following:

The important point is that it appears that hormonal adjustments and lifestyle changes can greatly reverse the negative effects of PFS.  And, undboubtedly, it may take to heal as well.  There is simply no reason to despair and give up hope, and, as always, I want to warn against is “just giving up”.  Men can assume that they have done permanent damage, when, in fact, that does not have to be the case.  However, if you give up, and succumb to the stress and erectile dysfunction and then post-finasteride syndrome often likely heads into a downward spiral.

Notice also that what they did for a cure was really not that complex: a good, clean nutrient dense diet with weight lifting coupled with a few supplements that emphasize omega-3’s, a multivitamin and maca. Of course, I prefer what I call Low Fat Paleo, which should be much more arterial protective based on my personal experience. Regardless, the point is that these men got off of their standard Western Diet and took control of their health. Weight lifting for those, who do not know, has several studies showing that it can boost T, something I document in my link on Testosterone and Weight Lifting. Weight lifting can also help you burn calories for 24 hours afterward and is a proven nitric oxide booster. You do have to be a little careful about Lifting Weights and Your Arteries perhaps.

Some men resort to pharmaceutical solutions that target GABA, which can be lowered by Propecia.  This is not good, of course, because these can be addictive.  Of course, I encourage always trying to find a natural solution even if it takes a bit more time.  In the long run, it is a much safer path to travel upon.

This is, in fact, exactly what I believe happened to me.  On my page How I Believe Propecia Negatively Impacted My Health, I discuss how looking through my old records revealed that I started really having difficulties with my health immediately after about six months on Propecia (to supposedly halt hair loss).  It took years before I finally got on testosterone therapy, but, when I did, it was a life saver for me.  It was like night and day mentally and psychologically.  My depression was completely gone and anxiety was lowered about 50%.  My boss commented on the positive improvements and said, “I don’t know what it is, but you’re a lot easier to work with!”

2.  Case #2 (Lifestyle + Supplements).  This young man was able, over time, to almost double his testosterone to 430 ng/dl. Of course, 430 is still pretty low testosterone, but a big improvement nonetheless.  He was determined not to go on HRT as he wanted to preserve his fertility and, hopefully, rebuild his HPT function.  However, he felt much, much better and here is how he said he did it: [1]

Female Libido, Increasing - Peak Testosterone

Is it possible that you could be doing everything right, but still find that she is not interested in sex? Yes, that is certainly possible and we will show some of the common reasons on this page and how to overcome them. Just like males, females can suffer from low libido and damaged endothelial tissue.

This makes sense, if you stop and think about it, because so much of a woman’s orgasm is similar to a males’.  For example, none other than Masters and Johnson found that the clitoris both increases in width and length upon sexual arousal. In other words, in some ways at least, the clitoris is really a mini-penis.  In fact, one could argue that blood flow is even more critical for the female.  And researchers have found that Nitric Oxide plays an important role in female sexual response as well, both for engorgement and lubrication. [1]

And it did this without increasing estrogen levels, which is important because of potential breast cancer risks.  Also, the supplement significantly helped perimenopausal and postmenopausal women as well:  “In contrast, among PERI women, primaryimprovements were reported for frequency of intercourse (86%; p =0.002), satisfaction with sexual relationship (79%; p = 0.03), andvaginal dryness (64%; p = 0.03) compared with placebo group.”  The postmenopausal group also improvment, but primarily in the area of sexual desire.  (NOTE:  The study was published in a peer-reviewed journal, but it should be noted that it was funded by ArginMax.)

The significance of these results is that ArginMax for Women is composed primarily of ginseng, L-Arginine and gingko.  All three of these have had clinical success with males by increasing some combination of Nitric Oxide, endothelial function or blood flow.  In other words, female sex drive and function is often dramatically helped by the same underlying issues that dramatically help male sex drive and function.

Is there additional evidence that this is the case?  Well, there is another study showing that L-Arginine and Yohimbe significantly helped women with physical arousal.  [3]  Again, L-Arginine is the substrate for Nitric Oxide and Yohimbe increases blood flow.  And, once again, both of these ingredients have clinical studies showing that they help male erectile dysfunction.  Clearly, the problem is that we too often assume that that male and female sexual physiology is completely different, which is clearly not the case. Obviously, the underlying fundamentals are there for both.  CAUTION:  I do not recommend yohimbe for anyone as it can increase blood pressure, sometimes dramatically.

