PT 3

L-Arginine and Erections - Peak Testosterone

L-Arginine and Pycnogenol. Both L-Arginine and Pycnogenol have good track records in the research for increasing endothelial Nitric Oxide, which is the prime chemical involved in erections. [8]  Several studies have shown that supplemental L-Arginine increases blood flow, even in healthy individuals. [11] Furthermore, a well-done study shows that these can significantly cure and often cure erectile dysfunction (impotence). Nitric Oxide relaxes the veins of the penis allowing blood to flow in which obviously is critical for an erection. (Viagra, Cialis and Levitra work on Nitric Oxide for example.) By the way, you bodybuilders may be interested to know that Arginine is used to make creatine as well.

NOTE:  Not all studies have shown L-Arginine in a positive light as far as being a promoter of Nitric Oxide.  For example, one study of healthy males showed no increased blood flow from 20 g/day of Arginine, which is a very large dosage [12].  Similarly disappointing results were found in patients in patients with heart failure as well. [13]  It is much more safe and effective to Boost Nitric Oxide Through Food and Drink.

Pycnogenol is a Nitric Oxide producer or stimulator.  (Several foods are.) L-Arginine is the precursor for Nitric Oxide in the body and for Nitric Oxide Synthase, the enzyme that crates Nitric Oxide, and thus can boost Nitric Oxide indirectly in several ways. [8] The idea that some researchers had was that Arginine could provide the building blocks for Nitric Oxide and then Pycnogenol would take that substrate and pump out more Nitric Oxide. One study had already showed that 50 men given 5 g L-Arginine per day doubled their urinary Nitric Oxide secretion. [4] However, that’s quite a bit of L-Arginine and so, I presume, the researchers wanted to find a safer approach using Pycnogenol.

Pycnogenol is a Nitric Oxide producer in its own right.  Arginine also boosts Nitric Oxide directly by being its precursor.   One study showed that 50 men given 5 g L-Arginine per day doubled their urinary Nitric Oxide secretion. [4] If you put the two together, reasoned one set of researchers, you ve got a potentially powerful solution to erectile dysfunction. And they reasoned correctly:  their study of men with erectile dysfunction [1] showed very significant improvement in the ability to achieve an erection though a combination of 1.7 G L-Arg per day along side 2X40 mg doses of Pycnogenol. Steven Lamm, in his book The Hardness Factor, recommends a dose of L-Arginine of 3 g per day. He chose this value because it would approximately double what a male would consume through an average diet.  (By the way, L-Arginine also increases sperm counts for those of you struggling with pregnancy-related issues.)

REFERENCES:

1) J Sex Marit Ther 2003 May-Jun; 29(3):207-213

2) Amer Jour Physio Endocrinol Metab, 291:E906-E912, 2006

3) Jour Applied Physiol 101:848-852, 2006

4) BJU Int,1999,83:269-273

5) J Nutr 2009 Feb;139(2):230-7

6) Molec Cell Biochem 244:125-8 (2003)

7) Acc Chem Res, 2005 Mar,38(3):191-201

8) Intl J of Cardiology, Apr 2007, 116(3): 300-308

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

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

11) Vasc Med, 2003 May,8(2):77-81

12) Journal of Cardiovascular Pharmacology, Jul 1996, 28(1):158-166, “Effects of In Vivo and In Vitro L-Arginine Supplementation on Healthy Human Vessels”

13) J Am Coll Cardiol, 1996; 27:1207-1213, “Dietary supplementation with L-arginine fails to restore endothelial function in forearm resistance arteries of patients with severe heart failure”

Italian researchers found that L-Arginine supplements actually helped blood sugar metabolism and insulin sensitivity of obese, Type  II diabetics. [2] Of course, elevated blood sugar and insulin sensitivity is not just a problem of obese diabetics but is the curse of many on a Western diet .  Those on a Western Diet also need the increased Nitric Oxide output in to help protect their cardiovascular system AND erections.

You may also be familiar with a nice side benefit of L-Arginine:  the stimulation of growth hormone release. But keep in mind that this only occurs when ingesting fairly high levels of L-Arginine.  Syracuse researchers found that 7 g/day of growth hormone increased growth hormone response. [3] And when coupled with weight lifting, an even greater growth hormone response was achieved. Other studies list doses (to achieve growth hormone output) between 8-12 g/day.  Again, I recommend caution with such high doses.  (See Side Effects below.)

Caffeine and L-Arginine

Caffeine and L-Arginine can act synergesitcally.  This is because one reason that we experience decreased Nitric Oxide output is because of an increase in our “arginase pathway”.  What happens is that more our precious arginine is funneled through arginase instead of being available to make Nitric Oxide for your heart and penis.

What is a good way to decrease arginase activity?  Well, one recent animal study shows that caffeine does just that.  Rats given a relatively small dose had significantly reduced arginase [6] and one reason is probably caffeine’s increase in Cyclic AMP.  This is just one study and is on animals, but it probably explains why caffeine and L-Arginine can be a winning combination.  (Be careful not to have so much caffeine that it disturbs your sleep!)

I should also point out that anther recent study actually investigated arginase inhibitors – there are drugs that will, like caffeine, inhibit arginase expression – for sexual disorders. [7] Their conclusion?  The study stated, “Accordingly, arginase inhibition can enhance NO-dependent physiological processes, such as the smooth muscle relaxation required for sexual arousal: administration of arginase inhibitors in vitro and in vivo enhances erectile function and engorgement in the male and female genitalia. Therefore, arginase is a potential therapeutic target for the treatment of sexual arousal disorders in men and women”.  But this is cutting edge and has not yet resulted in any actual treatment protocols.

However, you can get in on the ground floor with a combination of pycnogenol (or other dietary Nitric Oxide boosters specified in my Erectile Dysfunction Dietary Program), L-Arginine and caffeine.  This is definitely a winning combination.

Arginine and Weight Loss:

One recent animal study showed that Arginine may actually help with weight loss and fat reduction.  Animals fed L-Arginine had substantial weight reductions over controls.  [5] Granted, these were obese rats due to overfeeding, but the point is that the Arginine helped them significantly regardless as to whether they were eating a low fat or high fat diet.  It is definitely involved in blood sugar and insulin:  it is glycogenic, meaning it can be converted to glucose, or blood sugar and deficiencies can lead to decreases in insulin.

Side Effects of L-Arginine:

Side Effect #1: I do not advise taking more than 2-3 g of L-Arginine per day. Arginine can be converted in the body to Nitric Oxide, which is a good thing, or to a second amino acid, L-Ornithine.  Unfortunately, L-Ornithine can help cancerous tumors grow.  In addition, L-Arginine can increase body ammonium levels which could potentially lead to increased Herpes outbreaks.  Again, play it safe and stick to L-Arginine levels that would be approximated by a reasonable diet, i.e. 2-3 g/day. NOTE:  Arginine can also boost the immune system because it stimulates the thymus, a gland in your upper chest that pumps out an important leukocyte for immunity.

Side Effect #2: If you have a heart condition, work with your doctor before taking Arginine or any supplement. One Journal of the AMA study [Vol. 295 No. 1, January 4, 2006] reported that researchers gave 153 heart-attack survivors 9 g daily of L-Arginine. Six participants on the L-Arginine died, pushing the researchers to actually halt the study. Keep in mind that thousands and thousands of people have taken L-Arginine without incident and that the study individuals had heart problems. Also, keep in mind that this is a fairly high dosage of L-Arginine:  I would recommend more in the 2-3 g range.  Regardless, it underscores the need to get the advice of a medical professional.

Side Effect #3: L-Arginine taken at higher doses is alleged to cause higher body ammonia levels leading to potential herpes and/or shingles outbreaks.  This appears to be ameliorated through the consumption of cruciferous vegetables such as brocolli, cauliflower and cabbage which are high in indole-3-carbinol (I3C).  I3C interferes with the way that shingles and herpes viruses reproduce.

Also, if you do decide to take L-Arginine supplementally, it is probably more effective on an empty stomach.  It can compete with other dietary components, such as L-Lysine, and so is probably better absorbed just by itself.

Arginine – Other Advantages

L-Arginine is another chemical that is used in many of the body’s processes.  L-Arginine is a component of collagen and thus is important in skin maintenance and repair.  I also document in my How to Improve Male Fertility link the role that Arginine can play in improving our ability to achieve pregnancy. (Seminal fluid contains a lot of Arginine for starters and, of course, it can help with erections and some say libido as well.)  Also, a recent study showed some cardiovascular beneftis as well. [9] Men with high cholesterol were given 12 g/day, which is a lot in my opinion, resulting in a slightly decreased blood pressure and significantly decreased homocysteine, a leading heart disease risk factor.  Another study gave 6 g/day of L-Arginine and also found a decrease in blood pressure and an increase in blood flow. [10]

Antipsychotics and Testosterone-Antioxidant Suppliments

The problem with most supplements, especially at megadose levels, is that supplement companies and researchers tend to study only the glamorous positive aspects in the preliminary studies.  Thus, in the beginning the health world is flooded with good reports.  Then, a decade or two later, some negative aspects of the supplement beging leaking out and this is exactly what is happening with the antioxidants in some cases.

Before I go on, I want to call attention to something important:  I know of no study that shows that antioxidants in foods can cause the kind of issues below.  In fact, study after study shows the benefits of eating fruits and vegetables in particular, which are almost always packed with antioxidants.  If you haven’t seen the research, take a look at my page on The Incredible Benefits of Fruit and Vegetable Consumption and I’m sure you’ll become a believer.

NEWS FLASH: The co-discoverer of DNA (James Watson) believes that a lack of oxidants (free radicals) and not a lack of antioxidants is what causes the inflammation that kills of your pancreatic beta cells that make insulin. [10] His argument is that exercise, which creates a flood of free radicals, actually greatly benefits insulin resistance and protects against diabetes.  Furthermore, he points out that these benefits go away if you give them antioxidants before the exercise!  He did further research and found that these free radicals are actually critical for protein formation and maintenance. See #5 below for the actual study that Dr. Watson was referring to.

1. Grape Seed + Vitamin C. There was a very interesting study done on 69 people with high blood pressure. In this study they had four groups: those on a) grape seed, b) Vitamin C (500 mg/day), c) grape seed extract + Vitamin C and d) neither. Now both the grape seed extract and Vitamin C groups caused very small drops in blood pressure, one statistically significant and the other not. And so the two together combined to produce an even bigger drop, right? Actually, what happened is that the two together produced a pretty significant average increase in blood pressure of 4.8 mm systolic. The authors, with the characteristic understatement of researchers, noted that “these results suggest caution for hypertensive subjects taking supplements containing combinations of vitamin C and polyphenols.” [1] Therefore, it appears that mixing two powerful antioxidants together can at times do the exact opposite of what is hoped for.  Seriously, who would have guessed that a well-respected herb and a well-researched antioxidant like Vitamin C could together raise blood pressure.

2. Tempol (SOD mimetic) + Vitamin C.  An animal study in 2010 showed that the combination of these two antioxidants actually decreased oxygen delivery to muscles and increased the “fatigability” of the muscles. [2][3][4] So what caused the underlying problems?  The researchers involved in the study pointed out that peroxide, a free radical, is actually involved in vasodilation, i.e. relaxig of the blood vessels and arteries.  If you get enough antioxidants to actually lower peroxide levels too far, it can have a negative impact.  This may explain what was going in #1 above as well.

3. Vitamin E. Vitamin E is considered one of your most important antioxidants. It protects against lipid peroxidation and, therefore, is considered artery protective. [6] Epidemiological studies have shown the important of Vitamin E’s antioxidant superpowers. However, megadosing the alpha form of Vitamin E has turned out to be a very bad idea. And the alpha form is still the one used in the great majority of supplements out there.

So with Vitamin E, the risks appear to be twofold:  a) improperly formulation using only alpha tocopherol and b) megadosing beyond about 150 IU.

4.  Vitamin C versus Orange Juice.  Orange juice is one of the most maligned of juices.  It is fairly sweet and is pasteurized (heated) for bizarre reasons and is considered “unnatural” by many in the health community. (OJ companies pasteurize it for increased shelf life and then actually hire companies to add back in artificial flavors to make up for the taste that is destroyed through heating!) So researchers put these two up head-to-head to see which one would best protect against DNA damage.  They designed the study so that both raised plasma Vitamin C levels the same amount.  To their surprise, the Vitamin C alone provided no protection whatsoever, but the orange juice provided significant protection.  Their conclusion?  “The protective effect of BOJ was not explained by vitamin C alone, thus other phytochemicals could be involved.” [5]

Now this last study shows what I consider the subtle danger of megadosing antioxidants.  Many men do it thinking they are getting substantial protection, when they are not.  And, even more important, they ignore the power of food because a) it’s easy to take a pill and b) slick marketing by many of supplement companies.

NOTE: The dosage in the above study was pretty low (150 mg) and some might argue that Vitamin C does have studies showing it a) lowers blood pressure and b) provides cancer and other types of protection.  This is true.  But the point is that often, at least at high enough dosages, Vitamin C when coupled with another antioxidant can cause negative effects.  And, furthermore, isn’t it strange that a little orange juice could do what Vitamin C could not.  Now imagine if you throw in the another 9 fruits and vegetables that you should be getting each day and you get an idea of the incredible broad range of protection that whole foods can supply.

However, there is a chance that if you combine Vitamin C with other antioxidants that you may actually do more harm than good as study #1 shows above. Remember that Vitamin C is usually studied alone and not in combination with other supplements or antioxidants. So it appeart to be a gamble with our current, very limited knowledge.  Furthermore, even if combinations of supplements do not bite you, it is very possible that an incorrect form may as Vitamin E shows.

5. Antioxidants Reduce Insulin Sensitivity Benefits of Exercise! A PNAS study showed that a gram of Vitamin C and 400 IU of Vitamin E reduced the insulin benefits of exercise. [11] This is an incredible find and in my opinion casts doubt on megadosing of antioxidants.  See the News Flash above for further explanation. [10] The authors summarized with the following sobering thoughts:

“If transient increases in oxidative stress are capable of counteracting insulin resistance in humans, it is possible that preventing the formation of ROS by, for example, antioxidants might actually increase, rather than decrease, the risk of type 2 diabetes. While this remains to be determined, one metaanalysis of previously published studies (27) suggests that high dietary intake of fruits and vegetables, a source of antioxidants but also of numerous other bio-active compounds, may actually decrease the risk for type 2 diabetes. Nevertheless, and as stated by Hamer and Chida (27), all larger intervention trials evaluating the diabetes-preventive potential of defined antioxidant supplements have been unable to find any positive effects of supplementation (28–30). Moreover, antioxidant use in type 2 diabetics has been linked to increased prevalence of hypertension (31) and use of antioxidant supplements has recently been proposed to increase overall mortality in the general population (32).”

Again, notice the trend:  food helps but megadosing does the opposite (in diabetics at least).  This is a common pattern in the studies:  supplement provide little benefit or harmful effects and natural, whole foods improve health.  I discuss this in greater detail in my link on The Incredible Research-Backed Health Benefits of Fruits and Vegetables.

DISCUSSION:   There are GREAT reasons to take antioxidants.  In the case of Vitamin C, studies show that it increases intercourse frequency, boosts endothelial function, improves inflammatory cytokines, lowers cortisol reactivity and on and on the list goes.  I cover this in my link on Why Take Vitamin C?

Finally, the bottom line is that you can get all the benefits that you are looking for, such as lowered blood pressure, increased nitric oxide, decreased cancer and heart disease risk with food.  If you want antioxidants, get them in food along with the 100’s of other phytochemicals that you need.

6. N-Acetylcysteine (NAC) May Increase Prostate and Skin Cancer Risk. NAC is currently a very popular supplement and many men take it for liver support and anti-aging purposes.  However, a recent study casts doubt on the wisdom of this.  Researchers were concerned that a selenium and Vitamin E study had not done as well as anticipated and appeared to actually fuel prostate cancer.  (Other study work with selenium has been positive however.)  What the researches found in a study on mice was that N-acetylcysteine “decreased ROS levels in Nkx3.1 mutant mouse prostates, it failed to reduce prostatic epithelial hyperplasia/dysplasia. Rather, NAC treatment increased epithelial cell proliferation and promoted the expression of a pro-proliferative gene signature.” [12] Basically, you need ROS (reactive oxygen species or free radical) production for certain transcription factors that fight the spread of cancer.  In other words, ROS is just as important as antioxidants and megadosing on antioxidants can disturb that delicate balance.  A followup study showed that NAC may increase the metastes of melanoma as well. [13]

7. EGCG From Green Tea Extract and Liver Damage. EGCG is the most powerful antioxidant in green tea and is responsible for many of it’s excellent properties.  However, multiple reports and studies now show that it can be liver toxic in higher dosages and some people have actually been injured from it.  Researchers are not entirely sure of the mechanism of action, but it is important to note that it can actually lower one of the body’s master antioxidants, glutathione, in some tissues. The liver is highly dependent on glutathione for example. In fact, researchers in a recent study wrote that “In contrast, EGCG dose- and time-dependently decreased the amount of intracellular glutathione (GSH) levels.” [14]

NOTE: You may be interested to know that some antioxidants have been shown to boost testosterone (in large doses). See my link on Antioxidants and Your Testosterone for more information.

1) Journal of Hypertension, Feb 2005, 23(2):427-434, “The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial”

2) https://www.k-state.edu/media/newsreleases/jan10/antioxidant12610.html

3) Journal of Applied Physiology, Dec 2008, 105(6):889-1896, “Effects of antioxidants on contracting spinotrapezius muscle microvascular oxygenation and blood flow in aged rats”

4) Experimental Physiology, Sep 2009, 94(9):961–971, “The effects of antioxidants on microvascular oxygenation and blood flow in skeletal muscle of young rats”

5) British Journal of Nutrition, 2007, 97:639–643, “Orange juice vs vitamin C: effect on hydrogen peroxide-induced DNA damage in mononuclear blood cells”

6) Cardiovascular Research, 57(2):563-571, “Vitamin E inhibits lipid peroxidation-induced adhesion molecule expression in endothelial cells and decreases soluble cell adhesion molecules in healthy subjects”

7) Cancer Prev Res, May 1 2012, 5:701, “Does Vitamin E Prevent or Promote Cancer?”

8) AMA, 2007 Feb 28, 297(8):842-57, “Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis”

9) https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/, Office of Dietary Supplements, Vitamin E Fact Sheet

10) https://www.theguardian.com/society/2014/feb/28/dna-pioneer-james-watson-theory-diseases

11) PNAS, May 26 2009, 106(21), “Antioxidants prevent health-promoting effects of physical exercise in humans”

12) PLoS One, 2012, 7(10):e46792, “Antioxidant treatment promotes prostate epithelial proliferation in Nkx3.1 mutant mice”

13) Nature, Nov 2015, 527(23), “Oxidative stress inhibits distant metastasis by human melanoma cells”

14) Mol Nutr Food Res, 2009 Mar, 53(3):349-60, “The effects of green tea (-)-epigallocatechin-3-gallate on reactive oxygen species in 3T3-L1 preadipocytes and adipocytes depend on the glutathione and 67 kDa laminin receptor pathways”

Estradiol and HRT - Peak Testosterone

REFERENCES:

1. Jankowska, E.A., Rozentryt, P., and Ponikowska, B. (2009). Circulating estradiol and mortality in men with systolic chronic heart failure. Journal of the American Medical Association. 2009 May 13;301(18):1892-901.

2. Leder BZ, Rohrer JL, Rubin SD, Gallo J, Longcope C. Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. J Clin Endocrinol Metab. 2004Mar;89(3):1174-80

3. Zumoff B, Miller LK, Strain GW. Reversal of the hypogonadotropic hypogonadism of obese men by administration of the aromatase inhibitor testolactone. Metabolism. 2003 Sep;52(9):1126-8.

4. Raman JD, Schlegel PN. Aromatase inhibitors for male infertility. J Urol. 2002 Feb;167(2 Pt 1):624-9

5. Chearskul S, Charoenlarp K, Thongtang V, Nitiyanant W. Study of plasma hormones and lipids in healthy elderly Thais compared to patients with chronic diseases: diabetes mellitus, essential hypertension andco ronary heart disease. J Med Assoc Thai. 2000 Mar;83(3):266-77

6. Cengiz K, Alvur M, Dindar U. Serum creatine phosphokinase, lactic dehydrogenase, estradiol, progesterone and testosterone levels in male patients with acute myocardial infarction and unstable angina pectoris. Mater Med Pol. 1991 Jul-Sep;23(3):195-8

7. 386. Carlsen CG, Soerensen TH, Eriksen EF. Prevalence of low serum estradiol levels in male osteoporosis. Osteoporos Int. 2000;11(8):697-701

Estradiol monitoring and management is a hot topic in HRT (testosterone therapy) right now and a few recent studies Cestradiol is just as important to male brain and sexual function as testosterone itself. Unfortunately, the research is still in the early stages and there are multiple areas of controversing, including the fact that there are

a) several different kinds of estradiol lab tests with varying degrees of accuracy,

b) potential (but poorly understood) clotting issues even with low dose Arimidex,

c) AI-sensitivity in some men and

d) considerable variability in individual estradiol needs.

These issues and the general lack of studies have led to tremendous confusion. Most doctors are still completely ignorant about the subject and still other doctors think that it is okay for men on HRT to have high estradiol.  However, our guest author today is going to present the opposite view and the evidence that he has seen for it, i.e. that estradiol not only must be tested for regularly but must be controlled and kept in a tight range.

And there is considerable precedent for his view:  HRT and anti-aging clinics have been managing estradiol with considerable success with their men on testosterone therapy.  The general consensus, according to this school of thought, is that “men feel better in the 20-30 pg/ml range.”  I haver found this to be case as have many men on the Peak Testosterone Forum.  Ultimately, though, you have to do your own research and work with your doctor.

GUEST AUTHOR: Kierkegaard

Symptoms of E2 and Why You Need to Spot Estradiol Problems Yourself:

In my experience, both personally and with the countless talks I ve had with fellow TRT-ers, the single biggest reason why TRT doesn t work is because of estradiol (E2) management. In my case, every single instance of me feeling bad on TRT has been related to estradiol being out of balance. This makes sense for two reasons, one hormonal and the other institutional. Hormonally, testosterone always, each and every time, metabolizes to dihydrotestosterone and estradiol. Both can cause problems in different ways, with DHT causing oily skin and estradiol with a serious list of potential symptoms depending on whether it s too high or too low (we ll get to these in a moment).

Institutionally, Nelson Vergel points out that none of the medical guidelines recommend even testing estradiol when administering TRT, so it s clear that most doctors know not only nothing about this hormone in relation to guys, but many doctors scoff at the idea of treating estradiol, especially by an aromatase inhibitor, which prevents much of the conversion from testosterone to estradiol. As one whose name I ve forgotten put it, his doctor said, there s no way I m putting you on a medication for breast cancer.

So what this means is that if you re doing TRT, you need to know about estradiol by studying up on it yourself. Thankfully, you can do this by just reading this to the end. There are studies on the importance of testing estradiol, and even a study I ve found on anastrozole monotherapy for the treatment of hypogonadism. The data are out there, and it s always helpful to check them out and bring them to your doctor. See the references below for a wealth of information on how estradiol affects functioning in multiple ways.

Why E2 (Estradiol) Is So Important

So why is estradiol so important? It has profound implications for general health and has the potential to cause very unpleasant symptoms if unbalanced. One single study drives this point home (slightly edited for readability):

Among 501 men with chronic [heart failure], 171 deaths (34%) occurred during the 3-year follow-up. Compared with quintile 3, men in the lowest and highest estradiol quintiles had increased mortality For increasing estradiol quintiles, 3-year survival rates adjusted for clinical variables and androgens were 44.6%, 65.8%, 82.4%, 79.0%, and 63.6%; respectively (P < .001). [1]

Notice the most important phrase: Compared with quintile 3. What is a quintile? Any of five equal groups. Quintile 3 is smack dab in the middle. It turns out that moderation is the game with sex hormones as well. Notice further the five percentages listed in the final paragraph: 44.6%, 65.8%, 82.4%, 79.0%, and 63.6%. Which one is the third quintile? The one with the 82.4% survival rate. Notice how it starts small, at 44.6%, then goes up to 65.8% (looking better), then maxes at 82.4% (looking best), and then what happens? It starts declining! Higher is definitely not always better with estradiol. What does this middle quintile come to in raw data terms? Between 21.8 and 30.11 pg/ml. Interestingly, the TRT and steroid community has typically held between 20 and 30 pg/ml to be the best in terms of managing unbalanced estradiol symptoms.

What s interesting about this number? Well, not only does it correlate very tightly (hence the multivariate regression analysis study) with not dying of heart failure and other related problems, it also happens to be the Goldilocks zone for feeling best on TRT in terms of estradiol level. Shocking! That s how wise your body is: when you re feeling best, you re usually healthiest.

So what happens when people go too low or too high? This is a subject that has virtually no research behind it, so we re left with the anecdotal experiences of countless TRT patients. As a general point, erectile strength appears to be the best barometer for determining if estradiol is within the range mentioned above. If your erections start getting soft, this usually means high estradiol or considerably low estradiol, but for some guys their estradiol levels can be slightly low and still experience strong erections. However! They tend to experience weak erections. The following is a list of the most common symptoms of high and low estradiol. Note that these generally assume that your testosterone level is at least decent.

High and Low Estradiol Symptoms

Low Estradiol: fatigue along the lines of sleepiness; hypersomnia (sleeping too much and too often); strong erections but limited sensitivity; loss of erections; osteoporosis and osteopenia; joint pain, clicking or popping joints; eye fatigue (eyes seem more tired despite adequate sleep, dark circles); loss of libido (interest in sex); difficulty retaining water (constant urination); anxiety, depression, irritability. Exclusive to low estradiol (usually): sleepiness fatigue; hypersomnia; limited penile sensitivity; osteoporosis/osteopenia, joint clicking/popping, pain; difficulty retaining water (urination); anxiety/depression.

High Estradiol: soft erections, inability to maintain an erection; water retention (less frequent urination), leading to excessive sweating, including more than 2-3 pounds of weight loss after an intense cardio workout; blood pressure spikes or high blood pressure (from the water retention); insomnia; hot flushing (flushing around the ears or on the face); night sweats (from estradiol lowering, causing loss of water retention); bloating; brain fog (like your head is in a bubble); testicles seem smaller than usual (not accounted for by testicular atrophy via TRT). Exclusive to high estradiol (usually): soft erections, inability to maintain; water retention; excessive sweating; blood pressure spikes or high blood pressure; brain fog; night sweats; bloating.

An important tip: if you have only one or two symptoms, you might not actually be suffering from high or low estradiol. The more you have, the more likely you have high or low estradiol. Pay extra attention to the ones underlined.

Another tip: what s the biggest lesson here? Learn to listen to your body. Pay attention to what it s doing, and even create an Excel file charting changes day by day. I m at the point now where I rarely need bloodwork to know if my estradiol is too high or too low.

The following are tests I ve thought up for determining if you have high or low estradiol. Know that this overlaps with the symptoms mentioned above.

Tests to determine estradiol:

1. The ring finger test. If you wear a ring and it’s tighter than usual, this can mean water retention, which means high estradiol. If it s too loose, this can mean low estradiol. (Remember that sometimes drinking enough water actually makes your body lose water retention.)

2. Weight. If you weigh more than usual, especially in the morning before a meal, this can also mean water retention.

3. My favorite: the jogging pretest-posttest. I weigh myself before I go on a good run. The more I sweat and the lower my weight posttest will tell me how much I’m aromatizing. Note that you’ll always lose normal water weight when you sweat a good deal. E.g., going from 181 to 176 indicates moderate-high water retention, and going from 175 to 173 indicates low water retention.

4. Fatigue and eye tiredness. The more tired my eyes look earlier in the day, the more I’m usually at the higher end of estradiol. I’ve always had allergic shiner-like half dark circles, but when I get slight full circles, then I know something’s up. Note that this could indicate bad sleep related to alcohol or sleep apnea. The better I look and the less the dark circles, the know I m closer to being reeled in correctly.

CAUTION:  Don’t rely exclusively on self-tests.  Work with your doctor and get a regular estradiol test done.  My former HRT clinic pulled estradiol every 3 months and one month after any protocol alterations.  If your doctor will not pull your estradiol numbers due to ignorance, you can pull them yourself (in most states).  See my page on Reasonably Priced HRT Labs.

The following are methods people use to control estradiol. Know this information is covered in more detail on Peak s main page.

How to Raise Estradiol (for men on testosterone therapy):

How to Lower Estradiol (for men on testosterone therapy):

Weight Lifting and Arterial Stiffness - Peak Testosterone

This made me pause and reflect one day: with the lone exception of Jack LaLanne, I cannot think of a single illustration of a weight lifter or body builder that exemplifies health, fitness and longevity into his latter senior years. (And Jack LaLanne actually always did weights for an hour-and-a-half follow by a classic aerobic swimming session for 30 minutes.) When I think of longevity and health in the 70’s, 80’s and 90’s, I think of the Ikarians, the Hunza, the Kuna, the Okinawans and a handful of other supercultures whose lifestyle is the polar opposte of the bodybuilding community in many ways.

Could there be a reason? Why don’t we see the Masters (50+) bodybuilding events packed with fit and healthy seasoned 60 and 70 year olds who are the epitome of vitality, strength and virility? One of the reasons may be – and I’ve documented other reasons in my link on Muscle Madness – the arterial hardening and loss of vasoreactivity that some researchers have discovered from weight lifting.

The blood pressure achieved from a heavy lift will for a time literally “stun” or “shock” the arteries, leaving them hardened for all practical purposes, i.e. unable to expand at the normal rate. Of course, this is potentially very serious for our cardiovascular and penile health.

The blood pressure achieved from a heavy lift will for a time literally “stun” or “shock” the arteries, leaving them hardened for all practical purposes, i.e. unable to expand at the normal rate. Of course, this is potentially very serious for our cardiovascular and penile health.

Concern mounted when a study out of Japan [1] found that young healthy weight trained athletes who did no cardio actually had stiffer arteries, particularly in the heart and leg regions. And you don’t want stiff arteries if you want anything else to be stiff if you know what I mean. The authors point out that this is in direct contrast to aerobic training that leaves arteries less stiff and more reactive.

However, researchers remained concerned because the latter two studies were short term. Remember: the longer term study where athletes had to have been strength training for at least a year found significant arterial stiffness. [1] Furthermore, these athletes had more arterial stiffness than sedentary controls! If your arteries are in worse shape than the standard couch potato, what does that tell you? These were also young men in their 20’s. Researchers had great concerns that a lifetime of lifting may actually result in worse outcomes.

Of some comfort was the fact that this study on bodybuilders [1] and another on regular joes [5] found no mean increase in blood pressure from weight lifting. In fact, one study of healthy young men who underwent an Olympic Lift weight lifting program found that their systolic – the first number in a blood pressure measure – actually decreased. [6] Another similar study found that weight training decreased diastolic blood pressure, raised HDL, lowered cholesterol and decreased insulin levels, all big risk factors for heart disease. [7]

However, researchers remained concerned because the latter two studies were short term. Remember: the longer term study where athletes had to have been strength training for at least a year found significant arterial stiffness. [1] Furthermore, these athletes had more arterial stiffness than sedentary controls! If your arteries are in worse shape than the standard couch potato, what does that tell you? These were also young men in their 20’s. Researchers had great concerns that a lifetime of lifting may actually result in worse outcomes.

A 2005 study answered the question in a way that all of us long term weight lifters did not want to hear: long term early middle-aged weight lifters had worse arterial stiffness and higher blood pressure than age-matched controls. [8] Of course, blood pressure is a major risk factor for stroke, erectile dysfunction and lots of other nasty stuff. And who wants stiffer arteries, eh? (However, there was a bright spot in all of this: the authors found that endothelial function was not adversely affected.)

But let’s face it:  those of us concerned with long term health and good blood flow between our legs have to ask ourselves is pushing the steel and iron is really good for us as the decades pass by.  Maybe our bodies just weren’t designed to handle these kinds of internal blood pressures and stressors?  In fact, if you think about it, for most of our existence, we have not had to lift or carry massive objects in order to improve our survival. Walking, and lots of it, is really our primary ancestral exercise. Throwing boulders and hauling elk carcasses was simply not that useful.

So what is the answer? Well, here are a couple of solutions that can help overcome these issues with lifting weights and strength training:

Weight Lifting Arterial Solutions

1. Cardio and Aerobics.  One recent study showed that cardio after weight lifting seemed to cure the arterial stiffness issue. [9]  This shows, by the way, Jack LaLanne’s keen insight once again:  he always did swimming aerobics after his intense weigth lifting sessions as I mentioned above.

2. Volume.  Go for volume with lower weights and more repetitions.  One of the studies above showed that the bigger lifts with more weights raised blood pressure more.  The pattern seems to be that the less you lift, the less the pressure gradient experienced.  And weight lifting with less weight has been shown in one study may put on muscle faster, contrary to prevailing wisdom.

1) Hypertension,1999,33:1385-91, “Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure”

Blood Pressure Improvements from Viagra and Cialis - Peak Testosterone

One of the big risk factors for erectile dysfunction, stroke and other nasty conditions is high blood pressure, or hypertension.  High blood pressure is very hard on the arteries in particular and the added pressure actually increases the inflammation and damage to the lining of the arteries.  This can be a vicious circle, because as plaque builds up in the arteries and limits the flow space, blood pressure is increased.

Some guys think that Viagra and Cialis may help with high blood pressure.  After all, don’t these two drugs relax the arteries and allow more blood flow?  Well, the answer is not as easy as it might seem.

NOTE:  If you need to actually clear out your arteries, consider a Low Fat Diet, which actually reduces arteriosclerosis.  Also,

Just how much can Viagra and Cialis lower high blood pressure and help with pulmonary hypertension?  It all started with a 1999 study that documented an nice average reduction of 10 and 7 for systolic and diastolic presure, respectively. [1] This was verified by a follow up study in 2001. [2]

CAUTIONS:  These PDE5 Inhibitors have many side effects and issues associated with them, which I cover in my link on Viagra and Cialis.

Of course, the problem with Viagra is that few guys can take it daily, due to expense, side effects and other issues becuase its effect only last for a few hours.  Cialis is much more practical in the regards and its effects are generally considered to last about 36 hours.  In fact, there is a new daily version out now. [3]

These facts led to several follow-up studies using Cialis.  Unfortunately, the results from Cialis were not nearly as dramatic. [4]  A typical Cialis dose is 20 mg, although some guys might split the pill in half, and 20 mg was found to have to no significant effect on high blood pressure. A follow up study with 40 mg found some benefit, an average drop of 4 mm, but this is a rather high dosage level. [5] [6]

Therefore, there is really no practical way for most guys to use PDE5 inhibitors to control blood pressure.  Viagra cannot be taken daily and Cialis is not just effective at any reasonable dosage.  If you have chronic hypertension, you best bet is to read my link on How to Naturally Lower Blood Pressure and then work with your doctor to come up with a plan.

REFERENCES:

1) Am J Cardiol, 1999 Mar 4, 83(5A):35C-44C, “Overall cardiovascular profile of sildenafil citrate”

2) J Hum Hypertens, 2001 Oct, 15(10):707-13, “Effect of sildenafil on blood pressure and arterial wave reflection in treated hypertensive men”

3) https://www.cialis.com/Pages/cialis-for-daily-use

4) Eur Heart J Suppl, 2002, 4(suppl H):H32-H47, “Overview of the cardiovascular effects of tadalafil”

5) Circulation, 2009, 119:2894-2903, “Tadalafil Therapy for Pulmonary Arterial Hypertension”

6) https://www.medpagetoday.com/MeetingCoverage/CHEST/11524

Is There A Dosage for Chocolate? - Peak Testosterone

When it comes to chocolate, can there be too much of a good thing?  Much as a chocoholic like myself hates to admit it, the research seems to be pointing that way. It all started with a 2008 study that showed that healthy Italians who ate just one small serving, 20 grams, every three days had a substantial reduction in C-Reactive protein. [1] This is impressive as elevated C-Reactive protein levels are a leading indicator of Inflammation and inflammation is associated with an increased risk of heart disease, dementia, erectile dysfunction, autoimmune disorders and on and on.

This study said that dark chocolate, which is much more packed with cocoa than regular chocolate, is very powerful stuff and can provide therapeutic benefits even in small dosages.  Notice that the ideal dosage in this study, 20 grams, is the equivalent of one square of chocolate from the tyical chocolate bar (at least here is the U.S.).

It also attacked the “more is better” philosophy of Americans like myself, where we tend to believe that if a little of some nutrient is good for us, then a lot must be really good.  However, the researchers found that the reduction is C-reactive protein was significantly reduced in those who ate more.

One 2010 study (of middle aged and beyond women) showed a similar result: substantial protection against heart failure in those who ate just an ounce of chocolate – not necessarily dark in this case – once or twice per week. [7] Eating over one serving per day was associated in a loss of all protective benefits.  Again, though, this study clearly showed that consuming too much chocolate may be pleasing the taste buds but eliminating the benefits.

So what would cause this phenomenon of diminishing and even reversing returns?  Well, there are several possibilites.  One is that cocoa is so powerful an antioxidant that the body actually stops producing its own.  Or perhaps it alters an inflammatory metabolic pathway over a certain dosage.  However, the most likely explanation in my opinion is that it is the milk in chocolate that causes the problem.

First of all, milk degrades the absorption of the chocolate’s polyphenols responsible for its anti-inflammatory properties [3] and, most importantly, milk is actually pro-inflammatory in and of itself. [4] In fact, the same study summarizes that milk is associated with endothelial dysfunction which is anti-erection.  In addition, cassein, the primary protein in milk, is pretty nasty stuff and increases IGF-1, a potential cancer-causer.

NOTE: One contradiction of this are the Masai who historically drank substantial amounts of raw cow’s milk and yet experienced a very low rate of heart attacks and stroke.  However, they walked and exercised almost constantly, something that is impractical for the typical urban dweller.

There is another reason that I believe that milk is the culprit:  the Kuna.  The Kuna are one of the world’s supercultures that live an existence almost completely free of heart disease and other cardiovascular issues.  What is their secret?  Experts believe it is cocoa.  They drink cocoa (without sugar or milk) throughout their day and have it in teas and drinks almost nonstop.  Without the negative effects of milk or sugar, cocoa can do it’s arterial magic, lowering blood pressure and increasing blood flow – yes, even to your penis.

Regardless, if chocolate does have a “therapeutic window” where too little and too much are dealbreakers, then chocolate lovers clearly have to monitor themselves. After all, our taste buds are compelling us to have more (and more and more) and we need to put the brakes on in order to get the anti-inflammtory and heart-protective properties.

Or you could just go crazy and enjoy the state of ecstasy…

REFERENCES:

1) J Nutr, 2008;138:1939-1945, “Regular consumption of dark chocolate is associated with low serum concentrations of C-reactive protein in a healthy italian population”

2) Circulation: Heart Failure, 2010; 3:612-616, “Chocolate Intake and Incidence of Heart Failure: A Population-Based Prospective Study of Middle-Aged and Elderly Women”

3) https://www.futurepundit.com/archives/005578.html

4) J of Isfahan Med School, 25(87), “Association between Dairy Consumption and Circulating Levels of Inflammatory Markers among Women”

Bodybuilding Without Destroying Your Health - Peak Testosterone

For a large percentage of guys the fitness ideal is the natural bodybuilder, the guy who uses the lastest training techniques, is in good shape and eats relatively healthy and naturally. I mean who doesn’t admire someone who could bench a Z4 without resorting to steriods?  He looks good, feels good and undoubtedly has women right and left tripping over themselves to meet him.

Well, I want to challenge this ideal.  First of all, women do not, in general, like bodybuilding levels of muscle on a guy, be he natural or be he freakish from steroids. Massive muscle mass-building – say that three times fast! – is almost entirely a male-driven phenomenon.

Consider these results from a Psychology Today study:

Men and women also parted company in the domain of male muscle mass. Men value muscle mass, while women are less interested in oversized biceps and pecs. In ranking male body types, women gave first place to medium with moderate muscle mass while medium with competition muscle mass came in a lowly fourth. When men estimated women’s preferences, however, competition body build narrowly missed second place. We asked women directly, “how important it is for you that [a man] have noticeable muscles,” and we asked men how important muscles were to them. The differences were striking: twice as many women as men said that male muscles did not matter at all.

That’s right – competitive muscle mass is a negative with most women. Guys, let’s be honest:  if you’re not lifting for the women, then who are you lifting for?  Let me be more blunt:  why are you pursuing something that is an actual turn off for most women?  When I first read this, it hit me like a ton of bricks.  All those “curls for those girls” that I was doing was nothing more than narcissistic madness.

Yes, a certain amount of muscle mass is important for your metabolism, weight control, bone mass and other health factors. Furthermore, a youthful amount of muscle mass makes you look much younger:  we all know one of the best signs of middle age is a flat butt and flabby arms. But, that said, why do we guys do what we do to ourselves in the gym?  It just doesn’t make sense!

Let me give you just a few examples of how Muscle Madness actually can hurt or even kill you:

So, in my opinion, you should seriously re-think trying to go the speed of light, that is you should reconsider your desire for infinite mass. It’s not worth the price. Besides, women would much rather see a six pack on your abs.  And well-trained abs will do a lot more good in the bedroom than 20 inch biceps anyway. Think of some of the greatest athletes in the world right now – guys like Federer and Phelps – and they are much more the physically ideal of women around the globe.

I want to emphasize that I am NOT trying to talk you out of weight or strength training nor am I going to the extreme of saying that muscle is not good for you.  If you’ve poked around my site at all, you know that I emphasize the slow build up of Muscle Mass for many reasons, including the fact that it burns fat, builds testosterone and helps you look decades younger for starters.  But I encourage you to reconsider the traditional body building hype that is so often promoted on the web and in the mags:  it is probably just plain dangerous for your long term health.

I also want to point out that I tried an Ornish Diet, which is a quasi-vegan diet that actually reverses arteriosclerosis, and found that I put on several pounds of muscle while building a six pack on my abs! I had not seen that since my college days.  Again, this kind of healthy lifestyle is what you need:  building muscle, lowering fat, getting good abs and cleaning out your arteries!  So put on some muscle and get in shape and don’t kill yourself while you’re at it!  (For more information, read my link on the Great Diet Smackdown (Part II) and how the Ornish Diet appears to stop Prostate Cancer dead in its tracks.)

CAUTION:  New research shows that aerobics/cardio should always be done after weight training.   Please read my link on Weight Lifting and Arterial Stiffening for a detailed analysis.

REFERENCES:

1) Arch. Path, 1968,85:133-137;J Nutr,1972,102:53-60; Biochem Pharmacol,1973,22:1005-1014; Life Sci,1976,19:1191-1198.  There are about two dozen more studies documented on p. 372-373 of The China Study by T. Colin Campbell and Thomas M. Campbell II, Benbella Pub., 2006.

2) Adv Nutr Res,1979,2:29-55

3) J Natl Cancer Inst,2002,94:1099-1109; J Am Diet Assoc,1999,99:1228-1233; Am J Nephrol, 2001, 21:331-339; Brit J Cancer,2000,83:95-97

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

5) Hypertension,1999,33:1385-91

6) Experimental Physiol,2005,90(4):645-651

7) Experimental Physiol, 2007, 93(2):296-302

8) Angiology, 2000, 51(10):817-826

Cialis: Long Term Usage - Peak Testosterone

Cialis (tadalafil) is powerful.. What makes Cialis unique among the erectile dysfunction drugs is its long half life. Thirty six hours after taking Cialis, a guy will still have about a quarter of what he took circulating in his blood stream. This means that guys can take this every other day and get themselves back in bad almost full time.  Plus, many guys like the fact that they don’t have to anticipate their love-making sessions – who can predict a woman, eh?

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.

However, it turns out the benefits of long term, steady use of Cialis extend way beyond just simple bedroom convenience. (For some of the scary issues with long term Cialis use, see my link on The Dangers of Cialis for more information.)

Below are listed 9 Long Term Cialis Benefits. Again, keep in mind that Cialis and other PDE5 Inhibitors affect other PDE enzyme systems, which explains the frequent stomach, vision, head and hearing issues, something you can read about in my link on Issues with PDE5 Inhibitors. I am still taking Cialis but hope to get off of it some day. However, I have gotten my dosage as low as possible: 2 mg per day.

1.  Blood Flow Increases. Duh!  Cialis increases blood flow – that’s what erections are all about, eh? – but this can have important health benefits throughout the body as lack of circulation can effect many tissues including those in the brain.  One four-week study of  males (average age of 54) found that Cialis use induced profound and highly desireable cardiovascular and endothelial changes, including increases in the all-important FMD (Flow Mediated Dilation).

2.  Restoration of Normal Erectile Dysfunction. One study showed that about 40% of men with E.D. were actually completely “healed” through daily Cialis use. [10] The dosages were fairly high however:  5 mg.  I should point out, though, that we did have forum member who successfully quit it altogether, something I discuss here: How I Stopped Taking Cialis.

3.  Inflammation Reduction. Researchers also noted a “robust”, i.e. very significant drop in both C-Reactive Protein (CRP) and Vascular Cell Adhesion Molecule (VCAM) counts.  This is important because plaque buildup in the arteries is largely due to an inflammatory process where  leukocytes (white blood cells) adhere to and “attack” arterial walls.

Cialis attacks this plaque-building process in several ways, lowering both CRP, the systemic (body-wide) inflammation marker that is so intimately correlated with arterioscloerosis, and VCAM, which is a protein that helps white blood cells adhere to arterial walls and causes plaque buildup.  In other words, Cialis usage seems to directly improve two important markers of cardiovascular disease. So users may get both short term benefits in the bedroom and long term health results to go with it, although that has not been proven.

4.  Testeosterone and the T/E Ratio. Don’t forget that long term Cialis use has been shown to significantly improve the all-important testosterone to estrogen ratio by an average of 24%.  A one year study of males with an average age of 54 showed an increase in testosterone of 5.5% and a decrease in estrogen of 15%. [2] These are significant numbers and show the power of getting “back in the sack”.  Remember that the 24% increase means you have significantly more testosterone molecules floating around versus estrogen, almost always a good thing for us guys.

NOTE: Some men with erectile issues are fighting with low testosterone.  If you have any doubts, get tested and check out my pages Common Causes of Low Testosterone and How to Increase Your Testosterone Naturally for more information.

5. High Blood Pressure and Hypertension. Cialis has also been shown to lower high blood pressure.  Although it does not dramatically lower blood pressure, it will help most guys struggling with hypertension. [6,7,8]

6. Improved Relationships. One study found that, for guys with erectile dysfunction, a significant percentage had improved partner relationships after taking Cialis, suggesting, of course, that sex really does matter. [9]

7. The Benefits of Sex.  In my link on How Sex Is Good For You, I document many benefits of making love.  Cialis likely increases many, if not all, of these benefits.  By the way, Viagra has many studies showing that it decreases the refractory period.  This is the time post-ejaculation that it takes for guys to recover before they can become erect. Cialis likely has this same benefit.

8. Antidepressant Action.  In some Cialis may actually act as an antidepressant.

9. Enlarged Prostate. Many urologists will give Cialis to improve enlarged prostate symptoms.  In fact, it is one of the few pharmaceutical solutions that has a good track record.

So then Cialis is a no-brainer, right?  Well, not so fast. All the PDE5 inhibitors have numerous side effects including possible changes of one’s hearing, vision and GI tissues. I document this more extensively in my link on effects including possible changes of one’s hearing, vision and GI tissues. I document this more extensively in my link on Viagra, Cialis and Levitra.

So is there a more natural solution that might have the same benefits? Well, exercise increases Nitric Oxide, just like Cialis. [3] Exercise lowers C-Reactive Protein long term (probably primarily due to weight loss). [4] Weight loss strongly lowers C-Reactive protein in numerous studies. [5] And weight loss, as I document in this link on the Testosterone to Estrogen Ratio, also raises testosterone while lowering estrogen significantly. (Weight training also appears to directly raise testosterone long term as well.)

In other words, one could make a strong argument that Cialis is simply a potentially dangerous substitute for exercise and weight loss. A more moderate position would be that Cialis should be used as a short term substitute until you get an exercise and weight loss program sufficiently far along.

REFERENCES:

1) 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”

2) The Journal of Sexual Medicine, Jul 2006, 3(4):716-722, “Testosterone:Estradiol Ratio Changes Associated with Long-Term Tadalafil Administration: A Pilot Study” 3) Journal of the American College of Cardiology, Dec 1996, 28(7):1652-1660, “Cardiovascular Effects of Exercise: Role of Endothelial Shear Stress”

4) J Am Coll Cardiol, 2004, 44:2411-2413, “Effect of six months’ exercise training on C-reactive protein levels in healthy elderly subjects”

5)  Arteriosclerosis, Thrombosis, and Vascular Biology, 2004, 24:1868, “Can Exercise Training With Weight Loss Lower Serum C-Reactive Protein Levels?”

6) Eur Heart J Suppl, 2002, 4(suppl H):H32-H47, “Overview of the cardiovascular effects of tadalafil”

7) Circulation, 2009, 119:2894-2903, “Tadalafil Therapy for Pulmonary Arterial Hypertension”

8) https://www.medpagetoday.com/MeetingCoverage/CHEST/11524

9) International Society for Sexual Medicine, Dec 2009, 6(12):3458-3468, “Effects of 12-Month Tadalafil Therapy for Erectile Dysfunction on Couple Relationships: Results from the DETECT Study”

10) https://investor.lilly.com/releasedetail.cfm?releaseid=777416

Better than Beer? - 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.

REFERENCES:

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

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:

“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.

But, if you want the benefits, you have to have it in its raw form.  This is something you can order off of Amazon or get at a health food store.  Again, see my link on Raw Cocoa Powder for more information.

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.

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:

Causes of Andropause - Peak Testosterone

NOTE: For those of you who have forgotten your high school biology, testosterone is produced in the Leydig cells of the testes.  On this page we are talking about factors that can slowly squeeze the output from these all-important cells.

So what causes the steady, gradual loss of testosterone that almost all of us males experience to one degree or another?  (I say “almost all of us”, because there are men – or should I say ‘lucky bastards’? – in their 70’s with testosterone of 700 ng/dl.)  You are immediately going to recognize the culprits as they can be blamed for a host of other issues besides just andropause:

Read my links on How to Lower Inflammation and Juice and Inflammation for more information.

2. Mitochondrial Damage. There is a a whole field called The Mitochondrial Theory of Aging and for good reason:  it seems to be a root cause for much of our decline over the decades.  Your testosterone is no exception:  researcher have found that mitochondrial damage in the Leydig cells corresponds to a loss in testosterone. [2][3] The bottom line is that mitochondrial health is likely critical to decelerating andropause.  This translates to a diet high in certain antioxidants, avoiding fructose and perhaps taking certain supplements (CoQ10, ALA) as well.

NOTE: An interesting side note is that there is good evidence that some of the antioxidants, which again would guard and protect your mitochondria from damage, can powerfully boost testosterone.  For more details, see my link on Antioxidants and Testosterone for more information.

3. Estrogen. Our old enemy estrogen, specifically E2 or estradiol, is at it again, this time correlating strongly with inflammation levels. Many men as they age and gain weight find their estrogen levels rising dramatically and this study shows they may be putting themselves at additional risk for inflammation as shown by elevated C-Reactive protein levels. [1] See my link on How to Lower Estrogen for additional information.

CAUTION: Some hypogonadal males have low enough testosterone to where they actually become deficient in estrogen and experience osteoporosis. See my book https://www.peaktestosterone.com/ for actual testosterone levels.

Again, I hope that any younger guys will read this and avoid the modern plague of declining testosterone levels and andropause.  I have another link on https://www.peaktestosterone.com/ that discusses the Okinawan’s success in this area.

1) Clin Endocrinol (Oxf), 2007 Mar, 66(3):394-8, “Association of endogenous sex hormone with C-reactive protein levels in middle-aged and elderly men”

2) Diabetes Care July 2005 vol. 28 no. 7 1636-1642, “Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men”

3) Exp Gerontol, 2001 Aug, 36(8):1361-73, “Age-related increase in mitochondrial superoxide generation in the testosterone-producing cells of Brown Norway rat testes: relationship to reduced steroidogenic function?”

4) J Endocrinol Invest, 2005, 28(11 Suppl Proceedings):116-9, “The relationship between testosterone and molecular markers of inflammation in older men”

5) European Cytokine Network, Jun 2005, 16(2), “Testicular interleukin-6 response to systemic inflammation”

High Estradiol? It Can Lower Testosterone - Peak Testosterone

Do you have high estradiol? Consider the evidence that it can lower testosterone (if you are not on HRT / TRT):

One of the questions I get from time to time is if high estradiol can lower testosterone. The answer is ‘yes’ of course and below we will provide many lines of evidence from the research that this is the case.  However, let’s first look at two basic reasons a man can have high estradiol levels in the first place:

Regardless of the reason, there are multiple lines of evidence that high estradiol can significantly lower testosterone and I list those out below:

1. Estradiol-Induced Hypogonadism. Ironically, it is estradiol, not testosterone, that is the primary control mechanism ramping up or down your testosterone production.  It is well-known that rising estradiol levels are the way that your body ramps up the feedback loop to turn off testosterone production at the hypothalamus.  In a young, healthy male the testes produce an ample supply of testosterone.  Have you ever asked yourself what stops testosterone levels from just continually slowly accumulating to unhealthy levels?  The answer lies primarily in the estradiol that your body creates from your testosterone via aromatase.  As (free) estradiol rises – some sources say it is the free estradiol / free testosterone ratio – it is detected by the hypothalamus and the hypothalaums begins to shut down production. [1]

This feedback loop is very protective, but it also can backfire with a Western lifestyle.  In modern cultures, a high percentage of men are overweight and obese due to over consumption of calories coupled with a sedentary lifestyle.  Because fat cells contain aromatase, as men gain weight, their estradiol levels increase.  Research shows that if a man is overweight by between 50 and 100 pounds, he can make himself hypogonadal.  In other words, his rising estradiol (and plummeting testosterone) actually shut down the hypothalamus almost entirely.  I cover just how dramatic this shut down can be in my page on Testosterone and Weight Loss and discuss, for example, one study that showed obese men with average testosterone of 223 ng/dl, which is VERY low testosterone.

Another way we could test this is through steroid users.  Men taking steroids inject supraphysiological levels of testosterone (in one form or another), which then are aromatized into massive levels of estradiol.  And, sure enough, their testosterone production is shut down and part of any steroid cycle is the PCT (Post Cycle Therapy) that is designed to bring their testosterone production back to life.  (It does not always work, however, and they end up on HRT.)

4.  Weight Loss Boosts Testosterone (In Overweight Men). By the same reasoning in #3, one would hope that men who lose significant weight, would increase their total testosterone levels.  Again, this is the case and studies that show that dropping 50 or more pounds can double or even triple testosterone levels.  Men get many more benefits, of course, including ones that will help them in the bedroom, something I cover in my page on The Many Research-Backed Reasons to Lose Weight.

Also, dieting normally lowers testosterone.  However, one study showed that in obese men, weight loss actually resulted in increased testosterone levels.  The reasons is that the obese men were so low in testosterone that the weight loss actually reversed the situation.

CONCLUSION:  Again, multiple lines of evidence that show that high estradiol levels can lower testosterone levels.  There are other reasons that high estradiol is not good for us males as well.  Higher estradiol levels have been associated with multiple prostate issues for example.  And I believe there is good evidence now that they can actually lead to accelerated atherosclerosis (arterial plaque).  See my page on Estadiol and Your Arteries for more information.

What about natural estradiol lowerers?  I cover some of the supplemental solutions out there that men use on The Peak Testosterone Forum on this page: Natural Estradiol Decreasers. Men are using Calcium D-Glucarate, zinc, chrysin with piperine and high dose DIM to attempt this. I have cautions about many of these and list them on the above web page. Regardless, these solutions, at least based on what I have seen, do not lower estradiol that much. Therefore, I doubt that a man will get much of a T boost from these. Zinc is the one exception for some men with a deficiency. See my page on Low Testosterone And Zinc Deficiences.

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”][International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

2. Clomid.  Some of you may be familiar with Clomid, which many men use to maintain fertility and increase testosterone simultaneously.  Clomid works in males by blocking estradiol at the hypothalamus.  Again, the fact that Clomid works so well (in men with a functioning HPT axis) shows estradiol’s function in testosterone production and how higher estradiol levels can lower testosterone.  See my page on Clomid and Testosterone for some additional information.

3. Arimidex Raises Testosterone. If high estradiol really lowers testosterone, then one might expect, or at least hope, that lowering estradiol would raise testosterone. And this is indeed the case.  We can actually pharmaceutically lower estradiol with an aromataste inhibitor and see that estradiol climbs higher.  The most common aromatase inhibitor (AI) is Arimidex (generic: anastrozole) and, as I show in my link on Testosterone and Arimidex, T levels can be nearly doubled in some men with this strategy. Other AI’s have produced similar results.

CAUTION: Using Arimidex to raise testosterone can be risky for several reasons: a) Arimidex interferes to one degree or another with the clotting cascade, b) it is fairly easy to crash your estradiol as some men have a sensitivity and c) thus men with youthful estradiol levels could end up too low (with the potential for osteopenia / osteoporosis).

Cost_Testosterone_Replacement_Therapy - Peak Testosterone

Okay, so you have weighed The Benefits of Testosterone Therapy versus the The Risks of Testosterone Therapy, discussed with your doctor and decided to proceed. If so, you may be fortunate enough to be in the situation that I am in, where your TRT (Testosterone Replacement Therapy or HRT) is largely covered by insurance. However, not all of us are so fortunate. And some of us could be covered by insurance, but the physicians and/or protocols are so lousy that we choose to go to a doctor more proficient and knowledgeable. For these and many other reasons, some men would like to know the cash cost and least expensive ways of going on TRT.

Below I am going to cover what I consider to be some of the more reasonable and reliable testosterone replacement options out there to do this.  Of course, if you want to spend more and go to a good anti-aging doctor, the sky is the limit on what you can spend. Again, here are Six Lower Cost Options for HRT Available to Men that I know about from running the Peak Testosterone Forum:

NOTE: I did not discuss HCG Monotherapy or Clomid below, but these are also relatively inexpensive options for men to consider.  See my STEP 6:  Alternative Strategies to Raise Testosterone.

1. Local Doctor with Compounded Testosterone. Every PCP and urologist will have worked with a compounding pharmacy in the past for a variety of reasons that involve some individualized patient therapies.  Although not very well-known by the public, this is actually surprisingly common and the practice allows doctors to somewhat customize certain treatments for their patients.  For example, the urologist that did my TRT a few years ago used this strategy when Androgel just did not raise my testosterone levels.  Basically, compounders can add bioidentical testosterone to a cream or gel – can you say Barry Bonds? – that increases absorption through the skin.  Concentrations vary from about 1 to 10% and are usually very effective at raising testosterone, assuming your physician knows what he/she is doing.

My compounded testosterone was run through insurance, but I do know it was less than $100 per month even without insurance.  And this was verified by one of our senior Peak Testosterone Forum members, who said that he spent $75 per month. [1]

NOTE:  I have no current affiliation with any of these providers.

2. Local Doctor with Testosterone Cypionate Injections. This is my most recent strategy.  Basically, I used an HRT clinic to get on testosterone cypionate and then found a PCP that was willing to continue with the same protocol.  It worked quite well, except my doctor will not do HCG (for restoring testicular volume).  So, in my case, I have a nice cypionate protocol (subQ or subcutaneous self-injections) run through insurance.  I pay a $40 copay for a supply that lasts two or three months.

If you do not have insurance, testosterone cypionate injections are not expensive and generally run for about $100 per month (or often less) including syringes and needles if you are self-injecting.  This is the most popular option on our forum as you can see in this  Peak Testosterone Forum Treatment Poll and accounts for about 50% of all men on some kind of testosterone replacement therapy, including HCG and Clomid.

3. Defy Medical with Drs. Saya. One of the other apostles of testosterone therapy has been Dr. Saya and are huge fans of the clinic they are associated with (Defy Medical).  One of the big advantages that I see in men going to Defy is a certain amount of low cost customization for specialized situations.  Dr. Saya also has a good reputation for being personable, experienced and smart – a pretty rare combination out there!

What are the costs?  We have a summary page here: Cost of Basic TRT/HRT With Defy Medical.

My understanding is that they can also give you proper paperwork, so you can file claims with your insurance in some cases.

NOTE: Dr. Saya and Defy Medical is now a site sponsor. Just see one of their ads on almost every page of the site!

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

COST OF INJECTION SUPPLIES and CYPIONATE: I don’t shop around and get my syringe/needle combinations for around 20 cents each.  However, one poster wrote that “you can buy a box of 100 syringes + 100 larger draw needles for about $30 total.” [8] And the cash price of cypionate is about $100 for a 10 ml vial, which is 2000 mg or about 20 weeks of therapy for the typical guy.

NOTE: The prices in this article pertain to the U.S. only.  Unfortunately, many countries in the world are tightly controlled by endocrinologists, who almost universally do not like HRT and severely limit options except in the most extreme of cases.  In these countries, where there is an almost monopolistic control over men’s hormones, options are very limited, testing is scarce and prices are much higher than listed on this page.  The U.S. was like this around 10-15 years ago, but, fortunately, the urologists came to our rescue and opened the doors for more well-rounded men’s health options for us.  (I had a miserable time getting testosterone.  See my My Health Story if you are interested.)

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=2328.0

2) https://www.peaktestosterone.com/forum/index.php?topic=5811.0

3) https://www.peaktestosterone.com/forum/index.php?topic=6494.5;wap2

4) https://www.peaktestosterone.com/forum/index.php?topic=6786.0

5) https://www.peaktestosterone.com/forum/index.php?topic=6476.0

6) https://www.peaktestosterone.com/forum/index.php?topic=1278.0

7) https://www.peaktestosterone.com/forum/index.php?topic=6849.30

8) https://www.peaktestosterone.com/forum/index.php?topic=295.15

9) https://www.peaktestosterone.com/forum/index.php?topic=7199.15

Prelox Review: An Erectile Supplement with a Proven Track Record

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.

Visceral Belly Fat and Testosterone - The Powerful Link -

Call it anything you want, but it’s ugly and it’s hard on your health.  The subject recently came up in The Peak Testosterone Forum. A poster asked this question:

“So I’ve read in several articles how visceral fat (yes, the nasty deadly one) is harder to get rid of from diet and exercise than subcutaneous fat. I have not seen anything that compares these two as a result of HRT. With that said, here is a fairly obvious observation I’ve made from my TRT over the last 2-1/2 months:”

“…4) My waste has shrunk almost 2 belt notches after gaining this 5 to 6 pounds!…So from all of this it seems the only explanation for the belt reduction is visceral fat removal. Does picking up your T levels significantly cause visceral fat to fall away faster than subcutaneous? Is this fully understood?” [1]

As you can see, this man went on HRT and is asking if the increased testosterone could have improved his visceral (belly) fat levels?  The answer is “Yes!”

REFERENCES:

1) https://peaktestosterone.com/forum/index.php?topic=1347.0

2) International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity, 1992, 16(12):991-997, “The effects of testosterone treatment on body composition and metabolism in middle-aged obese men.”

3) J Clin Endocrinol Metab, 2008, 93(1):139-146, “Testosterone therapy prevents gain in visceral adipose tissue and loss of skeletal muscle in nonobese aging men”

4) International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity, 2000, 24(4):485-491, “Low serum testosterone level as a predictor of increased visceral fat in Japanese-American men”

5) J Clin Endocrinol Metab, 1998, 83:1886, “Testosterone deficiency in young men: marked alterations in whole body protein kinetics, strength and adiposity”

6) American Journal of Physiology – Cell Physiology, Aug 1 2013, 305:C355-C359, “Testosterone induces cell proliferation and cell cycle gene overexpression in human visceral preadipocytes”

Below, I will show some studies that show powerfully testosterone can lower visceral fat. But this should be a sobering reminder to most men out there: if a man overeats, his high testosterone levels end up creating deadly fat in the belly area, i.e. visceral fat through signaling of preadipocytes. [6] Yes, you are predisposed to deadly visceral fat!

1.  Obese Men.  In one study of obese men, they made no lifestyle changes but simply gave the men testosterone therapy.  The participants experienced many positive changes, but one of them was a significant decrease in visceral fat.[2] As I mention in my link on Testosterone and Insulin, testosterone has a powerful insulin lowering effect.

2. Non-obese Seniors. One study put men on patches and only modestly increased their testosterone levels by about 30% from their starting point.  Even with such relatively small changes, visceral fat decreased significantly in these senior men. [3]

So it’s literally no exagerration to say that if you are low or lowish T, adding testosterone will probably melt off your visceral fat.  Of course, deciding whether or not to go on HRT is a personal decision between you and your doctor that involves many variables, but it’s always good to know the truth and the truth is that testosterone is strongly related to your “gut”.

This fact has been verified in many other ways as well.  First of all, a study on Japanese American men found that testosterone levels were inversely associated with visceral fat. [4]  In other words, the more testosterone, the less the visceral fat and vice versa.  Another interesting study gave a little more understanding by essentially blocking testosterone signaling in healthy young men. [5]  What they found was that all fat increased, but especially visceral fat.  In other words, if you are low testosterone, you will very much be at risk for general weight gain as well.

NOTE:  See my link on How to Lower Fasting Insulin Levels for more information of interest as well.

Mouthwash, Erections and Sex - Peak Testosterone

Did you know that your tongue is an erection engine – no it’s not what you think – responsible for much of the nitric oxide production in your body?  Yes, much of health is counterintuitive and this is yet another example.

It turns out that bacteria on the tongue converts any nitrates you eat into nitrities.  These nitrites are in turn transported down the throat via saliva and, when they hit the acid in the stomach, are eventually transformed into the all-important nitric oxide that is responsible for your erections. [1]

Furthermore, in my Interview with Dr. Nathan Bryan, he explains how this is actually a very efficient pathway for middle-aged and older males, much more efficient, for example, than the standard L-Arginine process that so many supplements go after. My book, The Peak Erectile Strength Diet, discusses some of the higher nitrate foods for just this reason.

REFERENCES:

1) https:// findarticles.com/p/articles/mi_7396/is_334/ai_n57416886/?tag=content;col1

2) Cancer Detect Prev, 1998, 22(3):204-12, “Formation of nitrosamines during consumption of nitrate- and amine-rich foods, and the influence of the use of mouthwashes”

3) Cancer Res, Jun 1 1991, 51:3044, “Mouthwash Use and Oral Conditions in the Risk of Oral and Pharyngeal Cancer”

There is one thing that can easily sabotage your body’s natural efforts to produce nitric oxide:  many men consume mouthwashes that kill the nitrate-to-nitrite converting bacteria on your tongue. That’s right – most mouthwashes are 25 percent alcohol – and swishing that stuff around in your mouth kills just about everything, both good and bad.  With it goes the good bacteria that you need so badly.

Interestingly enough, this was shown clearly in a study of cancer-related issues. [2] Researchers have long known that processed meats, which are high in nitrate additives as a preservative, lead to increased rates of GI cancer. Scientists speculate that it may be because nitrates, under certain conditions, can lead to increased levels of nitrosamines, compounds that have been associated with increased cancer risk.  What this study looked at was whether or not mouthwash, by killing tongue bacteria, of course would decrease nitrite levels.

So, if you have gingivities or periodontal disease, you might want to discuss different possibilities with your dentist.

CAUTION: One study linked a 60 and 40 percent increase in oral cancer in women and men, respectively, to mouthwash usage. [3] Other studies, however, have not found the same result.  However, some experts would argue that smokers and drinkers need to be particularly careful.

A Forgotten Key to Erectile Strength - Peak Testosterone

Viagra and Cialis proved once and for all that testosterone has little or nothing to do with erectile dysfunction, right?  You just take a little pill and then everything works out in the bedroom again, correct?

Wrong! This has proven decidedly NOT to be the case and one (of many) key reasons is that taking Viagra or Cialis does not address the key issue of low testosterone that often plagues middle-aged males.  Yes, Viagra and Cialis will boost endogenous nitric oxide levels, but that simply isn’t enough when a man does not have satisfactory baseline testosterone levels.

NOTE:  Viagra and Cialis often do not work for other key reasons as well.  See my links on Viagra and Cialis Resistance and Why Viagra and Cialis Do Not Always Work for more information.

1) Fertil Steril, 1995 May, 63(5):1101-7, “The effect of androgen on nitric oxide synthase in the male reproductive tract of the rat”

2) Int J Impot Res, 1995 Dec, 7(4):209-19, “Nitric oxide mediated erectile activity is a testosterone dependent event: a rat erection model”

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

4) The Journal of Clinical Endocrinology & Metabolism, Jul 1 2006, 91(7):2509-2513, “The Relationship between Libido and Testosterone Levels in Aging Men”

5) Asian Journal of Andrology, 2010, 12:136 151, “Androgens and male aging: current evidence of safety and efficacy”

1.  Nitric Oxide. Viagra affects the NOS (Nitric Oxide Synthase) enzyme, allowing nitric oxide to essentially persist longer. However, what some researchers and physicians seemed to have forgotten is that NOS is strongly affected by testosterone. For example, castrated rats lose about half of their penile NOS activity. [1] And the only way to restore the rat’s “hardness factor?”  Give them testosterone! [2] You are definitely swimming upstream with low testosterone.

2.  Internal Penile Atrophy. Nerves, connective tissue and other internal structures within the penis begin to atrophy and harden in a low testosterone environment. If this goes on too long, it can result in Venous Leakage, a condition where blood leaks out of the penis as quickly as it goes in, making erections less and less firm as time goes on.

3.  Pelvic Floor Musculature. The muscles at the base of penis are packed with androgen receptors. These muscles naturally wither without adequate testosterone levels.  This is yet another reason why Kegels can often help men.

5.  Libido. It is no secret that testosterone and libido go together. [4] I cannot tell you the number of emails that I have received from men who have lost interest in sex altogether and, of course, they almost always have low testosterone levels. Low libido can lead to many erectile issues, since it can strain relationships, dulls desire and leads to decreased sexual activity and erections.

6.  Mood and Depression.  Testosterone has a monumental effect on the male brain and many studies have shown that low levels lead to depressive (and other related) symptoms. [5]  This can create a vicious cycle as depression, in turn, can lower testosterone.

So, as always, the bottom line is get tested if you have any Symptoms of Low Testosterone and/or symptoms of erectile dysfunction – one root cause could definitely be hormonal.  And here’s a teaser for my new book as well:  if you want to know the exact levels at which testosterone and erectile dysfunction collide, including surrounding issues such as morning erections and venous leakage, please check out Low Testosterone By The Numbers for further details.

REFERENCES:

IMT: What Are Normal Levels? - Peak Testosterone

What is an IMT?  It is a carotid (neck artery) ultrasound that has been used in many studies to monitor atherosclerosis (arterial plaque) and has a rich and broad research history behind it.  According to Track Your Plaque, it has about a 60-80% correlation with cardiac plaque so, while it’s not perfect, it does have some solid association.  The beauty of an IMT is that, as of this writing (in most states), you can order one through Lifeline without a doctor’s orders and it is only $70.  (I have no affiliation.)

Why would anyone go to all this trouble to measure their atherosclerosis?  Isn’t arterial plaque just a part of life?  No, it does not have to be.  Several  men, that I call the Plaque Regressers have founds consistent ways to reverse atherosclerosis and part of this, obviously, requires the ability to monitor your progress.  I have a significant amount of coverage on my site on the topic and you can start with my Links for Improving Erectile Strength for more information.

a)  Erectile Dysfunction. The fact is that it doesn’t take a lot of plaque in your penile arteries before erections start taking a little longer and things start becoming a little softer. And even if you are young, that does not mean you are completely immune.  In my page on Young Men and Erectile Dysfunction, I discuss how many studies have shown that about half up to even two thirds of men in their 20’s and 30’s already have significant arterial plaque.<

If you have plaque, you probably want to focus on reversing it and clearing out those penile arteries. This will improve blood flow and improve  nitric oxide levels, all of which will help you in the bedroom.  See my page on  How to Clear Your Arteries for more information. One of the things that I see on the Peak Testosterone Forum is men with erectile dysfunction who simply refuse to believe that their issues could be caused primarily by atherosclerosis. But the fact is that aterial plaque is the root cause of most erectile dysfunction in modern cultures.

b) Heart Attack Risk.  As the plaque mounts and/or if it grows quickly, you are at an ever-increased risk of a heart attack or stroke.  In the U.S. alone, there are about 735,000 heart attacks per year, resulting in 370,000 deaths.  And another 240,000 will die each year of other heart-related issues.

Okay, so let’s say that you are on board and decided to actually measure your arterial plaque via an IMT.  How do you know if your readings are normal? Or, better yet, how do you know if they are ideal?  It turns out that there has been quite a bit of research on the subject and they are even published full studies in the public domain, clearly for the purpose to help us with attacking heart disease. Here is a sampling of that material:

NOTE:  A Heart Scan is actually the initial route I chose and you can read about it here:  My Heart Scan Results. (Next time I will get an IMT as my Heart Scan showed zero cardiac plaque and I don’t want any more radiation unless absolutely necessary.)

CAUTION: Always go by the results and analysis provided by your specific lab and/or physician.  Techniques and methodologies can vary testing results.

Here are the results from this study by age bracket for men only and the purpose is to give us a picture of relatively health aging of the arteries:

2. Patients Without “Obvious” Atherosclerosis. This study eliminated all patients with obvious narrowing the arteries.  Doing so yielded a nice picture of a more “healthy” age progression: [4]

Their concept was to give us a pattern for healthy arterial aging. As you can see, in this case even late seniors were able to keep their IMT below 1.00 mm. Keep in mind that the above values are women and men grouped together and, as I mentioned, men tend to be a bit higher. Notice, though, how similar the results are to #1.

3. Rome, Italy General Population Study. One clinic just kept track of 1,600+ patients in a row.  Interestingly enough, the results were quite similar to #1.  Unfortunately, the did not break it out by gender and women tend to have lower IMT’s than men. However, the general pattern and slope of the Spanish was definitely confirmed. [3]

What Is an Ideal IMT Score?

As you can see from the above, there is a “natural” progression of aging in IMT scores even in those living a relatively heart-healthy lifestyle.  Of course, many of the supercultures likely have little to no atherosclerosis and so their scores are probably even a bit lower.  One such people are the Tarahumara Indians of Mexico and I give coverage to them here if you are interested:  The Tarahumara Diet.

However, the point is that researchers have looked at all this data and the above studies and come to some conclusions:  By looking at the above stats, you can see for yourself how they came to these conclusions:

1. 1.0 mm Is Somewhat Risky for Old and Young; 1.2 mm is High Risk.  The authors were clear that “it is common practice to call a CCA IMT >1.0mm as being abnormal, and >1.2mm as being high risk. There is general agreement that the presence of obvious plaque indicates high risk at any age. However, when there is only CCA IMT thickening and no plaque then the normal values need to be adjusted for age, gender and perhaps even ethnicity. [4]

Very similar thinking was echoed by researchers when they stated that “we defined plaques nonarbitrarily as a localized area of thickening of >1.2 mm because we believe that plaque should be considered to be qualitatively different from general increases in wall thickness. Plaques were very common in both men and women, and, in contrast to IMT, the presence of plaques was strongly associated both with cardiovascular risk factors and with prevalent cardiovascular symptoms and diagnosed disease. [2].”

Notice that both sets of scientists noted that arterial wall thickness increases with age and so your IMT score must take this into account.  Thus, if you exceed the average progression by age, then you likely have plaque and are at risk.  However, if you are over 1.2, you definitely have significant plaque according to their research and, clearly, anything over 1.0 likely is indicative of problems as well, because even senior-aged healthy individuals have IMT’s less than that number.

2. An Increase Over .02-.05 mm Per Year. According to some guidelines, you should also watch the rate of change in IMT.  Notice that 1.0 and 1.2 figures from #1 are supported as well:

“It was suggested that an average thickness of the combined intima and media ranging between 0.5 and 1.2 mm is considered to be normal, and that >1.2 mm is used to define the presence of a plaque. It was also reported that the abnormal range of IMT is age dependent, and an IMT >1.00 mm is considered highly abnormal in younger patients, and is sometimes used as the cutoff in clinical trials (Feinstein 2002). The estimated progression of atherosclerosis per year is 0.02 to 0.05 mm (Feinstein 2002). IMT may be a potential useful marker for coronary atherosclerosis, as well as an indicator for its progression or regression, on the condition that the carotid atherosclerosis reflects coronary atherosclerosis.” [5]

SUMMARY:  Ideally, one would work with a qualified cardiologist or other physician that has a passion for plaque reversal.

1) Rev Esp Cardiol, 2010;63:97-102, “Carotid Intima-Media Thickness in Subjects With no Cardiovascular Risk Factors”

2) Stroke. 1999; 30: 841-850, “Carotid Plaque, Intima Media Thickness, Cardiovascular Risk Factors, and Prevalent Cardiovascular Disease in Men and Women”

3) J Ultrasound Med, 2007, 26:427–432, “Common Carotid Artery Intima-Media Thickness Determinants in a Population Study”

4) https://www.pulsus.com/journals.html, “NORMAL VALUES FOR COMMON CAROTID INTIMAL MEDIAL THICKNESS SHOULD BE ADJUSTED FOR AGE”, MF Matangi, DW Armstrong, M Nault, D Brouillard

5) Group Health Cooperative, Clinical Review Criteria, “Carotid Intima Media Thickness (IMT or CIMT) for Coronary Artery Disease Screening and Monitoring”

6) https://www.cdc.gov/heartdisease/facts.htm

Which Estradiol Test is Best? - Peak Testosterone

Pull your estradiol with the best test available. (Always discuss everything with your doctor first.)

A lot of men (and physicians) do not realize that low and high estradiol can cause just as many of the classic symptoms that men deal with, such as erectile dysfunction, low libido, anxiety, depression, etc.

One big issue with men on HRT (Testosterone Therapy) is dialing in their estradiol to the correct level.  Nothing is quite as frustrating as finally convincing your physician to put you on testosterone, feeling better after he does and then finding out a few weeks later that all the benefits have gone.  You no longer feel as good; your libido has tanked; and your erectile strength is right back where it started.

More often than not, the reason for this has to do with estradiol.  When a man goes on HRT, his estradiol rises and, in some men, it can go too high to the point where the extra estradiol cancels out the benefit of his newfound testosterone.  And, from what I’ve seen, this effect usually takes a couple of weeks to kick in.

After that, yet another estradiol problem can arise.  Many doctors and HRT clinics will put a man with high estradiol on an aromatase inhibitor – usually Arimidex – and some guys are quite sensitive to it.  Their estradiol crashes to an abnormally low level and they feel miserable.  Often their joints will ache with an accompanying loss of libido and erections.

So getting estradiol tuned right is extremely important for a man on HRT and most clinics shoot for 20-35 pg/ml, although a few will go a little above or below that.  (This is controversial, so discuss with your doctor.)  Of course, estradiol is very important for men not on testosterone therapy, but, from what I’ve seen, very few doctors look at it.  You’re lucky if you can get a blood draw for testosterone out of them much less one for estradiol!  (In the last year there have been two studies on the important of estradiol in HRT, so, hopefully, it will hit the mainstream doctors sometime soon.)

CAUTION: You have to be extremely careful in lowering your estradiol. If you go too low for too long, you can end up with osteoporosis. In addition, setting an estradiol target is more difficult now, because the big labs are no longer using the old assays but rather a more accurate technology called LC-MS/MS. However, this test lowered the range and so more research needs to be done to correlate the old versus the new values.

So how do you find out your estradiol level?  You just get a blood draw similar to testosterone, right?  Wrong!  Estradiol is much more problematic.  A man’s estradiol levels are, of course, much lower than a pre-menopausal woman and so it’s actually trickier to read our estradiol levels.  There are potentially 4 kinds of estrogen/estradiol-related tests.  Here in the U.S., Labcorp is the biggest lab and so we’ll use them as an example:

NOTE: To make matters more confusing, Quest has an “ultrasensitive test” that is actually the LCMS technology. So, again, you should probably get the test number from your doctor and research exactly what kind of test it is. I wouldn’t go by the name. Get the actual number and look it up on the lab’s site for verification. Remebmber that most of these tests you can get for yourself: Inexpensive Self-Testing Testosterone and Estradiol Labs.

First of all, we will throw out #4 as this is just the wrong test, because it includes the other estrogens (estrone, estriol) in addition to estradiol.  However, I mentioned it, because I have seen (on the Peak Testosterone Forum) physicians who have mistakenly ordered this test.

That leaves us with three legitimate candidates for male estradiol testing. Here are the current ranges for an adult male for these LabCorp tests:

Now let me go to some comparisons of Labcorp’s Sensitive Test versus their regular test.  And the reason I am doing this is to emphasize that, at least in my opinion, the regular estradiol test is not very safe or accurate in many situation and illustrate that with some practical lab results.  As an example, one of our forum posters has actually had both of these estradiol tests pulled on the same day and same time and here are his results:

NEWS FLASH: These results are no longer valid as this test has now changed to LCMS.The first thing to notice is that he was easily in the range of both tests. Therefore, both tests should have provided reasonably accurate results. Yet there is a 73% difference! The standard test is almost double the value of sensitive test.

And here is what is so dangerous:  estradiol too high or too low has been shown in several studies to be dangerous to a man’s health, due to (primarily) increased cardiovascular risks.  Therefore, if you choose the wrong test, you could potentially be putting yourself at risk for heart disease or stroke.  Life Extension Foundation sites studies that show:

“The men in the balanced quintile with the fewest deaths had serum estradiol levels between 21.80 and 30.11 pg/mL. This is virtually the ideal range that Life Extension has long recommended male members strive for. The men in the highest quintile who suffered 133% increased death rates had serum estradiol levels of 37.40 pg/mL or above. The lowest estradiol group that suffered a 317% increased death rate had serum estradiol levels under 12.90 pg/mL.” [1]

Even worse in many cases, is the fact that low estradiol can easily slowly lead to osteopenia and eventually osteoporosis, a potentially crippling and painful condition.  Look at the man’s standard reading above of 33.  His doc could potentially decide to put him on some Arimidex (if he was on HRT) to get him closer to 20 pg/ml.  Yet, using the sensitive test, he would probably have estradiol of 12 or 13!

Making matters worse is the fact that many doctors are trying to save money by using the less expensive standard test and think to themselves, “Well, my patient is probably in range, so this is fine.”

Here is an example from another forum poster.  In this case, his doctor used the lab’s sensitive test and he the same morning pulled the regular estradiol test.  His numbers, which includes total testosterone, were:

Total Testosterone=1080; Estradiol regular = 34.8  pg/ml

Sensitive: TT=1252; Estradiol sensitive = 25 pg/ml

Again, notice the identical pattern:  he is in range more than likely on both tests but the regular estradiol test reads significantly higher (40%) than the sensitive.  Since that time we have had several other posters end up with similar results.

The important things:

Stay in range for any lab test you do.

The gold standard should probably be the LCMS technology, but you will probably find some knowledgeable doctors still using the sensitive test.  Deciding on the best test is something, in this case, that you have to do with your physician, but make sure that he/she is knowledgeable and not just prescribing the cheaper test to save money.

1) https://www.lifeextension.com/

DHEA (and Pregnenolone) Got Rid of My Anxiety - Peak Testosterone

Two hormones that simply don’t seem to get enough airtime are DHEA and pregnenolone. Like testosterone, both can really help the brain, improving mental fog, cognition, alertness, mood, etc. They can also greatly help with sleep and anxiety.  Best of all, they can even restore morning erections and improve libido! Basically, if you are low in one of these hormones, supplementation can just plain help you feel better.

The tragedy in my opinion is that, since pharmaceutical companies cannot make money off of these two, they have taken a backseat and are ignored by virtually all physicians.  Yet I can easily make a case that they are just as important as testosterone.  To illustrate this let me relate a personal story (from early 2016):

MY SITUATION: I had been on TRT (testosterone therapy) using cypionate injections for a little over two years. I definitely felt much much better than I did pre-TRT.  However, I still didn’t quite feel right.  For example, TRT got rid of all of my pre-TRT depression and about half of my anxiety.  But there was still some anxiousness left.  Yes, I had worked hard on lifestyle factors, including diet and exercise, which is why I decided to pull labs for some of the other hormones (Jan of 2016). Here are the results:

Being low in any one of these three hormones could cause significant symptoms – similar to low testosterone -such as fatigue, mental fog, erectile dysfunction and lowered libido. In retrospect, I think the lifestyle changes and improved testosterone were what was allowing me to do so well in spite of low hormone output.

Fortunately, at about this same time I had signed up with Dr. Justin Saya of Defy Medical, who is one of the foremost HRT and TRT experts that I know of.  He immediately put me on a compounded preparation of 25 mg of pregnenolone and 25 mg of DHEA daily.

NOTE: While one can argue that compounded DHEA and pregnenolone are not absolutely necessary, they a) do provide pharmaceutical grade dosing and b) are without binders and fillers.

Dr. Saya recommended that I take this before bed, because the pregnenolone can have a mildly relaxing effect and  help many men with their sleep.  I noticed this benefit immediately.  I usually wake up feeling a bit “on edge” and “hyper.”  I had never really thought about it, but my sleep was obviously not providing the deep rest that I needed.  The pregenenalone and DHEA combination definitely gave me improved sleep.

The other thing that I noticed almost immediately was that my anxiety was gone.  For the first time in my life, I had no anxiety!  I remember thinking, “So this is what a normal person feels like.”  Testosterone had vanquished my depression, but it took DHEA and pregnenolone to get rid of my anxiety. I will add that I believe most of this anxiety-lowering effect is from the DHEA, because I had taken it briefly in the past and noted a similar effect.  And I believe that it is mostly the pregnenolone that helped with my sleep.

Fruits and Vegetables: The Miraculous Benefits 10 Servings Daily

REFERENCES:

1)   Social Indicators Research, “Is Psychological Well-Being Linked to the Consumption of Fruit and Vegetables?”

2) Current Atherosclerosis Reports, 2003, 5(6):492-499, “Dietary intake of fruits and vegetables and risk of cardiovascular disease”

3) JAMA, 1995, 273(14):1113-1117, “Protective Effect of Fruits and Vegetables on Development of Stroke in Men”

4) International Journal of Impotence Research, 2006, 18:370 374. “Dietary factors in erectile dysfunction”

5) American Journal of Epidemiology 160(12Pp):1223-1233, “Fruit, Vegetable, and Antioxidant Intake and All-Cause, Cancer, and Cardiovascular Disease Mortality in a Community-dwelling Population in Washington County, Maryland”

6) Current Atherosclerosis Reports, 2003, 5(6):492-499, “Dietary intake of fruits and vegetables and risk of cardiovascular disease”

7) Am. J. Epidemiol, 2005, 161 (3):219-227, “Dietary Patterns and the Incidence of Type 2 Diabetes”

8) Neurology, Nov 13 2007, 69(20):1921-1930, “Dietary patterns and risk of dementia The Three-City cohort study*”

9) https://www.cancer.gov/types/common-cancers

10) JNCI J Natl Cancer Inst, 2001, 93(7):525-533, “Fruit, Vegetables, Dietary Fiber, and Risk of Colorectal Cancer”

11) International Journal of Cancer, 20 Dec 2003, 107(6):1001 1011, “Fruits, vegetables and lung cancer: A pooled analysis of cohort studies”

12) Nutrition and Cancer, 1992, 18(1), “Fruit, vegetables, and cancer prevention: A review of the epidemiological evidence”

12) JNCI J Natl Cancer Inst, 2007, 99(15):1200-1209, “Prospective Study of Fruit and Vegetable Intake and Risk of Prostate Cancer”

13) JNCI J Natl Cancer Inst, 2000, 92(1):61-68., “Fruit and Vegetable Intakes and Prostate Cancer Risk”

14) J Nutr, 2004, 134:913-918, “Plasma C-reactive protein and homocysteine concentrations are related to frequent fruit and vegetable intake in Hispanic and non-Hispanic white elders”

The research clearly shows the incredible, nearly miraculous benefits of eating fruits and vegetables. Fruits and vegetables will protect you against the top 3 killers of men as well as the top 3 cancers of men. They will also guard both your brain and body.  The benefits range from psychological to cardiovascular to cancer protective and on and on.

Other than possibly exercise, there is nothing that confers this kind of broad range of protection against chronic disease.  If they found a drug that could do all of this, it would make front page news.  However, a food-based solution seems boring and scarcely any mention is made by the media or the medical profession.

But natural is where it’s at and that fruits and vegetables are miracle workers when consumed every day.  Elsewhere on the site, I document that they can give an incredible boost to blood flow, nitric oxide and your sex life in general.  This is also the subject of my book The Peak Erectile Strength Diet.  (You may also want to read about the potential for Higher Testosterone Levels through Plant-Based Eating.)

Right now the Paleo and Low Carb Diets are the rage.  But stop and ask yourself, “Where are studies that show that eating beef, chicken, pork, etc. can decrease cancer and cardiovascular risks?”  Good question, eh? Well, you can look as long as you want, but they are not there.  Again, abundant research, which I document below, shows the benefit of fruits and vegetables, but there is simply no equivalent for you carnivores out there (with all due respect of course).

I occasionally eat meat and have egg whites nearly every day, so it is not “religious” with me. But I long ago realized that the benes are with fruits and vegetables. This is Nature’s Sweet Spot and it can make all the difference.  Sure, there are a few supplements that are probably absolutely essential due to the conditions of modern living, such as vitamins C, D and the omega-3’s.  But there is nothing more powerful than plant-based eating and I’ll show why below with The Top 15 Benefits of Eating Fruits and Vegetables:

1.  Happiness. This says it all.  One study clearly shows the greater the fruit and vegetable consumption, the greater one’s happiness. [1] That’s because fruits and vegetables are so brain-protective and brain-building.  They do just what the brain needs:  supply a wide array of vitamins and minerals, bathe neurons in antioxidants, increase blood flow, protect against stroke – the list could on and on.

In fact, if your mood isn’t where it should be, one of the first places you should look is on your plate. the study that showed the above examined mental well-being and mood from a wide variety of states and confounders and still found a dose-dependent relationship up to 7-8 servings of fruit and vegetables. Yes, you just can’t get enough of them!

2.  Cardiovascular Disease. What is the number one killer of men (and women)? Most of us know that it is heart disease. And what has been shown in study after study to reduce this risk? Yes, fruits and vegetables. How do fruits and vegetables work their magic? It’s simple – they lower almost every known risk factor for cardiovascular disease. Look at what these researchers wrote: “Recent large, prospective studies also show a direct inverse association between fruit and vegetable intake and the development of CVD incidents such as coronary heart disease.” [2]

3.  Erectile Dysufnction. Peak Testosterone readers know how intimately heart disease and erectile dysfunction are tied together.  “As the arteries go, so goes the penis” is a good motto to keep in mind.  So it will be no surprise to find that fruit and vegetable consumption is correlated with male erections. [4]

4.  Stroke. If there is one thing that can instantly change your life, it’s a stroke.  And mini-strokes can hammer the brain and destroy cognition later in life. Research, including the well-known Framingham Study, has repeatedly shown that fruits and vegetables protect against all types of strokes. [3]

5.  Mortality and Survival. Want to increase your chance of surviving another decade? Well, guess who are some of your truest friends? As expected, fruit and vegetable consumption has been found to be associated with decreased cardiovascular, cancer and all cause mortality. [5]

6. High Blood Pressure (Hypertension). A huge risk factor for erectile dysfunction, stroke, heart disease and dementia is high blood pressure. Of course, fruits and vegetables have been shown in several studies to be associated with lower blood pressure. [6] It’s no wonder then that the plant-based DASH and Low Fat Diets are proven blood pressure lowerers.  See my link on The Benefits of Low Fat Diet for more details.

7. Diabetes. Several studies have shown that fruit and vegetable consumption can protect against the development of Type II diabetes. [7] Adult onset diabetes is a huge risk factor for just about every chronic disease that plagues modern society and accelerates aging in general.

8. Dementia. One of the scariest things to think about is losing your ability to remember, think and converse.  Once again, fruits and vegetables come to the rescue, significantly reducing your risk of dementia. [8]

9.  Inflammation. As I often write, “Inflammation is the root of all evil.”  And it truly is, being the root cause for heart disease, autoimmune disorders, many cancers and Alzheimers. Well, one study found a dose dependent relationship between fruit and vegetable consumption and CRP levels (C-Reactive Protein), a broad-based measure of systemic inflammation and a strong risk factor for heart disease.  Dose dependency is a very good sign of the accuracy of a study and, in this case, meant that the more fruit and vegetables eaten on a daily basis, the less the levels of inflammation. [14]

10. Colon Cancer. The big three cancers for men are prostate, lung and colon. [9) Wonder why I mention it?  That’s right – fruit and vegetable consumption are inversely correlated with colon cancer risk. Interestingly enough fruit, which gets a bad rap from the Low Carb and carnivore crowds often, conferred the highest protection. [10]

11.  Lung Cancer.  One of the biggest man killers is lung cancer.  And don’t be fooled:  non smokers can get lung cancer surprisingly easily.  Air pollution and  can contribute to risk for nonsmokers but the second leading cause for lung cancer is radon.  Many of us have been exposed to radon and have no idea, but the effects show up later as lung cancer.  What is one of your best protections?  You got it:  fruits and vegetables. Many studies have shown this.  One interesting thing came out of a meta-analysis:  fruit actually likely conferred the greatest protection. [11]

NOTE:  I talk a lot about the risks of fructose consumption.  However, looking at #10 and #11, fruit is so protective of these major killers, I cannot help but conclude that all the incredible benefits of fruit far outweigh the risks of the extra fruit.  I do believe some people are sensitive to fructose and many experts recommend that you keep your totally daily fructose in the 25-50 gram/day range.  For more information, see my header page on Fructose Consumption.  And, whatever, you do, do not consume High Fructose Corn Syrup or table sugar (which is half fructose).

12.  Prostate Cancer. (Cruciferous) The most powerful vegetable-related cancer protection for men probably comes from broccoli. Fruit and vegetable consumption is protective, but primarily through consumption of cruciferous vegetables (broccoli, cauliflower, etc.) and several studies have shown this effect. [12][13]

NOTE:  Whole grains have been getting a lot of negative press lately.  And I am very cautious about Modern Wheat and Soy.  Nevertheless, most whole grains are powerhouses, a fact I document on Whole Grains and Your Sex Life.

13. Homocysteine.  A big risk factor for heart disease is elevated homocysteine levels. One study found a dose dependent relationship with homocysteine levels, meaning the more the fruits and vegetables, the less the homocysteine levels. [14]

14. Oral Cancers.  28 out of 29 studies! [12]

15. Pancreas and Stomach Cancers. 26 out of 30 studies. [12]

Clarence Bass:Low Body Fat Percentages Year to Decrease Estradiol

Clarence Bass is one of those authors where I constantly say to myself, “Oh, why O why didn’t I read this twenty years ago?!?”  Ripped 2 is my most recent read of his books and it’s a jewel:  he answered a dozen key questions I have had for what seems like forever.  In fact, this book is one of the biggest myth-busting books out there if you ask me, and I believe his principles for muscle mass retention during weight loss are crtical in the battle for your health and your confidence in the bedroom.

First of all, let’s be honest here:  the Western lifestyle is designed to make us look awful.  Sure, your wife or girlfriend is polite to you about how good you look as a “hunk” – that’s a code word for the spare tire around your gut – and so “rugged,” i.e. wrinkled and sagging.  But the truth is that the same things visually attract her today as they did when she was a teen:  a lean, trim, muscular body.  So put on some muscle and fill in those sags and iron out those wrinkles.  And get your body fat percentage down and give her something decent to look at!  Clarence Bass, in Ripped 2, shows you how to get a youthful physique with low body fat percentages and great musculature in a sane, non-painful and reasonable way.  (Don’t forget to check out my interview with him on my other page called Clarence Bass: Senior Bodybuilding.)

MEN ON HRT:  One of the motivations for getting my body fat percentage down was to reduce estradiol as much as possible.  I have beefy, youthful testosterone levels (through HRT), but estradiol of 27 pg/ml without Arimidex! And my Tanita bioimpedance scale now shows my body fat percentage below 10 percent using Clarence’s methods.

Virtually every other trainer that I have read about builds himself up as a guru and deliberately creates an artifical and complex protocol to do the same thing that Clarence Bass does with ease, dignity and clear science.  Just check out the silly myths about this whole field that he shatters in this book:

1. A Low Body Fat Percentage Cannot be Maintained Year Round? Wrong! Clarence is now decades older in his mid 70’s than when he wrote Ripped 2 in his mid 40’s. And through all those decades, he has maintained very low body fat percentages by the typical American’s standards. And, even at the time of his writing Ripped 2, he wrote:

  “In my case, I’ve reduced my body fat below three percent every year since 1977.  Except for a few months in 1979, my body fat has remained below six percent for the last five years. I’ve had no problems.  In fact, I’m more energetic when I’m extremely lean.  I walk faster and am more active.  I don’t require as much sleep My resting heart rate is lower, in the low 50’s, indicating that my body operates more efficiently when I’m lean.” [1]

Is this any shock?  Do any of us still believe that we feel better when we have a bunch of “healthy fat” around our guts (and internal orgams!).

2. A Low Body Fat Percentage is Unhealthy? Wrong! This hurts to write and the reason is that I accepted this as an absolute truth without ever researching it.  I had someone on The Peak Testosterone Forum state that it was impossible to get under 12% body fat without going through an elaborate protocol, which I will discuss below. He said I would lose all my muscle mass and slam into “leptin resistance”, etc. Clarence points out that if you just follow a few simple rules, such as losing weight slowly, etc., you can continue to lose body fat all the way down to around 5%!

Oy vay!  I cannot tell you the number of articles that I have read that insist that you must do elaborate cutting and bulking routines, etc. I have been following his principles for a month now and already have my body fat below 10% and, by the way, have added some muscle mass at the same time. (This may be due to the fact I am on HRT and thus have an “unfair” advantage over most purely natural guys. But by following Clarence’s principles, you can still keep your muscle mass.)

3. A Low Body Fat Percentage Is Impossible Without Carb Backloading? Wrong! Carb backloading is the rage right now with American men trying to lose weight.  As I mentioned above, I have been told by a number of men on The Peak Testosterone Forum that this is the only to lose weight and maintain your muscle mass down to the single digits.  This was very disturbing, because I don’t want to eat like that.  I’m into making the bulk of my diet nitric oxide-boosting plant foods and this is exactly how Clarence eats.  Everyone that I know on carb backloading has low triglycerides but high LDL, something I do not want to risk.  I’ve worked hard to clear out my arteries and don’t want to take two steps backward.

For those who don’t know, carb backloading is basically an elaborate system where you don’t eat carbs in the morning and then you eat a ton of them later in the evening.  I never saw the point in all of this and found it hard to believe this was essential in order to get down to low body fat percentages. Clarence Bass shows that is indeed in the case.  Again, he has been sub-5% body fat for decades with no ill effects whatsoever.

NOTE:  You can buy this classic off on Amazon.  Check it out here:  Ripped 2 by Clarence Bass.

4.  You Can’t Build Muscle Mass With Low Body Fat Percentages? Wrong! This IS the subject of this book and, again, Clarence discusses directly just how to do it without any of the ridiculous constraints and systems that are out there.  If you stop and think about it, many of the supercultures are very lean and have achieve a low body fat percentage without any sort of education or any particular effort.  It just comes naturally because of their lifestyle.  What a concept!

5. A Low Body Fat Creates Metabolic Disturbances? Wrong! Without mentioning names, there is a popular and very well-educated trainer that discusses all the problems that competitive fitness models and bodybuilders have metabolically with lower body fat percentages.  This left me with the with the impression that it was dangerous to go this low in body fat percentage.  Again, Clarence Bass shatters these myths and he does it by doing weight loss S-L-O-W-L-Y (and with good nutrition).  There are no dramatic cutting phases.  There are no nutritional deficiencies or drugs or weird supplements – just a good dose of common sense instead.

CAUTION: There is theory out there that have some body fat helps you through times of extreme illness as a reserve. If you are concerned about this and believe it to be valid, then my two cents is stop around 12% body fat.  12% body fat will leave the typical 180 pound man with almost 22 pounds of fat reserve which is about 75,000 calories.  If that doesn’t get through a dark night, then you’re probably in trouble anyway!

6. A Low Body Fat Percentage Requires a Ph.D. Guru Teacher? Wrong! The most popular leaders (in the U.S. at least) seem to fit this category and I have seen many men fall into the trap that you need an advanced degree in order to accomplish this feat.  Clarence Bass is clearly a very smart guy – he’s a retired attorney – and, again, shattered that myth by coming up with a simple, clear and practical way to accomplish the same thing.

NOTE 2:  Don’t forget to stop by Clarence Bass Home Page – he has tons of great articles and tips on there.

7. A Low Body Fat Percentage Requires Large Amounts of Protein. You do need to consume a decent amount of protein in order to not lose your precious muscle as you slowly drop the pounds.  However, in several of his books, Clarence Bass talks about how he consumes relatively small amounts of protein compared to the typical “bro science” that is out there.  I had been studying simultaneously for my CPT certification, when I noticed in their study materials the same thing:  you do NOT need a gram per pound of body weight that I have repeatedly heard on bodybuilding forums. Again, Clarence was a succcessful bodybuilder and fell much more into the typical NASM guidelines of 1.2 – 1.7 gram/kg of body weight for strength athletes and bodybuilders.  And he lost weight and gained muscle using these “lower” levels of protein.

This was a big relief to find out about as it takes a lot of time (and money) to try to consume the oft-advised gram of protein per pound of body weight.  Again, thanks Clarence for being one of the few sane voices out there!  As I mentioned, I have gained muscle mass while losing weight consuming the lowest protein levels ever and near about 1.5 g/kg number (and I am using almost entirely lower quality plant proteins).

8.  A Low Body Fat Percentage Cannot Be Done Without Supplementation? Wrong! Clarence uses almost no supplements. In fact, about all he uses is a multivitamin. But he definitely does NOT use or recommend any fat burning or weight loss supplements.

CONCLUSION: Here you have a relatively simple, easy way to look the best in your life.  It’s inexpensive, does not require costly trainers, equipments or supplements.  All you have to do is spend a few bucks on a book.  (I also highly recommend another book of his and wrote about here in my page on Challenge Yourself by Clarence Bass.)

REFERENCES:

1) Ripped 2, Clarence Bass, p. 49.  (Clarence Bass Ripped Enterprises, 1982.)

Naltrexone: Boosting T and Solving E.D. - Peak Testosterone

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=2723.0

2) Pharmacology Biochemistry and Behavior, Nov 1980, 13(5):663 672, “Behavioural and endocrine effects of naltrexone in male talapoin monkeys”

3) Psychoneuroendocrinology, 1976, 1(4):359 369, “Acute effects of heroin and naltrexone on testosterone and gonadotropin secretion: A pilot study”

4) Physiology & Behavior, Feb 2009, 96(2):333-342, “Naltrexone effects on male sexual behavior, corticosterone, and testosterone in stressed male rats”

5) JPET, Sep 1980, 214(3):503-506, “Heroin and naltrexone effects on pituitary-gonadal hormones in man: interaction of steroid feedback effects, tolerance and supersensitivity”

6) Psychoneuroendocrinology, 1989, 14(1-2):103 111, “Endorphins in male impotence: Evidence for naltrexone stimulation of erectile activity in patient therapy”

7) https://www.stopthethyroidmadness.com/ldn/

8) Proc Natl Acad Sci U S A, 1999 Feb 16; 96(4): 1722 1726, ” -Endorphin blocks luteinizing hormone-releasing hormone release by inhibiting the nitricoxidergic pathway controlling its release”

One of the members on the Peak Testosterone Forum really got my attention one day when he posted that his testosterone had more than doubled from taking a medication called Naltrexone. Naltrexone is an opiod receptor antagonist that is typically used in the treatment of drug and alcohol addictions. It is a very interesting medication, but what caught my eye was the fact that this poster said his testosterone went from 400 ng/dl to 1,000 ng/dl! [1]

Not bad, eh? Well, I think that synthetic pharmaceutical solutions should be a last resort, but there may be a less to be learned here. Below I want to summarize the various pathways tat Naltrexone works on, but first let’s look at some interesting study results with Naltrexone that pertain to men’s health and/or hormones.

1.  LH (Leutinizing Hormone) Protection.  Normally heroin administration causes a big drop in LH (leutinizing hormone), which affects testosterone negatively.  However, Naltrexone protects against any such drop in LH. [3]

2. Testosterone Restoration. One study found that administration of heroin significantly lowered testosterone levels – as expected of course – and that Naltrexone restored it into the medium high range. [5] However, these results do not appear to be replicated in normal males.  See the next item:

3.  Erectile Dysfunction Aid. A fairly recent study look at 30 men with 1 year plus of idiopathic erectile dysfunction. [6]  This means that doctors did not know the cause of their E.D. nor could they solve it.  Look at the results that were achieved:

“The naltrexone therapy significantly increased the number of successful coitus compared to placebo after 7 and 15 days of treatment: improvement of sexual performance was evident in 11 out of the 15 treated patients. All the patients experienced a significant increase in morning and spontaneous full penile erections/week. No significant side effects were reported.”

The authors commented that testosterone was NOT increased.  So Naltrexone did its magic without the help of the Power of T.  What is even more remarkable is that fully one third of the patients who had already discontinued Naltrexone treatment had their erectile strength completely restored!

UPDATE:  LDN may have worked by upgrading eNOS according to this study. The researchers stated that “Conversely, the activity of NOS was increased by the -receptor antagonist, naltrexone.” [8]

More Naltrexone Superpowers

Protecting testosterone and (often) curing unsolvable erectile dysfunction are pretty impressive results to say the least.  However, this is just the beginning of some of Naltrexone’s extraordinary abilities:  it also has the ability to greatly help with autoimmune thyroid disease according to an underground, alternative health movement.  The treatment protocol is called “LDN” for Low Dose Naltrexone therapy and it seems to work remarkably well in patients who with the VERY common autoimmune thyroid disorders – Grave’s and Hashimoto’s. [7]

NOTE:  It also reportedly helps many people with lupus, Crohn’s and other autoimmune condition. [7]

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

So now let’s go back to the this Peak Testosterone Forum post where the poster said that he more than doubled his testosterone.  In his case, he had Hashimoto’s with significant antibodies and the Low Dose Naltrexone dramatically reduced his counts.  Of course, this is going to be good for his thyroid as well.  So Naltrexone, at least in some men, will have a doubling effect, because it is both helping lower an immune reaction and improving thyroid function.  Now studies show that if you correct hypothryoidism, you can boost testosterone around 30%, nowhere near the 150% increase of this poster. However, for some reason, in this man his testosterone went through the roof with the combination.  (I don’t advocate self-treating as this man did.  You should always be able to find a physician, naturopath or other practitioner who will work with you.)

NOTES: It is true that in a study on monkeys, males on Nalterexone “significantly reduced sexual behaviour in previously active males, while increasing grooming interactions.” [2] In other words, these monkeys got themselves all ready for the party, but then never showed up!  The authors commented that this was the opposite of that reported in rodent studies.  A recent rodent study showed that Naltrexone kept males from losing interest during stressful situations. [4] This appears, for whatever reason, to be the exact opposite case for human males however. In addition, Naltrexone increased prolactin in some male monkeys. However, in this study prolactin was increased only in those males that were lower prolactin in the first place. [2] So, although higher prolactin levels mean decreased testosterone and libido, in this case one could argue it re-established normalcy.

CAUTION: Low dose naltrexone appears to be pretty safe in the short term.  As far as I know, long term studies have not been done nor long term safety established.

Testosterone and Cluster Headaches: Low Levels

What type of common headache can be worse than a migraine?  If you guessed cluster headaches, you’d be exactly right.  These headaches can be completely incapaciting and that is why is it so important to find any root causes for the sake of its victims.  These headaches on one side of the head have even said to deliver the worst pain known to humans. (Suicide is tragically common.) And it affects more men than women – the opposite of migraines.

Researchers have found that an increase in two neurotransmitters (histamine and possibly serotonin) may be causative:

“Whole blood histamine was estimated before, during, and after 22 attacks of cluster headaches, and plasma serotonin was studied in 30 such headaches. The results were compared with changes in blood levels of both amines during headache in ten migrainous subjects and in ten controls. In cluster headache, whole blood histamine levels showed a statistically significant rise during the attack, whereas plasma serotonin levels showed a slight nonsignificant elevation.” [1]

However, hormonal links were much more scarce. This changed in 2006 when researchers found that low testosterone was correlated, interesting in both men and women, with cluster headaches. [2] Apparently, researchers had noted male cluster headache sufferers were often “overmasculinized” and decided to investigate a testosterone connection.  And they had also noted a diurnal (daily) pattern associated with it, which indicated that it may be located in the hypothalamus. What the researchers did in this study is measure the testosterone, LH, etc. of a small group of cluster headache sufferers, who had all been diagnosed and had tried, unsuccessfuly, a variety of  powerful medications.

–5 of 7 male patients had no cluster headaches for the first 24 hours.

–4 of the 7 male patients were completely cured.

So this appears to be yet another example as to how low testosterone increase your risk for a nasty chronic condition.

NOTE:  Migraine headaches, although more common in women, plague many men.  It turns out that low testosterone is also likely a root cause of these also, something I cover in my page Testosterone and Migraines.

1)  Arch Neurol, 1971, 25(3):225-231, “Histamine and Serotonin in Cluster Headache”

2) Headache, 2006 Jun, 46(6):925-33, “Testosterone replacement therapy for treatment refractory cluster headache”

3) https://www.theatlantic.com/health/archive/2013/11/cluster-headaches-the-worst-possible-pain/281524/

A Cure? (Supplement-based) - Peak Testosterone

Something that gets me really excited is when I see a nutraceutical approach that rivals or even beats traditional pharmaceutical approaches.  It turns out that one of top three financial bloggers, Mike “Mish” Shedlock, likely stumbled across just such an approach.  Mr. Shedlock was gracious to even grant me a short interview and discussion of what he did and why and I’ll discuss some of the highlights below.

NOTE: Mike has one great financial article after another and I highly encourage you to give his site a visit: Global Economic Analysis. Kudos to him also for doing some incredible fund raising for various medical conditions such as ALS and autism.

First, let’s discuss what happened to him and it all started with a high PSA reading of 6.65 in August of 2012.  He then had a biopsy which – and I’ll quote from his very detailed and informative article called How I Beat Prostate Cancer – that “of the 12 samples, only one had cancer and one was questionable. The cancerous sample was 10% cancerous.” His PSA climbed further to a peak of 17.65 on November 15th, which is a very high reading.

So he definitely had a cancerous sample, albeit 10%, and another sample that might be termed “precancerous” as well.  Coupled with the high PSA numbers, this paints a very serious picture.  Mr. Shedlock did not panic and then created a “Prostate Cancer Cocktail” of 10 different supplements in order to try to control or reverse his cancer and bring down his PSA.  His oncologist told him it would not help but would not hurt either and, of course, his urologist was generally opposed.

The results that he achieved from his strategy seemed to be nothing short of spectacular.  His PSA dropped like a rock from the 17.65 value to 2.99 on 12/13/2013.  All of his reads since then have trended downward and the last one listed was actually below 2.0!

In my discussion with him, he mentioned that he really thought that it was the first four supplements that really produced the lion’s share of the results.  I would agree with him but think that it may be very important to include the fifth for reasons that I discuss below.  Here is the list along with his dosages:

CAUTION: Always work with your urologist if you have a high PSA or prostate cancer. Mr. Shedlock very wisely showed his supplement regimen to both a urologist and oncologist ahead of time.  Prostate cancer is usually slow moving, but it can metatastize and spread to other organs, so get the experts involved.

What I find really fascinating is that Mr. Shedlock put together a formula that addresses almost every major aspect of a rising PSA:

These three, along with an enlarged prostate, are the conditions that can really elevate PSA according to what I have read.  Some men have high PSA’s and appear to have no prostate cancer.  Inflammation and abacterial prostatis are likely to blame.  This is one of the reasons that PSA as a prostate cancer test has really been under fire lately:  it does not always indicate prostate cancer but rather prostate problems, because some non-cancer issues can cause a rising PSA. Does this mean you should ignore a rising PSA?  Well, I sure don’t think so and I think Mr. Shedlock did the right thing by getting a biopsy done and working with his docs.

NOTE: There has actually been an abundance of research showing natural methods to lower PSA and prevent and treat prostate cancer.  I had just completed a page that summarizes a lot of this research and, interestingly enough, none of it overlaps with Mr. Shedlock’s formula.  This just goes to show how many techniques and strategies one can have in his arsenal and you can read about these in my link on How to Lower Your PSA. Of course, the real tragedy is that the great majority of urologists seem completely unaware of all this new research on prostate health that has been pouring out of the labs.  I think it is prudent for any man, even with normal PSA levels, to begin to shift to a more prostate-protective lifestyle, because asymptomatic prostate cancer is VERY common in men (~15% per one study). [1] In other words, it is very common for men to have underlying prostate cancer and not even realize it.

Also, it is possible that this small amount of cancer did not cause his rise in PSA.  Mr. Shedlock did not have the symptoms of chronic prostatits, but it is possible that inflammation of some sort caused his rise in PSA.  Perhaps he had more than one issue going on at a time – it is impossible to know for sure.  But this is the beauty of his formulation:  it addresses all the major players in one shot.  Let me explain in more detail:

1. Resveratrol. Resveratrol has many studies behind it showing that it attacks prostate cancer.  In vitro studies have been excellent and one researcher summarized by saying:

“Resveratrol affects all three discrete stages of carcinogenesis (initiation, promotion, and progression) by modulating signal transduction pathways that control cell division and growth, apoptosis, inflammation, angiogenesis, and metastasis.” [2]

However, recent followup work indicates that resveratrol may at times inhibit prostate cancer growth and at still other times promote it.  For example, a 2013 study on mice with transplanted prostate cancer cells found: [4]

“Resveratrol was associated with significantly worse survival with LAPC-4 tumors, but unchanged survival with LNCaP. Based on these preliminary data that resveratrol may be harmful, caution should be advised in using resveratrol for patients until further studies can be conducted.”

Now I asked Mr. Shedlock about this and he said that he was unfamiliar with the study.  However, he stated that his philosophy was to not take too much of any one supplement.  This is why he took a cocktail of ingredients so that one got synergies from all the ingredients.  He said that he considered his resveratrol protocol relatively low dose.  And keep in mind that he had a post-cocktail biopsy and no cancer was detected.  So not only did he have a monstrous drop in PSA to youthful levels but he also had a cancer-free biopsy.

The bottom line, as always, is that you’ll have to do your own research, talk to your doctors and make some kind of decision about resveratrol for yourself.

2. Quercetin and Bromelain. One very common male plumbing problem is prostatitis and, interestingly enough, the most common form of prostatitis is actually very poorly understood by modern science.  Although prostatitis is often caused by bacteria, more often than not it is caused by runaway inflammation and other poorly understood factors.  This type is called non-bacterial or chronic prostatitis and is sometimes accompanied by a rather painful condition called Chronic Pelvic Pain Syndrome.

Doctors do not currently have a reliable treatment for this condition and certainly have not been able to find a reliable pharmaceutical solution to the problem as far as I know.  This is where nutraceuticals have offered some hope according to several studies and bromelain and quercetin are leading the way.  One study found a nice reduction in symptoms from the combination of these two. [5]

3. Turmeric (Curcumin). If there is one thing that you want to combat when it comes to the prostate, it is inflammation, a root cause of both prostate cancer and chronic prostatitis.  It can inflate PSA levels as well.  Of course, turmeric is famed for its anti-inflammatory powers and is one of the most widely used supplements in this area.  It is used, for example, to fight arthritis (when coupled with quercetin in one study). [6] Like resveratrol, it has done very well in in vitro and mice studies.

Excited by the successes, researchers then decided to combine it with another proven prostate cancer fighter, soy, and found that it produced stellar results.  Dosages were relatively small – soy isoflavones (40mg) and curcumin (100mg) – and yet they found that PSA levels were significantly reduced by this combination.  The study examined men with existing cancerous or pre-cancerous cells but with elevated PSA.  In the group with PSA’s > 10 – these were all seniors – the average PSA went down from 18.8 to 10.2!  Needless to say, these are very impressive results by simply combining an Asian food with an Asian spice.

CONCLUSION: The evidence points to Mr. Shedlock not only dropping his PSA to a fraction of it’s peak levels but also to remission of his prostate cancer.  None of this can be proven, however, as biopsies are notorious for missing underlying cancer.  But keep in mind that the studies use the exact same techniques – biopsies and PSA – to evaluate the effectiveness of a prostate cancer treatment and so Mr. Shedlock is in good company if you ask me.

The only way to really be absolutely 100% that you eliminated all the prostatic cancer would be a prostatectomy.  Unfortunately, this procedure has not been perfected yet and, more often than not, the patient experiences short and sometimes long term incontinence and erectile dysfunction.  Thus, his decision to attack a non-aggressive form of prostate cancer with nutraceutical firepower will seem to many like a very reasonable approach until we come out with more reliable and less invasive prostate cancer-fighting techniques.

Hats off to Mike Shedlock for his bravery. It reminds of the story of Nathan Pritikin who was told that he would probably die if he ate a Low Fat Diet. He was very nervous to undertake such a program but found instead that he felt great and was vindicated when the coroner examined his arteries decades later and found that they were perfectly clean, like those of a teenager. [8] Again, diet, spices, juices and a few natural supplements can have powerful clinical effects that often exceed what can be achieved by standard medical practice.

REFERENCES:

1) https://www.lef.org/magazine/mag2008/dec2008_destroying-the-myth-about-testosterone-replacement-prostate-cancer_01.htm, “Destroying the Myth About Testosterone Replacement and Prostate Cancer”, By Dr. Abraham Morgentaler

2) Cancer Prev Res, May 2009, 2:409, “Cancer Prevention and Treatment with Resveratrol: From Rodent Studies to Clinical Trials”

3) https://www.nutraingredients-usa.com/Research/Researchers-Resveratrol-a-double-edged-sword-for-prostate-cancer

4) Prostate, 2013 May, 73(7):754-62, “Resveratrol worsens survival in SCID mice with prostate cancer xenografts in a cell-line specific manner, through paradoxical effects on oncogenic pathways”

5) Urology, Dec 1999, 54(6):960–963, “Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial”

6) Inflammation Research, Apr 2006, 55(4):168-175, “The antioxidants curcumin and quercetin inhibit inflammatory processes associated with arthritis”

7) The Prostate, 2010, 70:1127-1133, Combined Inhibitory Effects of Soy Isoflavones and Curcumin on the Production of Prostate-Specific Antigen”

8) N Engl J Med, 1985, 313(1):52, “Nathan Pritikin’s heart.”

DHEA Levels By Age and Supplement Targets - Peak Testosterone

Many hormones, enzymes, antioxidants and proteins fall precipitously with aging.  DHEA is no exception and there is little doubt among researchers that this only serves to acclerate the typical decline that we experience in our senior years.  DHEA levels are a tremendous example of this.  Check out this (eyeballed) table for just how dramatically DHEA levels fall with age, and that these are not DHEA-S value but rather plasma DHEA: [1]

The key takeaway here is that DHEA levels fall around 85 to even 90%  from ages 30 to age 80! That’s a monstrous drop.  And, considering that DHEA seems to play a role in nitric oxide production, insulin control and immunological function, it would seem hard to argue that DHEA levels that are about a tenth of one’s youthful peak are a healthy and desireable part of our existence.

Many alternative physicians and naturopaths now consider DHEA supplementation to be a standard part of their treatments. Still others believe that low levels of DHEA should be part of a DHEA Replacement Therapy Program that restores DHEA-S to some percentage of youthful values. Rather than just arbitrarily giving a certain dosage of supplemental DHEA, these practitioners give the amount of DHEA necessary to bring the patient within a certain range of DHEA. This minimizes side effects, which are quite low with DHEA anyway, and insures that levels are physiological, i.e. stay within normal lab ranges.

By the way, Dr. Saya, when he put me on DHEA, said that he preferred the oral form, because it increased DHEA-S, an important reserve “pool” for this hormone.  This was echoed and explained further in this Life Extension Foundation artcile: “Upon oral administration, DHEA is mostly converted to DHEA-S, which circulates in the blood far longer than DHEA. Circulating DHEA-S acts as a reserve upon which tissues can draw. Once taken up by tissues, DHEA-S is converted back to DHEA, which can then be locally converted to androgens and estrogens or exert direct action (Samaras 2013; Traish 2011).” [2]

So what levels do we actually target?  LEF (Life Extension Foundation) is probably representative of most practitioners who actually care about DHEA at all:  they try to keep men in a range of about 350 to 500 ug/dl, something I discuss in my page on DHEA Dosing.

REFERENCES:

1) Journal of Endocrinology, 1999,163:1 5, “DHEA deficiency syndrome: a new term for old age?”

2) https://www.lifeextension.com/protocols/metabolic-health/dhea-restoration/Page-01

Target DHEA-S Levels on DHEA Replacement Therapy

The Benefits of Low Dose HCG for Men on TRT - Peak Testosterone

Overtraining can make you sick, lower your erectile strenght and libido, lead to a collapse of adrenal hormones and even lower testosterone, something I discuss in my page on Overtraining and Testosterone. And there have even been cases, if OTS (Overtraining Syndrome) goes on long enough, that is has quite literally destroyed the individual’s health.  You might as well sign up as a prisoner of war in some remote corner of the planet – it’s essentially “anorexia for men.”

As men we are trained to ignore pain, much less the more subtle issues that arise from something like overtraining.  And, unfortunately, some of the best measures of overtraining are fairly subtle and subjective.  These include “poor performance in competition, inability to maintain training loads, persistent fatigue, frequent illness, disturbed sleep and alterations in mood state.”  [4] Unfortunately, if a guy can ignore major pain and discomfort, he will probably also easily ignore these kind of “soft” tests for overtraining as well.

Plus, a problem that I have seen a number of times on  The Peak Testosterone Forum is that guys who are overtraining can become like addicts.  They will even sometimes self-medicate with caffeine or energy drinks.  Poor sleep may come on slowly to where they almost forget what a good night’s sleep is like.  I have even known a marathoner who basically walked around with a cold all the time and said it was “allergies.”

So on this page I want to laser in some of the more objective measures of overtraining in the hopes that perhaps the hard numbers will get some guys to think a bit that maybe, just maybe they are overdoing it a little and that they could be compromising their long term health by doing so.

1. Hematocrit and Hemoglobin. Various markers of iron status have been found by many experts to be good markers for overtraining syndrome.  One of our posters explained why:

“There is lots of evidence here to suggest over-training. For example, a paradoxically and persistently low hemoglobin with no other explanation is consistent with a phenomenon called “march hemoglobinuria and hemolysis” due to excessive trauma to the feet and red blood cells. Trail marathons and long runs that last 3-4 hours are also excessive for most people. The author of the post also mentions that he notices a “reduction over time in my libido levels and muscle recovery after long runs or lifting.” [4]

What should you look for?  First of all, let’s look at the normal ranges for the latter two in men:

Hemoglobin:  14-18 g/dl

Hematocrit:  42-54%

Consider this statement from a research review that explained common signs of overtraining:

“Low levels of haemoglobin that remain within the normal range and iron deficiency are commonly recorded conditions among some groups of professional athletes, both female and male. These types of deficiency may result from an unbalanced diet, gastrointestinal (GI) bleeding during and after long distance running and, possibly, chronic low-grade systemic inflammation.” [5]

In other words, just because you are in range does not mean you are “out of the woods.”  Again, being in the low end of the range is often a sign – more on that below:

2. Ferritin. Related to iron status above is ferritin, which is a measure of the body’s iron stores.  Think of hematocrit and hemoglobin as a snapshot of current plasma iron levels, but ferritin a measure of the actual iron that gets stored in the body.  Ferritin is a great marker, because many athletes have been known to get low ferritin from overtraining. [5] Does this occur because of the low hematocrit and hemoglobin mentioned above?  This probably plays a role, but the actual driving force behind the low ferritin is actually much more insidious:

a) Excessive exercise leads to high levels of inflammatory cytokines. [6]

b) These cytokines cause increased levels of hepcidin, a hormone that controls iron.

c) Rising levels of hepcidin decrease iron absorption in the gut.

The bottom line is that if you have ferritin levels below about 25 ng/ml, you may be overtraining.

3. Low IgA. Because of the seemingly high incidence of URTI [UpperRespiratory Tract Infections] among athletes, much attention has focused on the mucosal immune system response to intense exercise training, using salivary IgA concentration as a marker. Low resting salivary IgA concentration has been reported in some elite athletes. Salivary IgA levels decline during prolonged periods of intense exercise training and IgA concentration is lower in overtrained compared with well-trained swimmers. Low salivary IgA concentration is predictive of the subsequent appearance of symptoms of URTI over the short and long term.””

4. A/G (Albumin/Globulin Ratio). Many men know overtraining can literally make you sick and increase the risk of upper respiratory infections.  However, some men just don’t get sick very easily.  So what is an early warning sign, ideally a lab test, that might show issues in this area?  One of them is a high A/G ratio, which basically shows immunosuppression, i.e. an immune system that is functioning suboptimally.  It is important to talk to your doctor about this, because it can in rare cases be a sign of something serious, such as leukemia.

However, a high A/G ratio can also tie into overtraining. It turns out that overtraining is known for suppressing the immune system – it’s kind of “Cancer Lite” if you will on your immune system, something I alluded to in #3 above. One study stated it this way: “A tentative trend may be discerned whereby light to moderate exercise may increase immune responsiveness but high-level competition sport, especially if it involves extensive endurance training, may lead to a degree of immunosuppression.” [1]  Thus, overtraining can suppress immunoglobulins (IgA) and can lead to an elevated A/G ratio as well. Check out these three interesting studies done in one paper as an example:

“Study 1: Recreational joggers ran on a treadmill for 40 min at 55% and 75% VO2peak and competitive distance runners ran for 90 min at the same intensites. In both groups, IgA secretion rate did not change significantly after exercise at either intensity.

Study 2: Competitive runners ran on a treadmill for 90 min at 75% VO2peak on 3 consecutive days. IgA secretion rate decreased 20 to 50% after exercise (p < .001). Post-exercise IgA secretion rates were significantly lower (p < .05) on days 2 and 3 compared with day 1.

Study 3: Elite swimmers were followed over a 6 month season, with IgA concentration measured at 5 times. Throughout the season, IgA concentration was significantly (p < .05) lower in stale compared with well-trained swimmers.” [2]

The latter comment is particularly interesitng, because swimmers that were not improving, perhaps the key marker of overtraining, also tied with low IgA concentrations.  This indicates that IgA is very valid sign of overtraining.

NOTE:  I hope you noticed this common theme in the research:  light to moderatre exercise is incredibly good for you.  More intense and long gets questionable very quickly.

High BUN and Creatinine. These numbers are often high in endurance athletes (and bodybuilders). The reason?  Both of these tend to be high from to the breakdown of muscle that occurs in these sports.  Endurance athletes also tend to be dehydrated, which further elevates these values.

Recently, I was looking at the lab work of a marathoner that had some of the classic signs of overtraing, such as irritability and reactive hypoglycemia in the middle of the night.  (It was effecting his erections as well.)  Here were his results (from LabCorp):

BUN  20  mg/dl  Range:  6 – 24 mg/dl

Creatinine 0.9 mg/dl  Range: 0.76 – 1.297 mg/dl

Should he be concerned?  The rule of thumb that I have heard is that, if you are near the top of the range for an exteneded period of time, you could be putting a lot of wear and tear on your kidneys. The exact value where that occurs probably anyone’s guess.

One thing to notice is that his BUN/creatinine ratio is high (22) which probably indicates dehydration, again a comon problem in athletes.  (It can also indicate something more serious, so run it by your doc to play is safe.)

NOTE:  Taking creatine can raise BUN a little as well, but long term studies have shown no kidney issues in those with no kidney disease.

1)  Br Med Bull. 1992 Jul;48(3):518-33, “Sport and the overtraining syndrome: immunological aspects”

2) Int J Sports Med, 1994 Oct, 15 Suppl 3:S179-83, “Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining”

3) Immunology and Cell Biology, 2000, 78:502 509, Special Feature for the Olympics: Effects of Excercise on the Immune System, “Overtraining effects on immunity and performance in athletes”

4) https://www.peaktestosterone.com/forum/index.php?topic=8652.msg75359#msg75359

5) J Sports Sci Med, 2013 Jun, 12(2):249 258, “Do High Blood Hepcidin Concentrations Contribute to Low Ferritin Levels in Young Tennis Players at the End of Tournament Season?”

6) Med Sci Sports Exerc, 2000 Feb, 32(2):317-31, “Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress?”

How to Increase Your Estrogen/Estradiol - Peak Testosterone

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 https://www.peaktestosterone.com/ 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 https://www.peaktestosterone.com/. 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, https://www.peaktestosterone.com/, out of the lining of the tin can it is stored in.  https://www.peaktestosterone.com/ 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 https://www.peaktestosterone.com/ 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

Vitamin D and Testosterone - Peak Testosterone

Researchers have known from an earlier animal study that this was likely the case. [1] This study looked at mice that genetically could not produce adequate Vitamin D levels.  As I have mentioned in my link on Vitamin D, Vitamin influences literally hundreds of processes and chemical reactions in the body and one of them affects testosterone.

The researchers found that it does this through two primary mechanisms:  1) calcium balance and 2) aromatase regulation.  Vitamin D’s primary purpose, you may recall, is to control the amount of calcium in our tissues and, calcium, as it turns out, is critical for everything from our bones to our neurons.  For example, the researchers found that by supplementing these mice with calcium, they could partially restore their hormonal levels. However, a complete restoration was not achieved because Vitamin D also affects aromatase activity.  Aromatase is the critical enzyme that converts testosterone to estrogen.

Of course, the acid question is if Vitamin D supplementation can actually raise Vitamin D levels in men?  Fortunately, researchers have begun looking at this basic question.  They started with overweight, nondiabetic, healthy men with lowish testosterone levels and gave them a little over 3000 IU of Vitamin D per day.  Also, these men had what they considered to be low Vitamin D levels of less than 50 nmol/l.

What happened was remarkable:  total, bioavailable and free testosterone levels increased by 25.2%, 20.0% and 20.3%, respectively. [3] Now this isn’t going to cure one’s hypogonadism, but it is a nice boost just from taking a cheap supplement, eh?

CAUTION: Recent research has shown that there is likely a rather narrow band where Vitamin D provides benefits and, furthermore, shows that high Vitamin D may actually be harmful. Check out my page on The Potential Dangers of High Vitamin D for more information.

Again, the bottom line is that there are a lot of guys out there wondering where their testosterone has gone, when, in reality, it’s simply that they are deficient in this all-important vitamin. Being indoors a lot, using sunscreen, having darker skin, being outside during non-peak hours – all of these things can lead to deficiencies in Vitamin D and, therefore, lowered testosterone levels.