Yet another example is the fact that Kegel Exercises, the very ones that help men with erectile dysfunction, also help women with their sex life as well. Other examples abound:  researchers have found that many of the same basic risk factors for male erectile dysfunction, such as high blood pressure, poor lipid profiles and cigarette smoking, are also risks for female sexual functionality. [5]

So the bottom line – after checking with a doctor of course! – is that most of the things in my pages for Erectile Dysfunction Supplementation and How to Improve Your Erectile Dysfunction should help the woman in your life as well.

Female Libido, Testosterone and the Thyroid Hormone

Females and males share another common issue with libido:  hormones can play a dramatic role.  It is probably no surprise that testosterone, estrogen and thyroid hormones can significantly influence sexual desire in females. Let’s start with the case of thyroid issues. Hyperthyroidism, an overactive thyroid, can turn your woman into a nymphomaniac, but then you probably wouldn’t be reading this thread then, would you?  Conversely, hypothyroidism, an underactive thyroid, will almost for sure do the opposite for the female in your life.  In women hypothyroidism can lead to high prolactin levels, which is very hard on her sex life. [6]  High prolactin levels lead to low libido, decreased lubrication and more difficulties achieving orgasm.  And the problems don’t just stop there:  low thyroid levels often decrease both testosterone and estrogen as well.

Testosterone, as is the case in men of course, is associated with libido.  One study showed that women at age 41 typically have about half of the testosterone they had at 21. [8] This is an even more steep decline than the typical male experiences during andropause and can definitely affect her libido, although some studies show not as much as you might think.  One study shows that females can substantially optimize their testosterone through a low glycemic diet. Scientists put a group of females on low and high glycemic load diets with a washout period in between.  What they found was that females produced on average 22% less testosterone on the high glycemic diet versus the low. [9]

Now this brings up an interesting point:  guys can send their Nitric Oxide and erectile strength through the roof by eating a healthy, low glycemic Mediterranean or Low Fat Diet. Plus, by encouraging their wives or girlfriends to do the same, they will likely boost their woman’s libido through testosterone and sexual function through increased Nitric Oxide and blood flow.  Talk about a win-win situation!

The alternative is to eat like everyone else and slowly destroy your endothelium and hormones, curse the darkness and bitch and moan about how unfair life is.

REFERENCES:

1) J Urol, 2000, 163: 888 893

2) J of Sex & Marital Therapy, 2006, 32:369 378.   (Note that a previous study showed good results as well: J Sex Marital Ther, 2001, 27:541-549.)

3) Arch Sex Behav, 2002, 31(4):323-332

5) J Urol, 2000, 163: 888 893

6) J of Urology, 2005, 174(5):1921-1925

7) Glamour, Apr 2008, p. 200.

8) J Clin Endocrinol Metab, Apr 1995, 80(4):1429-30, “Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women”

9) Endocrine Abstracts, 2007, 13:P286, “Effect of Glycaemic index of the diet on salivary cortisol and testosterone levels in females”

10) Fitness Magazine, May 2006, p. 52

Kegel - Peak Testosterone

Kegel Exercises for men are yet another natural solution that has been shown in many males to be as powerful as a Viagra or Cialis, exercise of course being another. The power of Kegel Exercises over Erectile Dysfunction was shown in one 2005 British study which put men in two groups:  1) men who made lifestyle changes (such as smoking cessation, weight reduction, exercise, etc.) and 2) those who made lifestyle changes + Kegel exercises. [1] After 3 months the results of group #2 were so dramatic that the researchers put everyone on Kegel exercises.

Think about that:  the Kegel Exercises for Men group did much better than a group that quit smoking, was exercising and reducing weight, all of which are proven erectile dysfunction fighters. After six months 76% of the men had significantly improved their erectile function. That’s three out of four and is on par with Viagra or any other erection-enhancing drug out there.  The researchers concluded that “this study suggests that pelvic floor exercises should be considered as a first-line approach for men seeking long-term resolution of their erectile dysfunction“.  In other words, Kegels improve erectile dysfunction in a strong majority of cases.

So what are Kegel Exercises?  They are the easiest exercise you will ever do in the sense that you can do them anywhere, anytime and noone will ever know.  You don’t have to drive to a gym or find a track or enroll in a program to do Kegel Exercises, nor do they take long to do.  The only trick for beginners is knowing which muscles they are supposed to exercise.

To find the right “pelvic floor” muscles for Kegel Exercises, simply urinate and then cut off the flow.  You should feel muscles at the base of the penis a little above the anus contracting. You should feel a contraction in this area, because these muscles run from the anus to the base of the penis. The technical name for this muscle is pubococcygeus or “PC group”. Whatever you want to call them, it is these boys that you’ve got to get back in shape!

1) BJU Int,Sep 2005,96(4):595-72) The G-Spot and Other Discoveries About Human Sexuality, Alice Kahn Ladas, MSS, Ed.D, Beverly Whipple, Ph. D., and John D. Perry, Ph. D., 1982, p. 88.

3) Sexologies, 17(1):S136, April 2008, Page S136, “The importance of the Kegel exercises for the erection of the male and female erectile organs (male and female penis)”

4) Benjamin Graber and Georgia Kline-Graber, Female Orgasm:  Role of the Pubococcygeus Muscle, p. 348-51.

5) ARCHIVES OF PHARMACAL RESEARCH, 2001, 24(5):437-440, “Effects of Eurycoma longifolia Jack on laevator ani muscle in both uncastrated and Testosterone-Stimulated castrated intact male rats

Another negative sexual symptom of atrophied, out-of-shape PC muscles in males is a long refractory period.  “Refractory period” refers to the amount of recuperation time that it takes after an orgasm before you can have another orgasm. [3] And it makes sense, because Kegel Exercises get the muscles back in shape that are used in creating and maintaining an erection.  And, cmon, aren’t you interested in anything that might help you more quickly do back-to-back orgasms??  Other reported benefits of Kegel Exercises for men are 1) lasting longer and 2) a stronger ejaculation. Woo hoo!

By the way, Kegel Exercises may tie into low testosterone as well.  One of the symptoms of low testosterone is atrophy of the penile muscles, including the PC muscles engaged through Kegel Exercises. That is why I highly recommend that you boost testosterone through natural means (sex, sleep and the mind for example) or through HRT.  But the point is that Kegel Exercises can undoubtedly help you partially overcome the effects of low testosterone.

HERBAL HELP?:  One herb that may help to build PC muscles is Tongkat Ali (Eurycoma Longfolia). A couple of animal studies have shown mild androgenic (testosterone raising) properties and still others that it is a strong libido enhancer.  Both of these will lead, directly and indirectly, to improvements in muscle tone in the pelvic area.  In fact, one animal study showed that.  One animal study even documented a significant increase in size in the leveator ani muscle. [5] For more information, on Tongkat Ali, see #28 in my link on Improving Male Fertility.

CAUTION: Watch the bike riding.  Bike riding (on standard seats) can damage the pudendal nerve, which innervates these same pelvic mucles.  This is one of the reasons that bike riding is often associated with erectile dysfunction.

Kegel Exercises and BPH (Enlarged Prostate)

You should also consider Kegel Exercises if you are experiencing urinary incontinence due to BPH (Enlarged Prostate). For those who don’t know:  often when men begin to experience BPH, the ensuing overstress of the bladder muscles leads to a little leakage after urinating.  Once again, Kegel Exercises come to the rescue. A weak, atrophied PC muscle is about a finger-width think, whereas a healthy one is usually about three fingers in thickness.  Remember that the PC muscles activated by Kegel Exercises are, among other things, blood movers and blood is what erections are all about.

How To Do Kegel Exercises for Men

So how do you widen and strengthen your PC muscle?  It is surprisingly easy.  Here are the basic Kegel exercises:

1. Contract your urinary flow muscles and hold for a count of ten (1000-1, 1000-2, etc.). NOTE: You don’t have to be actually urinating to do this of course!  Once you learn to feel these muscles, this can be done anywhere, anytime.  To learn to feel correct Kegel Exercises, you can also try the Towel Trick, which is simply to hang a small washcloth on your erect penis and then move the washcloth up and down from the contraction of the PC Muscle. You can then ‘graduate’ to a handtowel and even a regular shower towel from there.

2. Relax these muscles completely for another count of ten.

3. Perform ten of these cycles four times a day.

Every few days or each week, up the number of contractions and the count a little.  When your contractions become strong enough through the Kegel Exercises, you will feel the blood flow into the penis which will lead to stronger and longer-lasting erections.  Rumor has it that Kegel Exercises also help develop the ability to ‘shoot’ your sperm farther, although I have never been able to substantiate that with a study. However, one journal study did document that Kegels can actually help guys push out more semen volume which could explain this phenomenon. [3]  (And I’m not so sure it’s that important as the woman of your dreams would probably only be frightened by you flinging your little sailors onto the ceiling and walls.)