1) Endocrinology, Apr 2000, 141:1317-1324, “Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads”

2) Clin Endocrinol (Oxf), Dec 29 2009, “Association of vitamin D status with serum androgen levels in men”

3) Horm Metab Res, 2011 Mar, 43(3):223-5, Epub 2010 Dec 10, “Effect of vitamin D supplementation on testosterone levels in men”

Magnesium and Testosterone - Peak Testosterone

To answer that question, we have to discuss another key protein in the plasma called SHBG.  This binding protein “locks” your testosterone and effective inactivates it from doing anything in your tissues and receptors.  Another protein, albumin, also bonds to your precious testosterone, but much more loosely.  So, while you do not want low levels of SHBG, you also do not want high levels either, as it tends to lower these two numbers:

1.  Free Testosterone:  The testosterone not bound to either SHBG or albumin.

2.  Bioavaialable Testosterone:  The testosterone not bound to SHBG.

Both of these numbers are the indicators of the testosterone ready to do work for you.  And, holding all other things equal, as SHBG goes up, your free and bioavailable testosterone will go down.  Likewise, as SHBG goes down, your free and bioavailable testosterone go up.  I have a whole page dedicated to ways to naturally lower SHBG and thus increase these numbers:  Free Testosterone Increasers.

So what does this have to do with magnesium?  It turns out that some research shows that magnesium can actually (somewhat weakly) with SHBG. Now it’s not a super powerful effect, but it can be significant. [1] Furthermore, scientists have found that SHBG has metal and mineral binding sites, i.e. magnesium definitely would have a home in this molecule.

Another way to look at this is that a man consuming a healthy, high magnesium diet would have high magnesium levels and some of this magnesium would be binding to his SHBG and increasing his free testosterone.  This is the way Mother Nature intended things to be.  However, there are many things that can leave us with less-than-desireable magnesium levels and, in this state, too much of our testosterone is taken out of commission.  What are some of the things that can negatively impact our magnesium status?

1.  Poor Diet.  Many men just do not consume enough magnesium rich foods.

2.  Soil Depletion. Experts have noted how soils and crops have had steadily declining magnesium levels due to modern, agricultural practices. [3]

CAUTION:  Low SHBG men should not lower their SHBG further.  See my page on The Risks and Causes of Low SHBG for more information.

3.  Gut Issues.  A large percentage of men have intestinal issues.  I know on the Peak Testosterone Forum bacterial overgrowth, Crohn’s and IBS (Irritable Bowel Disease) crop up fairly often. Other chronic colon conditions that are quite common are diverticulitis, celiac disease, parasites and leaky gut. Put them all together and you’ve got a large percentage of the population that simply is not digesting their food well and this could end up in lowered levels of magnesium for a variety of reasons.

4.  Athletes. There is evidence that heavy exercisers and athletes need ample magnesium.  (Conversely, a magnesium deficiency can affect your gym or road performance:  one recent study summarized that “both iron deficiency and magnesium deficiency can result in a significant reduction in exercise performance.” [3])

5.  Plant Magnesium. I eat almost entirely whole food plant foods.  And when you add up the magnesium, it is well over the RDA.  However, as a plant food eater, I have to recognize that some of the magnesium will end up bound up in phytate form, albeit this effect is not as powerful as in iron and zinc. [2] Vegetarians and high plant food consumers need to be diligent in my opinion to truly eat whole foods and NOT rely on all the processed foods that are now available at least here in the U.S.  (Plant foods will send your nitric oxide through the roof and give you fantastic gut flora and help you in the bedroom in a 100 different ways.  See my book The Peak Erectile Strength Diet for more details.)

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

So how much of an increase can you get by getting rid of low levels of magnesium?  Well, I have done a lot of researching and there are very few stories of guys increasing free testosterone with magnesium.  If it was a large effect, you would be reading about it everywhere, because college and professional programs would be handing out magnesium tablets like breath mints.  So my guess is that, if you are deficient, you might see a 10-20% increase in free testosterone.

But beefing up your dietary and supplemental magnesium can also make you feel better.  Several men on our forum have said that magnesium improved their sleep. And magnesium is famed in its ability to decrease anxiety, lower cholesterol and decrease inflammation.  The bottom line is that you will likely feel subtely better and, if you feel better and sleep better, your long term baseline testosterone will likely bump up a bit.

WHAT FORM OF MAGNESIUM? If you got into a decent health or supplement store, you’ll see literally dozens of choices for magnesium – it can be overwhelming.  There is one form that you probably want to avoid and that is magnesium oxide.  This is the cheapest form but is poorly absorbed and has a laxative effect.  This could make the cure worse than the disease!  One governmental fact sheet stated that “mall studies have found that magnesium in the aspartate, citrate, lactate, and chloride forms is absorbed more completely and is more bioavailable than magnesium oxide and magnesium sulfate.”  [3] That said, it was magnesium sulfate that was used in the above study.  One thing that is popular right now is transdermal magnesium, i.e. “magnesium oil” as well.

REFERENCES:

1)  International Journal of Endocrinology, Volume 2014 (2014), Article ID 525249, “The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men”

2) https://en.wikipedia.org/wiki/Phytic_acid

3) https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

Female Libido and Viagra - Peak Testosterone

As I often point out, in a physical and physiological sense,  sex is good for us males (although we do have to be careful with https://www.peaktestosterone.com/). Of course, sex is good for females, too, and so that leads to some interesting questions:  “Why are there so many drugs that can help males with sexual function?” and “Will those same drugs that help middle-aged and beyond guys possibly help middle-aged and beyond females as well?”

Of course, the drug companies have looked into this, since that would open up a whole new market for them and found that there is some potential there.  This is not surprising since, as we have covered elsewhere, women have some analagous chemical, structural and circulatory similarities to us in their sexual response.  The clitoris and vaginal walls, for example, are dependent on blood flow and nitric oxide during sexual activity to a significant extent. In my article on the G-Spot, I even cover have researchers have discovered erectile tissues in women.

Here’s another important key:  lubrication in women is tied to nitric oxide and blood flow as well. [1] In fact, studies have shown that women with heart disease, and therefore impaired endothelial function, have decreased vaginal blood flow and lubrication, leading sometimes to “sexual arousal disorder”. [2]  Not that disimilar from us guys, eh?

So, then, why not Viagra for women?  Why can’t women achieve the same boost in sexual performance that guys experience?

The answer is that Viagra (sildenafil) has had significant success already in the research.  For example, one study of post-menopausal women found solid improvements in orgasms and clitoral stimulation from taking sildenafil and there was also an increase in mean – as in average – lubrication as well. [3] In fact, it is interesting to note that about one in eight women actually withdrew from this study because of “clitoral hypersensitivity”.  NOTE:  It should be noted that one study of women with Female Sexual Arousal Disorder (FSAD) showed no improvement in sexual outcomes, however. [4]  This may be why Viagra, Cialis and Levitra are not generally prescribed for female sexual dysfunction.

There is also evidence that another large class of women, those on traditional antidepressants, may be helped by sildenafil. Scientific American reported that about 11% of women (in the U.S.) were on an antidepressant [5], and, undoutedly, this is higher in the block of women (over 35+) that would likely consider or need treatment. In this huge category of women, literally tens of millions worldwide, Viagra has been shown to improve overall sexual function significantly. [6]

NOTE: Have her talk to her doc.  Loss of libido and sexual function in women can be the results of various serious medical conditions.

Of course, you can probably guess what I am going to say at this point:  instead of taking a drug, women can very likely experience similar improvement from the non-drug improvement of blood flow and nitric oxide that I recommend for guys.  See this link on How to Improve Erectile Strength to know the kind of things I am talking about.  Any of these items will likely improve clitoral sensitivity and sexual function in a much more natural way that avoids or limits the use of drugs.

In other words, if you’ve made significant lifestyle changes to improve your erectile strength, including exercise, https://www.peaktestosterone.com/ and supplements, be sure to include the woman in your life. The changes that you are making will likely help her as well.  Furthermore, not only will it help you grow closer, it will help her become healthier, the rewards of which will likely manifest ifself in the bedroom as well.

CAUTION: Women on Viagra commonly experience many of the same side effects as men, including stomach upset and headache.  As far as I know, the lose-your-hearing and lose-your-sight side effects have not been reported.

REFERENCES:

1) International Journal of Impotence Research, 2003, 15:461 464, “Topical administration of a novel nitric oxide donor, linear polyethylenimine-nitric oxide/nucleophile adduct (DS1), selectively increases vaginal blood flow in anesthetized rats”

2) Eur Urol, 2000, 38: 20 29, “Anatomy and physiology of female sexual function and dysfunction: classification, evaluation and treatment options”

3) Urology, 1999 Mar, 53(3):481-6, “Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction”

4) Journal of Women’s Health & Gender-Based Medicine, May 2002, 11(4):367-377, “Efficacy and Safety of Sildenafil Citrate in Women with Sexual Dysfunction Associated with Female Sexual Arousal Disorder”

5) Scientific American, Feb 2008, “The Medicated Americans: Antidepressant Prescriptions on the Rise”

6) JAMA, 2008, 300(4):395-404, “Sildenafil Treatment of Women With Antidepressant-Associated Sexual Dysfunction”

Iodine: Can Mega-dosing Boost Testosterone in a Safe Manner ?

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=2347.msg21522#msg21522

2) https://lpi.oregonstate.edu/infocenter/minerals/iodine/

3) Kenneth L Becker 2001, Principles and Pracice of Endocrinology and Metabolism, p. 957

4) The Journal of Clinical Endocrinology & Metabolism December 1, 2002 vol. 87 no. 12 5499-5502, “Effects of Chronic Iodine Excess in a Cohort of Long-Term American Workers in West Africa”

5) https://curezone.com/forums/am.asp?i=1948274

6) https://curezone.com/forums/am.asp?i=1919312

7) Journal of Andrology, May-Jun 1988, 9(3):215-219, “Serum Levels of Total Testosterone and Sex Hormone Binding Globulin in Hypothyroid Patients and Normal Subjects Treated with Incremental Doses of L-T4 or L-T3”

Now those taking extra iodine or painting the scrotum with iodine would argue that they are not taking enough to trigger iodine-thyroid issues.  This idea would would seem debatable, because the RDA for iodine (in an adult male) is actually a very small number:  150 mcg/day. Those using iodine are definitely megadosing.  And, what they seem to be ignoring, is  the fact that a number of studies show that TSH levels begin to rise at relatively low iodine levels in the 1,700 mcg/day range. [2]

I am not trying to be insensitive toward someone trying to boost their testosterone through what they see as a reasonable alternative, but I just do not see the wisdom here. For example, let’s take a hypogonadal male that has total testosterone of 300 ng/dl who starts megadosing iodine.  He might get a boost up to 450 ng/dl.  Now that increase is a nice increase, but it is probably not going to make that much of a difference for him.  And he is risking hypothyroidism and goiter for this relatively small boost.

So why do iodine fans do it then?  Well, there is some grey and poorly understood areas of the research.  In fact, the evidence seems to point that some people can consume extra iodine and be affected less than one might expect.  In fact, there is even one study of northern Japanese seaweed workeers, who consume a lot of seaweed – between 50 and 200 mg/day! [3] Of course, this is about a 1,000 times the RDA and yet the prevalence of goiter is only about 6-12%. Of course, that is a high rate of goiter, but pro-iodine advocates like to point out that hypothyroidism is not common there, a fact that has baffled the researchers.

Again, though, there is ample research that megadosing iodine can cause problems.  For example, a number of studies that show high iodine levels in the diet can really causes problems.  One study of Peace Corp volunteers in Ghana found that 44% had goiter from excessive iodine in their water filters.  When this was taken care of, their “mean serum iodine decreased from 293 ± 306 to 84 ± 46 μg/liter.” [4] And, correspondingly, their TSH dropped from a high 4.9 to a very sound 1.8 mU/liter.

So, to me it seems like risky business to consume extra iodine. One of the partipants in the above-mentioned forum had her rheumatoid arthritis flare up when she took 15 mg per day.  It got worse from there:

“At about 20 mg per day, my throat starting closing in. I didn’t know it at the time but it was a goiter developing. At 30 mg per day, I experienced very scary double vision, heart palpitations, light headedness, cold tingly numbness in my head  and nausea” [5]

Better safe than sorry…

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”

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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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…

The Incredible Importance of Testosterone for Men .

So let’s look at the profound effect that testosterone has males:

1.  Cheat Death. Several studies have shown that low testosterone men have higher death rates. [1] The reasons for this will become very obvious when we cover the health benefits of reasonable testosterone levels below.

2.  Red Blood Cells. Testosterone affects, of all things, your red blood cell counts.  One of the proofs of this is the fact that low testosterone men are very often anemic.  Another is the fact that men on HRT (testosterone therapy) have to have their red blood cell counts monitored.  And it all makes sense, because testosterone affects red blood cell production through a “backdoor” pathway.  It alters a renal hormone called erythropoietin that is responsible for triggering stem cell involvement in the bone marrow.

4.  Subcutaneous and Visceral Fat.  Various studies have shown that as testosterone lowers both total fat and deadly visceral fat increase. One of the most interesting studies was on young men and showed a dose dependent loss of fat with increasing testosterone. [3] Other studies have verified the same thing. Many men struggling with weight don’t realize they are actually struggling with hormones.

5. Venous Leakage.  Can’t maintain your erections?  It could very well be because you have a condition called venous leakage where penile tissues cannot trap the blood flowing in the penis during an erection.  This can lead to quickly disappearing erections or the inability to even achieve an erection.  For more details, see my link on Venous Leakage.

6. Quasi-Senility. Testosterone is VERY important for brain function.  Many studies have shown that it controls and influences various types of memory and mental processing.  Here I will just mention that one study found that low testosterone actually turned men into quasi-senile seniors. [4] Of course, I don’t mean it gave them literal Alzheimer’s.  However, the study did show that the men literally performed like an old man with dementia.  Many men with classic low T symptoms can attest to how their hypogonadism has affected their careers, simply because they could no longer process information like they used to.

8.  Blood Flow and Nitric Oxide. One thing that few men know is that testosterone actually increase nitric oxide and blood flow levels in men.  The increase can be quite substantail.  In fact, one study found that the difference in blood flow between the lower and higher quartiles by testosterone was well over double! [5] And, yes, this means testosterone is important to your erectile strength.

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9.  Insulin and Blood Sugar. What does testosterone do?  Well, probably the most important is its governance of insulin levels.  Of course, exercise and diet play major roles as well, but testosterone is one of the Big Three.  Many studies have shown this directly and indirectly and that both blood sugar and insulin levels rise with falling testosterone. [6]

10.  Inflammation. “Inflammation is the root of all evil.”  (Insulin is a close second in the evil category.)  This statement is close to true being responsible for the Big Three Killers of men:  heart disease, cancer and autoimmune disease.  (Yes, you do need some inflammation for immunity, tissue repair, etc.) Probably the most infamous of the inflammatory cytokines, as they are called, is a signaling molecule called TNF alpha. TNF alpha has been implicated in many nasty medical conditions from arteriosclerosis to arthritis to Alzheimer’s.  And, as you may have guessed, low levels of testosterone have been shown to be associated with increased TNF alpha levels. [7]

11. Libido. Testosterone is the “passion hormone” for us men and researchers have verified that, in general, the higher the testosterone, the greater the libido and vice versa. In fact, men that are low testosterone will quite often write into The Peak Testosterone Forum saying that their libido has essentially vanished. They literally will feel castrated and without sexual desire whatsoever. [8] And, of course, this is almost always a startling contrast with their younger days when that is all they could think of!

12.  Prediabetes.  The hallmark of prediabetes is insulin resistance and rising insulin levels and – you guessed it! – lower testosterone are linked with approximately doubled risk for prediabetes. [9] This is, of course, because of the relationship presented in #8.

13.  Diabetes.  This is one of the reasons that men with low T have over double the risk of developing diabetes!  Furthermore, I recently talked to the P.A. at a HRT clinic and every one of their type II diabetic men on testosterone was able to completely get off of insulin. Some still had to stay on Metformin, but, still, this will yield a huge improvement in blood sugar control and an increase in quality of life. One can’t help but wonder how many cases of Type II diabetes could be completely eliminated simply through testosterone therapy.

14.  Nocturnal Erections. There are many factors in achieving those all-important nocturnal erections, but one of the most important is having adequate testosterone levels. [10] To understand their criticality to penile health, see this link on How to Maintain or Rebuild Your Morning Erections. I have noticed that I get morning erections when my testosterone levels are greater than 600 ng/dl.  Not everyone is the same on this, but this seems to be the levels that I need, and this is why testosterone cypionate really made the difference for me in this area.

15.  Arterial Plaque. If there is anything that has greater importance than your arteries, I don’t know what it is.  Low testosterone appears to be an independent risk factor for atherosclerosis, or the infamous buildup of arterial plaque that clogs arteries and contributes to heart attacks and high blood pressure. One study of seniors verified this and found arteries significantly more clogged in hypogonadal men independent of other known cardiovascular risk factors. [11]

16. Sleep. Several studies have shown that, as testosterone levels fall, male sleep quality is lowered.  In other words, low testosterone can actually negatively alter the stages of sleep. [12]

1) Circulation. 2007; 116:2694-2701, “Endogenous Testosterone and Mortality Due to All Causes, Cardiovascular Disease, and Cancer in Men”

2) Eur J Endocrinol. 2009 May;160(5):839-46. Epub 2009 Jan 27, “Effect of testosterone replacement therapy on arterial stiffness in older hypogonadal men”

3) Am J Physiol Endocrinol Metab, 2001 Dec, 281(6):E1172-81, “Testosterone dose-response relationships in healthy young men”.

4) Oregon Health & Science University. “Testosterone Deprivation Makes Men Forget.”ScienceDaily, 22 Oct. 2004. Web. 23 May 2011

5) Hypertension Research, 2007, 30:1029 1034; “Low Testosterone Level Is an Independent Determinant of Endothelial Dysfunction in Men”

6) “Androgens, Insulin Resistance and Vascular Disease in Men: Testosterone and Insulin Resistance”, https://www.medscape.com/viewarticle/512077_4; Table 1

7) J Clin Endocrinol Metab, 2004; 89: 3313 3318, “The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men”

8) The Journal of Clinical Endocrinology & Metabolism, Jul 1 2006, 91(7):2509-2513, “The Relationship between Libido and Testosterone Levels in Aging Men”

9) Diabetes Care. May 2004 v27 i5 p1036(6), “Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men”

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

11) Journal of Internal Medicine, 2006, 259:576 582, “Low testosterone levels are associated with carotid atherosclerosis in men”

12) J Clin Endocrinol Metab, 2008 July, 93(7):2602 2609, “The Association of Testosterone Levels with Overall Sleep Quality, Sleep Architecture, and Sleep-Disordered Breathing”

Testosterone and the Skin - Peak Testosterone

Testosterone affects everything in men, so it should be no surprise that it affects the appearance of your skin in multiple ways. Most guys aren’t too worried about their appearance, but I occasionally receive questions about it.  For example, on the Peak Testosterone Forum, I once received this question: “I have a reddish nose, dry flaky skin on nose and broken blood vessels on cheek…Can low [testosterone] give you bad skin?”  [1]

Of course, skin condition is related to many things, including diet, sun exposure and growth hormone.  That’s right – lower growth hormone levels can actually thin the skin a little.  So it’s difficult to definitively say anything without some individual experimentation.  However, as I’ll show below, the flakiness could be partially related to low testosterone-related issues.  But first I want to cover the three key mechanisms whereby testosterone has a big influence on the skin:

1.  Sebum.  Most of us know that testosterone can affect acne, but are not really sure how.  Testosterone is actually converted by an enzyme called 5-alpha reductase to DHT (dihydrotestosterone).  And it is DHT that controls the sebaceous glands in the skin and the production of sebum.  Sebum is one of the things that you don’t want too much or too little of.  It is composed of a variety of cellular material including fat and keratin and is a natural lubricant for your skin and hair.  However, too much sebum is a root cause of acne.

For this reason, there have been various anti-DHT solutions that have been developed to help with acne, including one herbal compound that did quite well according to one study. [6] Furthermore, sometimes HRT will result in acne as a reported side effect even in middle-aged men.  (It is not common though:  see my link on Hormone Replacement Therapy for more details.)  And, at least theoretically, low testosterone could lead to low DHT, which could, in turn, lead to low sebum levels, “asteatosis” in its extreme case, resulting in dry, scaly skin.  As always, there appears to be range that is best.

2.  Estrogen (Estradiol or E2). Estrogen in males come almost entirely from the conversion of testosterone via aromatase. (The “bad” estrogen is estradiol or E2.)Aromatase is stored in fat cells and, as we age, we tend to put on weight and convert more testosterone to estrogen. This trend lowers testosterone and raises male estrogen levels over time. So that means that low T men have high estrogen, right?

In actuality, many hypogonadal men actually end up with low estrogen levels even if they are overweight, because their testosterone levels fall so far that no amount of aromatization can rescue the situation..In fact, it is a very common problem for men with low testosterone to actually develop osteopenia initially and later osteoporosis unless it is caught and treated early enough. (There are other nasty problems associated with low estrogen levels, which I cover in this link Do Men Really Need Estrogen?) Several studies have noted this.  One in partcular found that low total testosterone was strongly correlated to bone loss and associated with an 88% increased risk of hip and 28% of non-spinal fractures, respectively. [3]

3.  AGE’s (Advanced Glycation End Products). Testosterone is very much associated with insulin levels.  In general, the more the testosterone, the lower the insulin levels. As I point out in my book Low Testosterone by the Numbers, low testosterone leads to decreased insulin resistance and elevated glucose levels. [2] This is why hypogonadism is associated so strongly with diabetes and Metabolic Syndrome. One HRT clinic that I talked to said that all their men on testosterone therapy had been able to completely get off of insulin. (A few still had to take Metformin but, still, it is remarkable that they could completely eliminate their insulin regimen.)

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

The point here is that lower testosterone will tend to raise both insulin and glucose levels, which could lead to accelerated AGE’s.  AGE’s are glycated proteins that accumulate and age various tissues.  This is one of the reasons that diabetes is such a debilitating disease:  it ages many, many tissue due to this whole issue.  The skin is no exception and can age overly rapidly from this as well.  See my link on Advanced Glycation End Products for more information.

So, really, the bottom line is that, although high testosterone can lead to acne in some sensitive men, lower testosterone levels may be even more problematic, leading to accelerated aging of the skin via decreased collagen production and lubrication along with and increased levels of glycated proteins.  As always, I urge men to Get Tested Regularly for Testosterone and Estradiol.

REFERENCES:

1)    https://peaktestosterone.com/forum/index.php?topic=835.0

2) Clin Endocrinol (Oxf), 2005 Sep, 63(3):239-50, “Androgens, insulin resistance and vascular disease in men”

3) Arch Intern Med, 2008, 168(1):47-54, “Endogenous Sex Hormones and Incident Fracture Risk in Older Me: The Dubbo Osteoporosis Epidemiology Study”

4) Arch Dermatol, 2008, 144(9):1129-1140, “Induction of Collagen by Estradiol: Difference Between Sun-Protected and Photodamaged Human Skin In Vivo”

5) https://www.medicalnewstoday.com/articles/122057.php

6) European Journal of Integrative Medicine, Nov 2008, 1(suppl 1):40, “Dermal application of a Cimicifuga racemosa (CR)-containing cream has beneficial effects on acne”

Testosterone and Cluster Headaches: Low Levels

What type of common headache can be worse than a migraine?  If you guessed cluster headaches, you’d be exactly right.  These headaches can be completely incapaciting and that is why is it so important to find any root causes for the sake of its victims.  These headaches on one side of the head have even said to deliver the worst pain known to humans. (Suicide is tragically common.) And it affects more men than women – the opposite of migraines.

Researchers have found that an increase in two neurotransmitters (histamine and possibly serotonin) may be causative:

“Whole blood histamine was estimated before, during, and after 22 attacks of cluster headaches, and plasma serotonin was studied in 30 such headaches. The results were compared with changes in blood levels of both amines during headache in ten migrainous subjects and in ten controls. In cluster headache, whole blood histamine levels showed a statistically significant rise during the attack, whereas plasma serotonin levels showed a slight nonsignificant elevation.” [1]

However, hormonal links were much more scarce. This changed in 2006 when researchers found that low testosterone was correlated, interesting in both men and women, with cluster headaches. [2] Apparently, researchers had noted male cluster headache sufferers were often “overmasculinized” and decided to investigate a testosterone connection.  And they had also noted a diurnal (daily) pattern associated with it, which indicated that it may be located in the hypothalamus. What the researchers did in this study is measure the testosterone, LH, etc. of a small group of cluster headache sufferers, who had all been diagnosed and had tried, unsuccessfuly, a variety of  powerful medications.

–5 of 7 male patients had no cluster headaches for the first 24 hours.

–4 of the 7 male patients were completely cured.

So this appears to be yet another example as to how low testosterone increase your risk for a nasty chronic condition.

NOTE:  Migraine headaches, although more common in women, plague many men.  It turns out that low testosterone is also likely a root cause of these also, something I cover in my page Testosterone and Migraines.

1)  Arch Neurol, 1971, 25(3):225-231, “Histamine and Serotonin in Cluster Headache”

2) Headache, 2006 Jun, 46(6):925-33, “Testosterone replacement therapy for treatment refractory cluster headache”

3) https://www.theatlantic.com/health/archive/2013/11/cluster-headaches-the-worst-possible-pain/281524/

HRT, Effective Levels- (Testosterone and Estradiol)

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://peaktestosterone.com/forum/index.php?topic=1577.0

15 Common Tests for Men - Peak Testosterone

Unfortunately, there are many physicians out there still new to diagnosing and testing low testosterone and often important items get overlooked.  For this reason, until the medical community gets better up to speed as a whole, it is important for men to know the fundamentals of testosterine testing in order to ask important questions.

For this reason I have compiled what I call the 15 Common Tests for Men with Suspected Low Testosterone. These testosterone tests are very important, because they can have such a strong and direct bearing on either a) testosterone levels or b) safe administration of Testosterone Therapy (HRT):

NOTE:  If you suspect you might have low testosterone, check out my pages on the Standard Hypogonadal Symptoms and Classic Hypogonadism.

1.  Total Testosterone. This testosterone number is the most widely studied and heavily researched number.  While it is true that one can debate whether free or bioavailable testosterone is a better indicator, total testosterone gives doctors a very good snapshot as to general testosterone status.

If you’ve been around my site much, you know that most men begin to experience strong low testosterone symptoms in the 300’s (and a few even in the 400’s).  Furthermore, you hopefully know that in the 300’s, a man’s risk factors for many serious medical conditions (diabetes, osteoporosis, Metabolic Syndrome, erectile dysfunction, etc.) begin to increase signficantly, something I document in my book Low Testosterone By The Numbers. (NOTE: Some men seem to do fine and are symptom-free in the 300’s and 400’s, however.)  Total testosterone, and all the tests on this page for that matter, are generally pulled through a blood draw and should be done as early in the morning as possible (since a man’s testosterone falls throughout the day).

[4]NOTE: Non-U.S. readers should use a conversion factor of 29.4 to convert to nmol/l.

Notice that all of these reference ranges are between 241-286 ng/dl. Let’s say that your lab results show up with the 241 number and your actual total testosterone is 242. Many physicians will simply say, “Sorry, fella, but you are clearly normal.  You are clearly within the normal range.”  Meanwhile, you could be limping through life with erectile dysfunction, horrendous memory and concentration, a non-existent libido and a complete loss of morning erections. But, by golly, that doc is absolutely certain that your issues have NOTHING to do with low testosterone because of that lab result and the range listed right beside it.

Fortunately, many doctors are now realizing that the 200’s are abyssmally low numbers for most men.  Furthermore, the biggest lab, LabCorp, has now bumped up the lower end of their total testosterone range for males over 18 years old to 348-1197 ng/dl. [5] Of course, the lower end of this range for normal testosterone, 348 ng/dl, is higher than past ranges.  Even better, I have seen this figure quote by several on the Peak Testosterone Forum. [6][7] Essentially, LabCorp is arguing that our current definitions of hypogonadism are much too low and, perhaps, doctors will listen.

2. Free Testosterone. Free testosterone, which can be thought of as the testosterone that can actually do work on your tissues and receptors, runs about 2% of total testosterone. An acceptable range for testosterone is often give as 1.5-2.5%.  To read in more detail, see this page on  Free Testosterone and SHBG.

Plasma levels of LH are useful primarily for diagnostic purposes, because there are two “categories” of low testosterone:  primary and secondary hypogonadism.  In the case of primary hypogonadism, usually LH and FSH are overly high and this indicates that the problem is in the testes.  Basically, the pituitary tries to compensate for the testes’ lack of production by trying to pump out more LH in order to normalize testosterone production.  LH just keeps climbing and climbing with no significant change in testosterone.

In the case of secondary hypogonadism, both LH and FSH are generally low or low normal and, in this case, the problem is somewhere rooted in the pituitary or the hypothalamus rather than in the testes themselves. Thus, with secondary hypogonadism the problem is not in the testes but in the brain’s signaling to the testes.

Knowing whether you are primary or secondary can help a doctor know best how to treat you, or, at least, a knowledgeable one  Some treatment methods, such as Clomid, are designed to work on men with secondary hypogonadism as a root issue.

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

4.  Follicle Stimulating Hormone (FSH. FSH is also produced by the pituaitary and, coupled with testosterone, is responsible for sperm production.  Doctors will pull this number primarily for fertility purposes.

5.  Estradiol (E2). There are actually several estrogens in the blood stream of both men and women.  Estradiol is the most well-known and “potent” estrogen and is responsible for most of its properties, both good and bad for us males.

Estradiol is one of the most important, and often ignored, hormones that should be pulled in men who are experiencing sexual or erectile dysfunction issues.  The reason is that estradiol has a relatively tight range that men should, ideally, fall within. If estrogen goes too high (in men), it can cause many of the same issues associated with low testosterone:  erectile dysfunction, low libido, fatigue, etc.  Furthermore, it is a) fat-promoting, b) cancer promoting (in the prostate) and c) potentially fuels gynocomastia (“man-boobs”).

Overly high estradiol can cause issues, but, more often that not, low estradiol is the culprit in men with lowered libido and erectile strength.  It is very important that you get the right estradiol test, which is an LC-MS/MS test designed for the low levels that men have.  Low estradiol can lead to bone less and eventually osteoporosis, but an important new study shows that low estradiol causes virtually the exact same symptoms associated with low testosterone.

Tests to Find the Root Cause of Low Testosterone

6.  Zinc Status. Every doctor should, in my opinion, test for zinc status.  There are several tests that are applicable including the zinc taste test and zinc plasma levels.  And the reason is that, if you are low in zinc, restoring proper zinc levels can double or more your testosterone levels.  See this page on Zinc Deficiencies and Low Testosterone for more details.

7.  Vitamin D. One of the most important low testosterone tests is actually Vitamin D, due to the fact that Vitamin D deficiencies are so widespread.  The standard for Vitamin D monitoring is called “25-hydroxy” test and can be obtained from a simple blood draw.  Therefore, it can be pulled at the same time that you have your testosterone tested.  Most labs and physicians now consider 30 ng/ml to be the threshold for a deficiency.  However, many experts recommend that Vitamin D be maintained somewhat above that level.

What does your Vitamin D reading have to do with testosterone?  It turns out Vitamin D is actually correlated with testosterone and appears to be partially causative.  In other words, keeping your Vitamin D levels up to healthy levels may give you a boost in testosterone.  (Some experts even consider Vitamin D much more a hormone than a vitamin.) For more information, see my link on The Benefits of Vitamin D.

8.  Prolactin. If this hormone goes too high, it drive down testosterone levels by negatively impacting dopamine.  The net effect is usually significantly lowered libido and sexual function.  I cover this in more detail in my link on Prolactin and Prolactinomas.

9.  Thyroid Stimulating Horomone (TSH). If this is high, then you may have hypothyroidism.  TSH actually comes from the pituitary and not the the thyroid gland. In general, when the pituitary senses that your thyroid hormones are falling too low, it pumps out more TSH in order to compensate, similar to elevated Leutinizing Hormone (LH) in men with primary hypogonadism.  However, TSH is just the beginning and free T3, free T4 and reverse T3 should also be pulled at a minimum.

What does this have to do with testosterone?  Well, researchers have found that hypothyroidism is associated lower testosterone levels and it is no wonder since it usually comes with fatigue, weight gain and a slowed metabolism and libido, i.e. symptoms that are very similar to those of hypogonadism.  Furthermore, correcting hypothyoridism can lead to a nice boost in testosterone often, something I discuss in my page on Testosterone and the Thyroid.

10.  T4 and T3. These two thyroid hormones, which are triggered by TSH coming from the pituitary, can be low as well.  Somewhat like testosterone, these can come as total T4 and/or T3 and free T4 and/or T3. When these are below the reference ranges, you will usually find that your physician will consider you hypothyroid.

Tests to Establish a Baseline Before You Go On TRT (If You Do)

11.  PSA. Physicians will generally monitor your prostate before administering TRT, HCG Monotherapy or Clomid over concern regarding prostate enlargement (BPH) and prostate cancer as a side effect.  Several large studies have hsown these not to be a concern, but, as I always say, you have to discuss with your doctor and do your own research.  Regardless, it is prudent to pull your PSA before TRT in my opinion.  The PSA has been under sharp criticism in the last ten years, because it does not just show an increase in cancer but also an increase in prostate size and inflammation.  In fact, the latter is the most common reason for a significant rise in PSA.  (It happened to me.)

12.  Red Blood Cell Count/Hematocrit/Hemoglobin. Testosterone actually governs male red blood cell counts in your blood and this is the reason that we have more red blood cells in our plasma than our wives and girlfriends. A good physicians will always monitor your RBC count, as it is called, to make sure that you are neither too high or too low.  However, the key is that, if you are anemic from low testosterone, then something probably needs to happen.

Again, men with low testosterone often see their RBCs fall significantly and can even end up anemic.  This is yet another reason that men can experience fatigue with hypogonadal testosterone levels.

There is another reason to get RBC Counts/Hematocrit/Hemoglobin:  if a man is on the high side of these numbers before TRT, he may struggle while on TRT trying to keep his levels in check.  You cannot let your levels go too high or it can increase the risk of stroke or an MI.  (Some of the Tour De France riders have almost died from this condition due to doping). [8] One of our forum posters actually found himself in this condition, for example, even though his most recent testosterone reads were 290 and 301 ng/dl. [9]

So what are acceptable RBC counts?  Different labs have a little different ranges, but the range given as normal is generally around 4.3-5.7 million cells/mcl.  Notice, however, that this forum poster’s range was 4.1-5.6 and thus differently slightly. [10]  I have seen higher levels as well, say, at 4.7-6.1.

Also, some men may wonder why testosterone increases red blood cell counts.  The reason actually ties into a kidney hormone called erythropoietin which induces red blood cell production in the stem cells of the bones. Testosterone actually increases erythropoietin production and, therefore, actually causes an increase in red blood cells due to its downstream influences.

13. SHBG. This is the binding protein that attaches itself to a little over half of our testosterone and effectively takes it out of commission.  If you are low SHBG, you may struggle with TRT and require a little different protocols.  This is also possible with high SHBG as well.  Low SHBG men may also be insulin resistant, something I discuss in my page on Low SHBG.

14. Other Hormones. If you end up on TRT, just trust me:   you’ll be glad that you pulled your DHEA-S, progesterone and cortisol and established some kind of a baseline.  There is one school of thought out there that TRT can slow down these hormones over time, so pull these while you can to see if you have changed over time.  And, by the way, all of these can affect sexual function and energy levels.

15. Liver Function.  This is an important test for low testosterone men,. because testosterone is metabolized in the liver.  A good physician at a minimum will check to make sure that you do not have any existing liver disease or disorders.  In addition, some of the injectables (cypionate, enanthiate, etc.) actually have to be broken down into testosterone.  The topicals (Androgel, Testime, etc.) have a good liver side effect profile but should be checked regardless from time to time as occasional issues do occur.

1)  Quest Diagnostics, Table 1, Testosterone Reference Ranges in Adults, https://www.questdiagnostics.com/hcp/ intguide/EndoMetab/Gen_Misc/Testosterone/Table%201.pdf

2) https://peaktestosterone.com/forum/ index.php?topic=114.msg1641#msg1641

3) https://peaktestosterone.com/forum/index.php?topic=179.15

4) https://peaktestosterone.com/forum/index.php?topic=213.0

5) Labcorp, Technical Review, “Testosterone: Aiding in the diagnosis of androgen dysfunction and hypogonadism”

6) https://peaktestosterone.com/forum/index.php?topic=290.msg2580#msg2580

7) https://peaktestosterone.com/forum/index.php?topic=175.msg2161#msg2161

8) Dtsch Arztebl Int, Jan 2008, 105(4):62 68, “Congenital and Acquired Polycythemias”

9) https://peaktestosterone.com/forum/ index.php?topic=346.msg3221#msg3221

10) https://peaktestosterone.com/forum/ index.php?topic=221.msg1733#msg1733

11) https://www.lef.org/magazine/mag2010/ may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

Nitric Oxide Benefits - Peak Testosterone

Is the most important molecule for a man testosterone? Well, in spite of the name of this web site, I would probably have to vote for nitric oxide as slightly more important. You can be a little low on testosterone and still do pretty well in the bedroom. But the reverse is not necessarily true. Regardless, nitric oxide can make a much greater improvement in male health and fitness than many men realize.

As a testimony to this, I recently conducted an experiment where I verifiably raised my NO levels and – wow! – did I feel better. This effect will not be particularly obvious for the younger guys that still have ample NO, but for us 40+ males, it can really make a difference. Below I summarize some of the impressive benefits of nitric oxide that have been found:

1.  Arteriosclerosis Protection. Nitric oxide, although a free radical, actually protects your arteries from plaque buildup.  Researchers have documented several key reasons why this is so, including “preventing smooth muscle cell proliferation and leukocyte adhesion.” [1] Regarding the latter, remember that white blood cells sticking to the walls of your arteries is one of the key processes triggering arteriosclerosis.  This is one of the very important reasons that it is so critical that you keep reasonably youthful NO levels.

2.  More Erections; Better Erections. Does anyone not know that nitric oxide greatly improves erectile strength?  Of course, this is the ultimate goal of Viagra and Cialis.  Animal studies shows that nitric oxide improves sexual function in both males and females. [4][5]

3.  Decreased Premature Ejaculation. Animal studies show that nitric oxide helps with premature ejaculation.  Of course,  many younger men struggle with premature ejaculation, so this is certainly not the only factor.  But it is interesting that this is such a problem as our arterial health steadily declines in the West.  One study noted that “the data also suggest that NO inhibits seminal emission, probably by decreasing sympathetic nervous system activity; this may help prevent premature ejaculation.” [4]

4.  Improved Mood and Alertness.  Now I can’t prove this one, but I can tell you that when I Boosted My Nitric Oxide through Food-Based Nitrates, I enjoyed improved mood and alertness. The effect was quite remarkable and reminscent of what I felt when I went on HRT. Now this could be due to many reasons, since the brain is very dependent on blood flow and increase NO will improve blood flow. However, the other reason is that nitric oxide is considered a neurotransmitter in and of itself now. One study pointed out that “NO brings about smooth muscle relaxation by binding to iron in the heme that is part of soluble guanylyl cyclase, stimulating the formation of cGMP. cGMP in turn stimulates a protein kinase, hich phosphorylates the light chain of myosin, eliciting relaxation. The cerebellum contains the highest levels of cGMP in the brain, with its formation stimulated by glutamate acting via N-methyl-o-aspartate (NMDA) receptors.” [3]

“NO has an autocrine anti-inflammatory impact on endothelium, owing in part to antagonism of NF-κB activity; since induction of IL-6 is dependent on NF-κB, this may explain recent evidence that NO inhibits macrophage IL-6 production. It is reasonable to postulate that, analogously cerebrovascular NO decreases IL-6 production in the brain. Vascular NO may also have direct neuroprotective activity.” [6] For more information, see my page on How to Reduce Inflammation and Inflammation and Erectile Dysfunction.

1)  Mediators Inflamm, 1997 Feb; 6(1):3–21, “Nitric oxide function in atherosclerosis”

2) https://en.wikipedia.org/wiki/Tetrahydrobiopterin_deficiency

3) Neuron, 8:3-11, Jan 1992, “A Novel Neuronal Messenger”

4) Neuropharmacology, Nov 1994, 33(11):1499–1504, “The roles of nitric oxide in sexual function of male rats”

5) PNAS, Jul 1994, 91(14), “Nitric oxide mediates sexual behavior in female rats”

6) Medical Hypotheses, Nov 1999, 53(5):369–374, “Vascular nitric oxide, sex hormone replacement, and fish oil may help to prevent Alzheimer’s disease by suppressing synthesis of acute-phase cytokines”

7) Arteriosclerosis, Thrombosis, and Vascular Biology, 2004, 24:998-1005, “Dysfunction of Endothelial Nitric Oxide Synthase and Atherosclerosis”

8) Clinical and Experimental Pharmacology and Physiology, Nov 1998, 25(11):945–946, “THE NITRIC OXIDE SYSTEM AND CORTISOL-INDUCED HYPERTENSION IN HUMANS”;

9) Circulation, 1997, 96:25-28, “High Glucose Increases Nitric Oxide Synthase Expression and Superoxide Anion Generation in Human Aortic Endothelial Cells”

5.  Decreased Inflammation.  Some researchers have stated that “inflammation is the root of all evil.”  And it sure seems to be true, since it has been implicated in heart disease, diabetes, cancer and many, many autoimmune disease.  One would not think that nitric oxide, a free radical, could calm inflammation, but that is indeed the case.  One of the nastiest – and I say “nasty” even though you do need some IL-6 – inflammatory cytokines is IL-6.  It looks like nitric oxide in many cases lower IL-6:

“Under conditions in which vascular tissue levels of tetrahydrobiopterin (BH4), a cofactor for NOS, are deficient or lacking, eNOS becomes dysfunctional and produces superoxide rather than NO. Experimental studies in vitro have revealed that NO from eNOS constitutes an anti-atherogenic molecule. A deficiency of eNOS was demonstrated to accelerate atherosclerotic lesion formation in eNOS knockout mice.” [7]

As you can see, this is yet another reason that low NO can lead to tissue damage and arterial plaque.

7. Decreased Refractory Period. Recovery time post-orgasm can be a big issue for many men, even younger ones. Some men actually feel lousy after The Big O and then take several days to recuperate and be ready for another love making session. [7]  For additional information, see my page on How to Improve the Male Refractory Period.

CAUTION: Watch out for elevated cortisol levels.  Most of us are under chronic, unrelenting stress and have not learned to manage it effectively.  Lack of sleep and overtraining can also raise cortisol levels.  All of these, per one study, can sabotage your nitric oxide levels by depleting nitrites. [8]

CAUTION 2:    You can also artificially raise NO by jacking up your blood glucose levels.  Unfortunately, this also artificially raises superoxide free radicals (O2-) levels and can lead to vascular damage. [9] So short term gain for long term pain is not a good trade in my opinion!

CAUTION 3:    This is a big subject, but you don’t want to “go crazy” with nitric oxide. Too much can be hard on the brain and is associated with a variety of psychological disorders. For those who suffer with migraines, too much too quickly may make things worse. Middle-aged and senior men have already lost about half of their NO, but younger guys should probably not seek every NO Booster they can find and artificially raise their levels in my opinion.

REFERENCES:

Clarence Bass Interview: Senior Bodybuilding - Peak Testosterone

I’m not sure why exactly, but I’ve noticed on The Peak Testosterone Forum a lot of guys 50+, like myself, who want to lift weights, put on muscle and look good in their senior years. Well, I had the privilege of interviewing one of the undisputed kings of bodybuilding who has written many articles for the biggest bodybuilding publications and web sites, Clarence Bass. Many of you will recognize his name as some of what he has written has become bedside reading in the bodybuilding community over the years. And, if you do not believe that Clarence walks the talk, check out these Pics of Clarence Over the Decades. He is clearly in an elite few who has stayed healthy, avoided major injuries and build mass year after year. Check out the interview with him below:

NOTE: By the way, one of the very interesting things about Clarence Bass is his hormone profile: he is NOT a high testosterone guy and is NOT on HRT. You’ll see that he built his house with testosterone right around 500 ng/dl. I see guys all the time saying that they cannot build muscle any more with T levels right around that. I grew some muscle in my late 40’s with testosterone in the 300’s. It’s definitely more difficult, but it can be done. So, once again, there are no excuses for avoiding the gym, pavement or pool time.

Q. I saw your pics and was just stunned with what you achieved in your senior years. Guys like you, Jack LaLanne and Bob Delmonteque give me hope that I can look good through my senior years! I’ll start by asking you which of your books and web pages are most relevant for guys who want to try to achieve muscle mass?

A: My 3-book Ripped series is aimed at hard core bodybuilders. Ripped 2 focuses on building muscle without fat. I would also suggest Great Expectations, which was written when I was 70 and has a broader focus. More about each of our books and our website follow.

Q. And one follow up question that I have is if you trained any differently after, say, 50 than in your younger years? More volume? Less heavy compound lifting? Less/more intensity? Or did you continue with “business as usual?”

A: I trained just as hard, but less often. Biggest mistake older bodybuilders make is training too much and too often. The key is to find a proper balance of stress and rest. You ll find a good discussion of this in my book Challenge Yourself.

Q. Looking at your pics, it seemed like you actually added muscle from your mid-50s to mid-70s. Is that true? If so, do you think you are just gifted genetically or do you believe all guys can put on a lot of mass in their senior years, i.e. “it’s never too late?”

A: Muscle can be added after 50 and much older. No question about it. You ll find case histories in Biomarkers by Evans and Rosenberg. Everyone, of course, responds best in the early stages of training. My physique came along quite nicely after 50. I kept my workouts short, hard and infrequent and continually challenged myself. Diet is also a factor; I never starved myself. My photos from 15 to 75 are in the training pictorial on our website.

Q. One of the common complaints of aging men is that it is so easy to put on weight, especially that gut fat. Of course, there isn’t anyone, senior or not, that does a better job of maintaining a low body fat percentage year round than yourself. So can you give us a couple of tips and point us to the right place to find out how you did it?

A: It is true that excess calories are more likely to be stored as visceral fat when you are older. Regular training, strength and endurance, and calorie control (bulking up usually adds fat) is the best way to combat the trend. I started training when I was 13 and never stopped. I also paid attention to my diet, more so when I turned to bodybuilding in my late 30s.

My 10 books cover my training over a 35 year period, from 40 to 75. Each book has a different focus; as I changed the books change. The core ideas of my diet and training stay the same, but the application becomes more focused on fitness, health, and the aging process. Importantly, I never stopped learning and trying to improve. If you want the whole story, read the books in the order they were written. Each book stands on its own. Our first book, Ripped, has sold over 50,000 copies and just went into its 12th printing.

Q. To me it seems that joint and connective tissue stress is a stronger limiting factor as you age. Any supplements or tips to overcome this issue?

A: My rule is: If it hurts don t do it. You have to be more careful about your joints as you grow older. That s one of the reasons why I switched from Olympic lifting to bodybuilding as I approached 40. I also switched from running to biking to save my joints. Making small changes as I went has allowed me to keep training a very high level.

I focus on sensible training and healthy eating and don t rely on supplements for joint health.

Q. A lot of the guys on my site were hypogonadal and are now on HRT like I am. However, you have never been on HRT and have been natural your whole career, correct?

A: My book Ripped tells about my brief experiment with steroids. It explains what happens when you take steroids and more importantly what happens when you stop. I decided that steroids were counterproductive for lifetime fitness and never took them again. I have never used HRT.

Q. Do you have any idea what your testosterone and estradiol levels have looked like over the last 10 years? I’m asking, because many of the men will be interested to know your stats.

A: My health and fitness have been evaluated regularly at the Cooper Clinic in Dallas since 1988, when I was 50 years old. My testosterone was measured for the first time in 2000, when I was 62; it was normal at 483 ng/dl. The reference range was 241-827. Interestingly, my latest test, in May of this year, at 76, was slightly higher, at 514. My doctor calls my testosterone readings quite healthy.

I ve written a number of articles about HRT on our website; the latest and most comprehensive was added in our current update: Clarence Bass Article on HRT.

Q. My impression is that very few of the professional bodybuilders made into their 60’s and 70’s in good shape. The exceptions are, I believe, yourself, the names above, Steve Reeves and Bill Pearl. So what is the reason that so few last into the senior decades? All the chemicals? Past injuries? Chronic disease?

A: It varies from case to case. Those that keep training and take care of themselves do pretty well. The more consistent you are with training and healthy eating the better you do.

Q. So what is your take on protein requirements for senior lifters? Do you believe that the standard 1 gram per pound of body weight is ideal or is that too much or too little protein?

A: Your body can only use so much protein at each meal. The important thing is to include some high quality protein (eggs, milk and fish, for example) in each meal. Excess calories from any source, including protein, are deposited as fat. I focus on eating a balanced diet of whole foods and don t count calories or macronutrients.

Q. And should 50+ guys be taking any of the standard bodybuilding supplements such as creatine and BCAA’s? Or is that really necessary (or possibly detrimental) in your opinion?

A: I take creatine before and after workouts, but don t take bodybuilding supplements otherwise. Again, I rely on eating a balanced diet of whole foods.

Q. I know you try to stay as natural as possible, but you eventually went on a statin. Did you struggle with any myopathy-related issues while on a statin and do you take supplemental CoQ10?

A: I take a low dose statin and haven t had any trouble. I do take CoQ10 along with the statin, as recommended by my doctor.

Q. I know that many men would benefit and enjoy reading your articles and books. Can you point us all to the best location to find these?

A: I write one or more articles each month for our free website, 396 in 10 different categories to date. Our books are available directly from us or on Amazon; they can also be ordered at your local bookstore. You ll find details on each of our books and DVDs on our website: Clarence Bass Home Page.

INTERVIEW WITH CLARENCE BASS

Flax seed: Control and Possibly Clear Arterial Plaque .

Flaxseed to Clear Your ArteriesI kind of stumbled upon flaxseed and started putting it in my smoothies about a year ago.  I did that because I had a high PSA read, which result in my HRT clinic yanking me off of HRT (TRT).  That was not fun – my testosterone dropped to 111 ng/dl – and I describe the whole event in my page High PSA But No Cancer. The good news that came out of it is that I noticed that flaxseed had a couple of great studies under it’s belt against prostate cancer, and so I started using it immediately.  (See my page on Flaxseed and Prostate Cancer for the recent research on the subject.)

Later I found out that this was just the beginning of flaxseed’s miraculous super powers:  it also has considerable evidence behind it that it can stabilize and/or great slowly down the buildup of arterial plaque.  And, in case you didn’t appreciate the significant of that, it means that flaxseed has the potential to help you clear out penile arterial plaque.  Nice!

The evidence for flaxseed in this comes mostly from animal models at this point.  Rabbits provide a good model of atherosclerosis for researchers and one recent study found that a 10% flaxseed diet actually regressed plaque by 40%! [1] Now few of us want to eat 10% flaxseed.  My three tablespoons per day is probably around 4% for example.  However, I can consume flaxseed daily for years and thus likely slowly accumulate the benefits over time, something that a short term laboratory model like the above cannot do.  As a side note, I love a quote from the authors of this study:  “Akin to pharmaceuticals, functional foods can also be used to prevent and treat CVD [cardiovascular disease].”  Hallelujah!

1.  Lowering Triglyceries and LDL but not HDL.  Flaxseed somehow reduces the “bad” lipids while maintaining your good cholesterol levels. [2] Notice that this is very similar to the effect that Niacin, which is used by some of the plaque regressers, has on lipid metabolism.  Niacin, though, has the advantage of also raising HDL.  However, niacin can have side effects and flaxseed has no side effects that I know of – it is a food that has been used for centuries.

One research summary stated that “multiple clinical dietary intervention trials report that consuming flaxseed daily can modestly reduce circulating total cholesterol (TC) by 6% 11% and low-density lipoprotein (LDL) cholesterol by 9% 18% in normolipemic humans and by 5% 17% for TC and 4% 10% for LDL cholesterol in hypercholesterolemic patients.” [6]

These are powerful results and one can’t help but ask the question why doctors don’t hand some of their patients a bag of flaxseed instead of a prescription for statins??

3. Lowering Blood Pressure.  Flaxseed contains the lignan secoisolariciresinol diglucoside (SDG), which is a powerful blood pressure lowerer. [4] In fact, a recent study showed that flaxseed lowered blood pressure by an average of 15 points (mm) systolic and 7 points (mm) diastolic! [5] This is a huge drop and rivals that of most of the phamaceutical solutions out there!

4. Lowering Blood Glucose.  Yes, flaxseed was also found – the lignans again – to lower blood glucose levels in a dose dependent manner. [8] Yes, flaxseed does it all, battling prediabetes and diabetes on top of everything else.  And the key thing to note is that both #3 (high blood pressure) and #4 (high blood sugar) are risk factor for arterial plaque.

CONCLUSION: I think that men should think of flaxseed as a protector of all they hold dear.  If you stop to think about, the things that can take you out of commission in the bedroom and otherwise are plaque buildup, prostate cancer, diabetes and prediabetes, etc.  All evidence points to flaxseed greatly reducing the risk for all of these, although I freely admit that more studywork needs to be done.

NOTE:  See also my page on The Incredible Benefits of Flaxseed for more reasons every guy should be thinking about flaxseed.

1)  Amer J Physiol Heart Circ, Apr 12 20131, “The Effects of Dietary Flaxseed on Ahterosclerotic Plaque Regression”

2) Drug News Perspect, 2000, 13(2): 99, “Flaxseed: A source of hypocholesterolemic and antiatherogenic agents”

3) Nutrition, Metabolism and Cardiovascular Diseases, Sep 2008, 7:497-502, “The effect of a lignan complex isolated from flaxseed on inflammation markers in healthy postmenopausal women”

4) Journal of Cardiovascular Pharmacology, Nov 2009, 54(5):369-377, “Flaxseed and Cardiovascular Health”

5) https://www.reuters.com/article/2013/11/01/us-flaxseed-bp-idUSBRE9A00R520131101

6) Applied Physiology, Nutrition, and Metabolism, Oct 2009, 34(5), “Experimental and clinical research findings on the cardiovascular benefits of consuming flaxseed”

7) Atherosclerosis, Feb 2998, 136(3):367 375, “Reduction of hypercholesterolemic atherosclerosis by CDC-flaxseed with very low alpha-linolenic acid”

8) British Journal of Nutrition, Jun 2008, 99(06), “Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercholesterolaemic subjects”

REFERENCES::

-Tarahumara Diet: Perfect Arterial Health Through Age 90-100

My fitness heroes are poor, short in stature and virtually unknown by the outside world.  Although they live just a few hundred miles south of me in northern Mexico, I have never met any of them or seen even one of their tribesman on television, although my parents have.  My parents had absolutely no idea that they were dealing with fitness gods – that is how unassuming these people are.

NOTE: My other fitness hero is Jack LaLanne.  Who can’t admire a guy who swam a mile off the coast of California shackled and towing 13 boats with 76 people on board at age 62? You can read more about him on my page Jack LaLanne: Nobdy Like Him.

But it is no exaggeration to say that these people could alleviate the suffering of 100’s of millions of men worldwide if their example was just followed.  Who are these people?  They are the Tarahumara Indians. And consider their accomplishments:

I’m not so sure about how the last two items fit into a life of fitness, but the rock and roll lifestyle seems to work for them: they have no suicide or depression.  And clearly they have achieved what all of us here in the U.S. desire:  a happy, disease-free existence.  And they have done it without drugs, without pharmaceuticals and without a multibillion dollar health care system.

1)  Amer J of Clin Nutr, Apr 1979, 32:905-915, “The food and nutrient intakes of the Tarahumara Indians of Mexico”

2) NEJM, dec 12 1991, Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet

So what is their secret?  Well, clearly exericse is a biggee as I mentioned above.  But their other secret may surprise a lot of you out there:  a low fat diet built almost entirely on plant-based carbs. That’s right – these guys have no hypertension into their 90’s for a reason.  Their low fat diet and exercise gives them a low LDL, low cholesterol and plaque-free (almost for sure) existence.

What are the actual numbers of the Tarahumara?

PLAQUE REGRESSION: If you’re into regressing arterial (including penile) plaque, you’ll be excited when you see the above numbers. Basically, the Tarahumara have naturally – without any pharmaceuticals or supplements – achieved the “Trifecta” in plaque regression:  low LDL; low triglycerides and decent HDL. For example, let’s look at Dr. Gould’s plaque regression numbers as I have laid out in my page on HDL, LDL and Triglyceride Targets.

Now Dr. Gould’s numbers are pretty conservative, but, even so, notice how close the Tarahumara came to meeting those goals. No wonder they have no heart disease! And no wonder they have hypertension! This is why I asserted that they very likely did not have atherosclerosis: they meet the requirements of the Plaque Regessers. And, yes, they achieved these stellar numbers without any pharmaceuticals or supplements!

CONCLUSION: A properly done low fat diet (coupled with significant exericse) is probably the elite diet on planet earth. If done correctly, it appears to completely keep off plaque and eliminate all elevations in blood pressure even into advanced age and appears to even extend age and life span. There are four other lower fat diets – not quite as low as the Tarahuara but close – that enjoyed incredible longevity and . These cultures ate lower levels of calories however and thus some believe caloric restriction may have played a role. However, the Tarahumara men consumed around 2,800 calories per day and yet enjoyed exceptional longevity. Note that Nathan Pritikin also completely regressed his plaque on a diet similar to the Tarahumara coupled with an hour of jogging every day.

Health Myths That the Tarahumara Shatter

MYTH #1:  You Need High Cholesterol and LDL. I hope that some of you will notice how low their cholesterol is by American standards. Americans, due to their extreme affluence, are used to very high cholesterol levels and believe that this is required for brain health and many other things. Even prominent health bloggers have popularized this myth.  The Tarahumara Indians and other cultures I mention in My Review of Healthy at 100 just shatter the silly idea that you need higher cholesterol levels for good health. For those living a reasonably healthy lifestyle, our livers manufacture all the cholesterol we need and that our brain needs. Again, the Tarahumara have incredible longevity and a high percentage of centennarians. Brain health is just not an issue even though their LDL is “low” by our standards.

MYTH #2:  Carbs and Grains Are Unhealthy. The Tarahumara eat little fat and a LOT of carbs.  Contrary to the typical American health rhetoric out there, they should be dead very young.  The fact is, though, that there are good carbs and bad carbs and they eat the good ones and exercise a lot. While I don’t think most Westerners would do well with 580 grams of carbs, the point still remains:  you can eat probably a medium amount of carbs and do very well as long as they are low glycemic and you exercise (both of which should be a given).  The Tarahumara are not eating white rice and bread.  They are consuming high fiber corn and beans.  And notice that their main food is a grain – horrors!  (Those in the U.S. must be careful with corn as most of it is GMO’d with BT toxin.)

MYTH #3:  Low Fat Diets Are Unhealthy. A poorly done low fat diet can be unhealthy and two of the Plaque Regressers warn about some people increasing plaque rather than regressing it.  The Tarahumara are an example of doing it the right way with little wheat, lots of exercise and using low glycemic carbs.

MYTH #4:  You Need High HDL for Heart Health. Most men would be appalled to have HDL in the low 30’s  However, low fat diets produce low HDL and the Tarahumara show that, generally speaking, HDL is not needed if you do a low fat diet properly.  (If you do a low fat diet the wrong way, you can end up with very low HDL and higher triglycerides.)

MYTH #5:  Vitamin C is Critical for Heart Health (Pauling Theory). The Tarahumara get about an RDA of Vitamin C and that’s it, yet the enjoy incredible arterial health.

REFERENCES:

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:

Questions for Your First Visit with a Potential TRT Doctor.

So here are a few questions that you can ask that will really help find a well-trained physician:

1.  Target Testosterone Level.

A. A knowledgeable physicain will know that you don’t want to go too high with testosterone, because it can lead to an increased risk of side effects such as high hematocrit, acne, high estradiol (bloating, moodiness, E.D., low libido).  Likewise, beware a physician that thinks most guys will feel good in the 300’s and 400’s (ng/dl).  I had lackluster results for years, because my urologist refused to raise my testosterone over about 480 ng/dl.  I was not getting morning erections for example.

2.  Type of Hypogonadism.

Q.  “Am I primary or secondary?”

A. Doctors may or may not be willing to investigate whether or not you have  primary or secondary hypogonadism, but they should know and understand the difference between the two and how to diagnose them at a minimum.  LH and FSH within range are general guides, and the acid exam is the HCG Stimulation Test.

3.  TRT Failure.

Q.  “What would cause you to take me off of TRT?”

A. A medium high PSA is fairly common and this happened to me once.  I had a read of 6.3 and my clinic (at the time) immediately took me off of TRT.  Some physicians will not do this to you:  they will give you time to make an appointment with a urologist and discuss it with him.  High hematocrit is another reason doctors will take you off of TRT.  You need to know if your physician knows how to handle this situation and under what circumstances they would force you off of TRT.  Other issues could be high blood pressure. The key is to find your doctor’s parameters, so that you don’t end up like I was – without TRT and not understanding what just happened to you and why no one ever told you!  See my story of High PSA But No Cancer to see a personal example as to how this can happen.  (I was back on TRT a month later.)  You may also want to read through my page on Ways to Lower Hemoglobin.

Q.  “Do you monitor estradiol and, if so, how do you handle high and low values?”

A. In my opinion, a well-trained TRT physician knows the proper test for estradiol and the symptoms, ranges and issues associated with low and high values.  That said, the great majority of doctors out there have absolutely no knowledge of estradiol in men and its importance, so don’t be too surprised if you get a blank stare or an uninformated answer like “that’s a woman’s hormone!”  I have tons of information on the subject here:  My Pages on Estradiol. Just scan through some of these key pages, and you’ll a reasonable background knowledge to know whether or not your doctor has done his or her homework or not.

5.  Pre-TRT Tests.

Q.  “What tests will you run beforehand to see if I am a good candidate for TRT?”

A. At a minimum the physician should look at testosterone, liver function, RBC/hematocrit/hemoglobin, blood pressure and PSA.  Ideally, he or she would also pull LH, FSH, DHEA-S, SHBG, progesterone, DHT, thyroid and cortisol as well, because these can be altered by TRT according to considerable anecdotal, clinical and/or research-based evidence.  Thus it is helpful to have baseline values beforehand.

6.  Post-TRT Tests.

Q.  “What tests do you typically pull post-TRT and how often?”

A. Savvy physicians typically monitor PSA, hemtocrit/hemoglobin, and blood pressure every 3 months and estradiol 1-2 months afterward and then every six months after you get dialed in.  (It is hard to monitor estradiol if you are using Nebido/Aveed [undecanoate] or pellets.)  Liver and kidney function are also typically monitoried every six months or annually.

7.  HCG and Testicular Volume / Libido.

Q.  “Do you use HCG to restore testicular volume and libido?”

A. The great majority of physicians will know very little to nothing about HCG, or they may think of it as a fad hormone used for weight loss purposes.  However, HCG is very commonly used by fertility specialists, anti-aging doctors, TRT clinics, etc. to restore testicular volume – yes, your testes will shrink on TRT – and to restore libido and fertility.  For more information, see My Pages on HCG.

8.  Delivery Systems.

Q.  “What types of testosterone do you offer your patients and why?”

A. Beward of urologists that push pellets – they get nice insurance reimbursements – and endocrinologists that administer testosterone cypionate (or enanthate) every two to three weeks!  Physicians should have a variety of options available and considerable flexibility, including (ideally) Subcutaneous and Intramuscular Testosterone Cypionate (or Enanthate), Compounded Testosterone Creams and brand name topicals such as Androgel. Some men also like the longer term delivery systems such as testosterone undecanoate and pellets: you just don’t want them pushed on you at the exclusion of other options.

OPTIONAL BUT CRITICAL FOR SOME YOUNGER MEN:  Fertility

Q. “How can I maintain my fertility?”

A. Some men want or need to be fruitful and multiply.  This can be done through three methods:  a) TRT + HCG, b) HCG Monotherapy or c) low dose Clomid.  If this is a concern for you, read this page for more details:  TRT (Testosterone) and Fertility.

CONCLUSION:  A doctor that cannot answer or defend his positions on most of the above questions is not, in my opinion, someone who should be running your TRT program on an ongoing basis.  Sometimes you have to just take any doctor to get “into the system.”  But having a knowledgeable doctor over the years can greatly help one’s long term success.  It is not uncommon for the benefits of TRT to fade with time, and it is important to have a physician who knows what to do about it and when.

By the way, good luck getting even half of these questions answered:  most doctors feel like they can only afford to spend 15-20 minutes with you!  However, keep in mind that, even if they do cut it short,  you should still be able to get an idea as to how well-versed they are in the basic issues of TRT.

Fructose: Aging Accelerator through AGEs - Peak Testosterone

Advanced Glycation End Products (AGE’s) are basically the nasty byproducts of glucose metabolism.  The typical Western Diet, coupled with a sedentary lifestyle, too much fat and insulin resistance, leaves our bodies churning out excess glucose and unable to burn it.  It stays in our blood stream too long and there does incredible damage.

One of the most damaging aspects are the Advanced Glycation End Products (AGE’s), which includes visible structures such as “liver spots” on the skin to accumulated wastes in various tissues that  interfere with normal metabolic processes on the cellular level and lead to Inflammation, one of our sworn arch enemies.