If you’re low testosterone or if these muscles have just gotten out of shape from disuse, you may find step one very difficult to do.  You may find that you can only hold the contraction for only a few seconds at first.  But keep working at it and you will find your abilities increasing rapidly – these muscles respond quickly to exercise.

NOTE:  Kegel Exercises are very important to females as well.  They have many clinical uses, but one of the interesting ones is that Kegel Exercises can actually increase vaginal lubrication in women. The reason is that as a woman contracts her pelvic muscles, blood flow increases to the area which acclerates her natural lubrication.  This can be an important tip to women that are older or have gone through menopause. Furthermore, some women (through childbirth or atrophy) will leak a little urine when laughing or playing sports, for example. Kegel Exercises can often heal these kind of problems.

By the way, Kegel Exercises are often quite arousing for women. Researchers have found that many women have actually quit Kegel Exercises because of the unresolved sexual tension created by exercising these pelvic muscles.  In fact, in many women healthy PC muscles can be the key sexual enjoyment and orgasm.  [4]

So, guys, don’t let the women have all the fun.  It is time to get busy –  Kegel Exercises for Men are yet another one of those all-to-gain-and-nothing-to-lose things that I put on this site.  Next the Little Woman comes into the bathroom, I want you to toss her a towel – with your hands tied behind your back…

Low Carb Diets: Do They Fuel Inflammation? - Peak Testosterone

I have gotten some heat, because I state that Low Carb Diets often increase inflammation.  And, for the record, I didn’t make this up:  a number of studies have shown this to indeed be the case.  However, I do have to admit that there are two sides and so, to be fair, I’ll cover some of the key research, both pro and con, so you can make up your own mind.

Also, keep in mind that I am not biased against meat eating per se and eat some meat myself:  I just prefer low fat cuts for arterial and nitric oxide protection.  Furthermore, I love weight lifting and consume a lot of protein, so I’m not biased against protein.  So, while it is true that I have my biases against high fat meals – you can see this in my page on The Potential Negative Consequences of a High Fat Meal (including Testosterone) – I do try to be open-minded.

That said, I’ll start with some of the studies that show issues with Low Carb Diets and increased inflammation:

4. Overweight Men and Women with Reduced Calories.  In this study, participants were put on either a “Low Fat Diet” or a Low Carb Diet. [5] Now, first of all, notice that this is not really a Low Fat Diet. As I often point out, what is a Low Fat Diet to you and me (10-15%) is not a Low Fat Diet to researchers.  Here were the macronutrient percentages so that we all know exactly what is being talked about here:

Low Carb:  28%/12%/60% (Protein/Carb/Fat))

Low Fat:  20%/56%/24% (Protein/Carb/Fat)

Again, 24% fat is not even close to a Low Fat Diet. That said, the most important take away from these two studies is that both diets dramatically reduced virtually all inflammation parameters.

Which diet produced the greatest reductions in inflammation?  Interestingly enough, the Low Carb Diet reduced the two ultra-critical cytokines the most:

IL-6  5.5 (Low Carb) versus 6.3 (Low Fat) [pg/ml]]

TNF Alpha   1.9 (Low Carb) versus 2.3 (Low Fat) pg/ml

Part of this may be because the Low Carb group dropped their calories the most, from an average of 2351 to 1504, whereas the Low Fat cohort only dropped their calories from 2082 to 1478.  Nevertheless, one can’t avoid the fact that the Low Carb Diet did a fantastic job of lowering inflammation, seemingly contradicting the three studies above.

“But I thought Low Fat Diets were the king of inflammation lowering?”  Well, under weight loss conditions, this study shows that in some cases Low Carb Diets do remarkably well. The authors concluded that “these data implicate dietary carbohydrate rather than dietary fat as a more significant nutritional factor contributing to inflammatory processes; although increased fat in the presence of high carbohydrate may be particularly deleterious.” [5]

5. Overweight and Obese Young Adults. Now let’s go to a second study that looked at 3 diets in “weight loss maintenance mode”. [6] All cohorts had calorie levels around 1,600, which to me is dieting and not maintenance, but the results are interesting.  The press widely reported that this study showed that Low Carb Diets were higher in inflammation.  That is true, but only by a small amount (~10%) and the real point is that all diets showed CRP < 1.0.  In other words, inflammation was low regardless of macronutrient composition.

So what is a fella to do? One large, very well done study shows that Low Carb Diets do excellent with inflammation and yet a significant body of previous work says that Low Carb Diets can boost inflammation and other cardiovascular risks. My guess is that it really depends on several key factors:

Personally, I think the safest way to go is to just avoid Low Carb Diets. However, there is another option: monitor inflammation before and after a Low Carb Diet. Hopefully, your doctor will work with you on this. Perhaps you can get some of your testing covered by insurance. If not, then check out my page on Reasonable Labs for Self-Monitoring. If you go on a Low Carb Diet and you see that your inflammation and other heart disease parameters are looking good, then all may be well and you may have found the sweet spot for these kind of diets.

REFERENCES:

1) https://www.atkinsexposed.org/atkins/192/ Atkins_Ignores_More_Important_Risk_Factors_which_Worsen_on_Atkins.htm

2) Mayo Clin Proc, 2003 Nov, 78(11):1331-6, “Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease”

3) Prev Cardiol, 2002 Summer, 5(3):110-8, “The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors”

4) Circulation, 2007, 116:II_819, “Abstract 3610: Comparative Effects of 3 Popular Diets on Lipids, Endothelial Function and Biomarkers of Atherothrombosis in the Absence of Weight Loss”

5)  Lipids (2008) 43:65–77, “Comparison of Low Fat and Low Carbohydrate Diets on Circulating Fatty Acid Composition and Markers of Inflammation”

6) JAMA, Jun 27 2012, 307(24), “Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance”

1. Obese Men with Heart Disease. One study found that after six weeks on a “high saturated fat, no starch diet”, participants lost weight yet doubled their CRP. Of course, CRP is C-Reactive Protein and is considered an excellent broad range marker of systemic inflammation. [1][2] And it has been shown in various studies to be a risk factor for heart disease, autoimmune conditions and even Alzheimers.

2. Normal Men and Women. This study found that fibrinogen – a clotting-related inflammatory risk factor – and MANY cardiovascular disease markers were uniquely worsened on a Low Carb Diet. [3] The authors stated that “only patients following HF [high fat] diets showed a worsening of each cardiovascular disease risk factor (LDL-C, TG, TC, HDL-C, TC/HDL ratio, Ho, Lp(a), and fibrinogen), despite achieving statistically significant weight loss.”  Like #1, this was particularly surprising because usually patients improve during weight loss no matter what is eaten.

3. Young Adults.  Other research looked at a Low Carb diet with 50% fat versus a true Low Fat (10%) Diet and found that “in the absence of weight loss, the high fat Atkins [Low Carb] diet is associated with increased LDL-C, reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis.” [4] In other words, once you stop cutting calories and the dieting is over, your inflammation will rise and your blood flow will decrease.

A Low Carb Diets: Inflammation Action Summary

Branched Chain Amino Acids - Peak Testosterone

Branched Chain Amino Acids are a magical set of aminos called L-Leucine, L-Valine and L-Isoleucine.  Ever wonder why you need protein to put on muscle?  The correct answer is “Branched Chain Amino Acids”.  There are many aminos in animal and vegetable proteins, but it is just the BCAA’s that signal your body to rebuild your muscles, initiate protein synthesis and promote recovery.

Below are some of the wonder-working powers of BCAA’s for us males according to the research:

1) Protein Synthesis. BCAA’s increase protein synthesis and decrease protein degradation in muscle tissue due to activation of certain key enzymes. [1]

Well, one could go on and on about the near miraculous properties of these BCAA’s when it comes to muscle.  Now some guys might be asking, “Well, I don’t want to look like Arnold.  Who cares about putting on a bunch of muscle mass, anyway?”

To those naysayers, I have to explain that muscle mass is likely one of the keys to anti-aging.  (It’s also a key to your bedroom success and self-image.) Preserving your muscle is very critical, because “muscle burns fat”.  As we age, it’s easy to simultaneously lose muscle and gain fat tissue.  This reduction of our muscle to fat ration is very dangerous and makes it even easier to put on more fat. And extra body fat, as I document in my links on the Dangers of the Bulge and Nasty Visceral Fat, kills your health and your sex life.