WARNING: AGE’s have been tied to diabetes [11] and heart disease [12], both of which are strong risk factors for erectile dysfunction. Even worse for your erections:  AGE’s are tied with endothelial dysfunction, meaning less nitric oxide and blood flow, the stuff of erections. [13]  The good news is that AGE’s have also been linked to Alzheimer’s and demenita, so you may not even remember how great sex was, eh? [14]

2.  Exercise.  Exercise burns calories, lowers insulin resistance and these will in short order stabilize your blood sugar.

3.  Fructose. Fructose speeds up Advanced Glycation End Products. One researcher summarized it nicely: “This study demonstrates that long-term fructose feeding accelerates aging as expressed by changes in various age-related markers measured in collagen from skin and bones.” [9] The title of another study says it all: “Fructose Ingestion Enhances Atherosclerosis and Deposition of Advanced Glycated End-products in Cholesterol-fed Rabbits” [10]  In other words, fructose ages you internally (your arteries) and externally (your skin).

4.  Vinegar. Several studies have shown that a tablespoon or maybe two will lower blood sugar levels even after a starchy meal.  One study showed, at least in diabetics, improved insulin sensitivity after consumption of vinegar. [4]

5.  Cinnamon. One study of diabetics, but keep in mind that most Westerners have blood sugar issues of varying degrees, demonstrated “that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes”.  [5]  This is not a lot of cinnamon and would seem like a no-brainer to help defend against Metabolic Disorder, Advanced Glycation End Products (AGE’s) and Heart Disease, except for one problem:  there is a certain type of “mock” cinnamon (Cassia) that has significant amounts of coumarin, which can be poisonous to the kidneys. You only want to buy true cinnamon, which is Ceylon Cinnamon.

6. Alpha-Lipoic Acid. Again in diabetic patients, alpha-lipoic acid has shined, showing that it reduces glucose levels. Maintenance levels for relatively healthy individucls is typically about 50 mg/day.  [6]  NOTE:  Alpha-lipoic Acid also has another huge benefit:  increase one of the body’s primary antioxidants, glutathione. For more information, read my link on How to Raise Levels of the Body’s Natural Detoxifier.

7. Dietary Fat. Scientists found that rats fed a high fat diet developed cholecystokinin (CCK) resistance. [8] Cholecystokinin, or CCK, sends a signal to the brain, which in turn sends a signal to the liver to decrease glucose (blood sugar) production. A high fat diet sabotages this process, which means increased blood sugar levels for you.  In other words, you may think that you are doing your skin good by eating a diet high in fat because you are then avoiding carbs, but this is not the case.  I noticed my skin clearing up immediately – yep, smooth as a baby’s butt – when I went on a Low Fat Diet for example.

8) Food. Meat and fats cooked at high temperatures actually develop AGE’s.  Of course, I urge great caution when it comes to meat anyway, since consumption of all the Saturated Fat can lead to many male health and erectile problems.  But if you must eat meats, AGE’s can be reduced on the grill through various marinades.

REFERENCES:

1) Lancet,1990,336:129-33;Am. J. Cardiol,2003,91:1316-22

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

3) Circulation, 1992, 86:1-11

4) Diabetes Care, 2004, 27:281-282

5) Diabetes Care, 2003 Dec, 26(12):3215-8

6) Atzrieimittel-Forschung, 1995, 45:872-874

7) Arzneimittel-Forschung, 1992, 42:829-831

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) J of Nutr, Sep 1998, 128(9):1442-1449, “Long-Term Fructose Consumption Accelerates Glycation and Several Age-Related Variables in Male Rats”, Boaz Levi and Moshe J. Werman

10) J Atheroscler Thromb, 2005, 12(5):260-267, “Fructose Ingestion Enhances Atherosclerosis and Deposition of Advanced Glycated End-products in Cholesterol-fed Rabbits”

11) Recent Progress in Hormone Research, 2001, 56:1-22, “Protein Glycation, Diabetes, and Aging”

12) Experimental Gerontology, Jul 2007, 42(7):668-675, “Advanced glycation endproducts: A biomarker for age as an outcome predictor after cardiac surgery?”

13) Diabetes Care, May 11 2007, 30(10):2579-2582, “Single Oral Challenge by Advanced Glycation End Products Acutely Impairs Endothelial Function in Diabetic and Nondiabetic Subjects”

14) Neurobiol Aging, 2009 May 21, “Advanced glycation endproducts and their receptor RAGE in Alzheimer’s disease”

So are there some easy ways to combat Advanced Glycation End Products (AGE’s)?  Of course!  As usual, science has come to the rescue and showed us many ways to get our blood sugar (and AGE’s under control):

1.  Glycemic Load. If you’ve read anything health-related in the last ten years, you’ve probably come across an article or two about Glycemic Index.  Glycemic Index is just a fancy and rather polite way  of telling you that eating a bunch of sugar and starch is bad for you. If you understand that, then you understand the Glycemic Index and don’t need to read much from the 40,000 web pages on the subject out there..  I would like to point out that Glycemic Load is a more relevant topic and so I recommend that you keep it in mind.

Ginseng: Benefits To the Brain, Memory, Cancer and Insulin .

Supplements, especially herbs, scare me.  However, there are a few herbs, such as Korean Ginseng and Pycnogenol, that have very, very positive benefits and research results.  For example, Ginseng’s performance has been so outstanding that one could really qualify it as a food in terms of safety and beneficial properties.  Furthermore, and as we’ll show below, Ginseng seems tailor-made for the middle-aged and beyond guy battling some aging-onset maladies, including loss of erectile strength, mental sharpness and insulin resistance.  It’s not an inaccurate characterization to say that Ginseng is a turn-back-the-clock supplement in most of the key areas of health that males are interested in.  NOTE:  American Ginseng has many excellent properties as well, but we are only talking about the Korean variety here.

Side effects are rare with Ginseng.  Really the only major caution is that some supplement manufacturers have allowed lead contamination into their Ginseng products.  However, this can be avoided by buying brands, such as Solgar – Korean Ginseng Root Extract, 60 veggie caps , which have been tested for lead and pesticides (and deliver the active ginsenocides specified on the label).

REFERENCES:

1) 1) Diabetes Care October, 1995, 18(10):1373-1375, “Ginseng therapy in non-insulin-dependent diabetic patients”

2) Arch Intern Med, 2000, 160:1009-101, “American Ginseng (Panax quinquefolius L) Reduces Postprandial Glycemia in Nondiabetic Subjects and Subjects With Type 2 Diabetes Mellitus”

3) Curr Ther Res Clin Exp, 1996, 57:959 68, “A double-masked study of the effects of ginseng on cognitive functions”

4) J Ethnopharmacol, 1986;16:15 22, A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers”

5) Int J Clin Pharmacol Res, 1999, 19:89 99, “Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group”

6) Physiology & Behavior, Apr 2002, 75:739-751, “Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults”

7) Physiology & Behavior, Apr 2002, 75:739-751, “Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults”

8) Neurochemistry International, Jul 1992, 21(1):1-5, “Actions of ginsenoside Rb1 on choline uptake in central cholinergic nerve endings”

9) Horm Metab Res, 2005, 37(3): 146-151, “Improvement of Insulin Resistance by Panax Ginseng in Fructose-rich Chow-fed Rats”

10) ARCHIVES OF PHARMACAL RESEARCH, 27(7):790-796, “Wild ginseng prevents the onset of high-fat diet induced hyperglycemia and obesity in icr mice”

11) Acta Pharmacologica Sinica, Sep 2005, 26(9):1104-1110, “Antihyperglycemic effects of total ginsenosides from leaves and stem of Panax ginseng”

12) Life Sciences, Aug 8 2000, 67(11):1297-1306, “Anti-proliferative effect of ginseng saponins on human prostate cancer cell line”

13) Int. J. Epidemiol, 1998, 27 (3): 359-364″Non-organ specific cancer prevention of ginseng: a prospective study in Korea”

14) Int. J. Epidemiol, 1990, 19(4):871-876, “A Case-Control Study of Ginseng Intake and Cancer”

15) Annals of Pharmacotherapy, Published Online, 6 December 2005, “Systematic Review of the Effects of Ginseng on Cardiovascular Risk Factors”

CAUTION:  Ginseng does have a few drug interactions, such as with blood thinners, etc., so check with your doctor first as always.

What can Ginseng do for you?  Consider these benefits:

1) Erectile Strength and Libido.  As I document in my link on Ginseng and Erectile Dysfunction, Ginseng has been proven in many studies to boost your all-important Nitric Oxide and has even been shown to have a solid cure rate (two thirds to three fourths) for guys with erectile dysfunction.  In the same link, I also document Ginseng’s aphrodisiac qualities.

2) Blood Sugar Control.  Early work found that Ginseng had the admirable quality of lowering blood sugar in type II diabetics. [1] Of course, this was an important benefit of Ginseng considering that such a large percentage of individuals in industrialized societies struggle with blood sugar control.  Follow-up research showed that Ginseng lowered blood glucose even in non-diabetics. [2]  Many animal studies have shown Ginseng’s protective effects against insulin resistance, diabetes and hyperglycemia. [9][10][11]  This is a desireable property indeed, considering the erectile and health-damaging effects of Diabetes and Metabolic Syndrome.

4) Cancer.  Almost all males will get prostate cancer, a common and generally slow growing cancer.  One of ginseng’s many benefits, according to an in-vitro study, is likely protection against the most aggressive forms. [12] Other studies show significant protection against stomach and lung cancer [13] and cancers of all kinds. [14]

5) Blood Pressure.  Ginseng yields a small but significant blood-pressure lowering benefit. [15]

These are the major advantages that most guys are particular interested in.  However, it is important to note that Ginseng has also been found to benefit the central nervous system and battle certain neurodegenerative diseases and has excellent anti-inflammatory and antioxidant properties as well.  Again, as with Pycnogenol, the list of Ginseng’s benefits is difficult to summarize in one short page.

Testosterone the Same and Estradiol 50% Lower!.

STEP 7C:  If you are high estradiol, you may want to consider a low fat diet in order to slash estradiol levels: while maintaining your current testosterone:

One of the big myths out there is that low fat diets lower testosterone levels.  Of course, anecdotally, this could be true with some men, but the research is clear that is not generally the case and I outline just why below.  Before, we look at the pertinent studies, let me point out why you would even want to consider a low fat diet and what that has to do with estradiol levels::

I also want to mention that I am enjoying the benefits of a Low Fat Diet: I just had a Heart Scan and showed Zero Cardiac Plaque . However, I know what many men are thinking and some even write to me:

“Sure, you enjoy a Low Fat Diet. You’re on HRT!”

It’s true that I am on testosterone therapy.  But I would be consuming a Low Fat Diet even if I wasn’t.  In fact, I did consume a Low Fat Diet when I was still very close to hypogonadal.  Nevertheless, I don’t want to ignore the point of those who have brought up the subject.  These men are concerned that Low Fat Diets significantly decrease testosterone.  Lets look at the actual studies and see what they say.

NOTE: I always encourage a Low Fat Diet with minimal wheat and corn because these are heavily GMO’d foods. it is also critical that you eat a low glycemic, low fat diet.  Refined carbs, including white and basmati rice, must be avoided at all costs. See my page on Using a Low Fat Diet to Reverse Diabetes.

1.  Healthy Men Aged 19 to 46 (13%). This study took men and put them on either a 41% fat diet or a 19% fat diet.  The lower fat diet had more fiber and a lower saturated fat to polyunsaturated ratio, both of which are supposed to lower testosterone.  So the men on the Lower Fat Diet had dramatically lower T, right?  Wrong!  Their testosterone was 13% lower.  That’s it.

So think about it.  The men on the higher fat diet would very likely develop arteriosclerosis at an acclerated rate and steadily lose endothelial function.  The men on the lower fat diet would have much less arterial plaque and would have greatly increased blood flow and nitric oxide. Now that’s a fair trade for a 13% reduction in testosterone if you ask me!  The conclusion is clear:  dramatically increased nitric oxide for an inconsequential drop in testosterone.

2.  Cross Section of Men (0%).  This study found that men going on a true Low Fat Diet at the Pritikin Center experienced no change in testosterone levels.  Total T was 510 ng/dl before and about 510 after.  What was remarkable, though, was the fact that estradiol dropped like a rock and fell by a little over 50%! [2]

By the way, some of you mistrust Low Fat Diets, because you consider them a radicalized diet that is vegan only and allows no meat.  And it is true that some of the current leaders in the movement are vegans.  However, the real apostle of Low Fat Diets in the U.S. was Nathan Pritikin and he ate a little meat regularly.  (He only chose lower fat selections however.)  Dr. Gould, one of the physicians that I call a Plaque Reverser, actually encourages some meat consumption.  And Dr. Ornish, probably the most well-known of the Low Fat Diet gurus, allowed for egg whites and some nonfat dairy in his program.

So, again, this study shows NO drop in testosterone and a very significant boost in the T/E2 ratio.  This will almost for sure help you feel better and protect your prostate as well.

CAUTION: One reason that low fat diets do not lower testosterone levels is that they generally are not high protein.  Higher levels of protein tend to lower testosterone and most of these studies are not on bodybuilders and athletes trying to consume 160 grams of protein a day obviously.  If you are going to consume a lot of protein, then you may want to run your testosterone before and after as  precautionary measure.  You can do so by using one of the labs on this page:  Inexpensive Testosterone Labs for Men Who Wish to Self-Test.

3.  Early Senior Aged Men (12%). This study put men on a higher fat, low fiber diet and contrasted with a high fiber, lower fat diet.  Again, this is supposed to hammer testosterone levels according to anti-low fat pundits.  Of course, no such thing happened and testosterone levels fell by a meager 12%.

Again, who thinks that eating low amounts of fiber is going to improve health?  If you added fiber to the higher fat diet, it might erase the testosterone differential altogether.

These studies show that Low Fat Diets have been unfairly characterized as “Low Testosterone Diets”.  The research just is not there to support that idea.  The truth is that they may slightly lower your testosterone according to the research, but a very small amount.  Let’s say your testosterone is sitting at 700 ng/dl.  If it lowers 15%, you may go down to right about 600 ng/dl.  This is not something that you are likely to notice, especially since your nitric oxide and energy levels are probably going through the roof.

I recently wrote a page on binge drinking.  Those who consume a lot of alcohol may see their testosterone drop about 23% a half day later.  But what do you get for that loss in testosterone?  Hardened arteries and a hangover!  If you are going to trade a little testosterone, get something good in return.  And a Low Fat Diet delivers.

What about the fact that a Low Fat Diet will supposedly raises SHBG and lower your free testosterone percentage?  It is true that that could happen.  Again, though, you will be more than compensated for by the incredible drop in estradiol that you will likely experience.  Remember:  the testosterone-to-estrogen ratio is all important according to many experts and men on HRT.  (See my link on the Testosterone-to-Estradiol Ratio for more information.

One last thing: in my opinion you definitely want clear arteries. Don’t buy into the silly argument that arteriosclerosis is a normal part of life. Read the very popular Track Your Plaque by William Davis, who is a non-low fat cardiologist if you do not believe me. You can clear arteries.  Remember:  there is no substitute for clearing out your arteries.  If your arteries are clear and clean, you can almost always fix anything else.

LOW FAT TO PRESERVE YOUR TESTOSTERONE: One last thing to remember is that we do have one culture with documented high testosterone well into their senior years – the Okinawans.  As I discuss in my link on How to Avoid Andropause, the Okinawans had testosterone levels of the typical Westerner three decades younger. And what is remarkable about this is that they did everything wrong. The Okinawans ate some meat but not much – a little fish and pork for example, but nothing by modern Western standards. Furthermore, they ate relatively low amounts of total fat and saturated fat. And, finally, they even consumed a fair amount of soy, which is supposed to anti-testosterone!

Yet, in spite of all this, the Okinawans had the highest recorded testosterone levels in their senior years of any culture or people group. Here is how researchers described the Okinawan Diet in a recent review paper:

“Features such as the low levels of saturated fat, high antioxidant intake, and low glycemic load in these diets are likely contributing to a decreased risk for cardiovascular disease, some cancers, and other chronic diseases through multiple mechanisms, including reduced oxidative stress. A comparison of the nutrient profiles of the three dietary patterns shows that the traditional Okinawan diet is the lowest in fat intake, particularly in terms of saturated fat, and highest in carbohydrate intake, in keeping with the very high intake of antioxidant-rich yet calorie-poor orange-yellow root vegetables, such as sweet potatoes, and green leafy vegetables.” [4]

Again, what sounds good on paper doesn’t always work well in real life. There is hardly a day that goes by where I do not see someone in the health press criticizing low saturated fat, high carb diets. The Okinawans show that such arguments could not be more wrong.

Now, if you just simply feel that you cannot handle a diet without fat for some reason, then I would recommend that you follow a Mediterranean or standard (lacto-ovo-)vegetarian diet, both of which have done well in the studies.

WARNING ABOUT PROTEIN: I do have one caution about the above.  The above studies of Low Fat Diets would not have included high quantities of protein such as many men consume for athletics, strength training or bodybuilding consume.  There are a couple of studies that show that a higher protein to carb ratio can pull down testosterone levels.

For this reason, if you go on a Low Fat Diet, you may want to monitor testosterone before and after and make sure that it doesn’t dip.  There simply is no study work on this as far as I know.

In fact, it is not a bad idea, if you can afford it, to monitor testosterone levels before and after anyway.  Studies deal in averages and you may have a metabolism that is unique for some reason.

NOTE:  You may also be interested in my page on The Incredible Benefits of a Low Fat Diet .

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

Anti-Low Fat Mythology

Exercise Can Greatly Increase/ Lower Inflammation - Peak Testosterone

You ever feel like you live in Opposite World?  Well, I do sometimes as I read about the world of health, medicine and longevity.  I’ll explain what I mean below, but first consider this proposition:

Not only is the above true, but I will show below that moderate exercise is nearly as powerful as any anti-inflammatory drug.  The effects are both profound and long-lasting. The best example of this from the research is probably from a study that put the participants in two groups doing 30 minute bike rides.  One group did “regular” bike riding and the other the same but with a lot of braking.  What was the purpose of the braking?  Basically, to inflict greater muscle damage.

As you may have guessed, the partipants doing just normal cardio on the bike without all the braking achieved the powerful anti-inflammatory effects:  their IL-6 levels rose a little bit post-exercise – maybe 50% – and then dropped 50% below baseline values on days 2-7! [8] (IL-6 is your body’s Inflammation Increaser.) Yes, it looks like you can cut your IL-6 levels in half by simply sticking with moderate exercise rather long duration or intense exercise protocols that do significant muscle damage even though they are relatively equal as to how hard they push your cardiovascular system.

The title of this study was “Exercise-induced increase in serum interleukin-6 in humans is related to muscle damage”  and I highly recommend that you pull up the full study online and read through it here.

Keep in mind that this study is not the only one to show that moderate exercise, i.e. exercise such as a brisk walk, swimming or easier cardio style biking like the above, dramatically decreases inflammatory levels in the body.  There are also studies that show that moderate exercise decreases TNF alpha for days after, and TNF is your body’s other big Inflammation Increaser.

Again, why have I never read an article in any fitness or health magazine or blog on this subject?!  I believe this is underplayed by the health press because moderate exercise does not sell.  Nobody wants to hear about moderate exercise, because it is considered boring and time consuming.  But the fact is that there is no pill that can do what moderate exercise can do for you. Don’t forget that it also boost baseline nitric oxide levels and is a powerful anti-depressant.  But to get these benefits, you have to be willing to let your body rest and forego all the muscle (and I sure tendon/ligament) damage.  Don’t believe me?  Check out this:

DOES INTENSE AND/OR LONG EXERCISE RAISE INFLAMMATION? Let me answer that question with a question:  do you know what Overtraining Syndrome (OTS) is?  If so, you know you know that OTS is a nasty condition that afflicts men that have trained too intensely for too long.  Not surprisingly, recent evidence shows that inflammation is the root cause of Overtraining Sydnrome (OTS).  Check out this summary:

“A number of hypotheses have been proposed to explain various symptoms associated with OTS, yet none have sufficiently accounted for all the manifestations of the syndrome. A recent article in Medicine and Science in Sport and Exercise presents an all-encompassing hypothesis focused on the role of cytokines in initiating and perpetuating OTS. The Cytokine Hypothesis suggests that exercise-induced muscle and connective tissue microtrauma triggers the release of pro-inflammatory cytokines (e.g. IL-1 beta, IL-6 and TNF-alpha), which when sufficient rest is allowed, can aid in the healing process. The acute inflammation that results from excessive exercise with inadequate rest, however, evolves into a chronic response resulting in a systemic immune response involving the central nervous system (CNS), liver, and immune system (see Figure 1).” [11]

In other words, overexercising can do the polar opposite of all that you want to do as a guy.  Instead of de-aging yourself, you can actually put your foot on the accelerator to the grave.  Instead of avoiding all the chronic disease that you see all around you, you are actually embracing it.

SO WHEN DOES INTENSE AND/OR LONG EXERCISE RAISE INFLAMMATION?  To understand the discussion, I need to explain that there are two primary inflammatory “messengers” in the body:  IL-6 and TNF alpha. These messengers are called “cytokines” in the research, and, if you read health stuff, you will see them crop up all the time, because they are so fundamentally associated with the chronic disease that you see in modern societies – more on that below.

So at what point does exercise increase inflammation rather than lower it?  Here are a few key principles:

a) If you are overweight or obese, this will increase TNF alpha levels and TNF alpha is arguably the prime player in inflammation.  Exercise, by increasing metabolism and burning calories, can help with weight loss.

b) Exercise increases transiently IL-6  and IL-6, in turn, dampens TNF alpha.  This is one of the ways that exercise can lower inflammation in a positive way. [12] That said, exercise, if overdone, can actually lead to runaway inflammation.

c) Exercise (if done right) can lower both baseline TNF alpha and IL-6 levels.  However, if done for too long or with too much intensity or volume can increase inflammation.

Here are some example from the research of “over-exercising” and how it can dramatically raise inflammation for days afterward:

1. Equivalent to Trauma. Participants were put on a 2.5 hour treadmill run at 75% VO2max- pretty serious exercise indeed.  Researchers observed the following:

“The plasma concentration of IL-6 increased after 30 min of running, and peaked at the end of running with a 25-fold increase compared with the pre-exercise value. IL-1ra increased only after running, and peaked after 2 h of rest with an 18-fold increase compared with the pre-exercise value…The results suggest that very early events in exercise trigger the release of IL-6, and that the cytokine response to exercise has similarities to that observed after trauma.” [1]

2. IL-6 @ 2 Hours Post-Exercise. Another earlier study put particpants on a mere 30 minute bike ride but added in a lot of braking, which of course would tend to really work the muscles.  What they found was that two hours after exercis IL-6 levels were 4.75 X baseline values.  Again, just 30 minutes of exercise spiked IL-6 for hours after exercise. [8]

3. IL-6 Elevated for At Least 3 Days. This same study found that IL-6 was elevated between 2.0 and 2.5 X baseline IL-6 before the study.  In other words, just 30 minutes of exercise doubled inflammation for days afterward.

4. IL-6 Levels Increase a 100 Fold Post-Marathon. This astonishing increase is hard to argue as being good from the longevity and anti-aging perspective if you ask me much as I admire anyone who does a marathon.  It’s fun and impressive, but it is hard to believe these levels of inflammation are going to play out well in the long term if done regularly. [10]

REBUTTAL:  Anti-Inflammatory Molecules May Save the Day? Some may argue that a trained individual will secrete a barrage of anti-inflammatories that compensate for the astronomical increases in IL-6.

“Thus, the increase in TNF-alpha and IL-1beta levels is accompanied by a dramatic increase in IL-6. This release is balanced by the release of cytokine inhibitors (IL-1ra and TNF receptors (TNF-R)) and the anti-inflammatory cytokine IL-10. In addition, the concentrations of the chemokines IL-8, macrophage inflammatory protein (MIP)-1alpha and MIP-1beta are elevated after a marathon (K Ostrowski and BK Pedersen, unpubl. data, 2000). These findings suggest that cytokine inhibitors and anti-inflammatory cytokines restrict the magnitude and duration of the inflammatory response to exercise.” [10]

SO WHO CARES ABOUT IL-6 and TNF ALPHA? Let’s look at just IL-6. Elevated levels of IL-6 has been associated with just about every nasty chronic disease you can think of:

a. Atherosclerosis (Arterial Plaque). “…the interleukin-6 (IL-6) cytokines and their signalling events have been shown to contribute to both, atherosclerotic plaque development and plaque destabilisation via a variety of mechanisms.” [3]

b.  Alzheimer’s. “We investigated whether interleukin-6 could be detected in plaques of Alzheimer’s disease patients prior to the onset of neuritic degeneration. We found interleukin-6 mostly in plaques where neuritic pathology has not yet developed. This indicates that the appearance of interleukin-6 may precede neuritic changes and is not just a consequence of neuritic degeneration.” [4]

c. Crohn’s. “Increased levels of IL-6 and sIL-6R have been demonstrated in both serum and intestinal tissues of the patients with active Crohn’s disease. In animal model studies, anti-IL-6R monoclonal antibody (mAb) successfully prevented intestinal inflammation and systemic wasting disease by suppressing adhesion molecule expression by vascular endothelium.” [5]

d.  Irritable Bowel Syndrome. “IBS patients showed significantly (P < .017) higher baseline TNF-alpha, IL-1beta, IL-6, and LPS-induced IL-6 levels compared with HCs.” [6]

e. Rheumatoid Arthritis. “Interleukin 6 (IL-6) is a pleiotropic cytokine with a pivotal role in the pathophysiology of rheumatoid arthritis (RA). It is found in abundance in the synovial fluid and serum of patients with RA and the level correlates with the disease activity and joint destruction.” [7]

So bottom line for you guys 40+:  be careful.  If you can afford it, pull some of these values and see how you are doing.  You generally don’t want elevated IL-6 or TNF alpha.

REFERENCES:

1)  J of Physiology, Dec 1998, 513(3):889 894, “A trauma-like elevation of plasma cytokines in humans in response to treadmill running”

2) International Journal of Obesity, 2000, 24:1207-1211, “Moderate-intensity regular exercise decreases serum tumor necrosis factor-a and HbA1c levels in healthy women”

3) Thromb Haemost, 2009 Aug, 102(2):215-22, “How much is too much? Interleukin-6 and its signalling in atherosclerosis”

4) Neurobiol Aging, 1996 Sep-Oct, 17(5):795-800, “Interleukin-6-associated inflammatory processes in Alzheimer’s disease: new therapeutic options”

5) Curr Drug Targets Inflamm Allergy, 2003 Jun;2(2):125-30, “IL-6 and Crohn’s disease”

6) Gastroenterology, 2007 Mar, 132(3):913-20, “Immune activation in patients with irritable bowel syndrome”

7) Ther Adv Musculoskelet Dis, 2010 Oct, 2(5):247 256, “The Role of Interleukin 6 in the Pathophysiology of Rheumatoid Arthritis”

8) Journal of Physiology, 1997, 499(3):833-841, “Exercise-induced increase in serum interleukin-6 in humans is related to muscle damage”

9) J Am Coll Cardiol, Dec 2004, 44(12), “Effects of prior moderate exercise on postprandial metabolism and vascular function in lean and centrally obese men”

10) Immunology and Cell Biology, 2000, 78:532 535;, “Special Feature for the Olympics: Effects of Excercise on the Immune System”

11) https://www.rndsystems.com/resources/articles/cytokines-and-overtraining

12) Journal of Applied Physiology, Apr 1 2005, 8(4):1154-1162, “The anti-inflammatory effect of exercise”

Flaxseed: Dramatically Lower Your Hypertension (High BP)

What new superfood will, at least according to some recent studies, improve your triglyceride and cholesterol numbers, partially regress PSA and prostate cancer, protect against arterial plaque and better your omega-3 profile? If you guessed flaxseed, you would be dead on. Keep in mind also that lowering lipids and plaque will help those penile arteries stay healthy over the decades.

1)  Hypertension, 2013, 62:1081-1089, “Dietary Intervention Potent Antihypertensive Action of Dietary Flaxseed in Hypertensive Patients”

2) J CARDIOVASC PHARMACOL THER, Jan 2005, 10(1):23-27, “Effect of Flaxseed Consumption on Blood Pressure, Serum Lipids, Hemopoietic System and Liver and Kidney Enzymes in Healthy Humans”

3) J Med Foodm 2008 Junm 11(2):207-14, “Effects of dietary flaxseed lignan extract on symptoms of benign prostatic hyperplasia”

Another way that flaxseed can do this is by lowering blood pressure, especially in those with higher blood pressure levels.  In fact, that is an understatement:  flaxseed, according to the latest study on men and women with hypertension, dropped blood pressure like a rock.  Systolic and diastolic blood pressure decreased by an average of 15 and 7 mm, respectively. [1] These are huge drops and as good as almost any medication out there.

And what are the side effects?  Better cholesterol and less arterial plaque!  Seriously, I do not know of any side effects.  Perhaps someone can have a rare allergy to flaxseed – I don’t know.  And I supposed that someone already on hypertensive medications could lower their blood pressure too much potentially, so discuss with your doctor if that applies.  But what a contrast with modern pharmaceutical blood pressure medications, which are known for fairly frequent and nasty side effects.  And I am sure that the number of physicians that would recommend flaxseed as a natural solution are few and far between,, which, of course, is a tragedy, because hypertension is very common in modern societies, since it is so often part of developing prediabetes or Metabolic Syndrome.  It should also be noted that high blood pressure is a huge risk factor for developing plaque and erectile dysfunction.

Most physiciains are simply not aware of the many natural cures for high blood pressure that are out there.  In my page on Natural Ways to Lower High Blood Pressure, I point out some of them, many of which are just as powerful as flaxseed.  On the same playing field are Vitamin C and garlic, citrulline and high-nitrate foods for example. Again, check with your doctor if you are on existing medications, but you should be able to use some natural solutions and likely lower the dosages of any hypertension drugs you are currently using. We have had men on The Peak Testosterone Forum with resistant hypertension – the worst kind of high blood pressure out there – actually do just this.

So how does flaxseed work its magic?  We don’t know precisely yet, but researchers have identifieid four likely mechanisms:

The uncertainty of the causal effect behind flaxseed’s superpowers may bother some, bu the main takeaway in my opinion is that, because flaxseed works through so many different mechanisms and pathways, it is likely to provide synergies, i.e. additive effects, to almost any nitric oxide boosting strategy that you have already implemented.   This would range from PDE5 inhibitors to citrulline and high-nitrate foods for men with prehypertension or hypertension.

WHAT HAPPENS IF I AM HEALTHY? If you already have normal blood pressure to begin with, don’t expect flaxseed to make much, if any, difference.  That is exactly what one study showed on healthy subjects, i.e. blood pressure was not altered significantly one way or the other. [2] Again, though, flaxseed’s anti-inflammatory and lipid-lowering powers coupled with the fiber is likely to help even healthy subjects that experience no decrease.

NOTE: Some of you may have read that flaxseed is high in phytoestrogens and that is true.  However, I have taken it for a year now with no ill effects.  Clarence Bass, the famous bodybuilder and trainer, has taken it for many years.  And a number of men on the Peak Testosterone Forum also have taken it with nothing but good reports to date. I know of no downsides at this point and nothing but huge benefits. You can also read the research in my page on The Benefits of Flaxseed for more information.

REFERENCES:

Miraforte: Libido Booster - Peak Testosterone

Super Miraforte is the Life Extension Foundation’s libido, anti-estrogen and testosterone supplement. Life Extension is one of the oldest and most reputable of the supplement manufacturers out there, specializing in anti-aging in particular, and with Miraforte they have taken aim at many of the hormonal issue that so often accompany the middle age and beyond years.

What is interesting is that Super Miraforte is very often sold to bodybuilders, because of its powers to decrease estrogen and likely slightly increase testosterone.  Chrysin has a questionable history of decreasing estrogen.  However, Life Extension seems to have supercharged it with the addition of piperine for increased absorption.  This is likely the reason that Super Miraforte has been very well-received and reviewed and is used by bodybuilders in many cases.  (I have even read that some doctors are recommending it.)

Could Super Miraforte possibly increase testosterone?  One of the key things that most older men need is Estrogen Control and Miraforte does just that.  The reason that this is so critical is that, not only will estrogen “crowd out” testosterone, but it also can directly put the brakes on the testosterone output from your Leydig cells. [1][2]  This means that Super Miraforte , by decreasing estrogen, could lead to a T increase for middle-aged and beyond males that are struggling with inflated levels of the female hormones.

ARE YOU LOW SHBG? Miroforte contains Nettle and Nettle lowers SHBG. This is usually a good thing, unless you are a Low SHBG guy. Low SHBG is a fairly common condition, linked to insulin resistance, that makes HRT tough for example. Low SHBG should be cautious about using Nettle products in my opinion. I am talking about SHBG below about 18 by the way.

CAUTION: If you have any medical conditions or are on any medications, please consult with your doctor before taking any supplement.  Also, some men have such low T and E that their levels of estradiol are dangerously low.  See my link on Why Men Need Estrogen for more information.

1. Presented at the First International Congress on Ethnopharmacology, Strasbourg, France, Jun 5-9, 1990, Contributions to the clinical validation of the traditional use of Ptychopetalum guyanna.

2) J Clin Endocrinol Metab, 1978 Dec, 47(6):1368-73, “Direct inhibition of Leydig cell function by estradiol”

3) Prog Clin Biol Res, 1986, 213:359-71, “Iodothyronine deiodinase is inhibited by plant flavonoids”

Below I outline how Super Miraforte can benefit your sex life, including possibly increasing testosterone and libido and decreasing testosterone libido.

1. Chrysin. Chrysin is a known estrogen lowerer and it works by inhibiting the aromatization of testosterone to estrogen. As males age (and gain weight), an increasing percentage of their precious T is converted to E and chrysin can help.

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. [3] This could potentially lead to weight gain, which would sabotage estrogen control.

2. Nettle. Nettle is a well-known liver protector. What is not so well known is that it also fights aromatization of testosterone to estrogen as well.

4. Muira Puima. This herb is an aphrodisiac with a long history and some of its effects have even been documented in a few small studies. [1] Another study reported improved morning erections as well.

5. Maca.  This plant is another libido booster that I cover extensively in my link on The Superpowers of Maca.  Maca has actually been used as a food for centuries with an admirable safety profile.

6. Piperine. This compound from pepper, as in black, boosts the absorption of many supplements and compounds. Life Extension Foundation, by including, some piperine is essentially “supercharging” their supplement for better efficacy.

NOTE:  Increasing testosterone in men can also lead to increases in nitric oxide as well as testosterone works positively on NOS (Nitric Oxide Synthase).

REFERENCES:

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!

Dialy Testosterone Levels - Peak Testosterone

Your Daily Testosterone Just how much do daily testosterone levels dip from peak to valley?

This is an important question for many reasons, including the fact that almost every man will have his testosterone tested at some point.  Sometimes men even get their own tests through independent labs as well. So how important is the time-of-day in testing testosterone? It turns out that the answer to that question depends mostly on your age.  Young males experience a substantial drop in peak daily testosterone, which occurs in the early morning, to the lowest 24-hour levels that occur in the evening hours.

For example, one small, older study of young, healthy males found that testosterone peaked between 6-7 a.m. with levels of 670 ng/dl and then reached their nadir 13 hours later at an average of 464 ng/dl. [1] This is a substantial 31% drop.  A more recent study found a similar daily drop in average testosterone levels from 577 ng/dl to 420 ng/dl, a decrease of about 27%. [2] What if you’re a “little older” guy?  One 2009 study addressed this and found that men in their 30’s had average drops in testosterone of 20-25% from 8 a.m. to 4 p.m., which is about what one would expect based on the previous studies. (They were no measuring absolutely mins and maxs, but rather picking set times of day.)  However, the same study looked at the above with 70 year olds and found that the difference was only 10%. [3]  This means, effectively, that there is little difference in the typical senior’s morning and evening testosterone levels. What about free T and bioavailable T.  Do they follow a similar pattern during the day?  The answer is ‘yes’. These valleys and peaks in daily testosterone have to do with what is called the “cirdadian rhthym” of testosterone in males. Testosterone follow a cosine pattern – remember those trig classes? – and researchers have to handle this cosine pattern in their research as T levels to get higher in the early morning and lower in the evening. Testosterone, in turn, is triggered by the pituitary hormone luteinizing hormone (LH). LH travels in the blood stream and acts on certain cells in the testes to trigger testosterone production.  However, this whole process is gradually altered with aging, weight gain and other factors. So the bottom line is that it does not matter as much if you are older when your testosterone is drawn, although it’s a good idea to play it safe and get it drawn in the morning.  However, it is very important to get your blood drawn in the morning, because one study found that about half of young men with hypogonadal testosterone reading in the afternoon actually had acceptable testosterone values in the morning. [3] Of course, do whatever your doctor tells you, but I have personally never heard of a doctor requesting a daily testosterone test in the afternoon for just this reason..

REFERENCES:

1) Journal of Clinical Endocrinology & Metabolism, Sep 1 1973, 37(3):366-371, “Integrated Concentration and Circadian Variation of Plasma Testosterone in Normal Men”

2) J Clin Pharmacol July 1, 2000 vol. 40 no. 7 731-738, “Modeling of circadian testosterone in healthy men and hypogonadal men” 3) J Clin Endocrinol Metab, 2009 March, 94

3):907 913, “The Effect of Diurnal Variation on Clinical Measurement of Serum Testosterone and Other Sex Hormone Levels in Men”

Cortisol and Music - Peak Testosterone

One of the oddities of this universe is the profound effect of music upon us homo sapiens. Consider how music stimulates pleasure on the same level, to one degree or another, as that of food and sex. Of course, food and sex serve a basic purpose in our survival, yet how can that be said of music?

Well, I will leave you to ponder that cosmic question while you consider the other remarkable properties of music below and how they can be intimiately linked to our health:

1) Blood Pressure.  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. [1] Furthermore, the results persisted for one month. A variety of music was allowed, including classical, Celtic and Indian, but rhythmic consistency was required.  Another study of researchers found that  patients who selected music to listen to before, during and after an operation had significant decreases in blood pressure when compared with controls. [2]  Still other research on seniors showed a drop of   and  , respectively in the upper and lower blood pressure readings from listening to just 25 minutes per day! [3] This is unarguably a profound effect for something that many guys consider a waste of time.

Music therapy has also had considerable success and one well-known researcher, Alfred Tomatis, is quoted in the book Music: Physician for Times to Come stating that music is literally brain food.  He states that “a hidden but primary function of the ear…is to charge the brain with electrical potential.  Sounds, especially the ones we make ourselves as singers and speakers, are a fantastic energy food.” [8]

There is even one physicist who claimed that he could correspond musical pitch with the frequencies of the plant’s amino acid synthesis and thus accelerate growth significantly. [9] And, of course, many traditions from the Bible to Robert Monroe have even stated that there is a spiritual power behind music itself.  Whatever is going on, the power of music to heal and transform is amazing indeed.

REFERENCES:

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

2) Psychosomatic Medicine, 2001, 63:487-492, “Normalization of Hypertensive Responses During Ambulatory Surgical Stress by Perioperative Music”

3) Medicine and Biology Society, 2007, 29th Annual International Conference of the IEEE, “The Effect of Music on Hypertensive Patients”

4) Exp Clin Endocrinol Diabetes, 1994, 102(2):118-120, “Effects of music treatment on salivary cortisol in patients exposed to pre-surgical stress”

5) Neuro Endocrinol Lett, 2003 Jun-Aug, 24(3-4):173-80, “The effects of music and visual stress on testosterone and cortisol in men and women”

6) Oncol Nurs Forum, 1991 Nov-Dec, 18(8):1327-37, “The therapeutic use of music for cancer-related pain”

7) Journal of Advanced Nursing, Dec 2003, 44(5):517 524, “Effect of music on chronic osteoarthritis pain in older people”

8) Music: Physician for Times to Come, Don Campbell, p. 11

9) https://www.earthpulse.com/src/subcategory.asp?catid=2&subcatid=6

2) Cortisol. Many studies have shown that music can decrease cortisol levels. For example, one interesting study told patients that they needed to undergo surgery which, not too surprisingly, produced a large cortisol increase (50%) that stayed high even an hour later.  However, those that listened to music had no greater response than controls after the hour.[4] In other words, music completely eliminated the stress reaction by an hour afterwards!

3. Testosterone.  Music alters testosterone levels – higher in females and lower in males – according to one study. [5]

4. Pain Management. Music lowers pain significantly and in some dramatically according to one study of cancer patients. [6]  (Of course, some music can cause pain and it’s usually playing in someone car next to me at about 140 dB.)  Research has even shown that it could be used as an effective therapy in managing arthritis. [7]

SHBG: Exercise Increases It - Peak Testosterone

One of the fairly common problems that I have found on the Peak Testosterone Forum is low SHBG. Low SHBG should be a good thing, because it will boost one’s free testosterone. Unfortunately, it doesn’t work that way and low SHBG is actually a powerful sign (usually) of fatty liver and insulin resistance, something I discuss in more detail on this page:  Root Causes of Low SHBG. And once insulin resistance sets in, many problems, such as fatigue and erectile issues, often accompany it.  Plus, a significant block of men with low SHBG are also low testosterone (and low estradiol) and, therefore, have double trouble.  They also find that, if they go on TRT, they have tremendous difficulty getting “dialed in.”  The bottom line is that almost every low SHBG man is really struggling to feel good.

I do have good news though:  there are natural strategies that can help to significantly boost SHBG and one of them is exercise. The subject has actually been examined in a number of studies for the purposes of prostate cancer prevention with the idea that exercise my increase SHBG, bind to testosterone and thus be prostate protective.  (The concept that testosterone causes prostate cancer has since becomecontroversial however with some experts saying that it is actually low testosterone that increase prostate cancer risk.)

Below is a summary of what the researchers have found to date:

1. Sedentary, Healthy Men. One study examined sedentary senior men with no major health issues and had them exercise on stationary bikes.  Blood samples were taken every 10 minutes and what they found was that both testosterone and SHBG spiked during exercise and then quickly returned to baseline. [1] The reason for this is a phenomenon called hemoconcentration, which simply means that the volume of blood changes during exercise.  This can be a good thing during the short time that it happens, but it does really mean that the body’s total amount of SHBG (or testosterone) has really increased.

REFERENCES:

1) Metabolism, 1996 Aug, 45(8):935-9, “Exercise increases serum testosterone and sex hormone-binding globulin levels in older men”

2) Eur J Appl Physiol Occup Physiol, 1996, 72(5-6):425-9, “Differential effects of exercise on sex hormone-binding globulin and non-sex hormone-binding globulin-bound”

3) Med Sci Sports Exerc, 2008 Feb; 40(2): 223 233, “Effect of Exercise on Serum Sex Hormones in Men: A 12-Month Randomized Clinical Trial”

2. Athletes. A study published in the same year found similar results in athletes, i.e. that both testosterone and SHBG spiked after exercise but quickly returned to baseline. [2] Coupled with the study in #1, this would indicate that likely all men can give themselves a nice short term boost in key hormones and proteins, which may partially explain why most men feel so good when they exercise – that is, after they get over the initial pain!

3. What About Long Term? Of course, the all-important question is if exercise can boost SHBG on a more permanent basis.  Fortunately, we have a study that looked at this and the answer appears to be ‘yes.’  Researchers examined a 100 sedentary men between the ages of 40 and 75 and found that their SHBG had increased 5.7% at the 3-month point and 8.9% at 12 months. [3] Notice that the trend is upwards and so it is possible that SHBG would continue to rise even a little more if exercise was continued longer than 12 months.

CONCLUSION:  Some of you low SHBG guys may be thinking, “Okay, that’s nice, but I need a lot more than a 9% boost in SHBG!”  My response to that is that pulling up low SHBG requires a multi-pronged approach, where exercise is just one of the lifestyle changes that need to occur.  And the reason is simply this:  insulin resistance is, of course, partially a function of lack of exercise.  However, it also has a dietary component as well.  The root cause is that liver cells get stuffed with fatty acids – literally “bloated” and unable to function properly.  To clear that out requires a total lifestyle change.

LDL-P: Arterial Plaque Reversal - Peak Testosterone

Of course, the million dollar question is how you do all of this? (Actually, it’s probably a 10 billion dollar question as hospitals would be empty if we got heart disease under control.)  The key to managing heart disease is to manage arterial plaque (atherosclerosis).  No plaque – no (or very little) heart disease.  It’s that simple.  And to do that you actually have to monitor a wide variety of lipid and inflammatory markers.

The most common metrics are HDL, LDL and triglycerides and I give a lot of coverage to these on my site because of it.  These are very affordable and are part of almost every man’s annual physical exam, so it just makes sense to be well-versed in this “Lipid Trifecta.”. The men who have shown us the way in my opinion with these markers are  three physicians and researchers that I call The Plaque Regressers: Dr. Gould, Dr. Esselstyn and Dr. Davis. All three of them have strict guidelines on LDL and two of them on LDL, HDL and triglycerides. You can see the kind of numbers that they talk about in my page on LDL Levels and HDL, LDL and Triglycerides.

However, on this page, I want to discuss a less well-known, but every more powerful marker to monitor your lipids and make sure that you regress or maintain the calcification in your arteries:  LDL-P (the LDL Particle Count). As important as LDL, HDL and triglycerides are, the big gun according to the latest research is LDL-P and I’ll discuss just why below.

What is the difference between regular LDL and LDL-P?  It can be confusing at first, but LDL-C is the standard LDL number that you are used to.  LDL-P is the more important number and, unfortunately is a little more costly and less available in some ways than LDL-C.  Metrics for LDL-P are also not as well-developed.  In spite of these issues, LDL-P is simply too important to ignore.

1.  Low LDL-C Can Backfire.  All the Plaque Regressers want you to have low LDL (< 80). There are a hundred gurus out there who will tell you that LDL-C does not matter, but they are risking their arterial health in my opinion.  Their assumptions are based largely on studies comparing atherosclerosis in the general population.  But we don’t want to be just be a little better than the general public, who on average have very diseased cardiovascular systems.  We want NO plaque.

And, according to the Framington Offspring Study data, about 9% of all individuals will have low LDL-C and high LDL-P. [1] Those who fall into this category actually have high heart disease risk.  The clear message of this study was that low LDL-C is NOT a guarantee against heart disease – quite the opposite.  To truly proect yourself, you have to have low LDL-C and low LDL-P.

Another way to look at this is that, according to that same data, 18.4% of those with no known heart disease will have low LDL-C also have high LDL-P.  So, if you have low LDL-C, you cannot just assume you are out of the woods and, to play it safe, you should also pull LDL-P.

Low Fat Diets: Does this mean that the low fat diet gurus were all wrong?  No, of course not.  First of all, 82% of those with low LDL-C also have low LDL-P, so, generally speaking, going for low LDL is a great starting point.  Furthermore, the low fat gurus almost all emphasize a lifestyle that will try to keep a man out of prediabetes and prediabetes is what usually causes high LDL-P is individuals with low LDL-C.  However, a poorly implemented low fat diet based on wheat and higher glycemic carbs in a man that is overweight and/or sedentary could cause problems without a doubt.  Again, pulling that LDL-P number to play it safe is the way to go.

By the way, I really admire the original low fat guru Nathan Pritikin for his stance on this issue in the pre-LDL-P days.  He not only consumed a low fat diet but jogged an hour every day.  And it worked for him fantastically as he died, per a coroner’s report, with perfectly clear arteries (and very likely had significant arterial plaque early in life). The coroner examined him after his death and declared that “Nathan Pritikin’s arteries were free of any signs of heart disease, and were as “soft and pliable” as a teenager’s. “In a man 69 years old,” wrote pathologist Jeffrey Hubbard, “the near absence of atherosclerosis and the complete absence of its effects are remarkable.”” [4] No, it’s never too late to clear out arterial plaque.

According to the Framington Data, he is both high LDL-C and LDL-P, placing him in the worst category.  Of course, I hope that he is an exception somehow, but my point is that this is the big question with regard to Low Carb and some Paleo Diets that are higher fat.  (NOTE:  There is a study out there that says if you lose weight on Low Carb, you can regress plaque.  But what happens when you stop losing weight and you are in “maintenance mode?”)

NOTE:  I believe a https://www.peaktestosterone.com/ is the safest way to go and the best implementation of true Paleo, since wild game is almost always low fat.

2. LDL-P Best Predicts Heart Attack Risk.  The above study found that the LDL Particle Count was the single best predictor or future cardiovascular disease risk. The study basically looked at individuals without known heart disease and then followed them until their first cardiac event and, again, LDL-P was the superstar.

NOTE:  I cover this in even greater detail and more studies in this page:  LDL-P, the Best Predictor of Heart Disease.

3.  LDL-P Is Very Correlated to Arterial Plaque Levels (IMT).  Many of you know that I push getting a Heart Scan or IMT score to track your plaque levels. Of course, this isn’t my idea:  all the Plaque Regressers do it.  One of the ways you can monitor your plaque is through an IMT, which is a non-invasive ultrasound of your carotid (neck) artery.  One study found that IMT scores were correlated with LDL-P, i.e. the higher the Particle Count, the thicker the neck artery with plaque. [4]

CONCLUSION: Having Low LDL-P gives a good probability that you will have a much lower risk of heart disease. To improve these odds still further, you should also strive to have low LDL-C as well as low LDL-P. Generally speaking, men without prediabetes, which usually means a decent triglcyerides-to-HDL ratio, and low LDL-C will be in good shape and have a low LDL Particle Count.  But it is better to pull this number to make sure.  If you want to feel young and stay young, you have to keep those arteries plaque free.  This will also maximize your nitric oxide levels and improve your sex life as well.

What should you target for LDL-P?  I make a case for values between 700 and 850 nmol/l in this page on LDL-P Particle Count Target Levels for Plaque Reversal. Read this page and you will see some of the research data on this subject.

1)  J Clin Lipidol. 2007 Dec 1; 1(6): 583 592, “LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study Implications for LDL Management”

2) https://www.peaktestosterone.com/forum/index.php?topic=6105.msg51267#msg51267

3) https://www.athero.org/commentaries/comm564.pdf

4) N Engl J Med, 1985, 313:52, “Nathan Pritikin’s Heart”, https://www.pritikin.com/eperspective/specialissues/pritikinatkins/

5) May 2007Volume 192, Atherosclerosis, May 2007, 192(1):211 217, “LDL particle subclasses, LDL particle size, and carotid atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA)”

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]

Trazodone and Erectile Dysfunction - Peak Testosterone

Many men find that the traditional therapies just don’t do the job for them. And this is not too surprising as an erection is an incredibly complex process. Sure, when we are younger, it’s like “falling off a log,” but that can change rapidly with injury or with the abuses of a Western lifestyle.

Below, one of our guest authors documents a new medication that allowed him to actually have an erection by thought alone, something he had not done for a long time and is not a bad achievement for a guy in his late 50’s!  Of course, pharmaceutical solutions are always best considered short term solutions while you put lifestyle and other more natural solutions into place.  But these are impressive results that I thought I should pass on.

CAUTION: Trazodone is, among other things, an alpha blocker. All the alpha blockers should only be used under a doctor’s supervision, because they 1) interact very negatively with certain medications, 2) can cause swings in blood sugar, 3) can have very serious side effects and 4) can 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 no go away after an hour or two, go to the E.R. Your sex life is at stake.

NOTE:  If an alpha blocker works for you, it could be a sign of adrenal dysfunction – since it’s working on noradrenaline – and/or excess stress in your life.  Always try to get to the root causes.  See my pages on Adrenal Fatigue Testing and Cortisol and Stress Management for more information.

GUEST AUTHOR: Inigo

Trazodone is an antidepressant, of the serotonin antagonist and reuptake inhibitor (SARI) class. It is also used for sleep disorders. It was invented in the 1960s and approved by the FDA in 1981. The drug has a half-life of 3 to 6 hours. When used an anti-depressant, the starting dose is often around 100mg a day, rising to a maximum of 400mg a day for outpatients.

Anecdotal reports of increased libido and sexual function in patients taking trazodone have led to its empirical use in patients with erectile dysfunction.

Clinical Trials. A retrospective review of patient-reported responses to trazodone was reported in the July 1995 edition of Urology . In this report, relating to a period between 1989 and 1994, 182 patients were placed on oral trazodone as empirical therapy for erectile dysfunction. Patients ranged in age from 26 to 85 years, with a mean of 60 years. Patients were evaluated before receiving trazodone with a thorough medical history and physical examination. Patients received trazodone for at least 2 consecutive months, with daily doses starting at 25 mg, then and gradually increasing, to an average of 150mg a day. One hundred and twenty seven patients were available for follow-up by questionnaire. In patients less than 60 years of age, with no known risk factors for erectile dysfunction, 21 of 27 (78%) showed significant improvement in erectile ability. Smokers and patients older than 60 years with a history of vascular disease responded poorly to trazodone therapy. The duration of erectile dysfunction was inversely related to a response to trazodone. Of patients with a duration of impotence less than 12 months, 48% reported a positive response. Only 16% of patients with duration of erectile dysfunction greater than 60 months reported improvement in erections and sexual function. Trazodone was well tolerated by this population, with 62% reporting no side effects.

In conclusion, despite the limitations of a nonrandomized, retrospective study, trazodone appears to benefit younger patients with erectile dysfunction with few known risk factors. A prospective, placebo-controlled trial is needed to confirm the observations of this pilot study.

A report in PubMed (Sep 2003) concluded, after looking at six trials, that Trazodone may be helpful in men with ED, possibly more so at higher doses, and in men with psychogenic ED .

Another report was published in PubMed in 2009. 20 patients (11 men & 9 women) started the trial and 15 completed it. All patients were depressed, were taking SSRIs as treatment, and were suffering from (SSRI related?) sexual dysfunction. The patients were given 50mg trazodone each day for the first week, and 100mg a day for the next three weeks. The report concluded of the subjects who completed the study: results indicated improvement in sexual function and overall clinical improvement (depression, anxiety) as well. Specific gender differences indicated improvement in erectile performance in men and lubrication in women. No correlations were noted between clinical improvement of depression or anxiety and improvement in sexual dysfunction

A 1997 trial reported that in a group of 69 patients, not selected on the basis of the etiology of the erectile dysfunction, nor selected on the duration of the complaint, the efficacy of trazodone 150 mg/d could not be shown .

A trial by Costabile and Spevak in 1999 concluded that trazodone is no more effective than placebo in improving erections and sexual function in patients with severe physiological erectile dysfunction.

Darius A. Paduch summarises this drug on the Weill Cornell Medical College s website. Trazodone is an anti-depressant with the uncommon side-effect of priapism in approximately 1/10,000-20,000 users. It has been used for the treatment of erectile dysfunction without any clear evidence that it is truly effective. Its mechanism of action in promoting erection is not well known, but it is believed that it exerts its primary effect by stimulation of the serotonin receptors in the brain. The medication has been used at the dose of 50-200 mg by mouth each night at bed time (no relationship to intercourse timing). While some studies have cited trazodone s effectiveness to be as high as 60%, the arrival of Viagra has decreased the use of this medication significantly. The side effects of trazodone include drowsiness in 31%, dry mouth in 1% and fatigue in 19%. At the Sexual Medicine Program the combination of trazodone and PDE5 inhibitors can only be used in men failing to initial therapy with maximum dose of PDE5 inhibitor

As Trazodone may be helpful for insomnia, and insomnia is another cause of poor erectile function, perhaps insomniacs for whom Viagra has ceased working might be most likely to benefit.

Dependency? One Thai website reports that trazodone is the 17th-most abused drug in the USA. As both an antidepressant and a sleeping pill, the reasons for addiction are that an individual feels they cannot live life normally without it. This dependency can result from improper use and a lack of supervision of a patient suffering from depression, anxiety or insomnia. One reason for the drug s addictive quality is that it Trazodone works rapidly, achieving full absorption within approximately an hour of ingestion. As such, it can seem to offer a quick fix to life s problems and may be viewed as an easy solution for those who are clinically depressed or suffering from severe lack of sleep.

When combined with other substance dependency, Trazodone also has the potential to heighten this abuse and cause a relapse in recovering patients. This is especially true when it comes to alcohol, as the drug has been shown to increase an alcoholic s chances of reverting back to their old ways if they are undergoing therapy. After the intake of Trazodone is ceased, an individual recovering from alcohol addiction may then fall back into misuse and dependency.

My Trial. My trazodone arrived on 23rd Sept 2013, I took 25mg that day and 50mg for the next three days, then 100mg a day, divided into two doses. After the first day I thought yes, perhaps it helps ; but over the next 48 I thought the opposite. On the fifth day I took 100mg, and noticed unusually strong npt that night. And I didn t wake up at 3am, as I usually do. And seem to have gained weight, and have generally felt sweaty . By the tenth day I again doubted any positive effect, but by the thirteenth day I was again becoming convinced of its benefit.

I ceased taking trazodone one month after starting, as ten days previously I had started taking citrulline, and I presumed that continued improvements were down to the citrulline, not the trazodone. But I now think I was wrong, the improvements reversed. So I resumed the trazodone five days later, and after a further week I felt highly encouraged, – as whilst lying in bed after waking too early induced several lasting erections by thought alone. That was this morning and yesterday. So I m impressed with trazodone. But I m still on about 3 or 4mg citrulline a day, and it s hard to be sure what effect each would have on their own.

Brain and Sleep - Peak Testosterone

Many of us look upon sleep as a huge, boring waste of time, but nothing could be further from the truth:  your sleep time is when your brain is literally rebuilding itself and is critical for memory and neurotransmitter levels.  I would argue that Sleep, Exercise and Diet: are your greatest and truest friends.

During the REM cycles of the night, the body replenishes badly needed stores of neurotransitters. Particularly important is the rebuilding of seratonin and norepinephrine, which are critical neurotransmitters used for learning and retention that are normally depleted during the day. [17] In fact, during REM sleep the cells that use seratonin and norepinephrine actually become inactive, allowing the brain to more effectively rebuild itself.  Again, one secret to brain power is quality 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 increased arteriosclerosis, inflammation and high blood pressure is bound to lead to troubles for your grey matter as I discuss in this link on Sleep and Erectile Dysfunction. In addition, scientists recently found that poor sleep also directly increases beta amyloid and the associated plaques that are so characteristic of Alzheimer’s. [27]  You don’t want plaque in your brain anymore than you want it in your arteries!

Lack of sleep also whacks testosterone and growth hormone and both of these are critical for proper male brain function and cognition.  Studies have shown that both are about linear based on the amount of sleep.  In other words, the more sleep, the more testosterone and growth hormone.  You can read more in my pages on Sleep and Testosterone and Sleep and Growth Hormone.

Many sleep experts believe ten hours of sleep is optimal.  The reason?  Well, for one thing, they have found that cultures without all the insane busyness of modern life typically sleep ten hours.  Of course, to most of us that would seem impossible.  But it still pays to know their reasoning:  studies have shown that at ten hours we run at optimum performance. In other words, if you have times in your day where you need sheer speed and responsiveness, then ten hours is what you need.  In other words, lots of sleep is required for the brain to achieve its maxium speed and responsiveness.  (CAUTION:  Too much sleep has been shown to lead to weight gain, so be careful here.)

In fact, some would argue that you are so efficient with this much sleep that it more than makes up for the loss of time while you are sleeping.  Here is a quote from Dr. Haas in his excellent book Power Sleep that perfectly describes this concept: “[Researchers] have demonstrated that alertness significantly increases when eight-hour sleepers who claim to be well rested get an additional two hours of sleep.  Energy, vigilance, and the ability to effectively process information are all enhanced, as are critical thinking skills and creativity“. [16]

If you are looking for sheer mental and physical horsepower, sleep needs to be your engine.

REFERENCES:

16) Power Sleep, Dr. James B. Mass, 2001, p. 54.

17) Power Sleep, Dr. James B. Mass, 2001, p. 41

27) 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

e/ Viagra Resistance - Peak Testosterone

Just how big of a problem is this?  Well, no large studies have been done to date, but one smaller study showed clearly this is a serious issue.  Researchers looked at men with erectile problems that had taken Viagra successfully and continued use over an extended period of time. Of these men, fully 37% had to increase their dosage by 50 mg!  In a second cohort 50% of the Viagra users discontinued due to the decreased effectiveness of the drug. [2]

CAUTION:  Do not quit any medication without consulting your doctor.  Viagra and Cialis can lower blood pressure slig

This also creates a path to dependency as well. Imagine this all-too-common scenario:  you start on Viagra or Cialis and notice some slight side effects, maybe mild ringing in the ears, visual issues or stomach upset.  You are so happy to get your erections back that you ignore any negative aspects.  However, as the months roll on, the nagging doubts increase:  “What is this ringing in my ears doing to my hearing long term?”  Or maybe the stomach upset  or headache just gets worse over time to the pont where “the cure is worse than the disease.”

What is the solution?  Again, consult with your doctor, but read my link on Eliminating Cialis and Viagra Dependency for practical suggestions to discuss with him or her.

REFERENCES:

1) Curr Vasc Pharmacol, 2006 Apr, 4(2):89-93, “The management of phosphodiesterase-5 (PDE5) inhibitor failure”

2) The Journal of Urology, Sep 2001, 166(3):927-931, “LONG-TERM EFFICACY OF SILDENAFIL AND TACHYPHYLAXIS EFFECT”

Cell Phone Dangers - Peak Testosterone

Sometime in 2012 the world will hit 4.5 billion cell phone users. That’s 4.5 billion people who take an electromagnetic device and press it almost every day against their cranium without ever thinking that it might possibly have a dangerous effect on their brain, ears, mouth and other structures in close proximity. The cell phone industry has grown so fast that issues of health and safety have never crossed anyone’s mind.

That is until recently…

In the last decade one study after another has come out showing just how toxic cell phones are to humans. Is it any wonder?  Humans are, after all, primarily a vast electrochemical neuronetwork and a phone seems almost diabolically designed to interfere with our “wiring.”

The argument from the industry is that the output from a cell phone is simply not enough to damage DNA and, therefore, cell phones must be safe. That is a debatable theory as it turns out, but, regardless, there is much, much more to us than just DNA.  Cell phones affect us in many nasty ways that have nothing directly to do with DNA damage.

Think pesticides are bad? Cell phones may be even more deadly.  Read below and I’ll give you non-DNA 15 reasons to take that silly device in your pocket and drop it into the nearest fishtank:

1.  Upregulation of Genes. An animal study showed clearly that exposure to cell phone radiation upregulated genes. [2] So, while experts wrangle over whether cell phone radiation can alter DNA, it is somewhat a moot point: cell phones can clearly affect genetic material through upregulation anyway. The cells affected were neurons by the way.

2.  Free Radical Damage and Fertility. Recent studies have shown that cell phone radiation can alter DNA throught a surprising pathway:  increasing oxidative (free radical) load within cells, a huge health danger it goes without saying. [3] We all know that antioxidants are, in general, a good thing and help protect health.  The study above showed that cell phones accelerate the opposite phenomenon and actually damage the DNA within sperm and decrease male fertility.

It does this within the mitochondria of sperm cells and this leads to a frightening question:  “Does cell phone exposure accelerate mitochondrial damage in other cells as well?”  If so, this would be downright dangerous.  Mitochondria are so important to health that there is an entire theory of aging built around these cell structures.  Anything that negatively affects them will lead to health issues.

3.  Testosterone. Strangely enough, a study showed that cell phone exposure increased testosterone. [4] Again, this may seem like a good thing, but can anything that is frying your sperm be doing your body good? It may affect testosterone positively, but what other hormones does it affect negatively?

4.  Blood Brain Barrier. A number of animal studies have documented that cell phone radiation alters the permeability of the blood brain barrier, i.e. lets more molecules in the blood stream pass into the brain. (See my link on Electrosmog for more details.)  This is incredibly dangerous as it could potentially allow toxins, including excitotoxins, to more easily cross the only line of defense that your brain has. This research shows yet another way that cell phone EMF’s can affect cell functioning and processes.  Childhood leukemia and brain cancer have been on the rise. [6] Could this be contributing?

5.  Brain Glucose Metabolism. One study looked at PET scans of the brain before and after cell phone usage.  What they found was scary indeed:  after just 50 minutes of cell phone usage, the areas of the brain around the ear had altered glucose metabolism. [7] Again, this demonstrates that cell phones change activity on the cellular level.

NOTE:  I also give coverage to the very ugly health issues of “dirty electricity” here in my link on The Dangers of Electrosmog .

6.  Brain Tissue Damage. There is some evidence that cell phones may actually damage brain tissue, indicating yet another danger associated with long term usage. [8][9]

7. Mouth Cancer (Heavy or Rural Users). Many studies have shown that cell phone usage does not significantly increase cancer risk.  However, still other studies have. One disturbing example is a study of rural users.  The reason that rural users are of particular concern is that cell phones in this situation emit more radiation to reach more distant towers.

One study found, for example, that cell phone users in these regions were much more likely to get cancer of the salivary gland. [10] One 2009 meta-analysis explained that, although cancer and cell phone usage has been studied often, there are a number of important issues with almost all of the studies and the study periods have generally not been of sufficient length to come to a definitive conclusion. [11] Cell phone usage may very well lead to brain cancer over decades, for example.

8. Bone Loss. One recent study found that cell phones – many people carry them in their pocket – lead to increased bone loss in the hip area. [12] Although the bone density loss did not come close to that of someone with osteoporosis, this is yet another example of cell phone usage affecting tissue on a cellular level.

9. Behavior Problems in Children. Cell phone usage may pose a danger to the brains of our children as well.  One study showed that it affected behavior and mood in over 13,000 kids. [13] The most significant factor was in-the-womb exposure, which has a signficant relationship to childhood emotional problems and hyperactivity.  Again, this is another sign that cell phone exposure does in fact affect structures within the brain.