However, Branched Chain Amino Acids do not just fight fat metabolism issues long term – studies show they fight them short term as well according to several animal studies.  For example, one 2007 study on mice showed that in overweight mice on a high fat diet, doubling leucine resulted in a dramatic reduction in weight gain and reduction in fat tissues. [8] This has translated to human studies as well.  A 2010 study of middle-aged people found that those with the lowest (by quartile) intake of BCAA’s versus those with the highest had a 30% greater risk of being overweight. [5] In other words, BCAA’s do just as billed:  helping the middle aged and beyond  “lean out” and win the battle the bulge.

How do Branched Chain Amino Acids work their magic?  One way may be through impressive changes in blood sugar metabolism once one has Metabolic Syndrome or prediabetes. To demonstrate this, researchers gave mice a high fat diet, which induces insulin resistance, fatty liver disease and inflammation. They then doubled the mice’s leucine intake and the results were near miraculous:  it improved their insulin resistance and prediabetic state in many key metabolic pathways. [9][10]

Again, this is incredibly important because so many middle-aged and beyond adults in a modern lifestyle struggle with M, prediabetes and insulin resistance.  BCAA’s is likely another potent weapon in their glucose metabolism arsenal.  (See my link on Prediabetes Prevention for more information.)

All of this may be why a study of middle-aged mice showed even more impressive gains: a 12 percent average increase in life span from Branched Chain Amino supplementation. [6] Of course, longevity studies on mice don’t always translate into the equivalent gains in humans, but one can’t help but see that the current  research is showing that BCAA’s are likely just as beneficial for the middle-aged – and maybe more – than for young, healthy bodybuilders.  The middle-aged may be able to avoid much of the muscle-wasting effects of the latter years by taking just a few grams of this supplement or making sure to include enough protein in the their diet.

REFERENCES:

1) J. Nutr, 136 (1 Suppl):269S 73S, “Branched-chain amino acids activate key enzymes in protein synthesis after physical exercise”

2)  Int J Sport Nutr Exerc Metab, 2010 Jun, 20(3):236-44, “Branched-chain amino acid supplementation before squat exercise and delayed-onset muscle soreness”

3) Med Sci Sports Exerc, 2000 Jul, 32(7):1214-9, “The effect of BCAA supplementation upon the immune response of triathletes”

4) Journal of the International Society of Sports Nutrition, 2009, 6(Suppl 1):P1, “Consuming a supplement containing branched-chain amino acids during a resistance-training program increases lean mass, muscle strength and fat loss”

5) J. Nutr, Dec 15 2010, “Higher Branched-Chain Amino Acid Intake Is Associated with a Lower Prevalence of Being Overweight or Obese in Middle-Aged East Asian and Western Adults”

6) https://www.eurekalert.org/pub_releases/2010-10/cp-aas092910.php

7) Cell Metab, 2009 Apr, 9(4):311-26, “A branched-chain amino acid-related metabolic signature that differentiates obese and lean humans and contributes to insulin resistance”

8) Diabetes, Jun 2007, 56(6):1647-1654, “Increasing Dietary Leucine Intake Reduces Diet-Induced Obesity and Improves Glucose and Cholesterol Metabolism in Mice via Multimechanisms”

9) PLoS ONE, 2011, 6(6):e21187, “Dietary Leucine – An Environmental Modifier of Insulin Resistance Acting on Multiple Levels of Metabolism”

10) https://esciencenews.com/articles/2011/06/23/ dietary.leucine.may.fight.prediabetes.metabolic.syndrome

Varicocele Repair: Increasing Testosterone Levels - Peaktestosterone

STEP 9:  For this reason I have included taking care of a varicocele as a step in my Peak Testosterone Program.  (For the other steps to the program, see my Home Page.) Of course, varicocele procedures aren’t going to help all men, but they will definitely significantly help a big percentage and will help with some of the symptoms that seem to plague us guys in modern societies, such as low libido, poor sleep, lack of energy and low levels of various hormones.  And, again, what is particularly remarkable is that some doctors will tell their patients that a varicocele procedure will not improve testosterone or their health in general, when, in fact, there are multiple studies that show just the opposite.

As an example, look at what this M.D. wrote about varicoceles:

“If a teenager or young man with a varicocele has a smaller than normal testicle on that side, there is an increased risk of infertility and many urologists consider this an indication to fix the varicocele surgically. Rarely, a varicocele may lower the testosterone level. In this instance, the testes are usually smaller than normal. Such a circumstance may decrease the libido. Evaluation of the serum free testosterone level can detect this.” [10]

Rarely?!?  I just do not understand why a doctor would make such a claim when there are a number of studies that say just the opposite.  Let’s look at some of the research about varicoceles and what repairing them can do for you along with some of the experiences of men on the forum:

1. Increased Testosterone. Will every man get an increase in testosterone?  Of course not.  Nevertheless, the studies show very powerfully that most men likely will:

a) Infertile Men.  One study showed that testosterone levels in infertile men increased from 319 to 409 ng/dl, a nice 28% increase on average.  The authors noted that “men with at least 1 firm testis preoperatively had a greater increase in serum testosterone.” [7]

b) Using Microsurgery. Another urologist did a larger study on any man with a varicocele and found that every age group had lower testosterone than their non-varicocele counterpart cohorts.  Furthermore, after varicocle surgery, 70 percent of the men experienced an increase in testosterone.  So much for the theory that repairing a varicole does not affect testosterone!

c)  Nice Increase. Yet another study showed that men got a boost of 110-146 ng/dl from varicocele repair.  This is not going to correct hypogonadism in anyone, but is an impressive increase nonetheless. [9]

2. Increased Sexual Activity.  One study on men with fertility issues found that couples had greatly increased intercourse rates post-varicocele: “the improvement of sexual activity was 50-75%, the pregnancy rate for their partners was 37% and increased plasma testosterone levels over a period of 3 years of follow-up after varicocele repair.” [5]

3. Increased Libido and Energy. Let me quote one urologist: “a varicocele repair can help increase testosterone, improving energy level, sex drive, and the ability to have an erection.” [6][10]

4. Greatly Improved Sleep.  Why would libido and energy improve?  One reason may be sleep.  Look at what Sam wrote, one of our regular posters:

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“If you are a middle aged man and suffering from insomnia and low t make sure you don’t have a varicocele. While completely subjective and based entirely on my own personal experience, within 1 week of having my varicocele repaired I was sleeping through the night and haven’t had a bad nights sleep since. Coincidence?” [1] “I did and it had no impact on t levels but major improvements in sleep. Basically I went from waking up 3-5 times a night to sleeping through the night totally again.” [2]

5. Normalized Body Temperature.  Sam also noted something very interesting that indicates normalized thyroid function:

“So I was contemplating on how my average body temp went from an unstable but consistent 97.4ish to a steady 98.6 within a week of my varicocele procedure and it got me wondering if the body would down regulated your body temp if a varicocele was causing your gonads to operate at too high of a temperature. If so this could be a way for men to tell if they have a varicocele that is impacting testicular function.” [3]

6. Fertility. Correcting even a unilateral (one testicle) varicocele can make a very significant change in fertility.  For example, one study wrote, “Preoperatively, men with grade 3 varicocele had lower sperm counts and poorer fertility indexes compared to men with grades 1 and 2 varicocele. Sperm concentration improved significantly in men with grade 2 (33 +/- 5 million per cc preoperatively to 41 +/- 6 million postoperatively) and grade 3 (18 +/- 5 million preoperatively to 32 +/- 7 million postoperatively) varicocele after microsurgical ligation of the varicocele. Motility improved significantly in men with grade 3 varicocele.” [4]

1)  https://peaktestosterone.com/forum/index.php?topic=1675.0

2) https://peaktestosterone.com/forum/index.php?topic=1017.5;wap2

3) https://peaktestosterone.com/forum/index.php?topic=1386.0

4) J Urol, 1993 Apr, 149(4):769-71, “Relationship between varicocele size and response to varicocelectomy”

5) Systems Biology in Reproductive Medicine, 2003, 49(3), IMPROVEMENT OF SEXUAL ACTIVITY, PREGNANCY RATE, AND LOW PLASMA TESTOSTERONE AFTER BILATERAL VARICOCELECTOMY IN IMPOTENCE AND MALE INFERTILITY PATIENTS”

6) https://urologyaustin.com/urology-news/understanding-varicocele-identification-and-repair/

7) The J of Urol, 154(5):1752-1755, “The Effect of Varicocelectomy on Serum Testosterone Levels in Infertile Men with Varicoceles”

8) https://www.sciencedaily.com/releases/2011/06/110616142726.htm

9) https://www.doctoroz.com/blog/harry-fisch-md/hidden-testosterone-killer

10) https://en.allexperts.com/q/Urology-Male-issues-989/varicocele-loss-sexual-desire.htm