10. Tinnitus. Hearing also appears to be affected according to some studies which show a relationship between cell phone use and ringing in the ears. [14] Again, it’s the tissues that are closest to the cell phone that are affected.

11. Eye Damage. One study showed that electromagnetic radiation similar to cell phones was capable of damaging the eye. [15] While some recent studies have shown no increased risk of eye cancer from cell phone usuage, this study showed that it is very possible that a “bubbling” could be initiated on the surface of the lens, which fortunately appears to be reversible.  Nevertheless, who wants to take a chance?

12.  Headache, Fatigue and Sleep. One Saudi study found an association between cell phone use and “headache, sleep disturbance, tension, fatigue and dizziness.”  The incidence of headache was particularly high.  Of course, this is just one study but inicates possibly brain function issues could be associated with cell phone usage. [16]

13.  Erectile Dysfunction. A recent study shows that those with erectile dysfunction were 2.6 times more likely to carry a cell phone in their front pocket. [17] Ouch! Again, this is scary when coupled with the bone loss study above for the same. (See #8.)

REFERENCES:

1)  https://www.cellular-news.com/story/29824.php

2) Neuroscience Letters, Jan 22 2007, 412(1):34-38, Exposure to cell phone radiation up-regulates apoptosis genes in primary cultures of neurons and astrocytes”

3) PLOS, 2009, “Mobile Phone Radiation Induces Reactive Oxygen Species Production and DNA Damage in Human Spermatozoa In Vitro”

4)  https://www.sciencedaily.com/releases/2011/05/110519113022.htm

5) https://www.medicinenet.com/script/main/art.asp?articlekey=125152

6) https://www.kurzweilai.net/cell-phone-use-affects-brain-glucose-metabolism

7) https://www.kurzweilai.net/cell-phone-use-affects-brain-glucose-metabolism

8) Electromagn Biol Med, 2008, 27(2):103-26, “Radiofrequency and extremely low-frequency electromagnetic field effects on the blood-brain barrier”

9) https://www.huffingtonpost.com/scott-mendelson-md/your-cell-phone-will-not_b_416588.html

10) https://www.telegraph.co.uk/news/uknews/1579028/ Heavy-mobile-phone-use-a-cancer-risk.html

11) Environ Health Perspect. 2009 March; 117(3): 316 324, “The Controversy about a Possible Relationship between Mobile Phone Use and Cancer”

12) https://www.webmd.com/osteoporosis/news/20091027/cell-phone-on-hip-may-weaken-bone

13) Epidemiology, Jul 2008, 19(4):523-529, “Prenatal and Postnatal Exposure to Cell Phone Use and Behavioral Problems in Children”

14) PLOS ONE, Received: November 23, 2008; Accepted: March 4, 2009; Published: March 27, 2009, 4(3): e5026, “Association of Tinnitus and Electromagnetic Hypersensitivity: Hints for a Shared Pathophysiology”

15) The Open Ophthalmology Journal, 2008, 2:102-106, “Non-Thermal Electromagnetic Radiation Damage to Lens Epithelium”

16) Saudi Med J, 2004 Jun, 25(6):732-6, “Association of mobile phone radiation with fatigue, headache, dizziness, tension and sleep disturbance in Saudi population”

17) https://www.healthcentral.com/erectile-dysfunction/c/215658/158881/dy/

Broccoli - Peak Testosterone

REFERENCES:

1) JAMA, 1999, 282:1233-1239

2) J. Nutr, 2002, 132:307-309

3) Carcinogenesis, May 2003, 24(5):891-897

4) Cancer Res, 1994, 54:1976s-1981s; J Nutr, 2001, 131(suppl):3027s-3033s;

5) Cancer Res, 1998, 58:4102-4106

6) “Broccoli: A Unique Vegetable That Protects Mammalian Hearts through the Redox Cycling of the Thioredoxin Superfamily”, Jan. 23 2008 issue of ACS’ Journal of Agricultural and Food Chemistry.

7) J Natl Canc Inst, 2000, 92:61-68; Cancer Epidem Biomarkers Prev, 2000, 9:795-804

8) Cancer Res, 2005 Sep 15, 65(18):8548-8557

9)  Cancer Prev Res, April 1 2009

11) Brit J of Cancer, 2006, 94:407 426, Published online 24 January 2006, “BRCA1 and BRCA2 as molecular targets for phytochemicals indole-3-carbinol and genistein in breast and prostate cancer cells”

12) Cancer Prevention Research, Apr 1 2009, “Dietary Sulforaphane-Rich Broccoli Sprouts Reduce Colonization and Attenuate Gastritis in Helicobacter pylori Infected Mice and Humans”

13) https://www.naturalnews.com/027876_broccoli_arteries.html

Vitamin D and Magnesium are impressive supplements.  They both combat a wide array of diseases and conditions that plague modern societies.  But I would have to say broccoli, especially in the anti-cancer arena, is king.  In fact, as you study the research on this vegetable, it is almost mystifying that one vegetable could do so well against so many conditions.  It is, simply put, Mother Nature’s Special Forces to try to protect you from the enemy.

I should mention that any cruciferous vegetable has the same superpowers.  Therefore, consider cauliflower and cabbage your special friends as well.  And don’t forget to tell the Little Woman that broccoli will 1) lower her levels of the “bad estrogen” and 2) offer substantail protection against breast cancer.  (Among other things, it causes breast cancer cells to self-destruct.)  You might save her life and score a few points while you’re at it.  And, if you’re like most of us, you really need to score a few points!

NOTE: Broccoli is easy to cook.  Simply grab a coffee cup/mug and put a third or half of an inch of water in the bottom.  Then pull out some fresh broccoli and pull off enough florets to fill up the cup.  Put it in the microwave for about 2.5 minutes and the steam will cook the broccoli nice and soft.  Add a little salt and you are good to go.  And if you’re one of those people who just can’t stand the smell or taste of broccoli, then you’ve still got no excuse:  just eat cauliflower and cabbage instead.  All of these are in the cruciferous vegetable category and share similar properties.

The bottom line, though, is that one way or another you need to be cooking and eating this at least four days a week.  Here’s just a few reasons why:

1.  Stroke.  Broccoli, in a Journal of the American Medical Association issue, lessened the risk of stroke more than any other vegetable or fruit studied! [1].

2. Cataracts.  Broccoli decreases your risk for cataracts.

3. Herpes and Shingles.  We have already covered that broccoli’s Indole-3-Carbinol (I3C) protects against herpes and shingles viruses.

4.  Colorectal Cancer.  Animal studies have shown broccoli to be protective against colon cancer. [2]

5.  Prostate Cancer. Broccoli’s allyl isothiocyanate causes prostate cancer cells to self-destruct. [3]

6. Anti-carcinogens. These same isothiocyanates (ITCs) are recognized in multiple studies as powerful anti-carcinogens. [4]

7. Another isothiocyanate (ITAC) called phenethyl isothiocyanate (PEITC) blocked tumor promoters. [5]

8) Apoptosis. Many studies show IECs induce apoptosis, i.e. cause cancer cells to self-destruct.

9) Cardiovascular Protection. Broccoli has several studies showing that it is heart protective as well. [6]  Scientists recently discovered that this may be because sulfuraphane increases the activity of a protein called NRf2 that is known to be inactive at sites of arterial plaque buildup. [13]

10) Prostate Cancer.  Broccoli has long been known as protecting the prostate from cancer. [7]

11) Lung Cancer.  Broccoli slows the progression of lung cancer [8] and improves COPD.

12) H. Pylori and Stomach Cancer.  One kind of ITC in broccoli has been found to be extremely damaging to H. Pylori, the bacteria that often causes ulcers and stomach cancer. [9]  One 2009 study verifies this and found that those who ate broccoli sprouts had significantly reduced levels of H. Pylori and this will undoubtedly greatly reduce one’s risk of stomach cancer. [12]

13) Tongue (and Prostate) Cancer.  Sulfurophane has been found in the laboratory to fight metastic tongue and prostate cancer cells. [10]0]

14) Bladder Cancer.  You got the idea by now:  broccoli protects from bladder cancer as well.

And, trust me, this is just scratching the surface of broccoli’s power! Broccoli (and other cruciferous vegetables) have also been found to aid in DNA repair.  In other words, even if your DNA does get damaged the I3C in broccoli has been found to activate proteins that repair DNA. [11] So broccoli isn’t just about defense – it’s about offense as well.

So whether you love the taste of broccoli or hate it, figure out some way to consume it – it will very likely save your life someday.

10) Intl J of Cancer, 2008, 123(6):1255-1261

Low Carb High Fat Diets and Why They Are So Risky - Peak Testosterone

Right now high fat diets are very popular, and, unfortunately, if you implement them wrong, you can get yourself into trouble, potentially affecting testosterone and/or erections as I will explain below.  But, first of all, how do I definite high fat?  A high fat diet is one that gets about 40+% and above of total calories from fat.

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.

Most meat sold in the supermarkets here in the U.S. is between 30-50% fat.  These are incredibly high fat levels, due to modern livestock methods, with few equivalents in nature.  Yes, some fish are an exception, but then they are loaded with omega-3’s.  Can this possibly be good for a man, especially in the bedroom? I would argue that it is rarely going to help him and I explain why below based on what I am seeing in the research:

1.  Too High in Total Fat. One common middle-aged nightmare is insulin resistance.  Insulin resistance allows glucose levels to rise, leading to damaged tissues throughout the body and accelerated aging.  It also results in a number of metabolic changes that often lead to sexual dysfunction and put a man at risk for many medical conditions such as heart disease, dementia, high blood pressure and diabetes.  Another name for insulin resistance is “prediabetes”, which I cover here in my link on Metabolic Syndrome and Erectile Dysfunction.

Now what many men do not realize is that a High Fat Diet is so reliable at bringing about insulin resistance that researchers use it in lab animals all the time.  In the above link, I document some studies where research have found just how high fat diets do this and it includes alterations to the mitochondria, the powerhouses of your cell which are linked to aging and oxidative damage.

Now will a High Fat Diet always induce insulin resistance in all men?  Of course, I cannot say that.  But the bottom line is that one is clearly living on the “razor’s edge” and should carefully monitor his blood sugar parameters in my opinion.

2.  Too High in Saturated Fat. This is something that I cover in great detail elsewhere on the site, such as in my link on The Problems with Saturated Fat.  What you should know is that saturated fat slows down blood flow. Saturated fat literally stuns arteries and sludges the cells in the blood disrupting blood flow.  This is why young men can usually eat a lot of saturated fat with minimal impact on their sex life, simply because they still have ample nitric oxide to compensate for the negative effects of saturated fat.  This is NOT true for many 40+ men, however, and is something to really watch out for.  Decreased blood flow negatively impacts many tissues especially, of course, those in the penis and, according to some research, those in the brain.

I find on The Peak Testosterone Forum that few men over abou 45 will argue with me about saturated fat. It’s always the young guys pushing the higher fat meals.

3.  Too Low in Carbs. A big percentage of men on higher fat diets are actually Low Carb or Ketogenic.  There are different variabtions of these diets, but men will consume less than about 50 or  60 grams of carbs per day.  These diets have really struggled in the research lately and researchers have found that they signficiantly increase the risk for a) arrhythmias, b) heart damage, c) high LDL-P, d) decreased mood and on and on.  You can read about these in my page on The Potential Dangers of a Low Carb Diet for more information.  The also greatly limit your abilitity to do higher intensity exercise, something I hope all Peak Testosterone readers are doing.

  What is even more stunning is that a Low Carb Diet caused inflammation while losing weight!  This goes against the conventional wisdom that any diet will improve health markers as long as you are experiencing weight loss.  It takes a nasty diet indeed to increase inflammation under these circumstances.  And that is exactly what a Low Fat Diet did in the above study:  while CRP was actually lowered by 43% in the high carb, CRP in the Low Carb group increased by 25% even though the Low Carb participants lost more weight. [2] Ouch!

And here is a fact in a study that should catch every man’s eye:  endothelial vasoreactivity was reduced by the Low Carb Diet. [3] This means that the lining of the arteries were not as responsive to stimuli to relax and open and increase blood flow.  That could easily translate to worsened erections.  Again, high fat diets, from what I have seen on the Peak Testosterone Forum are almost always enjoyed only by the younger guys.

4. Too High in Carnitine? At least here in the U.S., most men consuming a lot of fat in their diet will also be consuming a lot of beef and pork.  Sure, it’s possible they could be slurping down coconut oil and/or fatty fish but this is unlikely from what I have seen.  (Doing the latter could lead to low grade mercury poisoning as I discuss in my link on The Safety of Fish Consumption.) Most men are going to consume meat and, at least here in the U.S, two of the most affordable and well-liked options are beef and pork.

However, in 2013 researchers found beef and pork and unique in that they contain MUCH more carnitine than is found in any other dietary source.  Furthermore, the carnitine uniquely fires up your gut bacteria which releases a chemical called TMAO that the researchers argued likely acclerates arteriosclerosis.  For more information, see #3 in my list of The Risks of Meat Consumption for more information.

REBUTTAL: This is a controversial result and there are studies that show that various forms are carnitine are of cardiovascular benefit, so some experts are skeptical that it is actually the carnitine that is the underlying issue.  More on that below.

5. Too High in Added Antibiotics, Hormones, . When the study in #5 came out showing that carnitine can cause arterial issues, the Paleo Diet gurus quickly rallied against it and attempted to counter the conclusions. And a good debate is always healthy of course. One of the Paleo objections was that modern livestock here in the U.S. are injected rather heavily with antibiotics and some of the antibiotics end up in the meat and can alter gut flora. In other words, the argument is simply that it’s not the carnitine changing the gut but rather the antibiotics that is causing the problems. [4]  However, this highlights a huge problem in my opinion with most men consuming Paleo and Low Carb Diets here in the U.S.:  few men can afford to pay for range fed meats and end up eating factory farm livestock.  These animals are corn fed. hormone and antibiotic injected, GMO BT toxins and arsenic (eggs and fowl).  How is this going to be good for long term health.

REFERENCES:

1)   https://well.blogs.nytimes.com/2012/11/07/can-exercise-protect-the-brain-from-fatty-foods, “Can Exercise Protect the Brain From Fatty Foods?”

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

3) 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”

4) https://www.bulletproofexec.com/the-red-meat-scapegoat-the-new-york-times-carnitine-heart-disease-and-science/

Measure Your Nitric Oxide Levels from High Nitrate Foods

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.

REFERENCES:

Please check Scientific Articles at Berkeley Test.

Progressive Muscle Relaxation: Relax Your Way to Solid Erections

The Benefits of Progressive Muscle RelaxationWhat’s a little neuroses among friends? Not much nowadays. Mental disorders are shockingly common in modern, industrialized societies. There are many reasons for this, including poor diet, chronic stress, lack of social support, lack of sleep and so on. Low testosterone can also increase anxiety, mood disorders and depression. Regardless of the reason, men are struggling with maintaining mental health and very often turning to pharmaceuticals for help.

This is problematic for many reasons including the many side effects of the typical drugs in this class.  And long term safetly is simply not known either.  Even worse, these medications often punch below the belt and lead to erectile dysfunction, orgasmic dysfunction or loss of libido.  (See this link on Erectile Dysfunction Drugs for some information.)

Sadly, many men turn to a pharmaceutical answer simply because it’s easy and seems legitimized by the fact a physician recommended it without even thinking there might be a more natural alternative.  Here is where Progressive Muscle Relaxation (PMR) can step into help and provide huge benefits.  Progressive Muscle Relaxation is a very simple technique that can be done by anyone in a relatively short amount of time.

And it has huge benefits.  Most of these benefits are in the psychological realm, because PMR is a proven cortisol reducer.  However, Progressive Muscle Relaxation also has the huge benefit of optimizing testosterone and erection through this same cortisol-lowering mechanism. Remember: anytime you lower cortisol, you are likely going to support and even improve testosterone (and muscle gains).  (NOTE: Elevated cortisol can even destroy neurons!  In fact, I have a number of (I hope) informative articles on How Cortisol Affects Men.

1) Holist Nurs Pract., 2003 Jan-Feb, 17(1):41-7. “Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan”

2) 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”

3) 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”

4) APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK, 1976, 1(3):253-271, “Biofeedback and progressive relaxation treatment of sleep-onset insomnia: A controlled, all-night investigation”

5) Journal of Behavior Therapy and Experimental Psychiatry, Sep 1983, 14(3):251-256, “Treatment of insomnia in cancer patients using muscle relaxation training”

6) Journal of Abnormal Psychology, Jun 1974, 83(3):253-260, “A comparison of progressive relaxation and autogenic training as treatments for insomnia”

7) Journal of Consulting and Clinical Psychology, Jun 1978, 46(3):389-404, “Psychophysiological effects of progressive relaxation in anxiety neurotic patients and of progressive relaxation and alpha feedback in nonpatients”

8) SUPPORTIVE CARE IN CANCER, (2005), 13(10):826-833, “Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life”

9) Behavior Therapy, Spring 1989, 20(2):261 282, “Behavioral treatment of panic disorder”

10) Behaviour Research and Therapy, 2988, 26(1):13-22, “Applied relaxation vs progressive relaxation in the treatment of panic disorder”

11) Journal of Behavior Therapy and Experimental Psychiatry, Dec 1994, 25(4):283 291, “A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder”

12) Journal of Substance Abuse Treatment, Aug 1992, 9(4):365 370, “The treatment of substance abusers diagnosed with obsessive-compulsive disorder: An outcome study”

13) APPLIED PSYCHOPHYSIOLOGY AND BIOFEEDBACK, 2005, 30(4):375-387, “The Impact of Abbreviated Progressive Muscle Relaxation on Salivary Cortisol and Salivary Immunoglobulin A (sIgA)”

14) Biological Psychology, July 2002, 60(1):1-16, “The impact of abbreviated progressivemuscle relaxation on salivary cortisol”

15) International Journal of Stress Management, Aug 2006, 13(3):273-290, “Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery”

16) Journal of Bodywork and Movement Therapies, Jul 2002, 6(3):177-182, “Parkinson’s disease symptoms are differentially affected by massage therapy vs. progressivemusclerelaxation: a pilot study”

19) 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”

20) Brain, Behavior and Immunity, Accepted Jun 27 2008, “Counter-stress effects of relaxation on proinflammatory and anti-inflammatory cytokines”

21) Exp Aging Res, 1984 Winter;10(4):211-4, “Effects of relaxation and mnemonics on memory, attention and anxiety in the elderly”

22) Neuropsychological Rehabilitation, 1999, 9(1):31-34, “Progressive Muscle Relaxation in the Management of Behavioural Disturbance in Alzheimer’s Disease”

23) Journal of Nervous & Mental Disease, Mar 1993, 181(3), “A Comparison of Behavioral Group Therapy and Individual Behavior Therapy in Treating Obsessive-Compulsive Disorder”

Remember that one of our biggest enemies is cortisol.  In fact, I have a number of (I hope) informative articles on How Cortisol Affects Men. And PMR is a specialist when it comes to cortisol control.  Again, although, no studies echo this, anything that effective manages cortisol, stress and poor mental states is going to improve erection-related issues (and relationships in general).

What about meditation instead?  Meditation is great but 1) generally requires a greater time commitment and 2) often comes with spiritual overtones which makes many men uncomfortable.  Progressive Muscle Relaxation is a straightforward,. secular technique widely used in the psychological community that was designed by a physician and psychotherapist, i.e. no gurus need be involved.  (There are several good books and many web articles on secular meditation as well for those interested.)

So consider these 15 Great Benefits of Progressive Muscle Relaxation and get started asap:

1.  Blood Pressure. One study out of Taiwan on men with hypertension (high blood pressure) showed that PMR had an immediate effect on both systolic and diastolic blood pressure, lowering them by an average of 5.44 and 3.48 mm, respectively. [1] And four weeks later, the participants had any additonal decreases in blood pressure of  5.1 and 3.1 mm, respectively.

These are very respectable improvements, but one study showed even more amazing gains.  For even more – more than 30 actually – ways to lower blood pressure, see the this link on Erectile Dysfunction and Hypertension.

2.  Pulse. The first study above showed a powerful ability to lower pulse rate, lowering it by 2.35 beats/min initially and 2.9 beat/min additionally (after four weeks). [1] For more information on the important of your heart rate, see the this link on Pulse and Cardiovascular Health.

3. Cortisol. Progressive Muscle Relaxation has been shown in several studies to decrease cortisol levels. Furthermore, it works very well even when the abbreviated form of PMR is used. [13][14]

4. Dopamine. PMR, at least, was found in Parkinson’s patients to increase dopamine levels. [16] Many of us, undoubtedly, have lost some of our ability to make dopamine as we age and thus it seems likely that PMR can raise dopamine somewhat even in non-Parkinson’s men.

5.  Anxiety. A number of studies have shown in a variety of populations that Progressive Muscle Relaxation can help relieve the actual symptoms of stress as well. For example, one study of victims with cancer showed that PMR was as very close to being as effective as a medication cocktail. [2] PMR did the same thing with patients who were suffering from chronic breathing difficulties. [3]

6.  Depression.  Both of the above studies showed patients significantly improving their depression. [2][3] Again, these studies and a few other like them show that this simple relaxation technique helps the men that need it most.  The higher your stress, the more likely Progressive Muscle Relaxation is to make a big difference. For additional information, see this link on Research-Backed Depression Cures.

7. Insomnia. Many studies have shown that Progressive Muscle Relaxation help with many kinds of insomnia.[4][5][6] I know that I have received significant positive feedback after giving this to many men to help with falling asleep. For other research-backed methods, see this link on Practical Sleep Aids.

8. Neurotic Persons. Are you a high stress person? One study showed that PMR helped lower the stress response in neurotic individuals. [7] It will likely help almost anyone under chronic stress and acting a little “eccentric” as well.  (See #6.)

9) Unusually Stressful Situations.  Several studies show that muscle relaxation can help with stressful situations, one of the most severe being a study on chemo patients. [8] It also decreased the nausea and vomiting associated before and after the therapy.

10. Panic Disorder. A couple of studies show that PMR can help reduce symptoms of panic disorder. [9] However, it doesn’t seem to work in all patients in this area, but is certainly worth a try.  It may best be used incombination with other therapies. One study found that it improved signficantly 38% of patients though, even when used by itself. [10]

11. Post Traumatic Stress Disorder (PTSD). Returning war veterans and many other men who have suffered a traumatic past can suffer from this debilitating condition that is very hard on heart and brain health.  Progressive Muscle Relaxation has done well in a couple of studies with PTSD, both solo and in conjunction with other therapies. [11]

12. Obsessive Compulsive Disorder (OCD). One study showed good results and the authors wrote that “Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed..” [23]

13. Handling Stress. Many studies have shown that practitioners manage stress more effectively than controls. [15] PMR affects the stress hormone – see #3 – as well as perceived stress and stress reactions as well.

14. Inflammation (TNF Alpha and IL-6). A number of studies have shown that many men can lower their TNF alpha and IL-6 through PMR. The two cytokines play a valuable role in the body but also trigger the nasty inflammatory cascades that cause so many problems and lead to hardening of the arteries, diabetes and many autoimmune disease and cancers. One study took second year med students – a pretty stressed out crowd if there ever was one – and put them under stress. It was found that those who practice Progressive Muscle Relaxation twice per day (for 15 minutes using an Abbreviated form that concentrated on the upper extremities) had greatly reduced TNF alpha levels (and IL-6). [20] If your stress levels are low, the benefit will undoubtedly be less, but how many reading this are not under a nearly constant assault of various stressors that are part of modern life?

15. Memory. It is no secret that cortisol is hard on neurons and the brain in general. Stress can literally unwire your neurons and one of the most vulnerable locations is the hippocampus, which has been shown to actually shrink under a variety of stressful conditions. This is why several studies have found that PMR can increase memory in several subpopulations, such as seniors and those with mild to medium dementia. [21][22] If you are middle-aged or beyond, you will very likely experience a memory boost from regular practice.

As you can see, Progressive Muscle Relaxation helps with almost every major psychological issue.  Few doubt that it will not help with the everyday stressors of life and offer cognitive and psychological protection and maintenance at the same time.ors of life and offer cognitive and psychological protection and maintenance at the same time.

HOW DO YOU DO PROGRESSIVE MUSCLE RELAXATION? One of the nice things about Progressive Muscle Relaxation is that it is very easy to do. Medititation can take significantly more discipline and experience – it’s well worth it of course! – but with PMR you can get started almost instantly. Basically, you just tense and release all the muscle groups one by one. I have always started at my feet and worked my way up to the face. However, you can start north and head south as well. I tense for about 10 seconds and then release for 20 seconds and do this most nights before sleep, because it is so helpful in getting me to instantly fall asleep. Here is an article that describes more detail as to how to do it but recommends 5 seconds of tension and 10 of release: PMR Protocol (Australian Government Site). The key thing is that you should feel VERY relaxed after doing this, and, of course, you don’t want to overtense any injured areas.

WEIGHT LIFTERS:  Notice that PMR will likely help protect your hard-earned muscle by limiting cortisol levels.

REFERENCES:

Doctor-Assisted Ways to Raise Testosterone - 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:

2. Clomid.  Clomid is a pill given to both men and women for fertility reasons.  In men, Clomid can improve fertility and raise testosterone, although not for all guys.  It does, however, often have side effects and more often than not does nothing for libido or even lowers it.  It is incredibly convenient of course.  For more information, read my page on Clomid and Testosterone.

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:  HRT Information and Deliver Systems.

Permanent and Irreversible Aromatase Inhibitors - Peak Testosterone

Many men know what an aromatase inhibitor is since Arimidex (anastrazole) is now used in so many HRT and fertility clinics. Or, if you’ve been around athletes or bodybuilders, the subject has very likely come up at one time or another. What most men don’t know is that there is a whole new class of aromatase inhibitors called “suicide inhibitors”, “permanent aromatase inhibitors” or “irreversible aromatase inhibitors”. One of the most famous of these is an FDA-banned compound called 6-OXO that took the bodybuilding world by storm about ten years ago and was subsequently banned in May of 2009.

The FDA’s Warning Letter sounded particularly ominous and stated that “the condemned Formadrol Extreme XL contained ATD and 3,6,17-androstenetrione (also known as “6-OXO”). Both of these substances are steroids that inhibit the activity of the enzyme aromatase and may be found in dietary supplements promoted to boost testosterone levels..” [1] Earlier in the letter it stated the FDA’s reasoning which was that “based on laboratory tests, the FDA determined that the products contain one or more unapproved food additives and/or new dietary ingredients for which there is inadequate information to assure that the ingredients do not present a significant or unreasonable risk of illness or injury.”

6-OXO is a very powerful suicide inhibitor and the FDA had a point:  why did the manufacturer not have to prove safety like other AI’s that have gone through clinical trials?  In fact, there is an actual suicide inhibitor that has received FDA approval for the treatment of breast cancer called Aromasin or Exemestane. (Aromasin is already significantly used in the steroid community even though it is relatively new.)

So what are the properties of these new AIs?  Are they really permanent and irreversible?

Here are a few facts about them:

So how dangerous are these drugs? Well, keep one thing in mind: they are fairly extensively used by the steroid community as I mentioned and have been used by women, of course, for breast cancer treatment.   So, generally speaking, they should be safe for short term use.  However, there are a few important things to keep in mind in my opinion:

1.  Permanent Means Permanent? We had one board member who seemed to have had permanent damage from taking a product with suicide inhibitors.  His symptoms of low testosterone starte appearing after he took a testosterone supplement called Arime Stage 5 PCT.  This appears to have several suicide inhibitors.  One them was Androst 5 and, based on the ingredient label naming, there were a couple more in their as well. [5] Almost 3 months later, this 22-year-old still had estradiol of 6 pg/ml!  This is a very low and dangerous level of estradiol and can lead to many issues including bone loss, as I document in my link Do Men Need Estrogen?

Now this may be a bad lab read.  This man have had some other medical issue that was pushing down his estradiol.  But it is very coincidental that immediately after he took this supplement he felt terrible and then his estradiol was in the basement.

2.  Permanent Means Semi-Permanent?. There have been reports of people experiencing multi-month side effects.  For example, check out this study of one woman’s case of hypothyroidism that may have been induced by Aromasin (Exemestane):  “We believe that the increasing fatigue and weakness in our patient might have been associated either with subclinical hypothyroidism or with administration of exemestane (a known adverse effect of the drug) or both. Further studies are required to investigate how exemestane influences thyroid function.” [7]

3. Untested Supplements. Labs are pumping out these AI’s and they are showing up in testosterone and AI-esque supplements.  I mentioned a couple above and Arimistane and 6 Bromo are also quie well known.  There are a dozen smaller permanent AIs as well.

Th problem with all of them is that of the users of these are young bodybuilders and athletes who often do not understand what they taking.  And the supplement in this case is certainly not going to say, “This is an irreversible suicide inhibitor that is untested and experimental”.

In fact, here is what one of the ads reads: “ArimePCT Stage 5 by EPG was created to suppress estrogen levels while you increase testosterone levels. ArimePCT Stage 5 helps restore your hormonal balance and prevent muscle loss after any testosterone boosting anabolic cycle.” This is just too muich temptation for some guys to resist.

So what’s the harm?  Think how powerul these drugs are.  They can deactivate one of the most important enzymes in your body.  Do they afffect other enzymes?  Well, no one knows, because there has been no testing done.  For example, Canadian authories reported that one popular supplement containing 6-OXO and a steroid named 1-AT likely caused seizures and clotting in one man. [7] This could be a life-changing event for someone needless to say.  Again, these are very synthetic and unnatural compounds and, based on virtually every other pharmaceutical that we know of, they will have some kind of negative impact on health. So, as always, I cannot think of any good reason to try an untested supplement.

In addition, some men will use one of these supplement inhibitors and push their estradiol too low.  This can cause many side effects from loss of libido to erectile dysfunction and so on.

NOTE:  There is another suicide inhibitor out there that is a legitimate pharmaceutical called Teslac (Testolactone). It is a different animal and is actually structurally similar to progesterone rather androstenedion. Nevertheless, it appears to be an irreversible and permanent aromatase inhibitor and I see steroid men discussing it from time to time, because its estrogen lowering effects are quite powerful. [4]

REFERENCES:

1)   https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm152358.htm

2) J Clin Endocrinol Metab, 2003 Dec, 88(12):5951-6, “Pharmacokinetics and dose finding of a potent aromatase inhibitor, aromasin (exemestane), in young males”

3) J Clin Pharmacol, 2005 March; 59(3): 355 364, “A predictive model for exemestane pharmacokinetics/pharmacodynamics incorporating the effect of food and formulation”

4) https://peaktestosterone.com/forum/index.php?topic=1636.0

5) Biol Pharm Bull, 1997 May ,20(5):490-5, “Aromatase inactivation by a suicide substrate, androst-5-ene-4,7,17-trione: the 5beta,6beta-epoxy-19-oxo derivative, as a possible reactive electrophile irreversibly binding to the active site”

6) https://www.cumberlandnewsnow.com/Living/2008-06-19/article-390626/ Health-Canada-warns-diet-supplement-can-lead-to-seizures,-blood-clots/1

7) Clin Drug Investig. 2008;28(10):669-71, “Exemestane-induced subclinical hypothyroidism : a case report”

1. They do indeed permanently and irreversibly bind to the aromatase enzyme.  However, don’t panic if you’ve taken one of these – I’ll explain more below.

2.  This permanent binding can cause a very significant decrease in the estrogens.  According to one study in young males, Aromasin decreased estradiol by about a third. [2]  6-OXO was shown to significantly increase testosterone as I discuss in my link on How to Increase Your Testosterone Naturally. (See no. 6.)

3. There are actually two types of aromatase inhbitors. Type I is the irreversible kind, such as Aromasin and 6-OXO, and type II are the classic AI’s such as Arimidex and letrozole.

4.  Aromasin and 6-OXO are both structurally similar to androstenedione and, therefore, are considered steroids. [3] (You may recall that andro was used by slugger Mark McGwire in the 90’s.)  The reason for their classification as a steroid is subtle.  If you’ll recall androstenedione is intermediate in the pathway from pregenenolone to testosterone/estradiol.  In fact, it can directly convery to estradiol by acquiring and permanetly binding to the aromatase enzyme. Basically, Aromasin and 6-OXO are slighly modified copies.

5.  Although many of your enzymes are permanently inactivated through a suicide inhibitor, it should not mean that your estradiol is permently lowered.  The reason is that your body will begin to manufacture new aromatase enzymes after a few weeks.  I have read, in non-authority sites,  that it generally takes between one to three weeks to recover.

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

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…

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

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”

How Long Before Testosterone Therapy Starts Working ?

In reality, that is simply not usually the case.  In fact, I am in the minority in the sense that I quite literally felt different on the first night that I had cypionate.  I was low testosterone for lliterally decades and so, when my T levels probably doubled or tripled, I felt like fireworks were going off between my ears.  I remember telling my wife, “This is a really weird feeling.  I can actually feel this in my brain.”  And cypionate had powerful positive effects for me that have only increased over the months and years.  (Not every one is so fortunate however.)

Most men, though, follow a very different trajectory and see some relief after a few weeks and then continued symptom reduction over the next 2-3 months.  Before we show some research that shows just how long testosterone therapy typically takes to work, let’s cover the classic low testosterone symptoms.  These will look familiar to many of you:

Of course, there are many more, but these are the ones that usually drive men to see out diagnosis and treatment. If no changes occur in these, then most men will be very disappointed to say the least.  So let’s look at what a meta-analysis of sorts actually said about all of this. First of all, this 2011 study performed the Herculean task of going through every relevant HRT study on men in the last 35 years and painstakingly estimated, when possible of course, the time until symptom relief occurred. [1] If you’ve read through many of these studies, you’ll appreciate just how daunting of a task this must have been.

Fortunately for us, they perservered and came to the following conclusions:

Now there is much, much more and I urge you to read this study when you get a chance, but I pulled out the above commentary, because these are the “red flag” symptoms than men are most concerned about and that are the most incapacitating usually.  Notice the pattern here, and I have seen this many times on Peak Testosterone Forum:

NOTE: Venous leakage is a condition that causes a loss of erectile strength and time-to-erection when blood escapes too easily from the penis, not unlike a leaky boat.  For more information, see my page on The Basics of Venous Leakage.

Important Conclusions for Men on HRT (TRT)

Men that have just put on testosterone therapy often feel that the rug has been pulled out from under their life.  Frequently marriages, relationships and careers are in jeopardy.  So, on top of feeling terrible, they feel that they have a lot riding on their treatment.  Here are some things for such men to keep in mind:

a) Patience Is a Virtue For a Reason. The study above noted that the earliest one usually experiences any signifiicant change whatsoever is at about 3 weeks and many issues take much longer. So the solid majority of men must be patient.  Yes, this is tough when you have erectile dysfunction and your dopamine is lows.  But there simply is no other choice in most cases.

b) Stairs Not an Elevator. If HRT works for you – and in my opinion well done HRT on men with truly low testosterone is generally successful – then improvements in various sympoms occur one at a time instead of all at once.  Your libido might improve after a few weeks.  Then a couple of weeks later you’ll notice that you’ve lost some of the stomach fat that has been plaquing you.  And then a few weeks after that, you’ll notice that morning erections have finally returned.  Again, it is not usually going to happen all at once.

c) Hurry Up and Wait for Your Erectile Strength. Of course, priority number one for most guys with erectile dysfunction is to get their hardness factor and morning erections back.  This study shows that this can often be one of the slowest things to repair.  Again, venous leakage repair often requires that the inside of the penis be rebuilt and that is just going to take time.  A good analogy is that you are watering a garden that must re-grow and come back to life.  Unfortunately, it is not usually just a tree transplant that is done in an afternoon.

d) HRT Failure.  The above study did not really address the issue that sometimes a man waits and waits for HRT to fix his issues and it simply never happens.  This is not necessarily a disaster, because it often a) means that one has other more critical underlying issues such as hypothyroidism, or b) that the protocol needs tuning.  In the case of the latter, high estradiol is a common culprit, since it essentially negates the beneifts of the increased testosterone levels.  In both of these cases, it pays to have a knowledgeable and experienced physician overseeing your therapy.

By the way, sometimes men are given downright horrible protocols and this completely sabotages all reasonable results.  For example, look at what this poor man wrote on the forum:

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

“I am 35 years old. I just started trt. My test levels 280 ng/dl. Immediately doc put me on 2cc of 400mg of test cyp once a month. I dont have blood results. I just know that I really start feeling terrible after about 2 and a half weeks. I know this is vague info. But does this sound normal? Feel so down and out. Any help or opinions will be greatly appreciated.” [3]

Cypionate has a half-life of around 5-8 for the great majority of guys, so this poor guy had little testosterone in his system after about 10 days.  Furthermore, he was given a massive dose – 100 mg is normal – so this would have sent his testosterone and estradiol through the roof!  In fact, you can argue that it is dangerous, since that massive estradiol spike could possibly cause clotting issues.

e) Testosterone Undecanoate Can Take Longer. What I have heard is that testosterone undecanoate, which is an ester with a much longer half-life than either cypionate or enanthate, can stretch out the time-to-heal factor.  This includes brands such as Reandron, Nebido and Aveed.

This seems to be vefifeid by one man who wrote:

“–1st shot – brutal come down from the patches. Felt like garbage. DIDNT get a booster at 6 weeks.

–2nd shot after 12 weeks – started to feel better. probably on par with before i started patches (i guess the patches shut down the little production i had and the needle didnt pick it up much).

–3rd shot – only 8 weeks later. I’m about 3 weeks in and I feel amazing – the same euphoric feeling I had on patches. I feel like I want to go for a run and then maybe bench press a car 🙂 From now on I will have a shot every 8-9 weeks.

–Apparently it takes 5 shots to really get levels up. So, we have gone from a “reandron failure” subject line to – Reandron rocks!!!” [2]

If you add up all the weeks and months, you’ll see it took him about six months to feel good.  Again, patience can be a virtue.

REFERENCES:

1) Eur J Endocrinol, 2011 Nov, 165(5):675 685, “Onset of effects of testosterone treatment and time span until maximum effects are achieved”

2) https://www.peaktestosterone.com/forum/index.php?topic=2432.0

3) https://www.peaktestosterone.com/forum/index.php?topic=121.0

Weight Loss and Sleep - Peaktestosterone

Need to change that spare tire around your middle?  Well, lack of sleep will sabotage your best efforts in a dozen different ways. Or maybe you are someone who feels like you have suddenly packed on some extra pounds inexplicably.  One of the first places to look is the quality and quantity of time on your pillow.

One of the primary reasons has to do with appetite.  Everyone knows how they get “the munchies” much more frequently when they are tired and there’s a reason for that:  your body dramatically alters your hormones to compensate.  For example, one study looked at participants with ample sleep and then after four hours of sleep.  It was no surprise that they  “found that sleep restriction was associated with an 18% decrease in leptin, a 28% increase in ghrelin, a 24% increase in hunger, and a 23% increase in appetite”. [1] Leptin and gherlin are two of your primary hunger hormones and sleep shifts both of them in the wrong direction.

This means your appetite and hunger skyrocket correspondingly and, unless you are iron-willed, you will end up eating more on little sleep. One 2009 study showed that those with 5.5 hours sleep ate 22% more in snacks compared with when they had 8.5 hours of sleep. [2] That’s a hefty boost in calories – over 200 on average – that will pack on the pounds faster than you can say lardbutt.

And a little extra snacking is just the beginning of your endocrinological nightmare:  lack of sleep also lowers your testosteorne and growth hormone (as I document in my link on Sleep and Testosterone and Sleep and Growth Hormone).   The ensuing loss of testosterone will likely eventually result in a loss of muscle and we all know “muscle burns fat”. In other words, low sleep will eventually reset your metabolism in the negative direction.  This is further amplified by the loss in Growth Hormone, which is responsible for “leaning you out”.

Sleep loss will also boost your cortisol levels and cortisol is associated with the most deadly kind of fat gain:  visceral fat.  That’s the kind of fat that accumulates around your internal organs and is associated with heart disease.

Just as deadly is the fact that lack of sleep will also whack your blood sugar metabolism and make you insulin resistant.  Of course, insulin resistance is part of the deadly (and sexually devastating) Metabolic Syndrome, but it will also make you fat.  The high insulin levels are deadly because the block the breakdown of fats by adrenaline and lipase. [3]

Lack of sleep also makes you feel much less like exercising.  Your cortisol, insulin and appetite are all increasing and your testosterone and growth hormone are decreasing, yet you don’t have the energy to help compensate.  The bottom line is that burning the midnight oil is going to pack on the pounds and those pounds will lead you to extra estrogen, calcified arteries, poor mental performance and a look of bewilderment as you try to figure out how in the world you put on all those pounds.

REFERENCES:

1)  Annals of Int Med, 2004, 141:846 850,”Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite”

2) Am J Clin Nutr, 2009, 89:126-133, “Sleep curtailment is accompanied by increased intake of calories from snacks”

3) Kobe J Med Sciences, 2007, 53:99-106

-Supplements - Industry Problems

As you know, I have little trust or faith in the food industry and on this site I put example after example of How the Food Industry Endangers Your Health Daily.  The problem is that they can make money – lots and lots of money – by putting your health at risk.

Most health-conscious people are, to one extent or the other, aware of this fact and try as best they can to “live naturally” by avoiding processed foods.  They try to eat whole foods instead and very often try to use herbal and other (seemingly more) natural supplements in order to improve and maintain their health.  By the same token, I find many guys that write into me have an inherent trust in supplements to improve their testosterone, erectile function and health in general and an inherent distrust of drugs and the pharmaceutical industry.

This often wholesale acceptance of supplement is potentially very dangerous.  The reason?  Greed.

The same motivator that has corrupted the food and pharmaceutical industries is little better in the supplement industry. Again, people can make money – and a lot of it – by selling you something that will hurt your health.  I have already covered How Many Everyday Supplements and Vitamins Can Be Dangerous. Imagine how dangerous some of the more exotic supplements that guys take for men’s health or bodybuilding are!  It’s not pretty.

The Men’s Journal recently did an excellent article on testosterone-related examples of this fact. [1] They gave many examples, but one of the most prominent was a “muscle activator” by Tren_Extreme. One innocent buyer took this product for several months and found that he itched, couldn’t sleep and lost 34 pounds inexplicably. These are all classic signs of liver damage and the FDA discovered that the manufacturers had been adding a powerful untested synthetic steroid.

As I cover in my link on Bioidentical Testosterone, steroids often have side effects and this one was no exception.  The individual involved was still struggling to recover from the damage that was done.  Why would Tren-Extreme put its purchaers at risk with an untested steroid?  Greed.

Guys have also gotten themselves in trouble with erectile dysfunction products as well. One poor guy took an erection-related supplement which produced a “super erection” from the Yohimbine ingredient. [2]  Of course, priapism, an erection that last over about four hours, will injure penile tissue and can cause permanent damage. The doctors actually had to operate on this individual and apply a shunt.

NOTE: Be very careful with yohimbe.  One 37 year old bodybuilder overingested it before a competition and lost consciousness, went into seizures and had about twice normal blood pressure levels. [3]

There was a drink supplement called Total Body Formula or Total Body Mega Formula that the FDA recalled in 2008 poisoned consumers with overdoses of chromium and selenium, leading to deformed nails, hair loss, diarrhea and a host of other nasty symptoms. [4] Again, this list could go on and on, but you are far more safe avoiding all such products all together unless it is from a manufactuer with a stellar, long term track record.

It’s simply not worth the risk.  Most of you can achieve incredible health results with just food and exercise alone.  You can Heal Your Erections with Food, Improve Your Testosterone Naturally and put on muscle without any additional chemical regardless of age.

You only get one life – don’t put it in the hands of some greedy fool that just wants to fatten his bank account…

REFERENCES:1) Men’s Journal, Nov. 2009, p. 63.

2) Journal of Medical Toxicology, “Refractory Priapism Associated with Ingestion of Yohimbe Extract”

3) Clinical Toxicology, Sep 2009, 47(8):827-829, “Acute neurotoxicity after yohimbine ingestion by a body builder”

4) https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program/medical-product-safety-information SafetyAlertsforHumanMedicalProducts/ucm070027.htm

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

Electrosmog and Excitotoxins - Peak Testosterone

Would you volunteer your back yard as a dump site for spent fuel rods?  Of course not, because the invisible radiation would penetrate your dwelling, alter your DNA and other tissues and greatly increase your risk of cancer.  Unfortunately, this is very likely what you are doing every time you hold a cell phone up to your head to one degree or another. [1]

The issue surfaced when staff and students at a school in California developed cancers at an extraordinary rate.  Reminiscent of Erin Brokovich, researcher Sam Milham investigated and found that the school, due to wiring and other issues, was rife with “dirty electricity”.  Dirty electricity is the kind produced from computers, cell phones and TV’s that are low power. This Interview with Sam Milham is very informative.

Prevention Magazine (Jan 2010) just broke this story and did a fantastic job of showing that Emag radiation is far more dangerous than previously thought and very likely causing significant cancers and other health issues. I had already been pointing out on my twitter account that one study had recently found that cell phones may cause bone loss in the hip area of cell phone carriers. [2]  However, the damage from electrical radition is probably far more insidious than just a little bone loss here and there:

1. EMF signals (at levels even as low as wi-fi) can overstimulate the immune system and may be partially responsible for some of the allergic and auto-immune epidemic seen in modern societies. [3]

2. There is likely a small, but significant risk of a brain tumor just from work exposure alone. [4]

3. Up to 80% of childhood leukemias may be attributable to EMF exposure during pregnancy and infancy. [6]

This list could go on and on. However, I want to focus on something extremely dangerous:  mobile phone radiation can alter the permeability of the blood-brain barrier. This had been verified in mammalian studies using standard cell phone signals and standard GMS signals. [5]  Even worse, the researchers found that effects from this electrical radiation persisted for weeks afterwards.

Furthermore, some researchers have identified that there are “hot spot” areas where electrosmog levels are significantly higher than others, including elevators, trains, cars and airplanes. [7] This is because cell phones actually emit microwave radiation and in these areas the microwaves are simply reflected and bounce around undampened, reaching levels much higher than normal.  Furthermore, it only takes a few cell phone users to produce these levels in many cases.  So this is not something that can be eliminated by avoiding cell phone usage and is analagous to the dangers of second hand smoke.

What does this mean?  It means that modern urban dwellers are potentially at much greater risk for excitotoxin damage than previous thought.  Hopefully, you have read my Excitotoxin page and know that excitotoxins, such as MSG and those in Diet drinks, can damage the hypothalamus and cause Excitotoxin Syndrome.  However, excitotoxins can cause their greatest damage in the brain itself. The food industry has always justified their use of excitotoxins in food on the argument that the blood-brain barrier will protect your precious neurons from damage. That, as it turns out, is a very poor assumption indeed:  even cell phone usage can allow significantly greater flow of any such chemicals into the brain.

To play it safe, I recommend that you do not come with ten feet of any excitotoxin.  It only takes minute amounts in the animal studies to do incredible damage to the mammalian brain and if indeed our blood-brain barrier has been even mildly compromised, the danger is substantial.  There is no one except you that can guard that all-important stuff in your cranium from the food industry.

Finally, be cautious about using a cell phone directly against your head or ear. It is much safer to use the speaker phone or ear phones. Blue tooth devices are also not considered safe. Remember that there is already a study showing a tenfold risk in childhood brain tumors and exposure to higher-than-average electronic emissions. [8] Why take a chance?

NOTE:  See my link on Cell Phone Dangers for additional information.

REFERENCES:

1) Bioinitiative Working Group, July 2007, “Evidence for Effects on Gene and Protein Expression”, Z. Xu, et. al.

2) https://www.webmd.com/news/20091027/cell-phone-on-hip-may-weaken-bone

3) Bioinitiative Working Group, July 2007, “Evidence for Effects on the Immune System”, Johannson, et. al.

4) Bioinitiative Working Group, July 2007, “Evidence for Brain Tumors and Acoustic Neuromas”, Hardrell, et. al.  (See also Brit J of Cancer, 2005, 93(7):842-848, “Mobile phone use and risk of acoustic neuroma: Results of the Interphone case-control study in five North European countries” and Revue d’Epidemiologie et de Sante Publique, 2007, 55(5):321-332, “Cell phones and risk of brain and acoustic nerve tumours: The French INTERPHONE case-control study”

5) Pathophysiology, 2009 Aug, 16(2-3):103-12, Epub 2009 Apr 2, “Increased blood-brain barrier permeability in mammalian brain 7 days after exposure to the radiation from a GSM-900 mobile phone”

6) Bioinitiative Working Group, July 2007, “Evidence for Childhood Cancers (Leukemia)”, Kundi, et. al.

7) Journal of the Physical Society of Japan, 2006, Received March 14, 2006; Revised May 18, 2006; Accepted May 23, 2006; Published July 25, 2006, “Passive Exposure to Mobile Phones: Enhancement of Intensity by Reflection”

8) J Epidemiol, 2010, 20(1):54-61. Epub 2009 Nov 14, “Power-frequency magnetic fields and childhood brain tumors: a case-control study in Japan”

How to Find a Doctor or Clinic - Peak Testosterone

Hormone Replacement Therapy Doctors

SELF-TESTING LABS (BOTH US and UK):

PHYSICIANS (CANADIAN):

STEP 12.  Find a Good HRT (Hormone Replacement Therapy) Physician:

Finding a good HRT physician can be a challenge for some men.  Fortunately, at least here in the U.S., it is now much, much easier than it was, say, ten years ago.  We now have TRT clinics and a growing number of doctors specializing in hormone replacement therapy.  In addition, many in the general physician population (PCPs and urologists) have grown considerably in their knowledge and understanding of the subject.  The bottom line is that you should be able to find a good doctor, but it may take some time.  Here are tips and ideas:

HOW TO FIND A DOCTOR (Gen’l):

HRT: Testosterone Therapy and Class Action Lawsuits

NEWS FLASH(ES): There have been a number of studies that have shown that HRT can improve many cardiovascular parameters, so many experts were skeptical of the results of these studies.  Sure enough, two very positive HRT cardiovascular studies followed immediately after the ones on this page.  See my page The Recent Positive Testosterone Therapy Cardiovascular Studies for more information.  The one except is a sutdy I discuss on the following page:  Possible Testosterone Injection Dangers or Just a Bad Protocol?. Also, the climate has completely changed since I wrote this page, and a federal judge recently threw out the most recent case that testosterone manufacturers increased their risk of cardiovascular issues. [5] My, how things change in a year or two! (Please consult with your physician, however:  it is his or her job to stay up on the latest research and evaluate any medical conditions you may have.)

1.  NEJM 2010. The first anti-HRT study was in published in 2010 in the prestigious New England Journal of Medicine. [1] This study look at testosterone administration to a group of “community dwelling” seniors. I’m not sure why they picked that group, but the results were ugly:  almost four times as many men in the testosterone had cardiovascular events versus the control group! The authors wrote that “during the course of the study, the testosterone group had higher rates of cardiac, respiratory, and dermatologic events than did the placebo group. A total of 23 subjects in the testosterone group, as compared with 5 in the placebo group, had cardiovascular-related adverse events. .”

2. JAMA 2013.  Then just a few years later, the equally prestigious Journal of the American Medical Association also found increased cardiovascular risk in men given testosterone.  This study was also widely criticized.  Life Extension Foundation wrote a particularly scarthing and insightful rebuttal that, in my opinion, tore apart this study piece by piece.  In fact, I would argue that this study mostly showed that the mainstream medical boards have a very low level of understanding of even the basics as to how to administer and monitor testosterone successfully.  For example, one of the things that the article points is that no mention of estradiol was ever given in the study! This is inexcusable as abundant data has made clear that estradiol is VERY important to arterial health.  The LEF writer, which included an M.D. and two N.D.’s, stated:

“In the paper published by Vigen, there was no report of the subjects’ estradiol levels. If estradiol was not monitored during testosterone administration, this oversight means that the men receiving testosterone could have experienced a concurrent rise in estradiol levels. This may have compromised their cardiovascular health and could partially account for the increased risk observed in the testosterone-treated group.” [3] The study was on vets and some of them probably were on the old big cypionate dose every two weeks.  These big dosages using this kind of “old school” protocol send both testosterone and estradiol through the roof for 4-5 days, which could put some men at risk.

1.  Men with hypertension.

2. Men with certain clotting disorders.

3. Men with kidney disease.

I cover these three cases in my page on The Potential Risks of Testosterone.

And I think that few have any doubts that the attorneys will likely have a field day with all of this. One of the big things that they have going for them is the fact that heart disease is the number one killer of men and an epidemic in our Western culture. This ensures that will be a huge pool of men with heart attacks, angina, angioplasties, strokes and so on that have been on HRT just due to the odds. Of course, that also means a potentially larger class in their class action law suit.

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

To file a law suit, attorneys need only net around 40 men with heart disease and on a particular type of HRT.  This, of course, should be easy and I think we will see a multitude of suits forming around the country.  A few quick searches on the internet will pull up literally hundreds of law firms already requesting names and information to forum such suits.

The End Result of the Lawsuits

There will some positive and negative outcomes from all of these lawsuits and class action suits. Many men with risk factors will be excluded from treatment. No doctor can afford to prescribe testosterone with the threat of a lawsuit hanging over him. So do you really think that if you have had a DVT, or an embolism, or angina, or an angioplasty or perhaps even hypertension, that a doctor is going to give you testosterone. I have my doubts.

So the best thing you can do for yourself, if you are would like to be on HRT is take care of your heart and arteries.  I have a lot of pages on the subject on my site, including How to Clear Your Arteries, Increase Your Nitric Oxide Naturally, and Erectile Dysfunction and Arterial Plaque for example. So start working on things like lowering your blood pressure and clearing out arterial plaque. Otherwise, you may find that your doc takes you off of HRT sometime down the road as the lawsuits hit.

And believe me: doctors are completely willing to drop you off of HRT in a heartbeat. My clinic recently dropped me almost instantly over a high PSA reading. I was off of HRT for a month and my testosterone dropped to 111!  It turns out that I did not have cancer, but it taught me a sober lesson: I need to carefully guard my health in order to be allowed to stay on testosterone. So get on a good clean, heart friendly diet. Lose those extra pounds. Drop the weight. It will pay off in the end…

1) N Engl J Med, 2010 Jul 8, 363(2):109-22. “Adverse events associated with testosterone administration”

2) https://www.zrtlab.com/blog/entry/testosterone-elixir-or-dangerous-drug

3) JAMA, 2013, 310(17):1829-1836, “Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels”

4) https://www.lef.org/featured-articles/ Response-to-Media-Reports-Associating-Testosterone-Treatment-with-Greater-Heart-Attack-Risk.htm, “Flawed Testosterone Analysis Spurs Misleading Media Headlines”, By Blake Gossard, Kira Schmid, ND, Luke Huber, ND, MBA, Steven V. Joyal, MD

5) https://www.courthousenews.com/2015/11/12/pfizer-dodges-claims-over-testosterone-drugs.htm

Scrotum- What If you Rub Testosterone Directly Down Under?

1)   https://www.drugs.com/pro/androgel.html

2) https://www.rxlist.com/testim-drug/medication-guide.htm

3) https://www.drugs.com/pro/androgel.html

4) https://www.endo.com/File%20Library/Products/Prescribing%20Information/FORTESTA_prescribing_information.html

5) Am J Med, 1987 Sep, 83(3):471-8, “Androgen therapy of hypogonadal men with transscrotal testosterone systems”

6) https://www.peaktestosterone.com/forum/index.php?topic=12214.0

One of our senior forum members (JustAskin) explained a protocol that Dr. Shippen (apparently) pioneered using scrotal testosterone in order to boost DHT.  Before I go on, let me say that this information is for men already on TRT (testosterone replacement therapy).  Men using injections can often end up with disproportionately low DHT levels and this technique could be considered to help.  (I don’t know of a non-TRT man that has been treated for low DHT with normal testosterone levels.)

The guiding principles behind this protocol is that you use a) a scrotum friendly compounded topical cream – more on that below – and b) do careful monitoring to make sure you don’t go too high with the DHT.  Another key point:  this is NOT something you do daily.  According to this poster, he only had to apply this once every 10-14 days and his DHT levels stayed elevated for that time period which was corroborated by followup labs.  Of course, work with your physician on that:  I am just reporting one case study.  Here is JustAskin’s protocol:

“First I tried every day, my DHT went above 3600!

Then I tried every third day, DHT was about 1800!

Then every sixth day, DHT was 500! I stopped completely for 2 months, DHT went back to 53.

Then I tried E9D and DHT was at 85. I went back to E6D and DHT was at 114.

Libido thru the roof but PSA raised 1/2 point. So after talking with Dr. Shippen, My schedule is now: Testosterone Cyp. .15cc. E3D (except on days I use T. Cream, then I drop injection to .14cc.) HCG .09cc. Daily. Testosterone Cream E9D on day of Injection. With this my hang is much fuller, can have sex when I want, and nuts feel tight, full, and warm.” [6]

SAFETY:  No long term studies have been done.  It has been done by a number of men on my and other forums and no bad reports to date.  You MUST monitor DHT.  If your doctor won’t monitor DHT afterwards, then don’t do this protocol.

TARGET DHT LEVELS: See my page on the subject:  Target DHT Levels and Physiological Ranges.

WHY NOT USE BRAND TRANSDERMAL TESTOSTERONE? One question that I get from time to time on the Peak Testosterone Forum is if their Androgel or other topical testosterone gel or cream would not better be applied directly to the scrotum? I guess this might seem logical, since the testes are are supposedly the source of the problem and the gel is the medication. However, the logic here just isn’t right for a few reasons:

1. The testosterone from testosterone gels goes straight into the plasma (blood) and reaches the testes only after being circulated just like any other such medication, i.e. it does not just magically shoot straight into the testes.

2. Exogenous (externally applied) testosterone actually will (partially) shut down the testes of even a hypogonadal man. So it is not “curative” in any sense as far as stimulating or “healing” the testes.

3. Most men have secondary or tertiary hypogonadism which means that their problem is not in the testes but rather the pituitary or hypothalamus.

There is another major problem with applying most of the topicals to the scrotum, according to one of our Peak Testosterone Forum members: topical products often contain alcohol in them, which is simply too harsh and drying for the delicate scrotal skin – ouch!  For example, Androgel users are cautioned to ” avoid fire, flames or smoking until the gel has dried since alcohol-based products, including AndroGel 1%, are flammable.” [1] Yeah, that’s a scary thought, eh?

And, just to summarize, this seems to apply to all the big brand name blockbuster testosterone topicals here in the U.S.:

a) Androgel inactive ingredients: “Carbomer 980, ethanol 67.0%, isopropyl myristate, purified water, and sodium hydroxide.” [3]

b) Testim inactive ingredients: “Inactive ingredients: purified water, pentadecalactone, carbopol, acrylates, propylene glycol, glycerin, polyethylene glycol, ethanol (74%), and tromethamine.” [2]

c) Axiron inactive ingredients: “ethanol, isopropyl alcohol, octisalate, and povidone.” (Notice that it has two forms of alcohol that are applied to the skin.

d) Fortesta inactive ingredients: “propylene glycol, purified water, ethanol, 2-propanol, oleic acid, carbomer 1382, triethanolamine and butylated hydroxytoluene”

So before you go running off and rubbing your T on the family jewels as an experiment, keep in mind that you might have to explain to the little woman that your testicular rash isn’t really all that serious.  I’ll leave you to decide whether or not she will believe you.

ALLEGED ADVANTAGES: I have not been able to verify this from an authority site, but there are two potential advantages to scrotal application of testosterone:

2.  Greater Absorption. Only about 10% of the testosterone in a standard topical is absorbed through the skin.  Reportedly, this number is much higher  and in the 50-70% range when applied to the scrotum.

POTENTIAL SIDE EFFECTS:

1.  High DHT Levels. For reasons unknown, topical testosterone applied to the scrotum will greatly increase DHT levels.  DHT (dihydrotestosterone) is the testosterone metabolite largely responsible for acne, BPH (enlarged prostate) and male pattern baldness.  Of course, if you are low in DHT, then that may be a different story, but potentially sending DHT levels through the roof is probably not a good idea for most men, since it can have as a side effect accelerated hair loss and enlarged prostate.

2.  Non-Physiological Distributions. ZRT Labs published an interesting article where they explained that topical testosterones seem to leave very high levels of testosterone (and estradiol) in the capillaries.  They felt that this could potentially be dangerous and should be investigated further.  I discuss this in my page on The Potential Risks of Testosterone Therapy if you would like more information.

REFERENCES:

Slightly Elevated Homocysteine Will Hammer Your Erections

What is the #1 determinant of non-diabetic erectile dysfunction?  According to one study it is a relatively unknown cardiovascular marker called homocysteine, where researchers looked at various lipid and CVD markers of non-diabetic men with erectile dysfunction versus controls.  What they found was I am sure surprising to many health experts:

“Logistic regression analysis revealed that age and Hcys [homocysteine] levels were the main determinants in ED [erectile dysfunction]. Hyperhomocysteinemia, known to be an important risk factor in endothelial dysfunction, seems to be an important determinant in ED. These data suggest that slightly elevated Hcys levels are significantly related with arterial and probably endothelial dysfunction in patients with ED.” [1]

Notice how I highlighted the fact that, at least according to this study, even SLIGHTLY elevated homocysteine levels could lead to problems in the bedroom.  I don’t know of any hormone or neurotransmitter where a researcher has said something equivalent.

Notice also that this study looked at non-diabetic men with no heart disease. Basically, a big percentage of these men are probably wondering why in the world they have erectile dysfunction.  They feel that they have been blind-sided.  I see these kind of men all the time on The Peak Testosterone Forum.  Yet the authors stated that homocysteine was the main determinant of erectile dysfunction in the non-diabetic men with no heart disease. So, yes, it is something worth monitoring even if your doctor does not and is something you can do through one of the labs on this page:  Inexpensive Testosterone Labs.

As a verification, another study looked at men with erectile dysfunction and with and without coronary arterial disease (CAD).  It found that men with erectile dysfunction and CAD had elevated ADMA levels. [9] This indicates that elevated ADMA levels may acclerate arterial plaque which then negatively impacts erections in a significant subpopulation of men.  As you will see below, this appears to be exactly what happens and I will discuss explain why a bit later.

So why are high homocysteine levels such an erection killer?  Check out these Major Reasons That Homocysteine Can Lead to Erectile Dysfunction below:

1) Metabolism, 2006 Dec;55(12):1564-8, “Hyperhomocysteinemia: a novel risk factor for erectile dysfunction”

2) Circulation, 2001, 104:2569-2575, “Homocysteine Impairs the Nitric Oxide Synthase Pathway: Role of Asymmetric Dimethylarginine”

3) Curr Atheroscler Rep, 2006 Mar, 8(2):100-6, “Homocysteine: role and implications in atherosclerosis”

4) Arteriosclerosis, Thrombosis, and Vascular Biology, 2001; 21:1385-1386, “”

5) Am J Clin Nutr, Aug 2000, 72(2):315-323, “Homocysteine and cardiovascular disease: cause or effect?”

6) https://eurheartj.oxfordjournals.org/content/ehj/30/1/6.full.pdf

7) The Journal of Sexual Medicine, Jan 2010, 7(1pt1):216 223, “Treatment of Erectile Dysfunction Due to C677T Mutation of the MTHFR Gene with Vitamin B6 and Folic acid in Patients Non Responders to PDE5i”

8) European Urology, December 2005, 48(6):1004 1012, “Elevation of Asymmetrical Dimethylarginine (ADMA) and Coronary Artery Disease in Men with Erectile Dysfunction”

9) https://www.peaktestosterone.com/forum/index.php?topic=8225.0

1. Increased ADMA Levels. I don’t know about you, but I like things that increase nitric oxide and don’t like things that decrease nitric oxide. Nitric oxide, after all, relaxes your arteries and increases blood flow, something that is pretty important for erectile strength.  Nitric oxide is also an anti-inflammatory (in reasonable quantities) and, therefore, actually helps protect your arteries from heart disease. So wouldn’t it be important to look at any molecules within the body that actually limit or inhibit nitric oxide? Of course, the answer is ‘yes,’ and one of these is ADMA (asymmetric dimethylarginine), which occurs naturally in all human cells.  ADMA  does its evil deeds by competing with arginine.  (The arginine pathway is our primary means of generating endothelial, or arterial nitric oxide.)

As you may have guessed by now, high homocysteine increases ADMA. It does this by negatively inhbiting the enzyme that breaks down ADMA, i.e. it effectively allows ADMA to build up in your system.  (The name of this enzyme is dimethylarginine dimethylaminohydrolase (DDAH).) [2] Researchers found that the more homocysteine, the more inhibition of DDAH and the greater the buildup of ADMA.

2.  Increased Inflammation. Animal models show that increasing homocysteine leads to an elevation in the body’s inflammatory compounds “including an increased expression of vascular cell adhesion molecule-1 and elevated plasma levels of tumor necrosis factor-a.” [4] These are both associated with heart disease, meaning injured arterial walls that cannot pump as much nitric oxide.  High homocysteine also leads to increased iNOS activity.  This means that your immune system will pump out more nitric oxide which can damage arterial walls, in contrast with upgrading eNOS, which usually helps arterial walls. [6]

3. Increased Arterial Plaque (Atherosclerosis). Again, as mentioned above, researchers have noted that “both markedly and mildly elevated circulating homocysteine concentrations are associated with increased risk of vascular occlusion.” [5] Occlusion is the $10 word for blockage.  In other words, elevated homosysteine is linked to blocked or clogged arteries.

Again, I will call attention to the fact that these researchers said that even SLIGHTLY elevated homocysteine levels can lead to accelerated plaque. And it is no wonder considering that rising homocysteine leads to increased oxidation, inflammation and lowered nitric oxide levels.  When it comes to your arterial health, it does everything dead wrong.

SOLUTION:  If you have high homocysteine, the first thing you should do is look for possible root causes:

a) Gut and GI Issues, such as Crohn’s, diverticulitis, IBS, atrophic gastritis, celiac disease, etc.  If you cannot absorb certain B vitamins, homocysteine levels will rise.

c) MTHFR (dual homozygous) SNP can lead to elevated homocysteine levels.

Of course, correct or treat these root causes and you will likely see improvement in your homocysteine.  In addition, you may want to supplement with the proper form of supplemental folate and B12 to pull your numbers down.  The powerful effect of this was shown in a study where men with MTHFR did just that and improved their erectile dysfunction. [7]

It is important that you take the correct form of folate.  The traditional form is folic acid, which the liver has trouble breaking down, and is associated with increased cancer risk according to some research.  (Folate stimulates DNA turnover, which is why pregnant women are advised to take it.)  Most experts that I am reading now recommend the less common methylfolate form.  This is critical for those with MTHFR in particular.  Discuss with your doctor or, better yet, nutritionist.

One of our forum members told me that I needed to point out that I need to add “a note that some people(like me) must supplement with B6 to normalise elevated homocystein; b12 and folic acid isnt always enough.” [9]

CAUTION:  There is also evidence that elevated homocysteine can increase the risk of thrombosis, i.e. a blood clot. [3] Of course, clots are responsible for both strokes and heart attacks.

NOTE:  Let me give you another example of a some other compounds that are known for lowering nitric oxide:  Prilosec and Prevacid.  These are actually drugs (medications) in widespread use to treat GERD (reflux).  They both lower nitric oxide levels,  and, as expected, now have research showing that they increase heart disease.  You can read more about it here if you are interested:  PPI’s (Proton Pump Inhibitors) and Erectile Dysfunction.

REFERENCES:

Aromatase Inhibitors: Can They Lead to Low Estradiol?

I wanted to report on a couple of disturbing cases that have surfaced recently on the Peak Testosterone Forum, where a couple of men have reported that aromatase inhibitors have permanently crashed their estradiol.  As I discuss on my The Need for Estradiol page, we men really do need adequate levels for endothelial (arterial and erectile) function, congitive and brain systems ( for libido), and bone mass maintenance.  So it might seem like a good thing to eradicate as much of that “nasty female hormone” as possible, but, in fact, that’s a virtual guarantee of misery and suffering.  You need some estradiol just like your wife or girlfriend needs some testosterone.

Fortunately, low estradiol is rarely an issue for men with respectable amounts of testosterone.  (Low testosterone men are often low estradiol however.)  Because we tend to gain weight as we age, estradiol levels (relative to testosterone) tend to go up.  But imagine if the natural order was disturbed and a medication somehow permanently took out your estradiol. These men aruge that this is exactly what happened to them.

Before I go on, let me just mention that literally millions of men have used these aromatase inhibitors and the vast majority do not report the kind of problem I am describing below.  But I feel that my job is simply to report what we’re seeing “on the field:”

CASE 1. Reversible Aromatase Inhibitior (Arimidex). The story of this poster is a bit unusual, but it started with him taking too much injectible testosterone accidently.  His testosterone went above 1500 ng/dl and his estradiol (sensitive) climbed to 161 pg/ml, which is very high.  Traditionally, he had been a lower estradiol guy, but this much testosterone really elevated his levels.  When he discovered the high estradiol, he decided to take action immediately and took some Arimidex (anastrazole).  Taking Arimidex as part of an HRT (testosterone therapy) protocol is actually quite common as men often find their estradiol a bit on the high side even though their testosterone is within youthful ranges.  This generally occurs from weight gain as we age, but some men are just “high converters.”

Just a few weeks after he took the Arimidex, he found that his estradiol was completely crashed.  His total testosterone had come down to 873 nd/dl, which is a youthful level, but his estradiol was < 2.5 pg/ml!  A followup blood draw 3 weeks later showed similar results and, again, abyssmally low estradiol.  It has now been about 6 weeks as of this writing since he took the Arimidex and yet his estradiol has not recovered. [3]

So the whole situation is unusual for many reasons:

a) His testosterone was quite high due to a personal HRT error..

b) Most men who crash their estradiol recover in just a few weeks.

IMPORTANT CONCEPT: Arimidex is a “reverisble aromatase inhibitor.”  Reversible aromatase inhibitors attach only weakly to the aromatase enzyme and can easily be removed with harming it.  Irreversible aromatase inhibitors are the opposite and powerfully bond to the aromatase enzyme. The chemical bonding that occurs in this case actually destroys the enzyme by effectively taking it out of commission.  However, normally a man will rebuild these enzymes a few weeks later.

Did Arimidex really permanently crash his estradiol?  See my theory section below for more details but first a similar case with Aromasin:

CASE 2. Irreversible Aromatase Inhibitior (Aromasin). Another poster, coincidentally at the same time, used an irreversible aromatase inhibitor called Aromasin (or exemestane).  This young man had used Aromasin during a steroid cycle and at a rather high dosage (25 mg per day) and, to his horror, found was that his estradiol never recovered.  He wrote:

“Everyone said its high E2 [estradiol], so I did aromasin for like 2 more weeks…I didnt recover went for blood work and found out that my E2 [estradiol] is below normal range…Testosterone 510, LH 4.1 and E2 was tested <5 where as normal range starts from 7 …I’m off steroids for about over a year and E2 is still shut down…I have all the symptoms of low estrogen.” [2]

So this man has had almost zero estradiol, even though his testosterone is currently midrange in the 500’s (ng/dl). His estradiol is very low and has been measured to be less than 5  pg/ml, which puts him at risk of osteopenia.  Now it is tempting to argue that he was damaged because he took too much Aromasin.  That argument, though, ignores the fact that there is a study out there where they gave normal 14-26 year olds 25 and 50 mg daily and found that plasma estradiol levels only decreased about a third,  (A larger dip did occur, maxing at 12 hours afterwards (62%).)  So, in this study, Aromasin did not vaporize anyone’s aromatase. [1]

CAUSE?  Theory 1:  Notice that in both cases testosterone was too high, an aromatase inhibitior was taken and then estradiol permanently tanked.  Is this – the high testosterone – the common ingredient and the reason that these men’s estradiol was set to near zero?  And, if testosterone skyrocked, estradiol likely did as well and so perhaps super elevated estradiol levels reset gene expression or receptors?  This theory seems doubtful, however, since literally thousands of steroid users use Aromasin.

CAUSE?  Theory 2: Could these men have high progesterone for some reason? High levels of progesterone would likely suppress estradiol levels through aromatase inhibition, something I discuss in my page on Progsterone Lowers Estradiol.

CAUSE?  Theory 3:  Perhaps liver issues can explain these aromatase issues? One of the men wrote in a followup post that “Saw the new naturopathic doc. As expected he’s being conservative and starting with the liver because it is so obviously overworked with a lot of different medications for various issues. Some are pretty tough on it. The liver enzymes I closely watch and treat with milk thistle and dandelion and have been in normal range over the years but according to him just because your enzymes are in range doesn’t mean that there isn’t a backlog on how the liver is addressing detoxification and protein synthesis and other things. For me, creating aromatase might just be a low-priority item that keeps getting knocked out of the queue every day. We’re going with castor oil externally to help it detox.” [2] And the poster using aromasin had been using steroids and so it is possible that some supplement or something in his cycle aggravated his liver.

CAUSE? Theory 4.  In men with a weakened liver, Aromasin will lead to very elevated levels. The FDA wrote that “The pharmacokinetics of exemestane have been investigated in subjects with moderate or severe hepatic insufficiency (Childs-Pugh B or C). Following a single 25-mg oral dose, the AUC of exemestane was approximately 3 times higher than that observed in healthy volunteers. The safety of chronic dosing in patients with moderate or severe hepatic impairment has not been studied. Based on experience with exemestane at repeated doses up to 9 200 mg daily that demonstrated a moderate increase in non-life threatening adverse events, dosage adjustment does not appear to be necessary.”  Could this affect some men?

REFERENCES:

1) J Clin Endocrinol Metab, 2003 Dec, 88(12):5951-6, “Pharmacokinetics and dose finding of a potent aromatase inhibitor, aromasin (exemestane), in young males”

2) https://www.peaktestosterone.com/forum/index.php?topic=7787.0

3) https://www.peaktestosterone.com/forum/index.php?topic=7760.0

4) https://www.accessdata.fda.gov/drugsatfda_docs/label/1999/20753LBL.PDF

HCG Injection Protocols - Peak Testosterone

The use of HCG with TRT has been around for a long time but still has not made it into the mainstream yet.  It is widely used by TRT clinics, anti-aging doctors and fertility specialists, but will probably be a few more years for widespread adoption.  I believe it will eventually happen, though, for the reasons I outline below.

Here are Seven Significant Reasons to Consider Adding HCG to Your TRT Regimen:

1. Activate a Dormant LH Receptor. I’ve been on testosterone cypionate for a couple of years now and, for the first time since I have been on TRT, had my LH (luteinizing hormone) pulled (December of 2015):

Labcorp: 0.1 mIU/ml Range: 1.7 – 8.5 mIU/ml

Ouch! Why was my LH so low? Standard TRT, especially if you boost testosterone significantly, will raise testosterone and estradiol levels and the hypothalamus will begin shutting down the signaling to the pituitary. This “shut down” is just one of the consequences of TRT, and it’s long term impact is poorly understood.  And, yes, LH will tend to go down to dang near zero.

Because I had never had LH pulled before, the consequences of such low LH started to bother me. Was it really good to have that low of a serum LH? Sure, my testosterone levels were beefy from TRT (650-800 ng/dl) from testosterone therapy – I feel very good on TRT by the way – but does youthful testosterone really compensate for abyssmally low LH levels in the long term?  I don’t believe it will, because the LH receptor is present and clearly biologically active (though poorly understood) in many key tissues, such as the hippocampus, adrenal glands and arteries. You can read more about that on my page on The LH Receptor in Men.

The good news is that someone got the creative idea to try HCG to compensate for this issue, because HCG is a hormone very similar in structure to LH and actually binds to the LH receptor.  And Mother Nature probably put ‘those receptor there for a reason, eh?

2. Boost Libido. A well done TRT program will generally boost libido in men, and, in fact, studies have shown the effect to be dose dependent on average.  See my page on Testosterone and Libido for more information.  However, there is a signifcant block of men who do not enjoy that benefit and HCG can help some of them.  HCG can also increase alertness and energy as well.  My former TRT clinic estimated the men that HCG significantly help at about a fourth of their patients.

3.  Increase Testicular Size (Volume). Another consequence of a TRT program (that actually boosts testosterone) is shrunken testes.  To be honest, I don’t think most women care or notice as the effect is not that pronounced., something I cover in my page on Testosterone Therapy and Testicle Size. Nevertheless, the last thing most ex-low T guys need is to feel demoralized with small acorns adorning their tree – they’ve been through enough already!  This is where low dose HCG can come in.  By simply adding 250-500 IU of HCG twice per week, volume is generally restored within 3-4 weeks in men on TRT.

NOTE:  If you do go on HCG, make sure your physician pulls estradiol during follow up testing (with the right test).

4.  Restoring Fertility. One of the big concerns for younger men on TRT is the fact that their fertility is greatly lowered.  Yes, you can still conceive in some cases, but your odds are significantly lowered.  Because HCG activates the testes by mimicking LH and attaching to LH receptors, men usually experience a big boost in fertility.  One study showed that 500 IU several times per week was enough to restore fertility to youthful levels in men on testosterone, something I discuss in detail in my page on Testosterone and Fertility.

5. Protection from TRT Failure. Tying into #3 and #4 is the fact that HCG (generally) keeps the testes “alive.”  Although this has not been formally studied as far as I know, keeping the testes fully functional could potentially help preserve testosterone production if one has to go off of TRT.  Granted, it’s not common to be forced off of TRT, but it can happen if your PSA, hematocrit or blood pressure climb from testosterone therapy.  In fact, it happened to me for a month, something you can read about it in my page on High PSA But No Cancer.  And it has happened to other men on our forum.

What happens when you go off of TRT is that you actually nosedive below your old baseline testosterone levels.  In my case I was alway in the low 300’s (ng/dl) before I went on TRT.  A month after being forced off of TRT due to a high PSA, my testosterone was 121 ng/dl!  If I had stayed off of TRT, I probably would have risen slowly in 2-3 months back to the low 300’s.

Or would I?  There are rumors that older guys do not always snap back to their old levels after being on TRT for awhile.  What if your testes have been shut down for 10 years and you have to stop?  Would your testes ever fully recover?  That’s a good question that deserves some research.  But, in the meantime, HCG is probably a good insurance policy against that situation, because basically your testes never get turned off if you are on HCG.

CAUTION:  I make the case that more is not better when it comes to HCG.  It is a placental hormones that is long-lasting (compared to LH) and stimulates EGF and VEGF.  See my page on Potential Dangers of Too Much HCG.

6.  Activate the Pregnenolone Enzyme. Pregnenalone tends to fall with age and is critical for optimal brain health and function.  In addition, there is a hormone “production line” that is critical for men to feel well:

Pregnenolone ==> Progesterone ==> Cortisol

Yes, progesterone can have feminizing traits and, yes, cortisol is associated with stress.  But what is poorly understood is that a significant block of men are actually low in one or more of these hormones and feeling lousy because of it.  HCG activates the enzyme that converts cholesterol to pregnenolone and thus can “backfill” the progesterone and cortisol pathways, raising levels of those key hormones in some men who are deficient.  Now it certainly does not always work out that way, but this certainly does happen and may explain why some men feel substantially better on low dose HCG accompanying their TRT.

7. Boosting Estradiol in low  Men. Low dose HCG will increase testosterone a little even in men on TRT.  The effect is not a lot, but it does make a difference.  HCG will tend to boost estradiol a little more proportionately than other methods of raising testosterone.  Many of you reading this will be wondering why in the world you would want to increase estradiol.  And the answer is that usually you don’t and most men do not need that.  However, some men, particulary https://www.peaktestosterone.com/, need a boost in free estradiol to feel good.  (Their total estradiol may be okay, but there free estradiol low due to being bound up by SHBG.)

Testosterone and Asthma: The Common Links between two

One of the senior poster in the Peak Testosterone Forum, who happens to have low testosterone, wrote the following:

“Being someone who struggled with severe childhood asthma and exercise and allergy induced adult asthma, this is a subject near and dear to my heart…The last link really makes me think if my use of asthma inhalers and corticosteroids for asthma is part of my current situation..” [1] What he was noticing is that there appear to be many links between asthma and testosterone, especially low testosterone.  Isn’t asthma all about the lungs and testosterone about the brains and the groin?  Sure, but we will show that they meet in the middle in many key ways.

The above poster accused his corticosteroid inhalers of causing his low testosterone.  Basically, these drugs are designed as copies of cortisol and are used because cortisol suppresses the immune system.  In asthma the immune system is “overreacting” and so a (supposedly) localized steroid is applied in order to help the situation.  And, if you’ve poked around my site much, you know that almost anything that elevates cortisol is going to lower testosterone.  I have many examples of Cortisol-Raising Stressors that Lower Testosterone for example.

But is this really the case?  Why aren’t physicians noting the connection, considering the number of patients on these sort of asthma medications, if this is really a significant issue?  And some research shows no real suppression of the HPAor testosterone with inhaled corticosteroids. [3] One study found that, while powerful oral steroids like prednisolone decreased testosterone by 33%, the inhaled version caused no significant drop in testosterone or leutinizing hormone. [6]

However, the real answer may lie somewhere in the middle:  one study found that testosterone was suppressed by long term inhaled corticosteroid therapy, but only to a small degree. In this study average testosterone was only decreased by 18%. [4]  So, yes, corticosteroids are not going to help, but they may not be the major factor at play here.  So it may be the length of time that the inhalers are used, but it’s difficult to say at this point.

The authors also mentioned hypoxia, clinically low oxygen levels, as a possible issue that could drive down testosterone levels.  One study on glucosteroids did indeed show a correlation between the degree of hypoxia and testosterone suppression. [10] A number of medical conditions, such as sleep apnea and COPD are linked to hypoxia.  Sleep apnea has definitely been found to lower many key hormones, something I cover in my link on Apnea and Testosterone .

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

In addition, asthma and testosterone are probably correlated through mitochondrial dysfunction.  Loss of mitochondrial function is a whole theory of aging and there are definitely connections to both hypogonadism and asthma.  Note the conclusions of this 2005 study in the journal Diabetes Care:

“These data indicate that low serum testosterone levels are associated with an adverse metabolic profile and suggest a novel unifying mechanism for the previously independent observations that low testosterone levels and impaired mitochondrial function promote insulin resistance in men..” [7]  In other words, low T and mitochondrial issue go hand-in-hand and seem to help promote insulin resistance.  The paper goes to actually explain that low testosterone itself may lead to mitochondrial dysfunction.

Furthermore, a number of studies have shown that mitochondrial dysfunction could lead to asthma or make it worse.  One set of researchers stated clearly that “aging and animal model studies have revealed that mitochondrial dysfunction and oxidative stress are involved and play a large role in asthma.” [8] Yet another study showed that giving subjects a compound that improves mitochondrial dysfunction also improved asthma. [9]

So all of this could conceivably lead to a worse case scenario where asthma, through medications and hypoxia, may lower testosterone and lower testosterone may worsen asthma through mitochondrial dysfunction, i.e. a vicious circle would be created.  Let’s hope there is more study work done as time goes on.

1)   https://peaktestosterone.com/forum/index.php?topic=1773.0

2) Vutr Boles, 1988, 27(4):29-32, “The serum testosterone level of patients with bronchial asthma treated with corticosteroids and untreated”

3) Respiratory Medicine, Nov 1992, 86(6):495 497, “Highdose inhaled steroid therapy and the cortisol stress response to acute severe asthma”

4) Respir Med, 1994 Oct, 88(9):659-63, “Testosterone levels during systemic and inhaled corticosteroid therapy”

5) American Journal of Respiratory and Critical Care Medicine, 2002, 165(5):708-712, “Role of Serum Cortisol Levels in Children with Asthma”

6) Respiratory Medicine, Oct 1994, 88*(9):659 663, “Testosterone levels during systemic and inhaled corticosteroid therapy”

7) Diabetes Care, Jul 2005, 28(7):1636-1642, “Relationship Between Testosterone Levels, Insulin Sensitivity, and Mitochondrial Function in Men”

8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066010/, “Mitochondrial Dysfunction and Oxidative Stress in Asthma: Implications for Mitochondria-Targeted Antioxidant Therapeutics”

9) J Immunol, 2009 Aug 1, 183(3):2059-67, “Esculetin restores mitochondrial dysfunction and reduces allergic asthma features in experimental murine model”

10) British Med Journal, Oct 1985, Vol 291, “Plasma testosterone concentrations in asthmatic men treated with glucocorticoids”, p. 1051

11) Circulation, 2005, 112:2660-2667, “Selective Activation of Inflammatory Pathways by Intermittent Hypoxia in Obstructive Sleep Apnea Syndrome”

High Estradiol: Decrease Dosage & Increase Frequency.

Increase Your Frequency and Lower Your Dosage.

Here is a situation I see all the time on the Peak Testosterone Forum after a man has been on testosterone therapy for a few weeks or months and gotten some lab results back:

–Total testosterone = 1200 ng/dl

–Estradiol = 50 pg/ml

Now 50 pg/ml is a high estradiol level by any research results that I have seen and often men with estradiol that high has  typical high estradiol symptoms, including water retention, bloating, low libido, moodiness, gyno and nipple tenderness, loss of erectile strength, etc.  (You can check out some of the studies for yourself on my page Normal or Average Estradiol Levels in Men by Age.)

Unfortunately, most men do not know how to lower estradiol naturally, so they think to themselves, “What pharmaceutical and supplemental solutions are there for me?”  And an aromatase inhibitor like Arimidex or Letrozole will dramatically lower estradiol – no doubt about it.  Fueling this way of thinking are many HRT clinics and anti-aging doctors who use Arimidex for just this purpose as part of their regular HRT protocol.

But, if you are in that situation, I want you to step back for a minute and ask yourself a question:

Why do I have to medicate my TRT (testosterone therapy)?

Seriously, doesn’t it strike you as odd that you have to take a pharmaceutical just to make TRT work?  That’s how I felt anyway when I first went on 150 mg/week of testosterone cypionate with an HRT Clinic and they gave me Arimidex almost immediately.  The reason that estradiol goes up on testosterone therapy centers around the fact that about 80% of our estradiol comes from testosterone via the aromatase enzyme in our fat cells.  That’s right – you get almost all of your estradiol from your testosterone.  (This is not true for women.) So when you significantly raise your testosterone through some kind of a TRT protocol, you will end up raising your estradiol as well – it’s just simple chemistry.  And the more you raise your testosterone, the more your raise your estradiol.

So what alternatives does a man have to naturally lower his estradiol without resorting to pharmaceuticals?  Well, I have already covered dropping those extra pounds around your midsection here: Estradiol and Weight Loss. But their are some other common sense ways to do it as well:

1. Drop Your Dosage. So let’s take the case I mentioned above where a man has testosterone of 1200 ng/dl and estradiol of 50 pg/ml.  If he cuts his testosterone back 20% to 960 ng/dl, he might expect roughly a 20% drop in estradiol as well, which would bring him down to 40 pg/ml.  Now, based on what I have seen, some men will struggle a bit at 40 as well, so this still isn’t perfect.  At that point, it’s time to look at the waistline:  most guys have 20-30 pounds of body fat to lose as well.  Losing that extra weight will probably decrease their estradiol to right where they will feel good and healthy.  Remember that the more bodyfat you have, the more aromatase you have and the more of your testosterone gets converted into estradiol.

And, no, the great majority of men do not need testosterone of 1200 ng/dl to put on muscle, have a great bedroom life, etc. Right now my last two testosterone reads (done simultaneously at two different labs) were 700 ng/dl and 800 ng/dl.  I have been putting on muscle, getting regular morning erections and my libido is high.  I simply have no compelling reason to go higher than that.  More is not always better.

Again, dropping your dosage down will lower your estradiol and is a great first step in many cases.  Discuss with your doctor of course.

2.  Increase the Frequency. Another thing you can do to lower estradiol, at least according the most of the guys on my forum, is increase the frequency of your injections if you are using cypionate or enanthate.  For example, not only did I lower my dosage down to 100 mg/week, but I also went to every other day subQ cypionate injections.  Losing some weight, lowering my dose and injecting every day got my last estradiol read down to 27 pg/ml, which is a good number in my opinion.  Of course, if you are on a topical, this is not a concern, since you are applying your cream or gel daily.

CONCLUSION:  Some commentators insist that men on HRT, as they age, become more “estrogen dominant” and will likely require a low dose aromatase inhibitor. This is risky, because a) there are issues in my opinion with the accuracy and consistency of the current estradiol tests for men and b) if a man accidently goes too low (from test inaccuracies or lack of monitoring), he could end up with osteopenia or osteoporosis several years down the road.  We have a couple of men on Peak Testosterone Forum with osteopenia, and I have no doubt that we have had quite a few more who are completely unaware of it. That one of the issues with bone loss:  you don’t usually “feel” anything until the damage has already been done.

Again, estradiol levels are often high in men on TRT primarily due to the fact that one third of Americans are overweight and another one third obese.  Men can usually drop their estradiol to a reasonable, youthful levels by doing the following:

a) Decreasing the dosage of their testosterone

b) Increasing the frequency of injections by going to subQ cypionate or enanthate injections (assuming is on one of the medium half life esters.) Disregard if you are on a daily topical.  [If you are on pellets, there is not much you can do obviously until your next procedure.]

c) Dropping one’s body fat percentage to about 15%, ideally 10-12%.  (Your partner will appreciate that as well!)

CAUTION:  Find a physician that understands testosterone therapy and osteopenia / osteoporosis and discuss all of the above.  Some men are very low estradiol even with solid testosterone levels, an issue that needs to be discussed with your doctor.

Clomid: Potential Long Term Risks to Your Vision.

1)   https://peaktestosterone.com/forum/index.php?topic=682.msg6258#msg6258

2) J Sex Med, 2010 Jan, 7(1 Pt 1):269-76, “Clomiphene citrate and testosterone gel replacement therapy for male hypogonadism: efficacy and treatment cost”

3) International Journal of Andrology, Dec 1980, 3(1-6):479-486, “The Effect of Clomiphene Citrate on Different Sperm Parameters and Serum Hormone Levels in Preselected Infertile Men: A Controlled Double-Blind Cross-Over Study”

4) Fertility and Sterility, 1977, 28(7):741-745, “Clomiphene treatment in oligospermic infertile males”

5) Fertility and Sterility, 1994, 61(2):390-391, “Optic neuropathy associated with clomiphene citrate therapy.”

6) Ocular Immunology and Inflammation, 2008, 16(1-2):23-24, “Bilateral Anterior Uveitis Associated with Clomiphene Citrate”

7) Fertility and Sterility, Nov 2008, 90(5), “Central retinal vein occlusion associated with clomiphene-induced ovulation”

8) Drug Development Research, Aug 2008, 69(5):272 278, “Effect of clomiphene on [Ca2+]i rises and cell viability in rabbit corneal epithelial cells”

9) Fertility and Sterility, Mar 2010, 93(4):1169-1172, “An investigation of the visual disturbances experienced by patients on clomiphene citrate”

Futhermore, many physicians feel comfortable with Clomid overall and consider it to be a safe long term alternative.  Consider what one poster wrote:

“My doc says he’s had guys on it ‘for years.’ There not that many (if any at all) studies on long term usage of clomid in men. Seems like most docs really feel/think it’s fine, but still – that’s what they *think.*” [1]

For years, eh? So what else is so great about Clomid and why is it so popular?

1. Convenience. Just take a pill.  That’s all you have to do with Clomid.  No messy gels. No driving to the doctors for injections or a pellet procedure.

2.  Inexpensive. One recent study pointed out how cheap Clomid is compared to many of the brand testosterone-boosting alternatives: “The monthly cost of Testim 1% (5 gm daily) is $270, Androgel 1% (5 gm daily) is $265, and CC (50 mg every other day) is $83.”  [Compounded testosterone products are much cheaper and are closer to Clomid in price.]

NOTE:  Standard testosterone injections and compounded creams are typically inexpensive as well.

3.  Fertility. Clomid is used by many fertility physicians to boost fertility.  In fact Clomid can have a very powerful effect in this area:  one study on infertile men showed participants more than doubling their sperm counts! Another study found that within 2-6 months nnot only had sperm counts improved but also sperm motility (mobility/movement) as well.

4.  Testes and Pituitary Activation and Preservation. Traditional testosterone therapy can can lead to some testicular shrinkage especially if the doctor goes into the 800+ ng/dl range.  The shrinkage is actually not very much, depending on the man’s testosterone levels and a few other factors, but many men are very sensitive about “the boys” getting smaller in any way and request HCG to overcome this. (See my link on Testosterone and HCG for more informatiion.) Because of #3, Clomid does not generally result in testicular shrinkage.

Put all this together and some men cannot understand why anyone would go on traditional testosterone therapy. (For some starter information, see my link on Hormone Replacement Therapy.) Clomid seems like the obvious alternative, especially for some of the younger guys wanting to preserve their fertility.  Furthermore, they are considering Clomid as a long term strategy.

The tragedy with this, though, is that these men forget that Clomid is a pharmaceutical and, as such, a synthetic substance that it does have side effects.  Yes, it’s widely used by the fertility and steroid communities and, yes, it has been around for decades.  But that does NOT mean it is suitable for long term usage.

Always keep in mind that Bioidentical Testosterone is just what your body is expecting.  It is the exact molecule that your body needs and uses every day.  This is not the case with Clomid: it is a synthetic molecule and is still not totally understood.  It has a powerful and poorly understood effect on many cells, affecting many pathways, including all-important calcium channeling.  Anytime you put a synthetic molecule into your body, you are taking risks and below we will discuss some of the potential lon term risks.

THE CRITICALITY OF LOW DOSE CLOMID: Before I go on, it is important to note that some of the most famous and respected TRT / HRT physicians use low dose Clomid and they feel that it is safe provided the patient has no side effects.  Furthermore, some patients go on low dose clomid – which can be as low as 12.5 mg EOD – and feel fantastic.  These men will get a nice boost in testosterone and LH, and they feel as good as successful TRT men.  The reason this is so important is that virtually all of the side effects listed below are from men taking higher dosage Clomid or ignoring side effects. So discuss with a knowledgeable physician:  perhaps low dose Clomid is viable option for you.  Keep in mind, though, that no long term studies have been done, and we do not have the extensive research that we have with testosterone replacement therapy.

1.  Mood. Clomid can have a major impact on mood in particular and men can get “estrogen crash” symptoms, i.e. depression, moodiness and so on.  This sometimes manifests itself in a subtle fashion in men.  Clomid will double or triple their testosterone levels, which normally would greatly increase their libido.  However, the men find that they have no increase in lbido and may not even be thinking about sex at all.  Clearly the Clomid in these cases is generally conteracting their increased libido. Going on lower dosages, as mentioned above, helps lower the risk for this issue, but it still happens quite often.

2. Stomach and Headaches.  Clomid can also give nasty headaches and stomach aches as well.  One of our Forum Posts stated “I do get some nausea but not that bad.” Not that bad?? What is 10+ years of mild nausea going to do for you?  For one thing it may be effecting your vitamin and mineral absorption.

3. Vision. On this page I want to focus on the potential long term risk to your vision.  First of all, there have been studies of a year with no major visual issues discovered.  And, yes, there was a study on women that found the following comforting news about Clomid:

“We found no differences between the washout and clomiphene citrate conditions for color vision, visual acuity, contrast sensitivity, and visual fields. The only statistically significant difference was found for foveal flicker sensitivity at 32 Hz in the right eye, with a similar trend in the left eye and at 8 Hz in both eyes.”

That said, there are many case reports and some research summaries have been done and here are just a few examples:

a) Vascular Sludging and Vision Loss.  How does Clomid sometimes effect vision and damage the eye? One issue is that it “gunks up” blood flow to the eye. One woman lost vision in one eye due to this. [5]

b) Uveitis. Several cases of uveitis have been reported, which is an inflammation of certain visual tissues. One study reported the case of a woman who lost vision from uveitis after initiating Clomid therapy, then recovered her vision and then lost her vision again when she repeated Clomid therapy. [6]

c) Retinal Blood Vessel Damage.  Other case reports include injury to retinal blood vessels. [7]

4.  Cytotoxicity. Clomid is known to be cytotoxic (cell-killing) to many types of cells in vitro.  One of these studies looked at rabbit corneal epitheal cells and found that “at concentrations of 0.5 20 M, clomiphene killed cells in a concentration-dependent manner.” [8] In my mind, this is the biggest risk of Clomid.  Is there a chance that it is pro-aging and not antiaging?  Dosage is everything and so maybe this is not an issue and, unfortunately, it is very unlikely to receive funding, because using Clomid to boost fertility and testosterone in men is off label and not particuarly profitable for anyone.

CONCLUSION.  Does it really happen in real life?  You bet it does.  One of our long term member on the Peak Testosterone Forum wrote the following: “When I first saw Shippen he put me on Clomid to test for secondary or primary. And I could have stayed on it but I have a side affect of eye blurriness.”

Again, I think it may be a BIG assumption to think you can take Clomid for 10, 20 or 30 years without risk to your vision. Talk to your doctor about this potential long term issue. (The PDE5 Inhibitors are also notorious for affecting vision and disturbing blood flow to the optic nerve.  Men taking both Clomid and Levitra, Cialis or Viagra should probably be doubly careful.)

So, if you are looking to use Clomid long term, I would definitely disciss the vision issue with your doctor.

REFERENCES:

HCG: Miracle Cure for Low T Testicular Shrinkage.

How does HCG (human chorionic gonadotropin or human chorionic gonadotrophin) raise testosterone? Structurally, HCG is very similar to LH (Leutinizing Hormone).  And, in fact, HCG’s testosterone superpowers come from the fact that the body thinks it is LH.  If you’ll recall, LH is sent from the pituitary and signals the testes to make testosterone. Therefore, HCG also acts as a signal to your testicles to pump out more T.

Is HCG “natural”?  To answer that question, you have to remember that the primary pulses for LH, come during the early morning hours during sleep.  HCG, on the other hand, is given by injection and lasts in the system only for a few days, gradually diminishing based on its half life.  So, although HCG is a natural molecule produced by the placenta and utiltized during birth, it really is not administered in the same way that your body is used to receiving LH. But then neither is HRT and it has done very well in the studies to date in my opinion.

Of course, HCG has been widely used in weight loss treatments (of debatable value) as I outline here in my link on HCG and Weight Loss. And, in males, it is used medically for pubertal issues, such as undescended testes, and fertility. However, there has even been an “underground” use of HCG for years to help steroid users recover their testosterone production.

Many, if not most, steroid users push their testosterone levels significantly beyond normal physiological ranges and end up shutting off virtually all natural production. The excess estrogen and DHT can cause a host of other issues as well, including gynocomastia (“bitch tits”), leaky/irritated nipples, water retention and acne! They have learned all kinds of tricks to help them get around these issues, but, in the case of shrunken testicles and low T production, they often have to resort to treatment with HCG..

One good thing that came out of all these steroid recovery treatments was a greater understanding of other ways that HCG might be used.  And, from what I can tell, more and more physicians are actually using it for treatment.  Consider what these forum posters wrote recently:

–“If the Clomid doesn’t do it for me, he said we’d try HCG.” [1]

–“He put me on a quick protocol of HCG stimulation which would provide a higher LH.”

And now HCG is being used for a wide variety of off label applications.  But it is interesting how many ways one molecule can be utilitzed.  Here are four of the more interesting ones:

1) Testicular Atrophy. HCG is sometimes given in order to induce short term stimulation of the testes and testosterone, generally in order to combat testicular atrophy that comes from steroids or overly aggressive testosterone therapy.

Generally, testosterone therapy (HRT) does not result in significant testicular shrinkage, especially the topicals (Androgel, Testim, compounding).  However, all testosterone therapy will tend to shut off the feedback cycle that occurs from the hypothalamus/pituitary to the testes to one degree or another.  Essentially, the body says, “Oh!  I’ve got plenty of plasma testosterone” and, therefore, does not pump out as much leutinizing hormone.  (The feedback is actually based on estradiol interesting enough, but estradiol rises with increasing testosterone due to aromatization.)  Of course, this is why hormone replacement therapy will almost always negatively affect male fertility. Again, though, testicular shrinkage should be minimal if dosed correctly.

However, I do occasionally receive complaints from men on injections,  because injections start a man off at very high testosterone levels which then taper off to very low levels at the end of the cycle. HCG may be a possible solution for a man that has experienced a significant loss in testicular size from this phenomenon. Discuss with your physician.

2)  Testing for Secondary Hypogonadism. Some knowledgeable doctors will actually test for secondary hypogonadism (low testosterone resulting from pituitary or hypothalamus dysfunction) using a short regimen of HCG.  The idea is that, if HCG can stimulate the testes to produce testosterone, then more than likely the gonads are still functional and okay. Finding a doctor that will even care or bother to look for secondary hypogonadism is difficult at best, however.

Does HCG raise testosterone in all men?  The answer is no and goes back to the mechanism by which it works.  Again, HCG mimics LH (Leutinizing Hormone) and thus “tricks” the testes into producing more testosterone.  Unfortunately, this does not work well with men who have primary hypogonadism, i.e. dysfunction of the Leydig cells in the testes. You can’t “squeeze blood out of a turnip”, eh?

HCG works best in this fashion with men who have some kind of issue with the pituitary or hypothalamus, rather than with the testicular cells that actually produce testosterone. This is why it is so popular with steroid users, who are most mostly younger males who have not yet developed traditional andropause and loss of testicular function.  Almost all of the men on the Peak Testosterone Forum are secondary hypogonadal.

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

NOTE:   It is important to find a good doctor when going on HCG.  Too much HCG can lead to over-aromatization, i.e. too much testosterone converting into estrogen.  Thus, solid experience and monitoring are in order.  Extreme cases can eve result in a kind of burn out of the testicular production of testosterone.

3.  Fertility.  HCG is used by many fertility doctors to help with fertility. For example, look what this forum poster wrote: “Definitely look into clomid and/or HCG to recharge/super charge your fertility again… Clomid took my sperm count numbers from very low into the way high end, and it improved the quality. My urologist said HCG (which i’m on now) is even more powerful/good for sperm..” [3] Again, traditional HRT will almost always lower fertility, whereas HCG can boost testosterone and maintain or even improve fertility a little.  (Check with your physician of course on something as important as fertility!) The reason for this is that HCG’s LH-mimicking abilities kickstart the testes into action and sperm is generally increased according to some fertility docs and urologists specializing in the subject.

4. Correction (Someday) of Secondary Hypogonadism? Apparently, there are a few doctors that believe they can actually solve low testosterone in some cases using HCG as the initial protocol. Of course, this cannot work on a man with primary hypogonadism where the testes themselves are simply not functioning properly. However, secondary hypogonadism can in some cases be caused by extreme stressors, such as trauma and (some experts believe very strong) emotional events. Could the “switch” somehow be switched back on using an HCG protocol?

One forum poster outlined how this worked for him: [2]

“The first reading I got from him in the morning was 498. Keep in mind during this time I had been getting readings from other doctors and all of them were around 305-363 ng/dl and also in the morning as well. I actually got checked into the hospital for a severe depressed episode and had a very sympathetic psychiatrist test my testosterone at around 6pm and it came to 199 ng/dl ( hypogonadal for almost any lab and yes I felt every bit the part of those low levels that many of us on this forum have come to unfortunately know). So the doctor I’m seeing prescribed me a quick regimen of HCG for four weeks. My levels per his lab went from 498 to 699 and this reading was taken in the afternoon because my new job currently requires my early mornings and cannot schedule a morning draw.”

My leutinizing hormone was rock bottom because the hcg supressed its secretion. Remember HCG mimicks LH in the body and will definately have an effect on the HPTA. After the HCG the doctor prescribed me nolvadex or tamoxiphene citrate (selective estrogen receptor modulator) at 20 mg per day for 4 weeks. Nolvadex is used to fight breast cancer in women but it also has an effect on blocking the pituitary from sensing any estrogen in the body and this in turn stimulates the hypothalamus to send messages to the pituitary to secrete LH. The labs taken after the nolvadex showed 701 ng/ml and again this was taken in the afternoon ( 4:30pm) where a man’s levels are definately not peaked. The LH reading was slightly over the normal range and this was due to the nolvadex really getting the pituitary to work.”

“Finally now after a month the doctor had another blood draw in the afternoon from me to see where the levsl were at after the nolvadex had left my system and the lab came to 625 ng/ml. This is very promising as the doctor feels it may be staying there and he thinks I might have a level around the high 700’s or low 800’s perhaps in the morning. I am definately not near as depressed and the libido has improved.”

So, according to this poster, a month afterward, the treatment had “stuck” and appeared to have been successful.  Does this mean that secondary hypogonadism can really be cured in some cases using these kind of “post-steroid recovery strategies”?  Well, this user later lost his gains and ended back where he started from.  But some steroid users have been able to heal post-cycle, so perhaps this will be possible in the future. Hopefully, some of the anti-aging and sports medicine physicians will test and develop strategies that can help some men with their secondary hypogonadism.  Right now, though, it is much more “art than science.”

5. HCG Monotherapy.  Some men are just leaving out the testosterone altogether and sticking to just straight HCG (and Arimidex almost always).  I discuss this option in my link on HCG Monotherapy.

Remember: almost all of these usages are off label and have little study work behind them.  With HCG you are almost always relying on the expertise and judgement of your physician, so get a good doc with good experience. Remember that more is NOT better with HCG and the knowledgeable docs advocate low dosage HCG. If you go high enough with HCG, it is common knowledge that it can desensitize receptors.

NOTE: One interesting potential benefit of HCG is the adrenal connection. Leutinizing Hormone actually stimulates, at least in men with low adrenal function, the cholesterol to pregnenalone pathway and thus may help some men in later stages of adrenal fatigue. [4]

HCG with HRT Protocol:

This is the protocol that my current HRT clinic uses and the pattern seems fairly common:

About 85% of the men at my clinic are on HCG and around half say that they feel some kind of significant positive effect. How much will HCG increase your testosterone? This is highly variable and varies between about 50-300 ng/dl according to the information that I was given. Of course, this does depend on the dosage you are given.

NOTE: HCG has a 24-hour half life and so this protocol only has significant HCG in your system for maybe 72 hours. However, this is enough to keep the testes alive and most men with shrinkage will see an increase in testicular volume from this.

NEWS FLASH: 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.” [5] 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!

REFERENCES:

1) https://peaktestosterone.com/forum/ index.php?topic=107.msg1176#msg1176

2) https://peaktestosterone.com/forum/index.php?topic=175

3) https://peaktestosterone.com/forum/index.php?topic=701.0

4) “AN UPDATE TO THE CRISLER HCG PROTOCOL”, By John Crisler, DO

5) 6) The Journal of Urology, February 2013, 189(2):647 650, “Concomitant Intramuscular Human Chorionic Gonadotropin Preserves Spermatogenesis in Men Undergoing Testosterone Replacement Therapy”

Best High Nitrate Supplement - Peak Testosterone

One of our senior Peak Testosterone Forum members (Prof) did some research and found a great study that looked at many foods, drinks and supplements in order to evaluate nitrate and nitrite content. [1] (It is available as a full study if you wish to read the details.) The best nitrate content was found in the following:

“Note that a desiccated vegetable dietary supplement (Nature s Way Garden Veggies; Nature s Way Products Inc, Springville, UT) had the highest nitrate and nitrite concentrations of any food tested, ie, 27,890 and 10.5 mg/100 g FW, respectively. Each capsule of this supplement contains 900 mg desiccated vegetable product, and label recommendations suggest a daily intake of 2 capsules daily, which equates to >500 mg nitrate and 0.2 mg nitrite per day.”

Now the above sounds very good, especially considering that, as supplements go, this is fairly cheap.  The entire bottle costs $8.95 as of this writing (5/7/2016) and so you the cost per 500 mg of nitrate is about $0.30. Obviously, this is considerably cheaper than buying bags of frozen organic spinach like I do at Trader Joe’s or somewhere similar.  .

However, here is the problem:  I tried this supplement and it did not move the Berkely Nitric Oxide Test Strips at all!  In fact, I took 5 of the capsules over a four hour period and measure twice at the appropriate time and the strips showed “DEPLETED,” which is the lowest level of salivary nitrites.  One of our senior posters observed the same thing and wrote: “I tested the Nature’s Way Veggie Blend capsules this morning. I took 4 of them mixed in with my smoothie (my normal smoothie does not move the Berkeley Test Strips at all from depleted). My reading before the smoothie plus capsules was depleted. My readings 1 and 2 hours later were depleted with absolutely no change whatsoever in the color.” [2]

NOTE: So you can try this product, but two of us now have had no luck with it.  Here is the product here: Nature’s Way Garden Veggies, 60 Vcaps.  Also, if you don’t know what I am talking about, then read my page on Spinach and Erections to get yourself motivated.  These increase my nitric oxide so much that it dropped my blood pressure 10+ points.  Note that this is why spinach (and arugula) are such powerful stimulators of arterial nitric oxide.  For details as to how this works, read my Interview with Dr. Nathan Bryan and keep in mind that you can measure your nitrate levels using the Berkeley NO Test Strips.  You can also read

Of course, one can’t dispute convenience of just popping a couple of capsules.  It obviously takes considerably greater effort to prepare and chew a bunch of spinach or arugula.  That said, let’s compare the above to the amount of nitrate in frozen spinach.  I buy my spinach at Trader Joe’s typically in 454 gram bags (16 oz.).  A reasonable serving in my opinion is a fourth of the bag.  The same study shows that spinach has 740 mg of nitrate per 100 grams of spinach.  Thus eating a fourth of the bag will give you 840 mg of nitrates!  This is about 68% more nitrates than the 2 capsules above.  And arugula can deliver even more nitrates!

1)  Am J Clin Nutr, 2009 Jul, 90(1):1-10, “Food sources of nitrates and nitrites: the physiologic context for potential health benefits”

2) https://www.peaktestosterone.com/forum/index.php?topic=10007.0

So why did I post about this?  My point was this:  stick to spinach and arugula!  Both of these will deliver a good dose of nitrates and, furthermore, they are very likely safe as well.  I always recommend consuming nitrates with low fat in your stomach and Vitamin C for reasons I discuss here:  see my page Are There Any Dangers to Consuming Nitrates in Foods? for details.

Benefits of Testosterone - Peak Testosterone

Testosterone Benefits

The benefits of testosterone therapy (HRT / TRT) were absolutely incredible for me.  I was low testosterone all of my adult life and testosterone gave me morning erections for the first time; helped with some loss in erectile function and libido; and, best of all, got rid of life long dysthymia (mild depression) that I had experienced for decades.  In my case testosterone therapy produced dramatic results and really gave me a quality of life that I simply had not experienced as an adult.  It was beautiful.

And it is really very strange, if you stop to think about it, that you can increase one hormone along the pathway from cholesterol breaking down into such major hormones as DHT, estradiol and cortisol, and produce such a dramatic effect on so many things. If you increase DHT or DHEA or pregnenolone, you just don’t get those kind of profound and widespread benefits generally. (You can read about my experience if you interested in My Personal Health Story.)

Below is STEP 9 in my Testosterone Evaluation Program, which includes Over 15 Very Common, Research-Backed Benefits of Testosterone:

1. Venous Leakage Reversal (Partial or Complete) and/or Erectile Dysfunction. You can have pristine penile arteries that pump out all the nitric oxide in the word, but, if you have venous leakage, you’re not going to be able to get or maintain an erection.  Basically, venous leakage is when your penis cannot trap the blood that flows into it, i.e. as much blood leaks OUT of the penis as enters in.  A common symptom associated with venous leak is a rapidly disappearing erection.  This can cause major problems in the bedroom as some men will lose their erection just walking over to get a condom or walking over to make sure a door is locked!

The most common reason for this is a surprising one:  low testosterone. It turns out that when a man’s testosterone level gets low enough, the nerves and connective tissue inside the penis begin to atrophy. Under this scenario the penis just cannot lock off the veins that carry the blood out of the penis and so inflow and outflow become very nearly equal.  In addition, low testosterone can lead to a loss of morning erections and less sexual intercourse, which decrease oxygenation of the penis.

The good news is that testosterone given to a hypogonadal male has been shown in several studies to reverse, partially or totally, venous leakage.  For details on the research, see my page on Venous Leakage.

HRT can also significantly improve erectile dysfunction itself.  Part of this for some men may be its improvement of venous leakage.  But testosterone, as I’ll discuss below, also raises dopamine, increases endothelial nitric oxide, decreases hardening of the arteries and inflammation and many other parameters that will likely greatly improve erectile strength.  See my page on Testosterone and Erectile Dysfunction for more information.

CAUTION:  Now, before I go on, I want to mention that not every hypogonadal man gets these kind of results.  On the Peak Testosterone Forum there are just as many guys that little or no benefit and some even have side effects.  I cover the dark side of HRT (TRT) in my page on The Risks of Testosterone, and I urge everyone to scan through it. Sometimes HRT-related issues can be explained by a poorly done or poorly monitored protocol.  However, that is certainly not always the case and so you have to be realistic in your expectations.  Furthermore, the root cause of your problems is not always low testosterone.  Of course, it is important to find a knowledgeable and experienced physician and run everything by him or her first.

2. Nitric Oxide.  A less well-known property of testosterone is that it activates endothelial nitric oxide.  This is a powerful anti-inflammatory and arterial protector:  Testosterone and Nitric Oxide.

3. Libido. Many women find it hard to believe that a man could ever have zero sexual desire, but low T will do just that. (So will many other things such as high prolactin, hypothyroidism, etc.) In fact, a couple of studies show that libido rises with testosterone in a dose dependent manner. To check out the research, see my page on Testosterone and Libido.

4. Restored Morning Erections. It is no secret that testosterone therapy can restore morning erections, especially if the testosterone levels are high enough.  As I mentioned, I did not have morning erections until I went on HRT.  More accurately, I did not get morning erections until my testosterone levels were consistently above about 600 or 700.  We have had other posters make the same claim, i.e. that morning erections were returned after a long period of absence due to low T. [5]

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

All of this has been verified by the research.  A number of studies have shown that nocturnal erections are increased and improved after testosterone replacement. However, it is important to note that recovery from lack of morning erections can take time. One study found that morning (and spontaneous) erections improved steadily over the course of 12 months. [7] This is likely because the body must literally rebuild tissues and receptors within the penis.

5. Decreased Anxiety. Many low testosterone men struggle with anxiety.  What is not so well-known is that as one testosterone drops, anxiety can go through the roof.  When I went on injections, that was one of the first things I noticed:  I finally felt peaceful and not so stressed out.  My boss actually made a comment to me and asked what had changed!  See my page on Testosterone and Anxiety for more information.

The reasons for this are probably numerous, but one of the most intriguing ones is that testosterone has been found to limit the cortisol response from CRH at the adrenal.  In other words, testosterone limits your body’s stress response.  See my link on Testosterone and the Adrenals for more information.

Whatever it is, look at the example below as to just how powerful this change can be for a man that increases his T from basement levels:

“I’m also much “calmer” than before and mind seems better able to focus. You would think raising T levels would make you prone to anger and violence? But it has had the opposite effect on me.” [6]

6. Fatigue. When I was low testosterone, I was excruciatingly fatigued and this is a common complaint on the forum.  Again, HRT dramatically helped with this and this is something I simply do not see in the studies.  It makes sense, though, as the studies tend to look at the more quantifiable medical conditions.

7. Desire to Workout. One of the most common comments about HRT is actually that men frequently feel like exercising and hitting the gym again. Hard workouts become the norm instead of the exception. In fact, my HRT clinic warned that men on HRT who complain about joints usually do so because now they are working out hard again and perhaps pushing themselves a little hard, as opposed to low estradiol. And I believe it based on some the comments that I see quite frequently on the forum such as these:

“At 44 yrs old this is the best I’ve ever looked or felt considering the fact that I was preparing to meet my maker 3 yrs ago! I honestly go to the gym now 5 days a week 3 hrs. a day and actually working out the whole time, and I look forward to it since I have the energy now. I’m now at 225 lbs with about 10% body fat and I’m seeing my body change in ways that I’ve never seen before. I have more energy now than when I was 17. Plus my wife is really liking it because she says that I’m acting 17 again when I comes down to our bedroom time ‘which is a lot more now day’s’ If you know what I’m talking about!” [8]

“This weekend I felt like I had to lift because I just took a T shot a day before and could not take a day time nap because I felt like I could not sit still. I went to the gym and ran a mile under 7 minutes, did hardcore ab workout with ab straps doing leg raises and knee raises, and lifted back intensely. Afterwards, I felt a weight off of my impatient feeling like a drug almost. I felt incredible. I love the fact that workouts for me does lifting of my spirit and takes a lot of stress and weight off of me. I do not mean a foggy depressed weight in my head but more so an urge to use my testosterone as a man. I told my wife at that point I had to go to the gym, not to get mad at me, this was an urge that had to be fulfilled. She understood from what she said she has read with treatments. I came back home normal and balanced. It is so nice to have this feeling that I can utilize in such a great way and come home even better than woken up.” [9]

8. Weight Loss. What is not so well known about testosterone is that quite a few studies show that you can lose weight simply by going on testosterone therapy. You don’t have to increase exercise. You don’t have to watch or cut back on calories. All you have to do is boost your testosterone (assuming you are low T of course). Now no study shows that testosterone is going to melt 50 pounds off of you. However, the studies do seem to show that HRT can help you lose a little weight, something I outline in my page on Testosterone and Weight Loss.

9. Lowered Depression. As far as I remember, I never had a morning erection in my adult life, so there is strong chance in my opinion that I was low testosterone my entire adult life.  And I struggled post-puberty with another common symptoms of low testosterone:  depression.  My depression was generally mild and was like “having the blues” or a feeling of melancholy almost continually.  The remarkable thing for me was, when I went on testosterone cypionate, the depression disappeared literally overnight. I have never felt depression a day since.

Now not everyone has this transforming kind of a change with HRT.  And it is important to realize that cypionate probably doubled my testosterone levels.  Nevertheless, many men report significant improvement in depression on The Peak Testosterone Forum and this is supported often in the research as well.  For more information, see my page on Testosterone and Depression. [Do not stop any medications without consulting with your doctor first.) In my opinion, if a man is depressed, one of the first things he should do is pull his testosterone. It’s a $25 test and can be done without a doctor’s orders: Inexpensive Testosterone Labs.

10. Sleep. As far as I know, the researchers have not really examined or quantified just how much testosterone affects sleep. Typically, they are looking at the more “sexy” parameters. However, I can tell you that I and several of the guys on the forum have had horrible sleep when they were hypogonadal. I know that I used to very commonly wake up with the sheets soaked, all of which went away once I got my testosterone levels up sufficiently. Look at what some of the other men on the forum have reported:

“I can tell you I noticed a huge improvement in my sleep quality after going on Tcyp. I sleep harder for sure and I don’t wake up at every little noise anymore, not even my wife’s snoring!” [2]

“I never slept good in my life until I got on testosterone. I sleep 7-8 hours a night usually now unless I’m really tired and then I meet sleep 11. Before that, I would get depressed and sleep 12 hours a day and still feel tired.”

11. Insulin, Prediabetes and Diabetes. This is the least sexy of the benefits of testosterone, but it is probably the most important.  Basically, as testosterone rises, insulin levels and resistance fall.  Because of this, a hypogonadal man that goes on a good TRT protocol can actually reverse his adult onset diabetes.  I discuss this in considerable detail in my pages on How to Reverse Diabetes and Testosterone and Diabetes.

12. Inflammation. Okay, I lied to you in step 10:  testosterone’s primary benefit may be it’s powerful anti-inflammatory action, especially in the arteries. I cover this in my page on Testosterone and Inflammation.

13. Marriage and Relationships. Relationships take a lot of work, especially during the more difficult times of life. Having no libido, no energy, mental fog, fatigue and mild erectile dysfunction is certainly not going to help! And we have had many men on the forum that have felt strongly that low testosterone was jeopardizing their relationship or marriage. For more information, read my page on Testosterone, Marriage and Relationships.

14. Career Building. Guess what the hottest drug on Wall Street is according to a recent ABC article?  Yep, it starts with a ‘T’. [13] For example, check out this commentary from the article:

“He said about 90 percent of his patients are guys who work in finance traders, CEOs, upper-level management. And it’s not just the little guys or executives from small companies. He s got patients from some of the biggest names in finance, including Goldman Sachs, Citigroup, Bank of America , American Express , and Morgan Stanley. The patient list at Cenegenics also reads like a Who s Who of Wall Street: Goldman Sachs, JPMorgan, Deutsche Bank, Bank of America, traders from the New York Stock Exchange and Nasdaq and a lot of hedge funds. Many complain that they used to love going to work but now they’re losing their edge. Their head s not in the game as much.”

So it’s no secret on Wall Street that testosterone can help the brain and there have been some articles and commentary lately that many executives are now on HRT primarily for the mental, career-building benefits.

15. Big Bedroom Boost. Middle-aged and senior guys will usually get the biggest bang – no pun intended – for their buck from PDE5 inhibitors, simply because usually their arteries are in much worse shape than their hormones.  However, that is not always the case and many men – especially young guys – get incredible bedroom benefits from HRT.  If you don’t believe me, check out the descriptions below.  And try not to get jealous while you’re at it!

“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.” [4]

“I make love to my wife on an average 6-8 times a week. I am taking advantage of this feeling because I never had it before and I am 34 years old. I love it. I am finally at the point where my wife has had enough in the bedroom and I am asking for more. This is the first in my life I ever felt so good and confident.” [14]

NOTE: If you read the article, it does have some information such as claiming that testosterone is expensive.  Injections and compounding are actually very reasonable and a number of men on the forum do not have insurance and use these options.

16. Anemia. Struggling with fatigue? Feel achy and drained? I sure did when I was hypogonadal. HRT seemed to slowly melt all that away. One reason that many men do not realize is that this can be partially due to anemia. In fact, it is quite common for low testosterone men to end up anemic, which of course can lead to fatigue and many other unpleasant symptoms. The reason for this is that testosterone stimulates a kidney protein that triggers red blood cell production. This is why men that go on HRT have to get their RBCs, hematocrit and hemoglobin regularly monitored. The good news is that several studies have shown that men who are anemic due to a testosterone deficiency can correct the problem through replacement therapy. [10]

17. Spatial and Verbal Memory and Function. Several studies show that low testosterone men do worse in verbal and spatial mental performance. The good news? Other studies show that men significantly improve in these areas after replacement therapy. [15][16]

18. Super Brain Power. As mentioned above, the most immediate and powerful benefits of going on HRT is often in the brain.  Now that isn’t always true, but many men have reported that the first night they can strongly feel the effects of testosterone right between the ears.  I have always described the experience of my first night on testosterone cypionate injections as “fireworks going off in my head.”  I know it sounds like I am exaggerating but look at what other men have written on the forum:

“On another note I injected Monday for the first time. Yesterday I could tell a difference just a bit. By 1 hour into my shift today I felt like the energizer bunny had hooked up to me for charge up:-)) I was completely shocked at how I felt today. I was told it will get better to in days and with the injections to come over the next weeks. I thought WOW. I felt ready to go to the gym after work to.” [12]

“Well, I have been on the 1st injection for only 48 hours and I actually do feel significantly better! Happier, full of energy, even after my lunchtime gym workout!.” [3]

“I feel better overnight than I ever was on Androgel the entire year I was taking it.” [11]

REFERENCES:

2)  https://peaktestosterone.com/forum/index.php?topic=2402.0

3)   https://peaktestosterone.com/forum/index.php?topic=997.04)  https://peaktestosterone.com/forum/index.php?topic=1243.60

5)   https://peaktestosterone.com/forum/index.php?topic=513.45

6)  https://peaktestosterone.com/forum/index.php?topic=433.0

7)  The Journal of Urology, May 1996, 155(5):1604-1608, “Improvement of Sexual Function in Testosterone Deficient Men Treated for 1 Year with a Permeation Enhanced Testosterone Transdermal System”; 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”

8)  https://peaktestosterone.com/forum/index.php?topic=1414

9)   https://peaktestosterone.com/forum/index.php?topic=513.120

10)  The Journal of Clinical Endocrinology & Metabolism, Aug 1 2000, 85(8):2839-2853, “Transdermal Testosterone Gel Improves Sexual Function, Mood, Muscle Strength, and Body Composition Parameters in Hypogonadal Men”

11) https://peaktestosterone.com/forum/index.php?topic=513.45

12) https://peaktestosterone.com/forum/index.php?topic=941.0

13) https://www.cnbc.com/id/48149955, “Wall Street’s Secret Weapon for Getting an Edge”, Published: 11 Jul 2012, By: Cindy Perman

14) https://peaktestosterone.com/forum/index.php?topic=513.105

15) J Androl, 2003 Jul-Aug, 24(4):568-76, “Cognitive changes associated with supplementation of testosterone or dihydrotestosterone in mildly hypogonadal men: a preliminary report”

16) Neurology, Jul 10 2001, 57(1):80-88, “Testosterone supplementation improves spatial and verbal memory in healthy older men”

Lubricants, Best Natural Lubricants for Intercourse - Peak Testosterone

Remember this famous saying: “Lubrication is of the essence.” Guys know that finding the best lubricant for intercourse is one of the most important things they can do for their sex life but put it off. It’s much more interesting to study sexual positions, eh?

Well, consider this:  all your bedroom technique and performance is absolutely meaningless if your woman is in pain. In another link on Female Libido and Pain, I cover the many, many reasons women can experience pain during sex (besides accidently knocking a lamp onto her head).

One of the most common is vaginal dryness, because females of any age can experience some vaginal dryness during certain times of the month that can make prolonged intercourse painful.  Furthermore, 40% of post-menopausal and/or post-hysterectomy women experience atrophic vaginitis, a drying and thinning of the vaginal walls that occurs from declining estrogen levels. [1]  The microtearing of the vaginal walls can lead to inflammation, yeast infections and even bleeding in some cases. [2]  Yes, this will be bad for your sex life.

So it’s time for Lubrication 101. It’s probably safe to say that most of you know more about lubing your car or truck than the ingredients in a good sexual lubricant.  Well, below I discuss (in descending order) the best ingredients and lubricants for intercourse and – trust me – it’s significantly more complicated than 10W30 versus 10W40.

1.  All Natural. In my opinion the best products are all natural.  As you’ll see below, most of the ingredients in lubricants are straight out of the chem lab and the petroleum fields and most will likely bother the woman in your life one way or the other.  Consider, for example, the top four ingredients in Astroglide Natural:  a naturally occurring sugar (xylitol), an aloe leaf extract, potassium ascorbyl tocopheryl phosphate (an antioxidant blend of vitamins C and E) and pectin (as in fruit). It is also very slippery, long lasting and non-staining, the three critical properties for females everywhere. These type of lubricants are starting to rapidly gain market share and, I believe, will soon dominate.

2.  Silicon. Silicon lubricants tend to be very slippery, relatively long lasting and, most importantly for many, petroleum free.  This makes silicon-based lubricants the preference of many couples. However, silicon definitely has its down side, the foremost being that it can stain clothing, sheets and any other fabrics that you come into contact as your are flailing around the room in ecstasy. The silicon stains can be cleaned, but it requires a certain amount of art and science that some people will not have the patience for. Again, though, many couples swear by it – silicon lubricants are used all the time in industrial applications for a reason! – and probably the classic brand is probably K-Y Sensual Silk K-Y’s Silk is one of the most slippery and slidey of all lubricants and has good staying power as well. One caution is that it is watery in feel and can drip easily upon application.  An alternate K-Y silicon brand is K-Y Intrigue, which is also long-lasting and a little less watery.  It has more of an oily feel which some couples prefer. It is, though, about double the price as Silk and has less of a slick feel. Personal preference I guess…

3.  Glycerin.  Most of the inexpensive lubricants out there, a la Walmart/Target variety, are glycerin-based. Glycerin is a “sugar alcohol” that is slick, slippery and fairly long-lasting.  However, glycerin can break down into sugars and so many experts believe that it can lead or exacerbate yeast infections.

4.  Parabens and Petroleum Products.  Many of the cheaper lubricants, including the ones that contain glycerin, contain propylene glycol which generally comes from the petroleum byproduct propylene.  Propylene glycol is nearly ubiquious in modern societies, being placed in toothpastes, foods, cosmetics and so on. Propylene glycol has survived a number of cancer studies. However, it has definitely been linked, in its airborne form, to increased allergies and asthma. [6] Why?  Because it is an irritant. Furthermore, it has been shown to be very irritating to the skin at even low dosages. [5] So why not put it in products that come into contact with delicate vaginal and penile tissue, right?  Wrong! Many compounding pharmacies actually create propylene glycol-free formulations for those who are sensitive to the stuff.

So, remember, “Sex shouldn’t hurt.”  Well, that is, unless you’re into that sort of thing…

REFERENCES:

1) AM FAM Physician, 2000, 61(10):3090-3096, “Diagnosis and treatment of atrophic vaginitis”

2) https://www.nlm.nih.gov/medlineplus/ency/article/000892.htm

5) Journal of The American Academy of Dermatology, 1991, 24:90-95, “Propylene Glycol Dermatitis”

6) PLOS One, 2010, 5(10):e13423, “Common Household Chemicals and the Allergy Risks in Pre-School Age Children”

Progesterone: The Many Benefits for Male Health - Peak Testosterone

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]

REFERENCES:

Hair Loss and Male Pattern Baldness - Peak Testosterone

Are you ready to put Super Laser Power to work for you?  Are you ready for the Little Woman to once again be able to run her fingers through your hair once again?  Well, it can happen for you.  Most guys will probably tell you that the most humiliating part of aging is was losing those golden locks.  So how can we regain lost youth from the tip of our toes to the top of our scalps?

Well, there’s a right way and a wrong way to do it if you ask me.  Most guys have heard of Proscar/Finasteride and Rogaine/Minoxidil as science-based hair loss solutions.  However, what guys are not told, usually until it’s too late, is that these have very nasty and fairly common side effects, including erectile dysfuntion and arrythmias, respectively.  (See below for more details.)  In addition, real life results seem to be significantly less than the studies.  Consumer Reports found that only 27% and 4% of respondents felt that Propecia and Rogaine, respectively, were “very effective”.. [17]

It takes about a half dozen treatments to generally stop the progression of hair loss and a half dozen more until you start seeing those precious new buds breaking out of the soil. (If you’ve been bald for ten years, don’t expect a miracle.  This is for those who still have some warriors on the moutain top.)

Side effects are minimal, sometimes a little redness and tenderness, and that’s about it. Treatments are usually done a few days or few weeks apart.  The cost is not cheap – around $2,000 – $4,000 for a full year of treatments – but doable for many guys.

NOTE:  The study showed that this was effective with both males and females.

Quite often in the world of health, the counterintuitive is actually correct.  This applies to the case of caffeine as a hair growth stimulant. Caffeine is known as a vasoconstrictor, i.e. it decreases blood flow which is generally bad for hair growth.  However, in vitro (lab/test tube) results show that caffeine is a potent stimulator of hair growth.  Basically, one study removed follicles from the scalps of men with male pattern baldness (androgenic alopecia) and put them in a test tube with and without caffeine. [9] Those in the presence of caffeine grew much more rapidly.

Why, you may ask, am I losing my hair when I have a couple of cups of coffee every morning?  Dr. Weil estimates that you would have to down 60 cups of joe to deliver enough caffeine to your hair follicles for this to work, so the only realistic solution is a topical one applied directly to the skin. [10]

Currently, there are several manufacturers creating caffeine shampoos that seem to be having some positive reviews.  Revita is an example on Amazon:  DS Labs Revita Hair Growth Stimulating Shampoo (2). And I have also read that there is a Swiss company making a line called Alpecin as well. There is a study that shows that shampoos can effectively deliver caffeine to the scalp, but so far there has been no study on whether or not caffeine actually gets rid of male pattern baldness or not.  In the meantime, you can try it if you like…

A small, but well-designed study showed that a combination of saw palmetto and beta-sisterol results in 60% of patients with improved hair growth. [8] These are high numbers, indeed, and saw palmetto likely will help with enlarged prostate and other male issues as well. Life Extension, for example, puts together a product that clearly tries to target this study, i.e. it contains both extracts of saw palmetto and beta-sisterol.  CAUTION:  Although side effects are much less pronounced than Proscar or Propecia, some men report some loss of erectile strength and other similar side effects while using Saw Palmetto.

One study demonstrated that ketoconazole, the primary active ingredient in Nizoral Shampoo, can maintain hair and actually increase its thickness, strength and thus negate the “thinning” effects of aging. [14]  Can it actually grow hair?  So far the only evidence for that is one study on mice. [15]

Of course, Zinc can potentially boost testosterone and reduce estrogen.  But did you know that one form of zinc may be able to put hair on your head as well. Yes, indeed, one study shows real, live, actual hair growth from use of a zinc pyrithione shampoo. [16]  Both Selsun and Head and Shoulders make products with this ingredient: Head & Shoulders and Selsun Salon Pyrithione Zinc Dandruff Shampoo. Better buy a blow dryer and brush while you’re at it.

Any discussion of legitimate hair loss treatments has to begin and end with Finasteride, i.e. Propecia or Proscar Lite, because it’s hard to beat its clinical results.  For example, one study shows that 80% of men were helped with additional hair regrowth is actually achieved. [1]  In this same study it beat Minoxidil’s 50% cure rate rather handily.

The problem with finasteride is that it works too good:  it lowers DHT throughout the body when, in actuality, all that is needed is for DHT to be lowered in the scalp.  This lowering of DHT systemically can cause muliple side effects for guys.  In fact, the side effect profile gets rather ugly rather quickly:

FINASTERIDE SIDE EFFECTS: The biggest concerns with finasteride, a.k.a. Propecia or Proscar, are erection-related and pregnancy-related.  First of all, every decent source that I know of warns against a pregnant woman coming into any kind of contact with this drug as the data strongly suggests that it can cause birth defects in the male fetus. This is scary indeed, because the majority of guys using finasteride are with females who are capable of becoming pregnant even if the likelihood is remote.

The other concern with finasteride is the commond side effect of erectile dysfunction and loss of libido. One study reported the percentage of men with such side effects to be about 15%, which is a very high number indeed. [2]  However, this documented that there is a strong “nocebo” effect from doctors warning that “this drug may cause loss of libido and impotence”.  Apparently, those words from a doctors can create quite the negative effect in many guys!

The well-known PLESS study reported a smaller figure of about 8% in the first year decreasing to 5% in years 2-4. [3] In fact, what is interesting is that 5% was also reported by the placebo group and so we are left the counterintuitive finding that fnasteride start out with a negative side effect that essentially disappears after a year or two.

And that’s not the end of the story. About one in fifty men on Propecia will experience permanent erectile loss due to androgen deficiency and/or resistance. This amounts to chemical castration and I cover the symptoms and one’s readers description of it in my link on The Risks of Propecia.

Studies show that number 2 in the hair repair category has got to be Minoxidil (Rogaine). [4]  Minoxidil induces hair growth in the 30%-50% range and thus is quite effective and with greatly reduced side effects when given in a 5% topical solution.  Minoxidil also has the significant advantage of being over the counter.

What about side effects?  Interestingly enough, minoxidil actually got its start as a blood pressure medication.  It appears to mimic your friend and mine, Nitric Oxide, and derive its magical powers from the same.  The side effects, when used for hypertension, are somewhat scary, including edema in about 7% of patients and altered brain waves. [5]

However, when applied topically on the scalp, the side effect profile is very low – please read the Caution section below! – with by far the most common reported issue being dryness of the scalp and/or or dandruff.  The reason for this is probably that minoxidil must immersed in a base of alcohol and/or propylene glycol, both of which can cause drying of the skin. You can combat this oftentimes by simply using one of the shampoo/conditioner combos that tend to moisturize the scalp.

CAUTION:  Minoxidil, in tablet form, is actually a powerful antihypertensive agent and, as such, can cause drops in blood pressure and irregular heartbeats. This is less common with topical applications on the scalp but can definitely occur. Discuss immediately with your doc if you have any such symptoms.  I personally shy away from minoxidil, because it is notorious (in tablet form) for increasing heart attack risk in lab animals. [11]  That same study found that minoxidil actually changed the ventricular (heart chamber) weights and coronary artery occlusions.  Again, these changes in the heart are not supposed to happen with topical minoxidil but does in some guys using only a lower dose 2% solution. [12]. “Don’t mess with Mother Nature”, I always say, “unless you  really know what you are doing” and this is an example where we don’t understand everything yet.  By the way, minoxidil is a potassium channel opener as well.  Who knows what effect that will have over decades of use??

However, there is one big turnoff for some guys:  the twice a day application with no showering for four hours afterward.  That’s right – you have to apply this morning and evening and then let it sit for four hours, which is a significant time commitment and can, depending on your hair, leave an oily look.

Some people will also be disturbed by the very non-natural propylene glycol, but this is much less problematic than ethylene glycol, bettter known as antifreeze.  In fact, propylene glycol is actually a food additive and used in many household products as well.  Studies show no toxicity or cancer-causing effects except at very high doses.

Several studies have shown that when you combine the active chemical in Retin-A with Minoxidil, superior results are achieved. [6]  In fact, one study showed hair regrowth in 66% of subject which is at finasteride levels. [7]  Researchers believe this is because the Retin-A increases absorption of the minoxidil, allowing it to be more effective.

This has been combined in a product called MinSaw-A and marketed as such. I do not know a cheap way to obtain this product, but mention it.  Again, see the warnings for minoxidil above.

REFERENCES:

1) Dermatology, 2004, 209(2):117-25, “An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia”

2) Sexologies, 17(1):S102, Apr 2008, “T07-O-05 Finasteride 5 mg and sexual side effects. How many of these are related to a nocebo phenomenon?”

3) N Engl J Med 338:557, 1998, “The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group”

4) J Am Acad Dermatol. 2007 Nov;57(5):767-74,  Epub 2007 Aug 29, “A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men”

5) https://www.drugs.com/sfx/minoxidil-side-effects.html

6) Am J Clin Dermatol. 2007;8(5):285-90, “Efficacy of 5% minoxidil versus combined 5% minoxidil and 0.01% tretinoin for male pattern hair loss: a randomized, double-blind, comparative clinical trial”

7) J Am Acad Dermatol. 1986 Oct;15(4 Pt 2):880-3, 890-3, “Topical tretinoin for hair growth promotion”

8) J Altern Complement Med, 2006 Mar;12(2):199, “A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia”

9)

10) https://www.drweil.com/drw/u/id/QAA400216

11) Hypertension, 2001, 37(2):209-215, “Mortality after coronary artery occlusion in different models of cardiac hypertrophy in rats”

12) https://www.drugs.com/sfx/rogaine-side-effects.html

13) International Journal of Cosmetic Surgery and Aesthetic Dermatology, Aug 2003, 5(2):113-117, “Hair Regrowth and Increased Hair Tensile Strength Using the HairMax LaserComb for Low-Level Laser Therapy”

14) “Ketoconazole Shampoo:  Effect of Long-Term Use in Androgenic Alopecia”, https://www.hairlosstalk.com/hair-loss-pdf/nizoral-study.pdf

15) J Dermatol, 2005, 32 (4):243-247, “Topical Application of Ketoconazole Stimulates Hair Growth in C3H/HeN Mice”

16) Br J Dermatol, 2003 Aug, 149(2):354-62, “The effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a randomized controlled trial”

17) WebMd Magazine, Jun 2010, p. 13.

18) Prevention, May 2010, p. 16.

CAUTION: If you’re currently taking medications, you should definitely check with your doctor or pharmacist if they could be causing or exacerbating your thinning hair.  Many blockbuster drug categories, including angiotensins, beta-blockers, ACE inhibitors, diuretics and blood thinners, can negatively effect hair. [18]

So is there no hope for us with Scalp Dysfunction Syndrome?  See my link on Hair Loss Factors for more natural solutions and protection.

Below I have outlined the approaches that have achieved good success in the research, although the pharmaceuticals are downright dangerous as I cover below:

Solution #1: Low Level Laser Therapy

Of course, surgical hair replacement is always an option to restoring your hair.  It is, however, quite expensive, time consuming and physically uncomfortable.  The hot new cosmetic technology involves firing up a good ol’ fashioned laser beam and directing that right at the top of your head. (Actually, it’s a bunch of laser beams.)  Who would have thought that laser technology might one day turn you back into a rock star? The treatment methodology is actually called LLLT, for Low Level Laser Therapy and produced solid results in one recent study where the number of hairs and the strength of existing hairs was increased. [13] What else could you ask for, eh?

Solution #2: Caffeine ShampooSolution #3: Saw Palmetto with Beta-SisterolSolution #4: Nizoral (Ketoconazole)Solution #5: Zinc Pyrithione ShampooSolution #6: Finasteride, Proscar or PropeciaSolution #7: Minoxidil or Rogaine

Testosterone-Killers - Prolactin and Prolactinomas

Some hormones just don’t tend to play well with your testosterone.  Cortisol and estrogen are examples.  Another hormone that can whack your testosterone and your sex life is prolactin.

Prolactin is a fine hormone and great for sleep, but, unfortunately, it makes a lot of other important things go to sleep, including your testosterone and fertility if levels are high enough. It is, not too surprisingly, often devasting to erections due to decreased testosterone levels and because it antagonizes dopamine and leads to an increased refractory (recovery post-erection) period. [4]  Excessive prolactin is also associated with gynecomastia, i.e. “male boobs”. [2] And probaby most dangerous of all in the long term, prolactin is probably an inflammatory cytokine (TNF alpha, IL-6, etc.) and has been linked to various inflammatory diseases, especially lupus. [7]

In females, hypothyroidism is a common cause of elevated prolactin levels.  In males, hypothyroidism likely raises prolactin

Consider the fact that one study noted that previous research found an “overall prolactin greater than 20 ng./ml. in 1.86% of 1,821 patients, prolactinomas in 7, 0.38%.” but found only five out of about a thousand men had prolactin exceeding 20, i.e. about 0.5%. [6]  In other words, high prolactin is generally not a root cause of low T, but it certainly can be and at a rate of somewhere around 1 out of a 100 hypogonadal men.  However, the researches still concluded that “prolactin should be determined only in cases of low sexual desire, gynecomastia and/or testosterone less than 4 ng./ml.”  This is an amazing statement because it recommends that prolactin be pulled for testosterone less than 400 ng/dl, something that is simply NOT done from all I have seen.  My impressions from the  The Peak Testosterone Forum is that probably one out of every ten men has their prolactin pulled.

NOTE: You can have very high prolactin and yet still not be hypogonadal.  The same study found that “testosterone was low in less than 50% of cases with prolactin greater than 35 ng./ml.” [6]

So how do males get very elevated levels of prolactin then? One all-to-common cause is a prolactinoma, a benign tumor of the pituitary that begins secreting, sometimes in great quantities, prolactin. This can have devastating effects.  Look at the description of this reader in his mid 40’s:

“I started experiencing longer and longer periods between being able to have sex starting about 4 years ago. It is to the point now that I don’t know when I can get it up. It has been very hard on my marriage and my wife has since moved out because she felt unloved and unattractive because of my lack of sexual desire. As you can imagine now that she has moved out I am taking this very serious. Here are my issues. I was going to a family doctor and wasn’t liking the results I was getting. He told me I had low testosterone and put me on Andogel packets.”

His low testosterone was devastating as you can tell. How tragic that a physical malady could lead to the undoing of a marriage.  However, he did write me back with some good news:

“Are you sitting down for my Prolactin reading? It was 200. Normal from what the doctor told me is 1 – 12. This is supposed to be curable from what I have heard so I am very exited as you can imagine. Thanks again.”

Elevated prolactin is very anti-testosterone and often leads to hypogonadism. [3]  His levels were astronomical and thus it is not surprising that his testosterone was so adversely affected.  (He was correct, of course, that normal prolactin levels are less than 12 ng/ml or maybe 15 ng/ml.) In his case, they did not find a prolactinoma or other tumor from an MRI, but put him on the standard medication and he got immediate results.

So, if you are wondering where your testosterone levels went, you may want to ask your doctor about getting a prolactin reading.

OTHER READING:  I have another page that covers Causes of Low Testosterone and it covers the frequency of pitutitary tumors in men with low testosterone.  Suffice it to say that the frequency is surprisingly high.  I also want to point out a must read journal article called “Long-Term Management of Prolactinomas” that is must-read for anyone with a prolactinoma. It looks about long term safety and issues, both positive and negative, with the dopamine agonists that are standard therapy.

CAUTION:  Read my link on The Importance of Avoiding Excitotoxins.  Animals studies show that prolactin levels can be negatively affected due to excitotoxin damage to the hypothalamus. In addition, minoxidil is suspected of causing prolactinomas and elevated prolactin levels. [5] Minoxidil (Rogaine) is a common over the counter hair loss treatment.

REFERENCES:

1) The American Journal of Medicine, May 1978, 64(5):782-787, “Serum prolactin levels in untreated primary hypothyroldism”

2) Psychiatr Serv, 51:983-985, Aug 2000, “Psychopharmacology: Galactorrhea and Gynecomastia in a Hypothyroid Male Being Treated With Risperidone”

3) N Engl J Med 1978; 299:847-852, “Prolactin-Secreting Tumors and Hypogonadism in 22 Men”

4) Rev Urol, 2000 Winter, 2(1):39 42, “Hyperprolactinemia and Erectile Dysfunction”

5) https://en.wikipedia.org/wiki/Hyperprolactinaemia

6) The Journal of Urology, 1997, 158(5):1764-1767, “Endocrine screening in 1,022 men with erectile dysfunction: clinical significance and cost-effective strategy.”

7) Rheum Dis Clin North Am, 2000 Nov, 26(4):713-36, “Roles of prolactin and gonadotropin-releasing hormone in rheumatic diseases”

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

Second Best HRT : My Vote is For Compounded Testosterone

I cannot think of anything more “unnatural” for a man than to be than low testosterone.  Low libido, mild depression, medium anxiety, erectile dysfunction, venous leakage, mental fog, elevated insulin levels – all of these are very common side effects or symptoms of reduced testosterone levels.  (Been there!)  For men struggling with Low Testosterone Symptoms, low testosterone is just miserable and no way to live.  One can often barely function and merely surviving the workday and home life.

Furthermore, men who go on HRT often experience a kind of renaissance.  One poster with major health issues found that he was likely going to have to go off of HRT (testosterone therapy) and wrote “I started my T replacement 3 months ago and feel better than I’ve ever felt in my life.” [1] This enthusiasm for testosterone therapy is a very common reaction on the Peak Testosterone Forum.  Yet another man wrote:

“Well, I have been on the 1st injection for only 48 hours and I actually do feel significantly better! Happier, full of energy, even after my lunchtime gym workout! I realize placebo can be powerful, however, I doubt that is what is going on here, at least for the most part. My cardio output on the life cycle today was noticeably up in cal/minute as well as rpm with less fatigue afterward than what I had prior. I also woke up a couple of times during the night with wood that hasn’t been around in that way for years! I don’t really have ED even before the HRT. Just no automatic or random wood. I could get wood if I got busy with the wife pretty easily, but I just had no interest in getting “busy”. Now half the girls that I previously barely noticed look pretty good. Getting that animal like feeling again! Lastly I seem to be more clear headed, but this could be placebo. I wasn’t terribly foggy prior to be honest.” [2]

Clearly this description of “life with testosterone” is the natural way a man is supposed to live, that is with a strong libido, clear head, etc.  But can we go a step farther?  Can we actually say that HRT is a natural solution?

This is actually an important and pertinent question.  For example, I get asked in one way or another why I am supportive of HRT when my site is supposed to be a natural men’s health site.  Well, that question makes a big assumption and that is that HRT is not natural.  I don’t think it’s that easy and I discuss both the pros and cons below.

NOTE:  I am only supportive of HRT when it is well done by a physician (on a man with verifed low or lowish tesetosterone) with proper monitoring and estradiol management.

1. Testosterone Replacement. Again, there is nothing natural about low testosterone.  It is a miserable existence for many men that negatively impacts their career, relationships and sex life.  So why not restore a man’s testosterone levels to a more youthful level?  This is what is meant by Testosterone Replacement Therapy:  you are simply replacing the testosterone that is “missing” and should be there in the first place.

CoQ10 levels fall precipitously with aging and most men would have no trouble taking some CoQ10 to boost their plasma levels to a higher, more youthful level.  Furthermore, there is a lot of research that taking CoQ10 can help with many key health parameters.

Is taking testosterone really any different?  Testosterone is just as ubiquitous of a molecule and every bit as important.  So why pay attention to antioxidants and ignore hormones?  Does that make any sense?

2.  Bioidentical. Remember that most of the standard testosterone therapies out there now use bioidentical testosterone, i.e. your body could not tell the difference between the testosterone molecule in the drug and one that circulates in your plasma.  This includes the topicals, such as Androgel and (generally) compounded creams along with pellets and patches.  The one small exception are the esters of testosterone (cypionate, enanthate and undecanoate).  In the case of these injectibles an ester is attached to the testosterone but is easily broken off immediately leaving one with bioidentical testosterone.

Of course, talk to your doctor, but, from what I have read there is a broad consensus that the esters are not harmful to the body in any way.  The real concern is with some of the synthetic steroids that are close to testosterone but not quite the same.  These can cause liver and other issues and are anything but bioidentical.  From what I have seen, these are rarely prescribed by physician for HRT and are pretty much the exclusive property of steroid users.

Why HRT Is NOT Natural

1.  Estradiol. Unfortunately, aging, stressors and weight gain all can lead to increased conversion (aromatization) of testosterone to estradiol, the “bad” estrogen or E2. In particular, most men put on anywhere from 10-50 pounds of extra fat in adulthood.  Even men who are fairly lean in middle age will often have a nice band of visceral fat around their middle.  Their legs and arms are pretty thin, so they don’t realize how much extra weight they’ve put on since their teens and/or 20’s.  But that extra weight can really accelerate the conversion of their precious T into the estrogens and that holds true for men on HRT.  Any man going on HRT with a lot of body fat is going to very likely produce a lot of estradiol as well.

And excess estradiol is probably the single biggest reason for problems during HRT.  It can lead to bloating, prostate issues, gynocomastia, depression, loss of libido and so on.  And, when estradiol goes too high, many HRT clinics and physicians will put their patients on low dosage Arimidex.  This is extremely common on the Peak Testosterone Forum .

Now the minute that you introduce a pharmaceutical into the equation, things definitely become unnatural.  However, it can be argued that this is of minimal concern for two reasons:

—Dosage.  The Arimidex required is very low dosage and almost all the side effects that are experienced from this medication are in patients taking much higher amounts, such as men with prostate issues or women with breast cancer.  The typical male on HRT will be taking a 1/2 mg twice per week as opposed to the typical male/female with cancer who is taking maybe a gram per day.

—Short Term.  Many HRT men can actually get off of Arimidex after 6-9 months, because a) testosterone helps them to lean out and lose weight and b) a natural “settling and rebalancing” process seems to occur.  This makes Arimidex a shorter term issue.

2.  Improper Delivery Methods. It can also be argued that HRT does not always properly mirror the body’s natural way of releasing testosterone.  For example, in a healthy male, testosterone is released in the early morning hours and then decreased significantly (~20-40%) by evening.  This does not really occur with many of the delivery methods such as injections and pellets. In addition, topicals may be particularly “unnatural” in the sense that there is some evidence that that they unnaturally raise testosterone and estrogen levels in the extremities. See my link on Testosterone Risks for more information.

3.  DHT. Some of your testosterone is converted to DHT through the 5-alpha reductase enzyme.  DHT is very important for many “male” functions including libido.  However, too much DHT can lead to accelerated male pattern baldness and enlarged prostate.  So one concern that early practitioners of HRT had was:  would some men given testosterone therapy experience negative results from the increased DHT?

As far as I know, there are no studies that show this to be a statistically significant issue.  However, some men do report hair loss and enlarged prostate as a side effect of their HRT.  So it is definitely possible that a small percentage of men have trouble with this issue.  And so one could ask if giving T to these men is really a natural solution since it seems to elevate their DHT to unneeded levels.  (The rebuttal is that these men may have something in their lifestyle that is causing them to be “high converters” – we just don’t understand this pathway well enough yet.)

4.  Proper Level.  There is also the issue that men have significantly varying baseline testosterone levels in their teens and 20’s.  So how do you know what is the correct level to restore them to, i.e. what will be natural for them?  Some men probably peaked around 1000 ng/dl, some 800 and some maybe even 600.  Their body’s and brains are probably tuned differently.

5.  Testes Function. If you are low testosterone and raise your T substantially, you will usually lower your fertility and in some cases even experience some shrinkage of the testes.  Many men would argue that is unnatural because it is extinguishing a natural process of the body.  And, for this reason, many men take supplement HCG during testosterone therapy to avoid testicular shrinkage.  See my link on Testosterone and HCG.

And, in all cases, probably none of them have baseline testosterone levels from that time period.  I have seen a few weird reactions on the forum from men who have undergone testosterone therapy and it is probably for this reason.  The change is testostserone created mood and mental issues for one man, in particular, who probably should not have had his testosterone pushed so high so rapidly.

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=1522.0

2) https://www.peaktestosterone.com/forum/index.php?topic=997.0

Toothpaste: Here Are Some Evidence-Based Natural Alternatives

Is toothpaste dangerous?  Could it even potentially harm erections and erectile strength?

After you read what they put in modern toothpastes, I think you’ll agree that one could hardly devise a more dangerous cocktail of chemicals to use in your mouth (and gut since you invariably swallow some of it).  And, yes, the potential is there for the stuff to actually affect your sex life as I’ll show below.

By the way, this is another beautiful example of a health-desiring person possibly sabotaging his (or her) health thanks to what I consider indefensible consumer product marketing. Again, no one is going to watch out for your health except you!

NOTE: See my link on Real Natural Toothpaste Alternatives for some very practical information. Of course, discuss with your dentist before actually making any changes.

Without even going into the flouride controversy, here are just a few of the rather blatant risk in standard toothpastes (at least here in the U.S.):

1.  Triclosan and Erections.  As I covered in my link on Antimicrobial Soaps, someone got the bride idea to put an insecticide and fungicide in toothpaste and now almost all the big sellers in the U.S. do so.  Now why, on God’s green earth, would someone put an insecticide/fungicide in toothpaste? Simple:  it kills not just bugs and fungus but also bacteria.

1) J. Antimicrob. Chemother, 2000, 45(2):153-158, “The effect of triclosan toothpaste on enamel demineralization in a bacterial demineralization model”

2) ANALYTICAL AND BIOANALYTICAL CHEMISTRY, 383(7-8):1119-1126, “Aquatic degradation of triclosan and formation of toxic chlorophenols in presence of low concentrations of free chlorine”

3) Environ Health Perspect, 1986 Nov; 69:49-58, “Enhancement of the hepatotoxicity of chloroform in B6C3F1 mice by corn oil: implications for chloroform carcinogenesis”

4) Environ Health Perspect, 1982 Dec, 46:141-149, “Dose-response study of chloroform carcinogenesis in the mouse and rat: status report”

5) https://isurvived.org/drMengele.html

6) https://en.wikipedia.org/wiki/Sodium_laureth_sulfate

7) Circulation, 2011, 124:A17704, “Abstract 17704: The Association of Tooth Scaling and Decreased Cardiovascular Disease -A Nationwide Population-Based Study”

8) Quintessence Int, 2011 Jan, 42(1):29-36, “The antiplaque efficacy of pomegranate mouthrinse”

9) J of Herbal Pharmacotherapy, 2006, 6(2):79-92″Punica granatum (Pomegranate) Extract Is Active Against Dental Plaque”

Bacteria in the mouth are what, depending on how you look at it, cause the plaque buildup on the enamel of your teeth.  So, applying standard military tactics to this simple health problem, the enemy needs to be eliminated and triclosan does the job quite well. Many studies have shown that triclosan reduces plaque for example. [1]

CAUTION: Good dental hygiene is very imporant.  I have to admit that many studies have shown that those who take care of their mouth with brushing. etc. have improved cardiovascular outcomes. [7] The reason? Any “infection” in the mouth can increase system, whole body inflammation and that leads to accelerated heart disease. So, ironically, diflucan may protect your arteries somewhat but limit  your nitric oxide output.  More study work should be done.

To all of this, I can only say, “There has got to be a better way!”  Fyi:  I have found that by not eating sweets, I get almost no plaque in my mouth and get comments from my dentist of the same. Let’s be honest here:  maybe the diflucan is only necessary because of the sugars and processed carbs that we consume?

2. Chloroform. Consumer product companies used to put choloroform directly in toothpastes. Fortunately, the FDA banned this. So how did the manufacturers get around this? Triclosan! That’s right – a lot of research has shown that this insecticide actually degrades into chloroform when exposed to the chlorine in tap water. [2]

So what’s a little chloroform among friends?? Well, it causes birth defects in animals, but we’ll skip that since this is a men’s site. The primary reason for us males is that chloroform has been shown in many studies to cause cancer, especially of the liver. [3][4] Yes, in this case the FDA was watching out for you. Unfortunately, toothpaste manufacturers were not.

NOTE: The Nazis used chloroform and the notorious Dr. Mengele used it to kill patients instantly by injecting it into the heart. [5]

3. Sodium Lauryl Sulfate. You may recognize this chemical from your reading your shampoo bottle sometime when you were bored. So what is it doing in your toothpaste? Because sodium lauryl sulfate is a strong detergent and also foaming agent. In fact, it is strong enough to clean your tile and floors and is used in some commerical products due to its cleaning powers.

Now so far it does not appear to cause cancer, but it is definitely an irritant. Furthermore, it can be contaminated with a side chemical that is a strongly suspected carcinogen. [6] That nice clean, foamy mouth feeling after you brush? You can thank corporate American for putting an industrial detergent into your mouth!

Natural Alteratives to Toothpaste?

So are there any better solutions?  Well, this is a bit tricky I’m afraid and you’ll have to do a bit of research on your own and/or discussion with your dentist.  One natural solution that I am investigating is Pomegranate Extract.  One recent study looks very promising and found that pomegranate was as effective as chlorhexidine, a standard antiseptic mouthwash that was once prescription-only (at least here in the U.S.) at preventing plaque buildup on teeth and enamel [8]  This verified previous study work that found pomegranate was anti-plaque. [9]

NOTE: See also my link on Periodontitis Prevention for other natural ideas and solutions as well.

CAUTION: Discuss with your dentist. Dental plaque and periodontitis is potentially serious and leads to systemic inflammation that can hurt long term cardiovascular health.

REFERENCES:

Binge Drinking and Testosterone - Peak Testosterone

REFERENCES:

1)  Alcoholism: Clinical and Experimental Research, Dec 1990, 14(6):928-931, “The Pulsatile Secretion of Gonadotropins and Growth Hormone, and the Biological Activity of Luteinizing Hormone in Men Acutely Intoxicated with Ethanol”

2) Journal of Steroid Biochemistry, Nov 1974, 5(7):655 658, “Low plasma testosterone values in men during hangover”

3) Am. J. Epidemiol. (2002) 155(3): 242-24, “Alcohol Volume, Drinking Pattern, and Cardiovascular Disease Morbidity and Mortality: Is There a U-shaped Function?”

4)  The Journal of Clinical Endocrinology & Metabolism, Feb 1 2002, 87(2):589-598, “Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men: Longitudinal Results from the Massachusetts Male Aging Study”

5) Strength & Conditioning Journal, Feb 2006, “Effect of Postexercise Alcohol Consumption on Serum Testosterone: Brief Overview of Testosterone, Resistance Exercise, and Alcohol”

6) “Alcohol Consumption, Binge Drinking, and Early Coronary Calcification: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Study”

7) AJP – Endo, February 1 2010, 298(2):E320-E328, “Binge-pattern alcohol exposure during puberty induces sexually dimorphic changes in genes regulating the HPA axis”

8) Alcohol and Alcoholism, March/April 2006, 41(2):126-132., “ACUTE IN VIVO EFFECT OF ETHANOL (BINGE DRINKING) ON HISTONE H3 MODIFICATIONS IN RAT TISSUES”

9) Hormones and Behavior, Nov 2001, 40(1):396 402, “Sensation Seeking and Hormones in Men and Women: Exploring the Link”

10) Am. J. Epidemiol, 2009, 169(9):1052-1063, “Sleep Duration in the United States: A Cross-sectional Population-based Study”

11) https://www.dailymail.co.uk/health/article-3057670/Binge-drinking-teenager-damage-brain-LIFE-Alcohol-triggers-changes-regions-affecting-memory-learning.html

I’ve never felt compelled to write a page about what alcoholism does. It seems pointless.  Everyone knows it is very hard on the body and brain, so I would just be stating the obvious. But what may not be so obvious are the evils of so-called “binge drinking.” Many men will drink heavily on a weekend night or two figuring that they “have the rest of weekend to recover.” The problem is that you don’t really recover. Sure the hangover goes away. And, yes, you feel fine in 24-48 hours. But, unbeknowst to most people, damage is accumulating.  And, if you binge drink repeatedly, it can take its toll.

It turns out that binge drinking has actually been quite heavily studied.  And the reason undoubtedly is that it is so hard on the body. They even have technical definitions for it, which usually is five or more drinks on one occasion (for men).

Below are eight nasty effects that result from binge drinking and, as you’ll see, these attack everything you hold near and dear as a man:

1. Testosterone. One study gave 1.5 grams of alcohol per kg of body weight during a three hour period to young men in their early to mid 20’s. [1] Now, admittedly, that is quite a bit of alcohol, but the results are instructive nonetheless and mimics what a lot of guys consume in a drinking contest or on a night with certain friends.  Let’s take the typical 180 lb man.  Those 180 pounds are about 81 kg and so he would need to consume about 122 grams of ethanol to match the dose in this study.  In the U.S. that would be about 8.7 “standard drinks”, or almost nine 12 oz beers.  Now that’s a lot of beer – at least for this cowboy – but certainly not totally unrealistic.

And let’s look at what happened to the testosterone levels of these young men.  The researchers took measurements every four hours and found that testosterone decreased on average by 23% with the nadir occurring between 10 and 16 hours afterwards.  This means that testosterone will be significantly suppressed for about 24 hours in most of these men. Another study found that the men with hangover symptoms had the most profound decreases in testosterone and found that “ten to twenty hours after drinking, the testosterone concentrations were significantly decreased in all subjects.” [2]

2. Growth Hormone.  The same study found that “ethanol profoundly suppressed the pulsatile secretion of growth hormone.” [1] So forget anything worthwhile coming out of your gym time the next day with testosterone and growth hormone hammered downward.

3.  Heart Disease.  Research shows that this kind of “drinking in bursts” can lead to heart disease.  One study found that “binge drinking increased the risk of coronary heart disease in both men (hazard ratio (HR) = 2.26, 95% confidence interval (CI): 1.22, 4.20) and women (HR = 1.10, 95% CI: 1.02, 1.18).” [3]  Now this is not that much of an increase for females, but notice that it more than doubled th risk for men.

4.  Arteriosclerosis and Hardening of the Arteries. One interesting study followed young people for 15 years.  It was found, in general, that the more alcohol consumed, the greater the arteriosclerosis.  However, the authors made special note that “calcification was also more common among binge drinkers (odds ratio = 2.1, 95% confidence interval: 1.6, 2.7). These associations persisted after adjustment for potential confounders (age, gender/ethnicity, income, physical activity, family history, body mass index, smoking) and intermediary factors (lipids, blood pressure, glucose, C-reactive protein, and fibrinogen).” [6]

5. .  There is no study that shows binge drinking is linked to erectile dysfunction.  However, if either #3 or #4 is true, then it very likely does affect hardness factor and bedroom performance.  Almost anything that affects the heart affects the penis after all.

6. Anti-Muscle.  One study showed that consuming alcohol post-workout sabotaged the best laid plans to put on muscle. [5] Their conclusion should surprise no one: “it appears that alcohol intoxication interferes with the testosterone response to resistance exercise workouts.”

7.  Permanent Weight Gain and HPA Axis Dysfunction. If you binge drink at a young enough age, it can lead to permanent changes in your HPA Axis such that you put on weight easier forever thereafter according to one study. [7] This shows the very toxic nature of alcohol intoxication and animal studies show that alcohol can actually alter one’s epigenetics in many different tissues. [8]

8. Disrupted Sleep. Alcohol is a sedative and helps you sleep, right?  Yes, that’s true, but what many men do not realize is that it acts like a sedative for a couple of hours and then as stimulant later on the early morning hours. For this reason,  binge drinking is associated with shortened sleep. [10] And sleep is one of your primary engines of testosterone.  It is during the early morning hours that the pituitary sends out pulses of leutinizing hormone that then triggers testosterone production in the testes.  As I discuss in my link on Sleep and Testosterone, the less the sleep, the less your testosterone.

9. Permanent Memory Damage. A recent study showed that binge drinking as a teen likely resulted in permanent loss of memory for the rest of one’s life. [11] I doubt anyone was too surprised, since other studies have shown that it increases the risk of dementia as well.

CONCLUSION and COMMENTS:  One comment that I have gotten on the Peak Testosterone Forum from time to time is that men, after a significant of drinking, notice strong morning or next day erections.  This may be explained by the fact that alcohol is a vasoilator..  However, more is not always better and binge drinking is a great example of that.

There are plenty of other drinks that can help you get and keep your erections.  I have a link on True Manly Drinks that gives you many ideas. One of them,  pomegranate juice, may actually clear out your arteries while it’s boosting your nitric oxide. For more information, see my link on Pomegranate Juice.

CAUSES: What would cause one to want to binge drink?  I have asked myself that question when I look back at my college days!  Researchers have found that, interestingly enough, as cortisol decrease, risky behaviors, i.e. “sensation seeking” go up. [9] So there may be an underlying cause that has its roots in the HPA axis.

Protein Myths: You Need Less Protein For Testosterone and Muscle

Most men reading this are under the assumption that more protein is better along with the idea that high protein diets are healthier, more satiating and pro-hypertrophy (muscle building).  Now all of those are true to one degree or another, but most of the advise out there is really suited only for a) men on steroids and b) protein manufacturers who want to sell more tubs of powdered protein.  At one time, I accepted the same dogma and was probably the typical guy out there that has consumed mountains of whey powders, egg whites, chicken and even a few raw eggs along the way.  (Don’t do that one please!)  [As I became more plant-based, I downed boatloads of rice, yeast, hemp and pea protein.]

As time has gone on, I have grown to realize that there is almost NO science behind any of the protein requirements that I believed and below is a summary of some of the most important research:

1. Weight Lifters Need a Gram per Pound of Body Weight.  False!  This shocked me when I first read it, but there is NO evidence that you need a gram per pound of body weight. I simply cannot tell you how many times I have read this in bodybuilding magazines over the years and read it in forums and blog articles – too many to count.  The truth is that the research shows that bodybuilders and strength athletes need between 0.5 – 0.8 grams per pound.  And it should be mentioned that the 0.8 number is more for the serious strength athlete.

Where do I get that range of 0.5 – 0.8?  Those are the current recommendation from the National Academy of Sports Medicine (NASM), who has merely summarized the research to date. [3] (NASM is one of the largest training organizations here in the U.S.) The ACSM has simiilar recommendations of 0.7-0.8 grams per pound for strength athletes. [4] These organizations did not just cherry pick a number out of the air, but rather did extensive research reviews.  Again, study after study has shown the same thing:  you simply do not get any benefits above about .8 gram per pound and the upper end is generally only for very serious athletes.

2. Endurance Athletes Need a Gram per Pound of Body Weight.  Again, this is another total myth:  the recommended protein levels for endurance athletes are 0.5-0.6 grams / lb for both NASM and ACSM. [3][4] No benefit has been found by exceeding these protein levels.

3. Protein Increases Testosterone. Actually, the opposite is true according to a number of studies.  This is something that I will cover in more detail on another page, but a few studies show that both total protein and a higher protein/carbohydrate ratio likely lead to decreased testosterone levels. [5][6]

4. Protein Is Good For You and Increases Longevity. Of course, some protein is good for you – no one disputes that.  But the real truth is that overly high levels of protein likely accelerate aging and may increase your risk of cancer. Can I prove that?  Well, give me a chance here as I have to give you a little background:

First of all, the protein in food is always composed of a blend of amino acids.  If you buy any protein powder, just look at the label on the jug and you can see all the constituent aminos contained and in what amounts.  One of these aminos will be methionine and it ramps up IGF-1, which stands for Insulin-Like Growth Factor.  IGF-1 is aptly named, becasue growth is what IGF-1 is all about.  It’s extremely important when you are young as deficiencies can result in a small stature and height.  IGF-1 is also considered anabolic: “the hypertrophic effects of muscle-specific IGF-I infusion are well documented in animal models and muscle cell culture systems.” [1] Clearly, IGF-1 seems like a good thing and something us guys want an abundance of, right?

The answer is ‘yes’ if you are less than 20 years old.  After that, you probably want to begin ramping down IGF-1 levels (but not too much of course).  The reason is that IGF-1 is extremely powerful and essentially signals many different tissues – not just muscle – to “grow! grow! multiply!”  (Insulin does the same thing.) This is why higher levels of IGF-1 have been associated with many kinds of cancer.  Basically, high levels of IGF-1 are analagous to the body having its foot on the accelerator 24/7 and that, of course, is not going to extend longevity.

But the story doesn’t end there unfortunately.  IGF-1 will also ramp up oxidation (free radicals) in the mitochondria.  Now you don’t want to go too low with IGF-1 – that is associated with Alzheimers and other neurological disorders – but you also don’t want to go too high.  If you go too high, you are overheating your engine effectively.  Most men consuming a lot of protein from what I have seen on Peak Testosterone Forum will end up with IGF-1 on the high side of the lab range.  My last test showed this and it means that I am likely increasing mitochondrial-related damage – and they are the furnaces of your cells –  in many tissues of my body.

There are many,. many example of this from the literature, but let’s look at just one.  One of the landmark anti-aging strategies is called caloric restriction.  Caloric restriction basically means reducing your calories until your body begins conserving and slowing down such that aging is also decreased and longevity is extended.  The effectiveness of caloric restriction has been verified in many animals and, recently, in primates as well (although more research is needed to make a long story short). One of the ways that caloric restriction works is by increasing a protein complex called SIRT1.  IGF-1 actually limits the increase in SIRT1 from caloric restriction:

“Another study provided evidence that insulin and IGF-1 attenuated SIRT1 activation induced by caloric restriction.” [2]

Bascially, IGF-1 (and increased insulin levels) partially undo the benefits of caloric restriction!  If you’re 55 like me, you probably do care about such things and you would like to decrease your risk of cancer and slow down the acceleraton into the grave.

CAUTION: IGF-1 levels vary according to a number of factors in the diet – not just protein levels.  It is better to pull the number before and after you make any dietary changes and monitor it for yourself.  Studies deal with averages and you may not be “average.”  You can pull your IGF-1 inexpesnively without a direct doctor’s orders here:  Testosterone Labs.

REFERENCES:

1)   Br J Pharmacol, 2008 Jun; 154(3):557 568, “Regulation of muscle mass by growth hormone and IGF-I”

2) Biochemical Society Transactions, 02/2013, 41(1):101-5. “Metabolic triad in brain aging: Mitochondria, insulin/IGF-1 signalling and JNK signalling”

3) NASM Essentials of Sports Fitness, Chapter 17 (Nutrition), p. 474-475.

4) https://www.acsm.org/public-information/acsm’s-sports-performance-center/sports-nutrition-un-plugged

5) J Appl Physiol. 1997;82:49 54, “Testosterone and cortisol in relationship to dietary nutrients and resistance exercise”

6) Life Sci, 1987;40:1761 1768, “Diet-hormone interactions: protein/carbohydrate ratio alters the reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man. Life Sci. 1987;40:1761 1768.

Stop and think about it:  would college and professional athletic programs be interested in knowing how much protein their athletes need to consume in order to maximize muscle gains?  Of course, and, as such, the subject has been extensively examined and the studies all say the same thing.  Here is just one example and you can look at: The Effect of Protein Intake on Strength, Body Composition and Endocrine Changes in Strength/Power Athletes. This was probably the most recent of the studies and was particularly interesting, because it looked at athletes.  Most of the other studies were done on beginners or untrained men and so the argument has been made that “hardened veterans” may need more.  But, according to this study, that was not the case:  athletes do not benefit from the gram per pound of protein either.  [And the solid majority of you are Weekend Warriors like myself anyway.]

So let’s take a guy like myself that lifts weights with some decent volume, but isn’t prepping for a bodybuilding contest trying to bench 500 pounds, etc.  I will actually likely do very well at HALF the protein mandated by the traditional advice.  I weigh 165 pounds (75 kg), so rather than needing 165 grams of protein, I likely need about half of that or 83 grams.

Jeez – what a difference this makes!  Trying to consume 165 grams of protein is painful,expensive and time consuming.  And I did for years, so I know what I’m talking about. Trust me – a big part of your day will be remembering, preparing and buying protein in foods and powders.  Every couple of hours you’ll be forcing down more of the stuff and there will a nagging thought in the back of your head asking, “Is this really natural?  Why am I doing this again?!?” The truth is that it’s not very natural and consuming feeding bags full of protein powders probably isn’t as well for many reasons.

But let’s go back to my actual requirement of 83 grams.  This is much more doable.  In fact, I can get this almost from food alone. I’m a mostly plant-based guy, but I can easily get 45-60 grams of protein just from what I put on my plate.  If I throw in a couple of scoops of protein powder, I’m up to 83 grams easily.  This requires little to no extra time out of day and little extra expense as well.  If I want to play it safe, I can throw in another scoop or some (BPA-free) sardines, etc.

So where did the 1 gram per pound of bodyweight theory come from?  I believe it came from the steroid community.  Men on steroids will push their testosterone to 2500+ ng/dl and they have a much greater capacity for muscle growth than those of us staying physiological.  In their case, they can probably make use of the extra protein consumed.  I have read many articles about and quotes by these top steroid bodybuilders and they absolutely believe that consuming at least 1 gram per pound is essential and some talk about 2+ grams. However, the steroid lifestyle is generally not a sustainable one for many reasons and so, to be frank, I regret ever reading those kind of articles.  I should have stuck to the scientific journals!

The Benefits of Low Dose HCG for Men on TRT.

The use of HCG with TRT has been around for a long time but still has not made it into the mainstream yet.  It is widely used by TRT clinics, anti-aging doctors and fertility specialists, but will probably be a few more years for widespread adoption.  I believe it will eventually happen, though, for the reasons I outline below.

Here are Seven Significant Reasons to Consider Adding HCG to Your TRT Regimen:

1. Activate a Dormant LH Receptor. I’ve been on testosterone cypionate for a couple of years now and, for the first time since I have been on TRT, had my LH (luteinizing hormone) pulled (December of 2015):

Labcorp: 0.1 mIU/ml Range: 1.7 – 8.5 mIU/ml

Ouch! Why was my LH so low? Standard TRT, especially if you boost testosterone significantly, will raise testosterone and estradiol levels and the hypothalamus will begin shutting down the signaling to the pituitary. This “shut down” is just one of the consequences of TRT, and it’s long term impact is poorly understood.  And, yes, LH will tend to go down to dang near zero.

Because I had never had LH pulled before, the consequences of such low LH started to bother me. Was it really good to have that low of a serum LH? Sure, my testosterone levels were beefy from TRT (650-800 ng/dl) from testosterone therapy – I feel very good on TRT by the way – but does youthful testosterone really compensate for abyssmally low LH levels in the long term?  I don’t believe it will, because the LH receptor is present and clearly biologically active (though poorly understood) in many key tissues, such as the hippocampus, adrenal glands and arteries. You can read more about that on my page on The LH Receptor in Men.

The good news is that someone got the creative idea to try HCG to compensate for this issue, because HCG is a hormone very similar in structure to LH and actually binds to the LH receptor.  And Mother Nature probably put ‘those receptor there for a reason, eh?

5. Protection from TRT Failure. Tying into #3 and #4 is the fact that HCG (generally) keeps the testes “alive.”  Although this has not been formally studied as far as I know, keeping the testes fully functional could potentially help preserve testosterone production if one has to go off of TRT.  Granted, it’s not common to be forced off of TRT, but it can happen if your PSA, hematocrit or blood pressure climb from testosterone therapy.  In fact, it happened to me for a month, something you can read about it in my page on High PSA But No Cancer.  And it has happened to other men on our forum.

What happens when you go off of TRT is that you actually nosedive below your old baseline testosterone levels.  In my case I was alway in the low 300’s (ng/dl) before I went on TRT.  A month after being forced off of TRT due to a high PSA, my testosterone was 121 ng/dl!  If I had stayed off of TRT, I probably would have risen slowly in 2-3 months back to the low 300’s.

Or would I?  There are rumors that older guys do not always snap back to their old levels after being on TRT for awhile.  What if your testes have been shut down for 10 years and you have to stop?  Would your testes ever fully recover?  That’s a good question that deserves some research.  But, in the meantime, HCG is probably a good insurance policy against that situation, because basically your testes never get turned off if you are on HCG.

CAUTION: I make the case that more is not better when it comes to HCG.  It is a placental hormones that is long-lasting (compared to LH) and stimulates EGF and VEGF.  See my page on Potential Dangers of Too Much HCG.

6.  Activate the Pregnenolone Enzyme. Pregnenalone tends to fall with age and is critical for optimal brain health and function.  In addition, there is a hormone “production line” that is critical for men to feel well:

Pregnenolone ==> Progesterone ==> Cortisol

Yes, progesterone can have feminizing traits and, yes, cortisol is associated with stress.  But what is poorly understood is that a significant block of men are actually low in one or more of these hormones and feeling lousy because of it.  HCG activates the enzyme that converts cholesterol to pregnenolone and thus can “backfill” the progesterone and cortisol pathways, raising levels of those key hormones in some men who are deficient.  Now it certainly does not always work out that way, but this certainly does happen and may explain why some men feel substantially better on low dose HCG accompanying their TRT.

7. Boosting Estradiol in low  Men. Low dose HCG will increase testosterone a little even in men on TRT.  The effect is not a lot, but it does make a difference.  HCG will tend to boost estradiol a little more proportionately than other methods of raising testosterone.  Many of you reading this will be wondering why in the world you would want to increase estradiol.  And the answer is that usually you don’t and most men do not need that.  However, some men, particulary https://www.peaktestosterone.com/, need a boost in free estradiol to feel good.  (Their total estradiol may be okay, but there free estradiol low due to being bound up by SHBG.)

2. Boost Libido.  A well done TRT program will generally boost libido in men, and, in fact, studies have shown the effect to be dose dependent on average.  See my page on Testosterone and Libido for more information.  However, there is a signifcant block of men who do not enjoy that benefit and HCG can help some of them.  HCG can also increase alertness and energy as well.  My former TRT clinic estimated the men that HCG significantly help at about a fourth of their patients.

3.  Increase Testicular Size (Volume). Another consequence of a TRT program (that actually boosts testosterone) is shrunken testes.  To be honest, I don’t think most women care or notice as the effect is not that pronounced., something I cover in my page on Testosterone Therapy and Testicle Size. Nevertheless, the last thing most ex-low T guys need is to feel demoralized with small acorns adorning their tree – they’ve been through enough already!  This is where low dose HCG can come in.  By simply adding 250-500 IU of HCG twice per week, volume is generally restored within 3-4 weeks in men on TRT.

NOTE:  If you do go on HCG, make sure your physician pulls estradiol during follow up testing (with the right test).

4.  Restoring Fertility. One of the big concerns for younger men on TRT is the fact that their fertility is greatly lowered.  Yes, you can still conceive in some cases, but your odds are significantly lowered.  Because HCG activates the testes by mimicking LH and attaching to LH receptors, men usually experience a big boost in fertility.  One study showed that 500 IU several times per week was enough to restore fertility to youthful levels in men on testosterone, something I discuss in detail in my page on Testosterone and Fertility.

-Super Sexual Herbshttps://www.peaktestosterone.com/

Sex – it seems so simple.  Well, until you hit middle age, right?  Then some guys find they need Cialis or Viagra or Levitra to boost their Nitric Oxide for increased blood flow.  Still other guys need prescription testosterone, i.e. Hormone Replacement Therapy, to rebuild those muscles at the base of the penis in order to trap and move the blood.  Finally, there are still other guys who have all the above chemical mechanics going on but have no sexual desire.  Their libido just isn’t there any more.  After all, when you’re the one saying, “Not tonight, dear”, you just might be in trouble, eh?

And, of course, you can have any combination or percentage of the above, but, either way, it spells trouble for life in the bedroom. That’s why it is ideal if you could find a herb that hits what I call The Big Three Bedroom Essentials:

1) Brit J Sports Med, Oct 2003, 37: 464 70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

2) J of Ethnopharmacology, Nov 12 2009, 126(2):308-313, “Influence of Eurycoma longifolia on the copulatory activity of sexually sluggish and impotent male rats”

3) Ann Acad Med Singapore, 2000 Jan, 29(1):22-6, “Proerectile pharmacological effects of Tribulus terrestris extract on the rabbit corpus cavernosum”

4) Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility.”

Interestingly enough, Viagra, Cialis and Levitra really only (directly) do one of these: raise Nitric Oxide. In other words, these are strictly One Hit Wonders.  NOTE:  Hormone Replacement Therapy will only hit two out of three of these.  It will definitely help with #3 by strengthening the pelvic floor muscles and testosterone definitely influences libido as well.

So what if I told you that there are herbs that work on all three of the above simultaneously!  Well, Tribulis Terristris actually does.  It is probably not going to dramatically raise any of these three, but it is well-known for increasing testosterone (by increasing leutenizing hormone) and an animal study showed it increasing both nitric oxide and libido. [3]  NOTE:  You can read more about Tribulis Terristris in my links on Aphrodisiacs (Male Libido Supplements) and the How to Increase Testosterone Naturally Guide.

Another herb that has studies increasing all three of these is Korean Ginseng. Ginseng is best-known for it’s nitric oxide boosting powers, which I cover in my Erectile Supplement Guide, but it also has been shown to boost libido and testosterone (in men with low sperm counts). [4]  Again, Ginseng is not going to send any of these through the roof, but it is rather remarkable that one herb will likely help with all three. (NOTE:  You can read more about it in this link on Ginseng and Erectile Dysfunction:  )

Finally, Tongkat Ali (Eurycomia Longfolia or LJ100) probably does #2 and #3.  There is one study showing an increase in muscle mass [1], which likely comes from somewhat of an increase in testosterone and a number of animal studies showing increased libido and sexual activity in animal studies. [2]

REFERENCES:

Grape Seed Extract and Erectile Dysfunction - Peak Testosterone

Many of you know that Pycnogenol has done quite well in a couple of studies on erectile dysfunction when combined with low dose arginine, something I cover in this link. However, Pycnogenol is a fairly expensive supplement and so one man in this thread posted the following question:

“Hey everyone — My question is if anyone has ever used Arginine with Grape Seed extract? I recently read that grape seed extract is pretty much the same thing as pycnogenol. (plus its a lot cheaper).”

“I bought 1000mg arginine and 250mg grape seed extract and I am planning on taking them twice per day to help boost my nitric oxide. I wanted to know if anyone has tried this? There’s a lot of information out there saying that taking regular l-arginine will get metabolized fast and we are all wasting our money.. However other information I read discusses about how arginine/grape seed or arginine/pycnogenol can boost nitric oxide and is great for erectile health.. so what gives? “

Well, that’s a great question.  It seems like a great idea overall and the reason is that Grape Seed Extract a) comes from an actual food, something you cannot say for Pycnogenol (pine bark extract), and b) it has many great artery and endothelial-related properties that should make it excellent for improving erectile dysfunction.  Here are just a few examples:

1.  Nitric Oxide.  A 2008 study sought to find out just how Grape Seed Extract relaxes arteries and the answer is simple:  it does it the old fashioned, time proven way by favorably acting on eNOS (endothelial nitric oxide synthase), the same enzyme that Viagra acts upon. [1] This means that Grape Seed Extract will increase nitric oxide levels just like Pycnogenol.  (For more information, see my page on  Pycnogenol and Erectile Dysfunction.) Other studies have verifed the same thing. [6][7]

1) Clinical Science, 2008, 114:331 337, “Mechanism of the endothelium-dependent relaxation evoked by a grape seed extract”

2) Metabolism, Dec 2009, 58(12):1743 1746, “Effect of grape seed extract on blood pressure in subjects with the metabolic syndrome”

3) Cell & Molecular Biology, 34(10), “Grape seed extract enhances eNOS expression and NO production through regulating calcium-mediated AKT phosphorylation in H2O2-treated endothelium”

4) Diabetic Medicine, May 2009, 26(5):526-531, “Effects of grape seed extract in Type 2 diabetic subjects at high cardiovascular risk: a double blind randomized placebo controlled trial examining metabolic markers, vascular tone, inflammation, oxidative stress and insulin sensitivity”

5) Acta Pharacologica, Dec 2001, 22(12), “Anti-inflammatory effect and mechanism of proanthocyanidins from grape seed”

6) Nitric Oxide, Apr 2001, 5(2):137 149, “Protection of Primary Glial Cells by Grape Seed Proanthocyanidin Extract against Nitrosative/ Oxidative Stress”

7) Journal of Cardiovascular Pharmacology, Oct 2005, 46(4):445-451, “Grape Seed and Skin Extracts Inhibit Platelet Function and Release of Reactive Oxygen Intermediates”

8) Journal of Biomedicine and Biotechnology, 2004, 5:272-278, “Effect of Grape Seed Extract and Quercetin on Cardiovascular and Endothelial Parameters in High-Risk Subjects”

9) https://www.webmd.boots.com/vitamins-and-minerals/grape-seed-extract

10) J Hypertensm 2005 Feb, 23(2):427-34, “The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial”

11) Cancer Res. 2006 Jun 1;66(11):5960-7

2.  Lower Blood Pressure.  Due to #1, it is no surprise that researchers found that it lowered blood pressure in patients with Metabolic Syndrome when given at a dosage of 150-300 mg/day. [2] The hallmark features of Metabolic Syndrome are elevated blood pressure, insulin resistance and triglycerides.

3.  Blood Flow. If there’s one thing you need for good erections, it’s blood flow, eh? Well, one study on men and women with above average cardiovascular risk found that increased blood flow by taking “2 g/day of GSE (1 g of polyphenols).” [8]

4.  Protection Against Arteriosclerosis. A 2010 study erified #1, i.e. that Grape Seed Extract increased nitric oxide and the authors noted that “has been shown to exhibit protective effects against cardiovascular events and atherosclerosis.” [3] Of course, protecting against arteriosclerosis should be one of the top goals for any male of any age.  As the lining of our arteries calcify and thicken, they lose their ability to pump out nitric oxide, and this leads to heart disease and erectile dysfunction.  How does it protect the lining of your arteries?  An animal study noted that it 1) scavenged free radicals, 2) protected lipids from oxidatative damage and 3) inhibited the formation of the inflammatory cytokines (inflammatory messenger molecules). [5] All of these ground zero for the the arterial lesions that eventually lead to the buildup of plaque.

6.  Glutathione. One very impressive result of the study in #4 is that Grape Seed Extract increased glutathione levels by 52%.  This is very impressive as glutathione is the master detoxer of the body and this should definitely protect one’s long term health.

7. Venous Insufficiency. Grape Seed Extract seems to significantly help with venous insufficiency. [9] Venous insufficiecy is a disease of poor circulation and should be confused with Venous Leakage, which has a more direct effect on erectile function. Venous insufficiency plagues diabetics, for example, who cannot get proper circulation to their extremities allowing fluid and toxins to build up there.

SUPERCHARGE FOR ERECTILE STRENTH: This has not been proven in any study, but it is likely that adding low dose Arginine or Citrulline daily along with Grape Seed Extract will yield synergies. Citrulline has shown beneftis by itself to lower blood pressure and improve erectile dysfunction as I discuss in my page on The Benefits of Citrulline. Basically, Citrulline can supply a much needed base quantity of nitric oxide, which is important for middle aged men and then Grape Seed Extract can act on eNOS to make sure that that nitric oxide is preserved. Common dosages with Citrulline are 3 X 500 mg or 3 X 1 gram daily.

DOSAGE:  Now, before I go on, I do have to say that one of the advantages of Pycnogenol is that they require solid standards with their extracts and seem to have good quality control.  There will undoubtedly be more variability in any Grape Seed Extracts purchased. Furthermore, notice that the above studies use a wide range of dosages, 150 mg – 2 grams per day – in order to achieve the desired clinical effect.

LONG TERM SAFETY:  It is true that Grape Seed Extract looks very promising to help men with erectile dysfunction, long term safety has not been established. As far as I know, all the studies have just looked at Grape Seed Extract for a few months and that is it.

CAUTIONS: Grape Seed Extact is known to be an aromatase inhibitor, which potentially could raise you testosterone a little [11]. 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 [10] and 2) it may slightly decrease free testosterone because it can raise SHBG, the protein that binds to testosterone.

REFERENCES:

Vitamin C and Phosphatidylserine: Libido and Erection Boosters

I recently recevied a very interesting email from an ADHD reader who had done a lot of research on supplements to help with his condition.  What he found was that some of these significantly helped with libido and/or erectile strength.  The first of these was the granddaddy of all supplements:  Vitamin C. He also mentioned phosphatidlyserine and fish oil as well.

As you can see below, his general comments were that all three increased libido but phosphatidlyserine also improved his erectile strength:

“I haven’t tried all three together so far, but definitely will later on. If I have fish oil alone, libido goes quite noticeably – so far as erections go, I’ll have to let you know when I resume taking it (I’m testing other substances these days and don’t want any interference from other supplements). On fish oil, I feel a little calmer, but don’t really notice much from a mood perspective, but libido does go up for sure. On PS, libido, mood, well-being and erectile function all go up noticeably. This is the single best OTC substance I’ve found to work for me so far – depends on your natural state as I mentioned in my previous email. Other guys feel horrible on fish oil or PS.”

CAUTION:  Always talk to a physician first, especially if you are on medications or have any kind of medical condition.

1) J. Nutr, Nov 1 2001, 131(11):2951-2956, “Oral Administration of Soybean Lecithin Transphosphatidylated Phosphatidylserine Improves Memory Impairment in Aged Rats”

2) Prog Neuropsychopharmacol Biol Psychiatry, 1989;13 Suppl:S77-88, “Nootropic drugs and brain cholinergic mechanisms”

3) Climacteric, 2003 Sep, 6(3):238-47, “Vitamin C improves endothelial function in healthy estrogen-deficient postmenopausal women”

4) J. Nutr, Sep 1 2002, 132(9):2506-2513, “Dietary Fish Oil Increases Acetylcholine- and Eicosanoid-Induced Contractility of Isolated Rat Ileum”

5) Diabetes Metab, 2003 Jun, 29(3):289-95, “Fish oil prevents the adrenal activation elicited by mental stress in healthy men”

6) J Int Soc Sports Nutr, 2008; 5:11, “The effects of phosphatidylserine on endocrine response to moderate intensity exercise “

Why would these help so much with libido and/or erectile strength?  I believe – and thanks to the reader who pointed out the beneficial effect on the HPA Axis/Cortisol of these three – that there are two primary reasons, which I have listed below.

1.  Acetylcholine.  It turns out all three of these can boost or restore acetylcholine (at least in some circumstances) and acetylcholine actually helps dilate arteries. [1][2][3][4] Of course, nitric oxide is the big gun, but acetylcholine plays a role as well. The research has concentrated on the nitric oxide connection – can you say Viagra and Cialis? – but acetylcholine can help relax those penile arteries and get blood flowing.

So is there any evidence that these three will improve help with erectile dysfunction? Well, there certainly is and I outline these in my page on Vitamin C and Erectile Dysfunction. As it turns out, Vitamin C is a pretty good Blood Flow Increaser and is worth considering in your arsenal.

Phosphatidylserine, by the way, is a famed nootropic, i.e. “brain booster”.  It is present in many foods.  The reader took 100 mg/day, in order to keep it line with what you might get through diet.  It is a somewhat expensive supplement but you can get it through Amazon: Natural Factors Phosphatidylserine 100mg 60-Count.

The reader also uses Ester-C (500 mg), same as myself.  The fish oil that I use is Ascenta Nutrasea Omega-3s, which comes to the health food supermarket where I buy it in refrigerated trucks.  I always bite open the first capsule in the container and have never had a fishy or rancid taste. In fact, two of my children actually take it by biting open the capsule since they are not too good on swallowing pills whole yet.

CAUTION:  You should also read about Some Potential Risks of Vitamin C as well.  To play it safe, it should probably be consumed only when you eating low fat.

REFERENCES:

Propecia and Depression - Peak Testosterone

What is the primary sex organ, the penis or the testes?  It’s a trick question, because the answer is ‘neither.’  The answer is that the center of your sex life is the brain.  Just ask any high prolactin man and he’ll tell you.  High prolactin lowers dopamine and that is a huge sex life killer.

So what does that have to do with Propecia (Proscar or finasteride)?  As I’ve discussed on other pages, research has shown that Propecia has an abnormally high rate of long term / permanent sexual side effects.  I even have reason to believe that this is what brought my own health spiraling downhill about fifteen years ago, something I discuss in my page Did Propecia Take Out My Health?

For a long time it was assumed that the issue to be hormonal, i.e. decreased testosterone or DHT (dihydrotesterone).  However, the research has not really backed this up. So researchers began looking elsewhere and it appears that the answer likely lies in the brain.  Look at the bullets points from the research abstract that looked at former Propecia users when compared to controls:

REFERENCES:

1) J Clin Psychiatry, 2012 Sep, 73(9):1220-3, “Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects”

2) BMC Clin Pharmacol, 2006, “Finasteride induced depression: a prospective study”

However, before I do that, let me just briefly discuss a 2012 study and shows this is a huge clinical concern.  This study showed overwhelming negative and long-lasting psychological side effects in former Propecia (finasteride) users, i.e. men who had not taken Propecia for at least three months: [1]

“Rates of depressive symptoms were significantly higher in the former finasteride users (75%; 46/61) as compared to the controls (10%; 3/29)”.

“Moderate or severe depressive symptoms were present in 64% (39/61) of the finasteride group and 0% of the controls.”

” Suicidal thoughts were present in 44% (27/61) of the former finasteride users and in 3% (1/29) of the controls.”

These numbers are staggering.  Propecia increases rates of depression by 75%!  And the lion’s share of these results in severe depression.  And suicidal tendencies are increase by 2700% and includes almost half of the former Propecia users!

Now I’ll ask an obvious question:  what do you think this will do to your sex life?  Well, of course it will be a sex life killer for many men. Depression is brutally hard on the (penile) arteries and the brain and thus delivers a one-two punch to your bedroom endeavors, something I discuss in my page on Depression and Erectile Dysfunction.

But all of this leads to an obvious question;  if finasteride is not changing testosterone or DHT much, just what is it changing?  It turns out that blocking 5-alpha-reductase – the enzyme that Propecia acts upon – also lower allopregnenalone and this, in turn, lowers GABA levels. GABA is critical neurotransmiter that, along with sertonin, is your “peace and tranquility” neurotransmitter.  If one lowers GABA much, you end up anxious and depressed.

A 2006 study explains the entire pathway that is disrupted by Propecia:

“5alpha-reductase is a critical enzyme in the conversion of several steroids such as testosterone, progesterone, aldosterone and corticosterone in the brain. This enzyme converts testosterone to the most natural potent androgen DHT, and also it acts an important role in conversion of progesterone to dihhydroprogesterone (DHP). DHP is further converted to allopregnanolone (5alpha, 3alpha-tetrahydroprogesterone) by 3alpha-HSD. Allopregnanolone is a modulator of gamma amino butyric acid type A receptor (GABA-A), and increases chloride conductance. This neurosteroid has been found to exert anti-convulsant, anesthetic and anxiolytic effects. Moreover, change in the levels of allopregnanolone is found to be associated with depressive disorders.” [2]

Of course, there is still a lot that we don’t know.  Is GABA permanently lowered?  Is allopregnanalone permanently decreased?  Or is there perhaps some other reason not yet discovered?  I don’t know the answer to those questions, but I can tell you that that is one of the riskiest of the more common medications out there in my opinion.

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.

Some Super Sexual Herbs - Peak Testosterone

Sex – it seems so simple.  Well, until you hit middle age, right?  Then some guys find they need Cialis or Viagra or Levitra to boost their Nitric Oxide for increased blood flow.  Still other guys need prescription testosterone, i.e. Hormone Replacement Therapy, to rebuild those muscles at the base of the penis in order to trap and move the blood.  Finally, there are still other guys who have all the above chemical mechanics going on but have no sexual desire.  Their libido just isn’t there any more.  After all, when you’re the one saying, “Not tonight, dear”, you just might be in trouble, eh?

And, of course, you can have any combination or percentage of the above, but, either way, it spells trouble for life in the bedroom. That’s why it is ideal if you could find a herb that hits what I call The Big Three Bedroom Essentials:

1) Brit J Sports Med, Oct 2003, 37: 464 70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

2) J of Ethnopharmacology, Nov 12 2009, 126(2):308-313, “Influence of Eurycoma longifolia on the copulatory activity of sexually sluggish and impotent male rats”

3) Ann Acad Med Singapore, 2000 Jan, 29(1):22-6, “Proerectile pharmacological effects of Tribulus terrestris extract on the rabbit corpus cavernosum”

4) Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility.”

Interestingly enough, Viagra, Cialis and Levitra really only (directly) do one of these: raise Nitric Oxide. In other words, these are strictly One Hit Wonders.  NOTE:  Hormone Replacement Therapy will only hit two out of three of these.  It will definitely help with #3 by strengthening the pelvic floor muscles and testosterone definitely influences libido as well.

So what if I told you that there are herbs that work on all three of the above simultaneously!  Well, Tribulis Terristris actually does.  It is probably not going to dramatically raise any of these three, but it is well-known for increasing testosterone (by increasing leutenizing hormone) and an animal study showed it increasing both nitric oxide and libido. [3]  NOTE:  You can read more about Tribulis Terristris in my links on Aphrodisiacs (Male Libido Supplements) and the How to Increase Testosterone Naturally Guide.

Another herb that has studies increasing all three of these is Korean Ginseng. Ginseng is best-known for it’s nitric oxide boosting powers, which I cover in my Erectile Supplement Guide, but it also has been shown to boost libido and testosterone (in men with low sperm counts). [4]  Again, Ginseng is not going to send any of these through the roof, but it is rather remarkable that one herb will likely help with all three. (NOTE:  You can read more about it in this link on Ginseng and Erectile Dysfunction:  )

Finally, Tongkat Ali (Eurycomia Longfolia or LJ100) probably does #2 and #3.  There is one study showing an increase in muscle mass [1], which likely comes from somewhat of an increase in testosterone and a number of animal studies showing increased libido and sexual activity in animal studies. [2]

REFERENCES:

DHT: 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.

REFERENCES:

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://carcin.oxfordjournals.org/content/early/2004/02/12/carcin.bgh106.full.pdf

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.

Mouthwash, Erections and Sex - Peak Testosterone

Did you know that your tongue is an erection engine – no it’s not what you think – responsible for much of the nitric oxide production in your body?  Yes, much of health is counterintuitive and this is yet another example.

It turns out that bacteria on the tongue converts any nitrates you eat into nitrities.  These nitrites are in turn transported down the throat via saliva and, when they hit the acid in the stomach, are eventually transformed into the all-important nitric oxide that is responsible for your erections. [1]

Furthermore, in my Interview with Dr. Nathan Bryan, he explains how this is actually a very efficient pathway for middle-aged and older males, much more efficient, for example, than the standard L-Arginine process that so many supplements go after. My book, The Peak Erectile Strength Diet, discusses some of the higher nitrate foods for just this reason.

REFERENCES:

1) https:// findarticles.com/p/articles/mi_7396/is_334/ai_n57416886/?tag=content;col1

2) Cancer Detect Prev, 1998, 22(3):204-12, “Formation of nitrosamines during consumption of nitrate- and amine-rich foods, and the influence of the use of mouthwashes”

3) Cancer Res, Jun 1 1991, 51:3044, “Mouthwash Use and Oral Conditions in the Risk of Oral and Pharyngeal Cancer”

There is one thing that can easily sabotage your body’s natural efforts to produce nitric oxide:  many men consume mouthwashes that kill the nitrate-to-nitrite converting bacteria on your tongue. That’s right – most mouthwashes are 25 percent alcohol – and swishing that stuff around in your mouth kills just about everything, both good and bad.  With it goes the good bacteria that you need so badly.

Interestingly enough, this was shown clearly in a study of cancer-related issues. [2] Researchers have long known that processed meats, which are high in nitrate additives as a preservative, lead to increased rates of GI cancer. Scientists speculate that it may be because nitrates, under certain conditions, can lead to increased levels of nitrosamines, compounds that have been associated with increased cancer risk.  What this study looked at was whether or not mouthwash, by killing tongue bacteria, of course would decrease nitrite levels.

So, if you have gingivities or periodontal disease, you might want to discuss different possibilities with your dentist.

CAUTION: One study linked a 60 and 40 percent increase in oral cancer in women and men, respectively, to mouthwash usage. [3] Other studies, however, have not found the same result.  However, some experts would argue that smokers and drinkers need to be particularly careful.

Packaged Foods, Dangers - Peak Testosterone

I do everything I can to keep packaged foods out of the hands of my children.  The reason?  It is simply too dangerous.  I want to give my kids the chance that I never had:  a relatively toxin-free existence so that they can maximized their potential.

Unfortunately, you just cannot trust the food industry with your kids.  I cannot emphasize this enough.  The great majority of companies have absolutely no conscience when it comes to your kids:  they will maximize profits even it means trading out the future health of your children.

To some of you this will seem alarmist and overstated, but let me list just a few examples – and there are many, many more – so that you will hopefully see what I am referring to:

1. Lead.  In 2010 the Environmental Law Foundation found dozens and dozens of children’s food products tainted with lead.  Lead is incredibly dangerous to the developing minds of children and is a known neurotoxin.  Furthermore, it was been associated with increased cancer risk.  Just look at this partial list of products that the ELF found with significant lead:

The list could goes on and on:  there are literally over 100 products commonly given to children listed that were contaminated with lead. Again, read this link on ELF’s Complete List of Packaged Food Products Contaminated with Lead

REFERENCES:

1) Environmental Health, 2009, 8:2, “Mercury from chlor-alkali plants: measured concentrations in food product sugar”

2. Mercury. Mercury is used to chemically process and produce sodium benzoate, citric acid and high fructose corn syrup.  These three products are used extensively in packaged kids food and mercury is another deadly toxin to the brain and testosterone of young boys. Several recent studies of high fructose corn syrup products have found that almost half of them are tainted with mercury.

3.  Bisphenol-A (BPA).  This is an incredibly toxic xenoextrogen that is found in signficant amounts in almost every canned product on the shelves.  I cover this in my link on The Dangers of Bisphenol-A in great detail, but you cannot get away from it if you use cans and this has been tied to future reproductive and cardiovascular issues, particularly for boys. (Some countries have banned BPA.)

4.  Excitotoxins.  I cover this extensively in another link on Testosterone and Excitotoxins, but suffice it to say that a large percentage of packaged food products, including those commonly given to children are loaded with excitotoxins.  Excitotoxins are deadly at any stage of life but are particularly toxic to the developing minds of the little ones and can lead to future mental and reproductive disorders.  It assaults the hypothalamus at a minimum and minute amounts can leak past the blood brain barrier and cause irreparable neuron damage in the brain, especially under certain conditions as fever and likely around “dirty electricity”.  It is very difficult to get away from excitotoxins in packaged foods:  MSG, monosodium glutamate, autolyzed yeast extract, maltodextrin,  aspartame and nutrasweet all contain excitotoxins in abundance.  Furthermore, savvy manufacturers can hide excitotoxins in “flavors” and “spices.

And I have not even covered the many dangers of giving fast food to your kids.  The bottom line is that the only safe way to feed your kids is for you to prepare the food for them yourself.  You’ll also avoid the trans fats that can cause problems for your child later in life.

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!

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…

The Benefits of Low Dose HCG for Men on TRT.

The use of HCG with TRT has been around for a long time but still has not made it into the mainstream yet.  It is widely used by TRT clinics, anti-aging doctors and fertility specialists, but will probably be a few more years for widespread adoption.  I believe it will eventually happen, though, for the reasons I outline below.

Here are Seven Significant Reasons to Consider Adding HCG to Your TRT Regimen:

1. Activate a Dormant LH Receptor. I’ve been on testosterone cypionate for a couple of years now and, for the first time since I have been on TRT, had my LH (luteinizing hormone) pulled (December of 2015):

Labcorp: 0.1 mIU/ml Range: 1.7 – 8.5 mIU/ml

Ouch! Why was my LH so low? Standard TRT, especially if you boost testosterone significantly, will raise testosterone and estradiol levels and the hypothalamus will begin shutting down the signaling to the pituitary. This “shut down” is just one of the consequences of TRT, and it’s long term impact is poorly understood.  And, yes, LH will tend to go down to dang near zero.

Because I had never had LH pulled before, the consequences of such low LH started to bother me. Was it really good to have that low of a serum LH? Sure, my testosterone levels were beefy from TRT (650-800 ng/dl) from testosterone therapy – I feel very good on TRT by the way – but does youthful testosterone really compensate for abyssmally low LH levels in the long term?  I don’t believe it will, because the LH receptor is present and clearly biologically active (though poorly understood) in many key tissues, such as the hippocampus, adrenal glands and arteries. You can read more about that on my page on The LH Receptor in Men.

The good news is that someone got the creative idea to try HCG to compensate for this issue, because HCG is a hormone very similar in structure to LH and actually binds to the LH receptor.  And Mother Nature probably put ‘those receptor there for a reason, eh?

5. Protection from TRT Failure. Tying into #3 and #4 is the fact that HCG (generally) keeps the testes “alive.”  Although this has not been formally studied as far as I know, keeping the testes fully functional could potentially help preserve testosterone production if one has to go off of TRT.  Granted, it’s not common to be forced off of TRT, but it can happen if your PSA, hematocrit or blood pressure climb from testosterone therapy.  In fact, it happened to me for a month, something you can read about it in my page on High PSA But No Cancer.  And it has happened to other men on our forum.

What happens when you go off of TRT is that you actually nosedive below your old baseline testosterone levels.  In my case I was alway in the low 300’s (ng/dl) before I went on TRT.  A month after being forced off of TRT due to a high PSA, my testosterone was 121 ng/dl!  If I had stayed off of TRT, I probably would have risen slowly in 2-3 months back to the low 300’s.

Or would I?  There are rumors that older guys do not always snap back to their old levels after being on TRT for awhile.  What if your testes have been shut down for 10 years and you have to stop?  Would your testes ever fully recover?  That’s a good question that deserves some research.  But, in the meantime, HCG is probably a good insurance policy against that situation, because basically your testes never get turned off if you are on HCG.

CAUTION: I make the case that more is not better when it comes to HCG.  It is a placental hormones that is long-lasting (compared to LH) and stimulates EGF and VEGF.  See my page on Potential Dangers of Too Much HCG.

6.  Activate the Pregnenolone Enzyme. Pregnenalone tends to fall with age and is critical for optimal brain health and function.  In addition, there is a hormone “production line” that is critical for men to feel well:

Pregnenolone ==> Progesterone ==> Cortisol

Yes, progesterone can have feminizing traits and, yes, cortisol is associated with stress.  But what is poorly understood is that a significant block of men are actually low in one or more of these hormones and feeling lousy because of it.  HCG activates the enzyme that converts cholesterol to pregnenolone and thus can “backfill” the progesterone and cortisol pathways, raising levels of those key hormones in some men who are deficient.  Now it certainly does not always work out that way, but this certainly does happen and may explain why some men feel substantially better on low dose HCG accompanying their TRT.

7. Boosting Estradiol in low  Men. Low dose HCG will increase testosterone a little even in men on TRT.  The effect is not a lot, but it does make a difference.  HCG will tend to boost estradiol a little more proportionately than other methods of raising testosterone.  Many of you reading this will be wondering why in the world you would want to increase estradiol.  And the answer is that usually you don’t and most men do not need that.  However, some men, particulary https://www.peaktestosterone.com/, need a boost in free estradiol to feel good.  (Their total estradiol may be okay, but there free estradiol low due to being bound up by SHBG.)

2. Boost Libido.  A well done TRT program will generally boost libido in men, and, in fact, studies have shown the effect to be dose dependent on average.  See my page on Testosterone and Libido for more information.  However, there is a signifcant block of men who do not enjoy that benefit and HCG can help some of them.  HCG can also increase alertness and energy as well.  My former TRT clinic estimated the men that HCG significantly help at about a fourth of their patients.

3.  Increase Testicular Size (Volume). Another consequence of a TRT program (that actually boosts testosterone) is shrunken testes.  To be honest, I don’t think most women care or notice as the effect is not that pronounced., something I cover in my page on Testosterone Therapy and Testicle Size. Nevertheless, the last thing most ex-low T guys need is to feel demoralized with small acorns adorning their tree – they’ve been through enough already!  This is where low dose HCG can come in.  By simply adding 250-500 IU of HCG twice per week, volume is generally restored within 3-4 weeks in men on TRT.

NOTE:  If you do go on HCG, make sure your physician pulls estradiol during follow up testing (with the right test).

4.  Restoring Fertility. One of the big concerns for younger men on TRT is the fact that their fertility is greatly lowered.  Yes, you can still conceive in some cases, but your odds are significantly lowered.  Because HCG activates the testes by mimicking LH and attaching to LH receptors, men usually experience a big boost in fertility.  One study showed that 500 IU several times per week was enough to restore fertility to youthful levels in men on testosterone, something I discuss in detail in my page on Testosterone and Fertility.

Losing Weight and Hormones - Peaktestosterone

What does losing weight have to do with hormones?  Everything! Well, that’s a slight exagerration, but don’t let anyone tell you a calorie is a calorie. Hormones can make or break almost any weight loss program as I’ll show below.

The problem is this:  if you are young with ample hormonal levels, weight loss is straighforward:  a little exercise and reduction in calories and the pounds melt off.  How many of us in middle age and beyond, though, have cut back in calories and increased exercise only to find not much happened?

One of the reasons for this is that so many of us in modern, industrialized societies have hormonal deficiencies.  The power of hormones over our health and weight maintenance cannot be overestimated and the studies show this conclusively.

This is a big subject, of course, but below we outline some of the key studies that show the intimate link between certain hormones and the body’s response to dieting.

So the bottom line with testosterone is that weight loss can be substantial, depending on your baseline testosterone before and after treatment.

2. Growth Hormone. Men rapidly lose growth hormone with aging and this hormone can have just as significant of an impact on losing weight as testosterone. For example, one study in senior men showed a 15% drop in body fat from administration of growth hormone. [4]  That’s a lot of fat to lose with no other real lifestyle change accompanying it.

Admittedly, the bodies of these men had very little natural growth hormone production, but many other studies have showed significant positive change in body fat and muscle from administration of growth hormone. [5][6]  See my link on How to Increase Growth Hormone Naturally for additional information.

NOTE:  Growth hormone will likely have little affect on young, health males with strong growth hormone production. [7]

3. Thyroid. “It’s got to be my thyroid.” We’ve all heard that excuse, eh?  Well, of course, it is true that an underactive thyroid can lead to significant weight gain.  A slow thyroid means a slow metabolism and to study how much of an effect thyroid function has on weight gain, reseearchers recently examined patients in the well-known Framingham Offspring Study.

They grouped participants into quartiles of increasing TSH (Thyroid Stimulating Hormone), which is a strong predictor of thyroid function. In general, if you have high TSH, it means you have an underactive thyroid. Researchers found that in men, there was a almost a three pound difference in body weight from the lowest to highest TSH quartiles over a 3.5 year period.  The authors noted that even “modest changes” in TSH could result in weight gain.

Of course, it’s possible to be deficient in one or more of these above three hormones, which only compounds the problem. Anyone at or past middle age and experiencng weight gain may want to consider going to an endocrinologist or other knowledgeable physician for a brief workup.  If you do have a hormonal issue, it’s something you want to know about.

NOTE:  Appetite is controlled by other key hormones, which I discuss in my link on Weight Loss and Appetite Hormones.

1. Sleep. Lack of sleep will lower both testosterone and growth hormone.  (Apnea sufferers can find their testosterone dropping by up to 40 percent for example.)  See my link on percent for example.)  See my link on Sleep and the Appetite Hormones as well:  poor sleep virtually forces us to overeat.

2. Vitamin D. This quasi-hormone has recently been discovered to have a profound impact on both testosterone and thyroid function, particularly if deficiencies are present. See my link on Vitamin D for more detail.

3. Cortisol. This stress hormone can affect both testosterone and thyroid function negatively. In addition, cortisol is famous for increasing belly, or visceral fat.  If that spare tire inflates rapidly, you may want to get your cortisol levels checked.  For more information on the cortisol-visceral fat connection, see my link on Visceral Fat.

SOBERING FACT: All of this can create a vicious circle: put on enough extra weight and it can significantly lower both testosterone and growth hormone.

The bottom line:  untreated medical conditions, poor lifestyle choices and ignorance can lead to decreased hormone levels, which in turn make weight management and loss much more difficult.

REFERENCES:

1) The Journal of Clinical Endocrinology & Metabolism, Aug 1 1999, 84(8):2647-2653, “Effect of Testosterone Treatment on Body Composition and Muscle Strength in Men Over 65 Years of Age”

2) The Journal of Clinical Endocrinology & Metabolism, Dec 1 1996, 81(12):4358-4365, “Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism”

3) Metabolism, Jun 1985, 34(6):571-573, “The effect of anabolic steroids on lean body mass: The dose response curve”

4) Hormone Res in Pediatrics, 1991, 36(Suppl. 1):73-81″Effects of Human Growth Hormone on Body Composition in Elderly Men”

5) Clinical Endocrinology, Jul 1992, 37(1):79 87, July 1992″The effect of growth hormone administration in growth hormone deficient adults on bone, protein, carbohydrate and lipid homeostasis, as well as on body composition”

6) Annals of Internal Med, Dec 1 1996, 125(11):883-890, “Effects of Physiologic Growth Hormone Therapy on Bone Density and Body Composition in Patients with Adult-Onset Growth Hormone Deficiency”

7) Acta Endocrinol, Apr 1 1993, 128 313-318, “Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes”

8) Archives of Internal Med, Mar 24 2008, 168(6):587-592, “Relations of Thyroid Function to Body Weight”

1.  Testosterone. One study of senior men looked at changes in body composition after medium term (3 year) testosterone administration.  These men lost nearly a kg per year, or 2.2 pounds, in fat mass just from the testosterone. [1] In other words, after three years these men had lost on average about seven pounds of fat without modifying their lifestyle.  Furthermore, these were not hypogonadal men necessarily, where testosterone administration would have produced even more pronouned results.

In hypogonadal men, i.e. if your testosterone is considered to be clinically low, results can be dramatic.  For example, one study of such men found that average fat loss was 14%! [2] Again, this is with no other change in lifestyle – nothing except letting this one hormone do its work. (Of course, muscle mass increased substantially as well.)  An earlier study showed that there was a dose dependent increase in body composition.  In other words, the more the additional testosterone given, the greater the change in lean body mass. [3]

Brain and Exercise - Peak Testosterone

Researchers have been stunned to find the remarkable linkage between exercise and your brain. The brain is incredibly dependent upon exercise, but it actually goes far beyond simple dependence: exercise can help you both maintain and even rebuild your brain. We all need improved memory, retention and learning and exercise is king when it comes to natural solutions.

Aerobic exercise raises levels of a brain chemical called BDNF, which can actually promote the formation of new synapses. [1] As you may recall, synapses are the connections between neurons and so the more synapses, the more interconnectedness that your brain has. This interconnectedness is one of the major factors that makes our brain the incredible computing and processing machine that it is.

However, it doesn’t just stop there.  Exercise can actually cause the rebirth of new neurons in the hippocampus, which is the seat of short term memory. One study on mice showed that aged mice could still experience 50% of the neurogenesis (in the hippocampus) of younger mice!  [14] This is astonishing for all you middle aged and beyond guys out there: if you stop and think about it, your brain is anything but dead if you will but exercise.

One question researchers asked themselves was if these new neurons that resulted from exercise were actually able to grow into fully functional, mature, usable neurons.  Again, the research has extended a very encouraging affirmation and one study of mice showed that adult neurogenesis does in fact lead to functional neurons that can be used by the brain. [13]

This is born out by many studies on humans which show the tremendous benefits of exercise to the brain.  One of the most amazing occurred on 59 individuals aged 60 to 79. These individuals did brisk walking (NOT relaxed, lazy-paced walking) only three times a week and after six months actually significantly increased the grey and white matter content of their brains. [2]  This is an incredible discovery: you can literally, through intense exercise, re-grow your precious grey matter!

How could such an incredible transformation occur?  Exercise does its magic through many different pathways.  First of all, it creates what I would call a super-neurotransmitter cocktail.  There is strong evidence that it increases dopamine [15], seratonin [16] and acetylcholine [17], all of which are known to improve learning and/or memory.  Researchers from the University of Illinois believe that exercise works its wonder through these mechanisms by “1) increasing capillary growth around neurons, 2) increasing synaptic density and 3) promoting positive cholinergic effects”. [10]  In other words, exercise feeds neurons, increases the cross linking between neurons and boosts the brain’s key neurotransmitter.  If you’ve looking for a Cognitive Fountain of Youth, you’ve just found it!

Exercise also boosts what some researchers an all-critical brain chemical named BDNF, which has been shown to “stimulate neurogenesis, increase resistance to brain insult and improve learning and mental performance”. [18] Researchers have also found that exercise significantly increases blood flow in the brain, thus bathing it in critical nutrients, and blood flow is correlated to neurogenesis. [22]  You don’t need Gingko to increase blood flow – you just need to get your butt moving!

Exercise improves so many abilities in the brain that it’s difficult to even keep up with all the research.  For example, one researcher found that it greatly increases something called “P3 latency”, which is kind of like your attention speed.  Normally, this declines with age but one study showed that exercise actually decreased the P3 latency levels of older adults to better than that of young, sedentary individuals! [19]  All you seniors out there should also take note of a meta-analysis that showed that exercise conclusively improved cognition, i.e. thinking and learning in your age group. [21]

Exercise is also known for boosting working memory, especially after aerobic exercise. [20] And on a Creative Note, exercise also increases creativity. It has long been known that exercise lifts mood and mood enhances creativity.  However, one study in the British Journal of Sports Medicine [12] showed that exercise enhances creativity independently of mood.  Exercise is also known for improving concentration, recall, productivity, test/exam speed – the list goes on and on.

Finally, exercise is also one of the few proven natural ways to prevent  Alzheimer’s and dementia. [11] One study from 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 reduced risks of cognitive impairment, Alzheimer disease, dementia of any type“. [3] 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.

REFERENCES:

1) Newsweek, 2/10/07, p.68-72]

2) The Jour of Gerontology 6) Cardiovasc Res,Apr 2002,54(1):25-35

3) Arch Neurol,2001,58:498-504

4)  Saving Your Brain, Jeff Victoroff, p. 135

5) Rev Endocr Metab Disord,Dec 2006,7(4):225-35

6) Cardiovasc Res,Apr 2002,54(1):25-35

7) PNAS, 2009, 106:1255 126, “Correction for Caloric restriction improves memory in elderly humans”, appeared in issue 4, January 27, 2009 of Proc Natl Acad Sci USA and first published January 26, 2009

9) Achieving Optimal Memory, Aaron Nelson, Ph. D, p.48, McGraw-Hill, 2005

10) Achieving Optimal Memory, Aaron Nelson, Ph. D, p.152, McGraw-Hill, 2005

11) 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

12) British Journal of Sports Medicine, 1997, 31:240-245, “Exercise enhances creativity independently of mood”

13) The Journal of Comparitive Neurology, 2001, 435:406-417, “Adult Neurogenesis Produces a Large Pool of New Granule Cells in the Dentate Gyrus”

14)  The Journal of Neuroscience, Sep 21 2005, 25(38):8680-8685; “Exercise Enhances Learning and Hippocampal Neurogenesis in Aged Mice”

15) Exp Neurol, 2003 Nov;184(1):31-9, “Can the brain be protected through exercise? Lessons from an animal model of parkinsonism”

16) Acta Physiol Scand, 1989 Jul, 136(3):473-81, “Effect of sustained exercise on plasma amino acid concentrations and on 5-hydroxytryptamine metabolism in six different brain regions in the rat”

17) Behav Brain Res, 1991, 46:123 133, “Enhancement of spatial learning in F344 rats by physical activity and related learning-associated alterations in hippocampal and cortical cholinergic functioning”

18) Trends Neurosci, 2002 Jun, 25(6):295-301, “Exercise: a behavioral intervention to enhance brain health and plasticity”

19) Psychophysiology, 2002, 39:3:303-312, “The relationship of age and cardiovascular fitness to cognitive and motor processes”

20) Med Sci Sports Exerc, 2009 Apr, 41(4):927-34 “The effect of acute aerobic and resistance exercise on working memory”

21) J Appl Physiol. 2006 Oct, 101(4):1237-42, Epub 2006 Jun 15, “Exercise, cognition, and the aging brain”

22) PNAS, Mar 27 2007, 104(13):5638-5643, “An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus”

Nitric Oxide Test Strips - Interview with Dr. Bryan-

All us middle-aged and senior men owe Dr. Nathan Bryan of Neogenis a lunch or two.  Dr. Bryan came up with an inexpensive saliva test to measure my second most favorite molecule – nitric oxide.  (Yes, testosterone is #1.)

I’ve had a lot of fun, being a certified health geek, using the strips and have found them to be quite revealing and accurate. I get emails and forum posts quite often from men wondering if their erectile dysfunction problems are testosterone-related or nitric oxide-related. Of course, testing for testosterone is only a blood draw away and now, thanks to Dr. Bryan, you can easily check your NO levels as well. (Amazon now carries these as Nitric Oxide Diagnostic Test Strips for those interested.)

Of course, when you use the strips on a regular basis, a number of practical questions come to mind.  Dr. Bryan was gracious enough to answer some of these for me below:Q. These work by measuring the nitrate on the tongue, right?

More times than not, ED is a result of NO deficiency. However, there are also other causes of ED than just a vascular problem such as anxiety issues, hormonal problems etc that may be unrelated to NO.

Q. Nitric oxide is a fairly volatile molecule? Does this mean you need to test daily for a few days and take a rolling average?

NO has a very short half life but since we are measuring more stable endproducts of NO metabolism, we get a better sense of NO production/availabilty. We recommend testing 1-2 times weekly first thing in the morning for the most accurate readings.Q. I know that most modern toothpastes actually have a rather harsh chemical in them specifically designed to kill the bacteria on teeth. Does this mean that results on the test strips could be skewed after brushing? And do you think that these toothpastes could be somewhat lowering nitric oxide levels by killing the good bacteria in your mouth along with the bad?

Many bacteria on the teeth and tongue are responsible for converting nitrate to nitrite and NO so anything that removes or kills these good bacteria will affect the test strips and NO production. In fact we think this may be the link between oral health and cardiovascular disease.

Q. I know you can improve your nitric oxide during the day through exercise, certain foods and various supplements. But let s say you want to establish a baseline nitric oxide reading to find out your unassisted endothelial function. Would this potentially be a valuable measurement? If so, is first thing in the morning upon waking a good time to do this?

Great question and we are currently attempting to determine how endotheliail function correlates with the salivary test strip. We think this will be a very valuable measurement. The most accurate test is first thing in the morning before brushing, before drinking anything so that this reflects a fasted state and a period of rest and no exercise.

The strips measure nitrite and nitric oxide in the saliva, not nitrate.

Q. Are there any cases where this will not translate as well to your actual cardiovascular nitric oxide levels? In other words, are theire circumstances where a saliva test would not correspond to actual plasma levels?

Yes, we have found that in cases of severe periodontal disease and active infections in the mouth, the saliva test does not translate well into actual cardiovascular NO levels but is a result of the infection in the mouth. Interestingly, although salivary levels may be high in this particular case, we have evidence that this overproduction of NO iin the mouth may actually shut down NO production throughout the rest of the body, causing systemic problems from a local oral infection.

Q. What if your nitric oxide levels look good on the test strips and yet your blood pressure is hypertensive? What could this mean?

Hypertension is the result of insufficient NO production throughout the blood vessels in the body. This is referred to as endothelial dysfunction. What we are measuring in the salivary strips is the amount of NO bioactivity that is recycled through the salivary glands. This activity is a reflection of what is produced by the blood vessels and what is consumed through the diet from nitrate rich vegetables. Eating a high nitrate meal such as a spinach salad will cause a temporary increase in salivary nitrite and NO 3-4 hours after the meal. So in this case, although the test strip may indicate normal, this is a short term spike and does not really reflect true steady state levels. That is why we recommend testing after a 6-8 hour fast.

Q. What if someone eats spinach or takes Neo40 and shows up consistently as depleted or low on your test strips an hour or two later? Does this mean a heavily damaged endothelium or could there be other explanations?

This typically means their body is really depleted and deficient in total body NO availability. The conversion of spinach nitrate requires adequate digestion and absorption. People who take proton pump inhibitors, antibiotics and/or antiseptic mouthwash will not be able to properly digest, absorb and utilize the nitrate from spinach to make nitric oxide. What we are measuring in the saliva is what is recycled from what the body has not used. If your body is using all the NO that we provide through the Neo40, there is none to recycle to show up in the saliva. Consider filling up an empty barrel. It takes time to fill the barrel depending on how low the levels was. We only know the barrel is full, when it starts to run over. The runover we are measuring in the body is what shows up in the saliva.

Nitric Oxide Boost Verified by Spinach Meal - Peak Testosterone

Can eating spinach help erections? Absolutely! And the way it performs this bedroom-enhancing phenomenon is primarily by being one of the higher-nitrate superfoods. Few foods have more nitrates than spinach – no one can beat arugula lettuce however! – and this is the reason that researchers recently studied spinach’s ability to raise nitric oxide and lower blood pressure. They took 26 healthy men and women between the ages of 38 and 69 and gave them enough spinach to get 200 mg of food-based nitrates and then matched them against a non-nitrate diet. [1]

The results were impressive:

Now what is so impressive is that they achieved these results in healthy men and women.  Many studies show that those with prehypertension and hypertension get much bigger drops in blood pressure from treatments both natural and pharmaceutical.  And this is exactly what I have seen on the  Peak Testosterone Forum, i.e. big improvements in men struggling with medical issues such as erectile dysfunction – which usually has an arterial / cardiovascular component – and higher blood pressure.

And, of course, it is also impressive that they achieved these results with just one dietary modification:  adding some spinach to their meals.  Plant foods have many other properties that increase blood flow and blood pressure, and this is the subject of my book The Peak Erectile Strength Diet. Again, many plant-based diets, such as the DASH Diet and a Low Fat Diet, have been shown to yield nice drops in blood pressure.  In fact, one study showed that even flavonol-rich apples resulted in a nice increase in salivary nitrites. [3] Spinach outperformed the apple in this study, but the primary point is that a diet rich in plants will maximize all the parameters that you need for erectile strength.  I can only say to just try it if you’re not eating a lot of vegetables and fruits (and brown rice) and you’ll likely immediately notice a difference.

1)  Nitric Oxide, 2013 Nov 30, 35:123-30, “Effects of a nitrate-rich meal on arterial stiffness and blood pressure in healthy volunteers”

2) https://www.berkeleytest.com/scientific-articles.html

3) Free Radic Biol Med, 2012 Jan 1, 52(1):95-102, “Flavonoid-rich apples and nitrate-rich spinach augment nitric oxide status and improve endothelial function in healthy men and women: a randomized controlled trial”

4) Atherosclerosis, 1972 Jan-Feb, 15(1):87-92, “Effect of spinach and wakame on cholesterol turnover in the rat”

5) Journal of Medicinal Food, Jul 15 2011, 14(7-8), “Dietary Spinach Saponin-Enriched Lipophilic Fraction Inhibits Platelet Aggregation and Blood Coagulation”

6) https://usatoday30.usatoday.com/news/health/diet/2002-05-03-spinach-stroke.htm , USA TODAY05/02/2002, “Spinach may reduce stroke risk”, By Kathleen Fackelmann

Spinach also may provide some long term protection against arteriosclerosis according to one animal study. [4] It also likely protects against clots and evidence also shows that it reduces the risk of stroke. [5][6] In other words, spinach looks very good as a general Artery and Cardiovascular Healer.

I can also tell you anecdotally that eating high nitrate foods has dropped my blood pressure by 10+ points.  In my page on How I Boosted My Nitric Oxide, I discuss an arugula-eating experiment that I did. Beets will also work and beetroot juice in particular has been in the health news lately. Beets are also high nitrate foods and the juice is particularly easy to consume. For this reason, researchers have studied beets in detail and the results have been quite impressive, something I document in my link The Benefits of Beetroot Juice.

These are impressive results from drinking a mere 8 oz. of beetroot juice and were documented in the presitigious journal Hypertension.  Again, the results achieved are not too far off those from standard medications. For another great blood pressure-lowering nutraceutical solution, see my page on Garlic and Vitamin C.

REFERENCES:

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.

Venous Leakage and Testosterone - 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.

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.

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”]

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”

Crash Dieting: Why It Does Not Work - Peaktestosterone

I’m going to give you a simple reasons that crash dieting (less than about 1200 calories per day) does not work in the long term:  hormones. We’ve all known many people who have rapidly dropped the pounds only to quickly regain the same weight again. Dieting is painful and we all want to see results quickly, i.e. an immediate reward for our pain, so crash dieting is a natural for many people. Unfortunately, crash dieting negatively affects several key hormones and can sabotage your long term efforts.

Below I am going to cover three of those hormones below:

1.  Thyroid. Imagine this:  you try to shed the pounds by rapidly dropping calories and your body resets its baseline metabolism making it much more difficult for you to lose weight.  Well, you don’t have to imagine it:  this is exactly what the body does according to one study on obese subjects. [1] Dramatic calorie reduction resulted in significant alterations in thyroid function, particularly decreases in T3 output. The researchers tried to compensate by restoring T3 but still baseline metabolism could not be fully restored. Some experts believe that crash dieting negatively alter your baseline metabolism long term.

Rapid weight loss also negatively alters most of the key appetite hormones as I outline in my link on Hormones and Your Appetite.  This requires crash dieters to display almost superhuman will power and can easily lead to rebound eating.

By the way, one area of anti-aging research is caloric restriction.  Reducting calories by about 30 percent extends maximum lifespan in mice and many animals. (It doesn’t seem to work as well in humans.)  How does caloric restriction do its magic in animals?  Researchers believe it may work in mice by “feminizing” them. In fact, here is the title of one article:  “Short-Term Calorie Restriction in Male Mice Feminizes Gene Expression and Alters Key Regulators of Conserved Aging Regulatory Pathways.”

Again, I ask if crash dieting really how you want to lose weight?

CAUTION:  Rapid weight loss may be desireable for some very obese individuals:  discuss with your doctor.

REFERENCES:

1) Metabolism, 1986 Apr, 35(4):289-91, “Decrease in resting metabolic rate during rapid weight loss is reversed by low dose thyroid hormone treatment”

2) The Journal of Clinical Endocrinology & Metabolism, Jun 1 1989, 68(6):1013-1018, “Fasting Alters Pulsatile and Rhythmic Cortisol Release in Normal Man”

2.  Testosterone. Significant drops in calories lead to significant drops in testosterone.  Over time this can lead to muscle loss, which is never good for weight loss, self-image or your general health.  See my link on Losing Weight the Right Way for more information.

3.  Cortisol. Researchers have found in several studies that crash dieting scenarios and/or fasting lead to increased cortisol output. [2] Cortisol dampens testosterone, depletes muscle and can increase visceral (belly) fat.  Again, none of this is good for weight loss, self-image or your general health in the long term.  See my link on Visceral Fat for more information on the cortisol-visceral fat connection.  CAUTION:  Crash dieting is also associated with arrythmias likely for this same reason.

Testosterone Testing: What Tests Are Important? .

Two very common questions I get on my forum are  “If I suspect low testosterone, what tests should I get?”  and “What testosterone tests will my doctor likely order?”

Unfortunately, there are many physicians out there still new to diagnosing and testing low testosterone and often important items get overlooked.  For this reason, until the medical community gets better up to speed as a whole, it is important for men to know the fundamentals of testosterine testing in order to ask important questions.

For this reason I have compiled what I call the 15 Common Tests for Men with Suspected Low Testosterone. These testosterone tests are very important, because they can have such a strong and direct bearing on either a) testosterone levels or b) safe administration of Testosterone Therapy (HRT):

NOTE:  If you suspect you might have low testosterone, check out my pages on the Standard Hypogonadal Symptoms and Classic Hypogonadism.

1.  Total Testosterone. This testosterone number is the most widely studied and heavily researched number.  While it is true that one can debate whether free or bioavailable testosterone is a better indicator, total testosterone gives doctors a very good snapshot as to general testosterone status.

If you’ve been around my site much, you know that most men begin to experience strong low testosterone symptoms in the 300’s (and a few even in the 400’s).  Furthermore, you hopefully know that in the 300’s, a man’s risk factors for many serious medical conditions (diabetes, osteoporosis, Metabolic Syndrome, erectile dysfunction, etc.) begin to increase signficantly, something I document in my book Low Testosterone By The Numbers. (NOTE:  Some men seem to do fine and are symptom-free in the 300’s and 400’s, however.)  Total testosterone, and all the tests on this page for that matter, are generally pulled through a blood draw and should be done as early in the morning as possible (since a man’s testosterone falls throughout the day).

So what will your doctor be looking for?  From what I have seen, most knowledgeable doctors will treat a man (with no risky medical conditions) if he is in the 300’s and classic low testosterone symtpoms.  Some doctors simply will not treat any man in the 300’s and often the upper 200’s.  Many of the laboratory reference ranges have their minimum for total testosterone still sitting in the upper 200’s and so doctors will classify any man above around 260 as “normal”.  For example, one of the biggest labs that physicians use (in the U.S.) is Quest Diagnostics and Quests “normal” testosterone ranges for adult males, ages 18-69 is listed as 250-1100 ng/dl. [1] Other similar ranges have been referenced on the forum as well:

1)  Quest Diagnostics, Table 1, Testosterone Reference Ranges in Adults, https://www.questdiagnostics.com/hcp/ intguide/EndoMetab/Gen_Misc/Testosterone/Table%201.pdf

2) https://peaktestosterone.com/forum/ index.php?topic=114.msg1641#msg1641

3) https://peaktestosterone.com/forum/index.php?topic=179.15

4) https://peaktestosterone.com/forum/index.php?topic=213.0

5) Labcorp, Technical Review, “Testosterone: Aiding in the diagnosis of androgen dysfunction and hypogonadism”

6) https://peaktestosterone.com/forum/index.php?topic=290.msg2580#msg2580

7) https://peaktestosterone.com/forum/index.php?topic=175.msg2161#msg2161

8) Dtsch Arztebl Int, Jan 2008, 105(4):62 68, “Congenital and Acquired Polycythemias”

9) https://peaktestosterone.com/forum/ index.php?topic=346.msg3221#msg3221

10) https://peaktestosterone.com/forum/ index.php?topic=221.msg1733#msg1733

11) https://www.lef.org/magazine/mag2010/ may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

[4]NOTE: Non-U.S. readers should use a conversion factor of 29.4 to convert to nmol/l.

Notice that all of these reference ranges are between 241-286 ng/dl. Let’s say that your lab results show up with the 241 number and your actual total testosterone is 242. Many physicians will simply say, “Sorry, fella, but you are clearly normal.  You are clearly within the normal range.”  Meanwhile, you could be limping through life with erectile dysfunction, horrendous memory and concentration, a non-existent libido and a complete loss of morning erections. But, by golly, that doc is absolutely certain that your issues have NOTHING to do with low testosterone because of that lab result and the range listed right beside it.

Fortunately, many doctors are now realizing that the 200’s are abyssmally low numbers for most men.  Furthermore, the biggest lab, LabCorp, has now bumped up the lower end of their total testosterone range for males over 18 years old to 348-1197 ng/dl. [5] Of course, the lower end of this range for normal testosterone, 348 ng/dl, is higher than past ranges.  Even better, I have seen this figure quote by several on the Peak Testosterone Forum. [6][7] Essentially, LabCorp is arguing that our current definitions of hypogonadism are much too low and, perhaps, doctors will listen.

2. Free Testosterone. Free testosterone, which can be thought of as the testosterone that can actually do work on your tissues and receptors, runs about 2% of total testosterone. An acceptable range for testosterone is often give as 1.5-2.5%.  To read in more detail, see this page on  Free Testosterone and SHBG.

Plasma levels of LH are useful primarily for diagnostic purposes, because there are two “categories” of low testosterone:  primary and secondary hypogonadism.  In the case of primary hypogonadism, usually LH and FSH are overly high and this indicates that the problem is in the testes.  Basically, the pituitary tries to compensate for the testes’ lack of production by trying to pump out more LH in order to normalize testosterone production.  LH just keeps climbing and climbing with no significant change in testosterone.

In the case of secondary hypogonadism, both LH and FSH are generally low or low normal and, in this case, the problem is somewhere rooted in the pituitary or the hypothalamus rather than in the testes themselves. Thus, with secondary hypogonadism the problem is not in the testes but in the brain’s signaling to the testes.

Knowing whether you are primary or secondary can help a doctor know best how to treat you, or, at least, a knowledgeable one  Some treatment methods, such as Clomid, are designed to work on men with secondary hypogonadism as a root issue.

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

4.  Follicle Stimulating Hormone (FSH. FSH is also produced by the pituaitary and, coupled with testosterone, is responsible for sperm production.  Doctors will pull this number primarily for fertility purposes.

5.  Estradiol (E2). There are actually several estrogens in the blood stream of both men and women.  Estradiol is the most well-known and “potent” estrogen and is responsible for most of its properties, both good and bad for us males.

Estradiol is one of the most important, and often ignored, hormones that should be pulled in men who are experiencing sexual or erectile dysfunction issues.  The reason is that estradiol has a relatively tight range that men should, ideally, fall within. If estrogen goes too high (in men), it can cause many of the same issues associated with low testosterone:  erectile dysfunction, low libido, fatigue, etc.  Furthermore, it is a) fat-promoting, b) cancer promoting (in the prostate) and c) potentially fuels gynocomastia (“man-boobs”).

Overly high estradiol can cause issues, but, more often that not, low estradiol is the culprit in men with lowered libido and erectile strength.  It is very important that you get the right estradiol test, which is an LC-MS/MS test designed for the low levels that men have.  Low estradiol can lead to bone less and eventually osteoporosis, but an important new study shows that low estradiol causes virtually the exact same symptoms associated with low testosterone.

Tests to Find the Root Cause of Low Testosterone

6.  Zinc Status. Every doctor should, in my opinion, test for zinc status.  There are several tests that are applicable including the zinc taste test and zinc plasma levels.  And the reason is that, if you are low in zinc, restoring proper zinc levels can double or more your testosterone levels.  See this page on Zinc Deficiencies and Low Testosterone for more details.

7.  Vitamin D. One of the most important low testosterone tests is actually Vitamin D, due to the fact that Vitamin D deficiencies are so widespread.  The standard for Vitamin D monitoring is called “25-hydroxy” test and can be obtained from a simple blood draw.  Therefore, it can be pulled at the same time that you have your testosterone tested.  Most labs and physicians now consider 30 ng/ml to be the threshold for a deficiency.  However, many experts recommend that Vitamin D be maintained somewhat above that level.

What does your Vitamin D reading have to do with testosterone?  It turns out Vitamin D is actually correlated with testosterone and appears to be partially causative.  In other words, keeping your Vitamin D levels up to healthy levels may give you a boost in testosterone.  (Some experts even consider Vitamin D much more a hormone than a vitamin.) For more information, see my link on The Benefits of Vitamin D.

8.  Prolactin. If this hormone goes too high, it drive down testosterone levels by negatively impacting dopamine.  The net effect is usually significantly lowered libido and sexual function.  I cover this in more detail in my link on Prolactin and Prolactinomas.

9.  Thyroid Stimulating Horomone (TSH). If this is high, then you may have hypothyroidism.  TSH actually comes from the pituitary and not the the thyroid gland. In general, when the pituitary senses that your thyroid hormones are falling too low, it pumps out more TSH in order to compensate, similar to elevated Leutinizing Hormone (LH) in men with primary hypogonadism.  However, TSH is just the beginning and free T3, free T4 and reverse T3 should also be pulled at a minimum.

What does this have to do with testosterone?  Well, researchers have found that hypothyroidism is associated lower testosterone levels and it is no wonder since it usually comes with fatigue, weight gain and a slowed metabolism and libido, i.e. symptoms that are very similar to those of hypogonadism.  Furthermore, correcting hypothyoridism can lead to a nice boost in testosterone often, something I discuss in my page on Testosterone and the Thyroid.

10.  T4 and T3. These two thyroid hormones, which are triggered by TSH coming from the pituitary, can be low as well.  Somewhat like testosterone, these can come as total T4 and/or T3 and free T4 and/or T3. When these are below the reference ranges, you will usually find that your physician will consider you hypothyroid.

Tests to Establish a Baseline Before You Go On TRT (If You Do)

11.  PSA. Physicians will generally monitor your prostate before administering TRT, HCG Monotherapy or Clomid over concern regarding prostate enlargement (BPH) and prostate cancer as a side effect.  Several large studies have hsown these not to be a concern, but, as I always say, you have to discuss with your doctor and do your own research.  Regardless, it is prudent to pull your PSA before TRT in my opinion.  The PSA has been under sharp criticism in the last ten years, because it does not just show an increase in cancer but also an increase in prostate size and inflammation.  In fact, the latter is the most common reason for a significant rise in PSA.  (It happened to me.)

12.  Red Blood Cell Count/Hematocrit/Hemoglobin. Testosterone actually governs male red blood cell counts in your blood and this is the reason that we have more red blood cells in our plasma than our wives and girlfriends. A good physicians will always monitor your RBC count, as it is called, to make sure that you are neither too high or too low.  However, the key is that, if you are anemic from low testosterone, then something probably needs to happen.

Again, men with low testosterone often see their RBCs fall significantly and can even end up anemic.  This is yet another reason that men can experience fatigue with hypogonadal testosterone levels.

There is another reason to get RBC Counts/Hematocrit/Hemoglobin:  if a man is on the high side of these numbers before TRT, he may struggle while on TRT trying to keep his levels in check.  You cannot let your levels go too high or it can increase the risk of stroke or an MI.  (Some of the Tour De France riders have almost died from this condition due to doping). [8] One of our forum posters actually found himself in this condition, for example, even though his most recent testosterone reads were 290 and 301 ng/dl. [9]

So what are acceptable RBC counts?  Different labs have a little different ranges, but the range given as normal is generally around 4.3-5.7 million cells/mcl.  Notice, however, that this forum poster’s range was 4.1-5.6 and thus differently slightly. [10]  I have seen higher levels as well, say, at 4.7-6.1.

Also, some men may wonder why testosterone increases red blood cell counts.  The reason actually ties into a kidney hormone called erythropoietin which induces red blood cell production in the stem cells of the bones. Testosterone actually increases erythropoietin production and, therefore, actually causes an increase in red blood cells due to its downstream influences.

13. SHBG. This is the binding protein that attaches itself to a little over half of our testosterone and effectively takes it out of commission.  If you are low SHBG, you may struggle with TRT and require a little different protocols.  This is also possible with high SHBG as well.  Low SHBG men may also be insulin resistant, something I discuss in my page on Low SHBG.

14. Other Hormones. If you end up on TRT, just trust me:   you’ll be glad that you pulled your DHEA-S, progesterone and cortisol and established some kind of a baseline.  There is one school of thought out there that TRT can slow down these hormones over time, so pull these while you can to see if you have changed over time.  And, by the way, all of these can affect sexual function and energy levels.

15. Liver Function.  This is an important test for low testosterone men,. because testosterone is metabolized in the liver.  A good physician at a minimum will check to make sure that you do not have any existing liver disease or disorders.  In addition, some of the injectables (cypionate, enanthiate, etc.) actually have to be broken down into testosterone.  The topicals (Androgel, Testime, etc.) have a good liver side effect profile but should be checked regardless from time to time as occasional issues do occur.

REFERENCES:

The G Spot Shot - Peak Testosterone

What if there was a way to insure that your woman achieved a vaginal orgasm almost every time you had sexual intercourse?  Do you think that would increase your likelihood of having sex?  Well, the answer to that question is probably not a straightforward answer as human sexuality is a rather involved and even complex subject.  However, one thing we can say:  us guys need everything we can in our favor, eh?  (Again, sex is good for you because it 1) increases testosterone, 2) improves erectile dysfunction, 3) helps you sleep better and even 4) lowers stress hormones.)

Many women struggle with achieving orgasm through sexual intercourse in the first place.  Some guys seem to be doing “everything right”, for example, yet the woman still cannot achieve a vaginal orgasm. As it turns out, all of this matches the research which indicates that some of the root cause may be organic or physical.  First of all, you should read this link on The Basics of the G Spot since, among other things, a small percentage of women may not even have a true G Spot. Secondly, some practioners assert that the G Spot may be somewhat out of reach in some women and/or actually move to a less accessible position with aging, childbirth and so on.

NOTE:  Another factor is the “C-V distance”, or Clitoral-Vaginal distance. Having a clitoral-vaginal distance of less than 2.5 cm is associated with a significantly higher rate of vaginal orgasms for example.

The G Spot, as you may or may not know, is located on the front wall of the vagina, i.e. not the side facing the spine.  Furthermore, its location is beyond the pubic bone and, apparently, in some women it can be somewhat hidden behind the same. In addition, some sexologists report that vaginal orgasm can become easier as a woman ages and attribute this to the thinning of the vaginal walls that occurs with the passing years.  This implies that, at least in some women, the surface accessability of the G Spot is also an issue.

This is where the G Spot Shot, a.k.a G Spot Augmentation or G Spot Amplification, can come into play. The G Spot Shot is a relatively new procedure where collagen is directly injected into the G Spot – after a local anasthetic of course! – in order to literally raise the Spot and make it protrude more into the vagina.  The collagen will actually create a raised area along the vaginal wall the size of a quarter and a 1/4 inch thick.

For many women, this is sexual dynamite creating more powerful orgasms and more frequent orgasms.  By the way, this is quite remarkable considering that many researchers, who I would venture to say generally don’t have a vagina themselves, still assert there is no G Spot.  Again, see my link on the Controversial History of the G Spot for some interesting scientific cage fighting.

This procedure may grow in popularity as time goes on because it appears to be quite safe, although we don’t have long term results of course, and convenient.  The actual injection happens in seconds and the whole procedure generally takes less than ten minutes.  In fact, intercourse can occur within four hours of having the procedure.  And I’m sure you would be right there to help her test it out, eh?

The safety record also seems very good as collagen has been FDA-approved and used for injections into the vaginal area for many years.  NOTE:  The FDA has not yet approved collagen for G Spot Augmentation yet. Another plus is that the results also last for about four months, making trips to the doctors office relatively infrequent.

The primary negative at this point is cost:  the G Spot Shot costs about $1,500 – $1,800 per visit and so will be out of the reach of many couples.  We suspect that the primary reason for this is that there are relatively few G Spot Augmentation practitioners and thus costs may come down with time.

Another negative, undoubtedly, for many women is the fact that it does require the use of a specialized speculum – yes, of pap smear fame – to apply the collagen filler.  Furthermore, the doctor has to initially find the G Spot in order to know how far to build the device that is used to reach the injection site, a procedure which may cause many women to blush.

Regardless, the reviews seem to be very good and many women are reporting a whole new dimension to their sex lives after G Spot Augmentation.  There are no studies that I know documenting the procedure’s effectiveness, but it is still something that some couples may wish to consider.

Liquid Face Lift for Males - Peak Testosterone

The best cosmetic procedures for males are ones with minimal downtime and loss of privacy.  Cosmetic procedures for guys are a rapidly growing part of the market, but still most men would rather keep it a deep, dark secret.  What would they say in the office, eh?  (I’ll tell you what the women would say:  they would applaud the fact that you look ten years younger!

The Liquid Face Lift is, by all these criterion, the perfect procedure for males. Men can come into the office on a Friday and be easily recovered by Monday.  And the results are generally very impressive and long-lasting: a good doctor can take a decade or more off of your appearance and some procedures last for about two years.

So how does it work?  It’s this easy:  the doc injects one of the new cosmetic fillers into various parts of your face to fill in wrinkles and sunken areas, typically in the cheeks, eye and mouth area.  Again, it sounds like a silly solution, but it works because so much of the facial aging process involves sagging, sunken skin. Inserting fillers into these areas simply raises skin to smooth out wrinkles and makes your face look less “hollowed out” and “saggy”. Almost every feature on the fact can be improved through fillers such as these.

And, perhaps most importantly, researchers have found that these fillers actually stimulate collagen synthesis.  Of course, collagen is the “backbone” of skin and boosting its production is one of the Holy Grails of facial anti-aging. What researchers at the University of Michigan found was that  in young people, fibroblasts, which produce the collegen, are stretched naturally.  However, this process is significantly reduced in older people and fillers help to stretch the fibroblasts resulting in more collagen production. [1] One study of seniors using Restylane showed just that. [2]

Results generally persist from 6 months to year depending on the procedures and filler used. The longer lasting fillers include injectables such as Radiesse, Artefille and Sculptra.  However, some may feel more secure with hyaluronic acid-based (Restylane and Juv derm) or collagen-based (CosmoDerm and CosmoPlast) fillers.

So why doesn’t everyone run out and get one of these liquid face lifts?  Cost is probably the primary reason, which generally runs in teh $3,000 to $6,000 range.  If you’ve got the money, they’re hard to beat for results, but let’s face it:  for most people, it means picking between a new face or a new car.

Still, the procedure is perfect of most males due to its private and incognito aspects.

CAUTION: Although shorter lived, the hyaluronic acid and collagen fillers are part of our skin matrix and can be naturally reabsorbed into the body making any long term effects less likely.  The longer-lasting fillers are based on collagen and/or hyaluronic acid, but have additional, non-natural components added that have uncertain long term health effects. Cosmetic surgeons argue that results have been good and side effects rare, but we simply do not know what occurs from decades of use.

REFERENCES:

1) https://www.med.umich.edu/opm/newspage/2007/restylane.htm

2) Archives of Dermatology, Feb. 2007, 143(2):155-163, In Vivo Stimulation of De Novo Collagen Production Caused by Cross-linked Hyaluronic Acid Dermal Filler Injections in Photodamaged Human Skin.

Bodybuilding Without Destroying Your Health - Peak Testosterone

For a large percentage of guys the fitness ideal is the natural bodybuilder, the guy who uses the lastest training techniques, is in good shape and eats relatively healthy and naturally. I mean who doesn’t admire someone who could bench a Z4 without resorting to steriods?  He looks good, feels good and undoubtedly has women right and left tripping over themselves to meet him.

Well, I want to challenge this ideal.  First of all, women do not, in general, like bodybuilding levels of muscle on a guy, be he natural or be he freakish from steroids. Massive muscle mass-building – say that three times fast! – is almost entirely a male-driven phenomenon.

Consider these results from a Psychology Today study:

Men and women also parted company in the domain of male muscle mass. Men value muscle mass, while women are less interested in oversized biceps and pecs. In ranking male body types, women gave first place to medium with moderate muscle mass while medium with competition muscle mass came in a lowly fourth. When men estimated women’s preferences, however, competition body build narrowly missed second place. We asked women directly, “how important it is for you that [a man] have noticeable muscles,” and we asked men how important muscles were to them. The differences were striking: twice as many women as men said that male muscles did not matter at all.

That’s right – competitive muscle mass is a negative with most women. Guys, let’s be honest:  if you’re not lifting for the women, then who are you lifting for?  Let me be more blunt:  why are you pursuing something that is an actual turn off for most women?  When I first read this, it hit me like a ton of bricks.  All those “curls for those girls” that I was doing was nothing more than narcissistic madness.

Yes, a certain amount of muscle mass is important for your metabolism, weight control, bone mass and other health factors. Furthermore, a youthful amount of muscle mass makes you look much younger:  we all know one of the best signs of middle age is a flat butt and flabby arms. But, that said, why do we guys do what we do to ourselves in the gym?  It just doesn’t make sense!

Let me give you just a few examples of how Muscle Madness actually can hurt or even kill you:

So, in my opinion, you should seriously re-think trying to go the speed of light, that is you should reconsider your desire for infinite mass. It’s not worth the price. Besides, women would much rather see a six pack on your abs.  And well-trained abs will do a lot more good in the bedroom than 20 inch biceps anyway. Think of some of the greatest athletes in the world right now – guys like Federer and Phelps – and they are much more the physically ideal of women around the globe.

I want to emphasize that I am NOT trying to talk you out of weight or strength training nor am I going to the extreme of saying that muscle is not good for you.  If you’ve poked around my site at all, you know that I emphasize the slow build up of Muscle Mass for many reasons, including the fact that it burns fat, builds testosterone and helps you look decades younger for starters.  But I encourage you to reconsider the traditional body building hype that is so often promoted on the web and in the mags:  it is probably just plain dangerous for your long term health.

I also want to point out that I tried an Ornish Diet, which is a quasi-vegan diet that actually reverses arteriosclerosis, and found that I put on several pounds of muscle while building a six pack on my abs! I had not seen that since my college days.  Again, this kind of healthy lifestyle is what you need:  building muscle, lowering fat, getting good abs and cleaning out your arteries!  So put on some muscle and get in shape and don’t kill yourself while you’re at it!  (For more information, read my link on the Great Diet Smackdown (Part II) and how the Ornish Diet appears to stop Prostate Cancer dead in its tracks.)

CAUTION:  New research shows that aerobics/cardio should always be done after weight training.   Please read my link on Weight Lifting and Arterial Stiffening for a detailed analysis.

REFERENCES:

1) Arch. Path, 1968,85:133-137;J Nutr,1972,102:53-60; Biochem Pharmacol,1973,22:1005-1014; Life Sci,1976,19:1191-1198.  There are about two dozen more studies documented on p. 372-373 of The China Study by T. Colin Campbell and Thomas M. Campbell II, Benbella Pub., 2006.

2) Adv Nutr Res,1979,2:29-55

3) J Natl Cancer Inst,2002,94:1099-1109; J Am Diet Assoc,1999,99:1228-1233; Am J Nephrol, 2001, 21:331-339; Brit J Cancer,2000,83:95-97

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

5) Hypertension,1999,33:1385-91

6) Experimental Physiol,2005,90(4):645-651

7) Experimental Physiol, 2007, 93(2):296-302

8) Angiology, 2000, 51(10):817-826

High Fat Meals: The severel Issues with Erections

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.

REFERENCES:

-Supplements,- A Secondary Guide-

Hopefully, you’ve already my Top Five Erectile Supplements with solid research and few side effects.  These top five can heal about two thirds to three fourths of guys with erectile dysfunction according to the studies.  However, there are a number of other very helpful supplements that can improve erectile strength directly and/or indirectly that I wanted to include as well:

Don’t forget to read my links on the following, all of which can be just as helpful as supplementation:  Erectile Repair Guide, Kegels, the https://www.peaktestosterone.com/ and Exercise.  Always get to the root of your problem  or eventually heart and arterial disorders will stop your sex life dead in its tracks.

Here is a list of secondary erectile dysfunction supplements with some reasonable evidence:

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.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?exprod=myyahoo&_r=0

1) Caffeine. Believe it or not, caffeine may actually improve erectile dysfunction. This theory is still in the beginning stages, but a recent study on diabetic rats showed that “caffeine consumption improved the erectile function of diabetic rats by up-regulating cavernous cGMP”. [20] Be careful about tanking up on caffeine though: it is too early to tell if the study results will translate to non-diabetic humans.

2) Citrulline. Citrulline is an amino acid present in watermelon, fish, eggs and a few other foods.  It is a pre-cursor, or building block, of L-Arginine and, as such, is an erectile dysfunction supplement that increases blood flow and Nitric Oxide throughout the body.  I have been able to find no side effects at this point, although one would expect that it would have, at a minimum, some of the profile of L-Arginine itself.  No one really has much of a doubt that Citrulline will increase Nitric Oxide levels – the debate is really “how much?”.  Many individuals have plenty of Arginine in their systems and, in that case, citrulline is unlikely to help much.  If you want a more natural route, a recent study showed that citrulline exists in substantial quanitites in watermelon rinds. [27] That ought to get you some attention at your next BBQ, when you chow down on a half dozen watermelon rinds while everyone else is enjoying coleslaw and beer butt chicken. You may have the last laugh, though, as a Web MD article s states that “a typical 4-ounce serving of watermelon (about 10 watermelon balls) has about 150 milligrams of citrulline”. In other words, you don’t even have to eat the rind to get a goodly amount.

3) Vitamin C.  Several studies have shown that Vitamin C keeps Nitric Oxide in your system longer, something almost any good erectile dysfunction supplement should do, and thus should be a mild help with erectile dysfunction.  One study showed that hypertensive patients actually had a measurable increase in dilation of the veins in the forearm for patients given Vitamin C. [24] This should translate to dilation of the arteries bringing blood to the penis as well. CAUTION:    Vitamin C has done well in many studies and has many possible side effects including cancer and hardening of the arteries.  Read about The Possible Dangers of Vitamin C before you make your decision to take it.  (And consult with your doctor of course.)  NOTE:  Regular Vitamin C is very acidic and hard on the stomach:  you may want to consider the Ester-C form for just that reason if you do decide to take it.  One interesting benefit of 1.5 g/day of Vitamin C i is that it actually decreases cortisol levels and cortisol lowers testosterone and is very hard on the brain.

5) Folic Acid.  A recent meta-analysis, a study of studies, revealed that folic acid supplementation improved endothelial function and that should improve erectile dysfunction as well.  Better blood flow and arterial dilation are good for your sex life and should improve erectile dysfunction while it’s at it. After all, you want all the veins in your body, especially the ones in the penis, to be able to expand easily and allow the blood to move freely.  Furthermore, researchers found that the higher the dose, the better the result. [11] Scientists speculate that folic acid’s potency may stem from its ability to lower homocyteine levels, which is one of the leading predictors of heart disease. In fact, scientists found that elevated homocysteine levels were as strongly correlated to heart disease as high cholesterol and triglycerides. [12] Folate also protects the Brain as well. CAUTION #1: There is some new evidence that too much Folic Acid can lead to colon cancer. [21] See this link for details. But, it should be added, many studies have found that Folic Acid supplementation actually lowered cancer levels. [22] Again, though, the safest way is always to get what you need through what you eat. CAUTION #2: You may have read that Vitamins B6 and B12 can lower homocyteine levels as well.  Be careful about taking B6 and B12 supplements.  These usually come in megadoses that can cause memory damage and/or exacerbate acne.  See this link f for details.

6) Magnesium.  Make sure you are getting enough Magnesium.  Studies have shown that adequate magnesium can decrease some of the effects of Metabolic Syndrome and lower inflammation (c-Reactive Protein, a.k.a. cRP) levels which are devastating to your endothelium. [13]  To improve erectile dysfunction and impotence, you definitely want to consider Metabolic Syndrome one of your arch-enemies.  If you’re eating a healthy diet, such as the Mediterranean Diet, that is so often recommended on this site, then you have little to worry about.  But if you’re eating like a typical Westerner, consider taking this inexpensive supplement.  Magnesium is so critical that I have devoted a separate link to the subject.

7) 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.<.

8) Tongkat Ali/Eurycoma Longifolia Jack.&. A libido enhancer worth mentioning because it has done well in studies on rats and because it is frequently in ex.  A libido enhancer worth mentioning because it has done well in studies on rats and because it is frequently in ex.  A libido enhancer worth mentioning because it has done well in studies on rats and because it is frequently in ex.  A libido enhancer worth mentioning because it has done well in studies on rats and because it is frequently in expensive supplement preparations in health food and nutritional stores.  No human studies have been done to date from what I have read, except for one that shows an increase in muscle mass [28].  And, unfortunately, the animal studies were all conducted by one researcher.

9) Tribulis Terristris  This is much-hyped in nutritional stores and bodybuilding sites as a testosterone booster.  The truth is that it has a few animal studies behind it in this area but little else. Tribulis works on testosterone by increasing Leutinizing Hormone, but this has a muted effect the older a guy gets.  However, Tribulis is an old friend and a lot of guys swear by it.  The reason is that Trib is very likely a jack-of-all trades.  We cover that here in a link on Super Sexual Herbs. .

10) Yohimbe. . One of the ways this herb seems to work is by increasing blood pressure. That’s the last thing anyone, especially those over 40, needs. So, yes, this can improve erectile dysfunction and impotence in the short term.  However, it is probably dangerous to your long term health.

11) Chrysin. Estrogen can crowd out testosterone and so an estrogen inhibitor can boost testosterone.  6-OXO was recently banned by the FDA, leaving Chrysin, which is a questionable estrogen-inhibitors at best.  For a more detailled look, read this link on Estrogen. .

12) Saw Palmetto/Pygeum/Stinging Nettle. All three of these herbs have a solid and generally safe track records and all three are known for their ability to block the enzyme that conversts regulard testosterone into DHT, one of the male androgens infamous for causing hair loss and enlargening the prostate.  This is exactly how the hair restoration drug Propecia (formerly called Proscar) works, i.e. by blocking this same enzyme. But here is what your doctor and pharmacist will not tell you:  Propecia can result in estrogen-like symptoms including enlarged male “breasts”, loss of sex drive, decreased semen volume, erectile difficulties and so on.  Saw Palmetto, which is the “natural” equivalent of Proscar produces these same symptoms in a certain percentage of men.  Pygeum and Stinging Nettle also block this same enzyme and thus, to one degree or another, probably produce these estrogen effects.  Bottom line:  these herbs are simply not worth the risk.  Start wearing a hat if you’re that sensitive about your scalp.

13) Carnitine. An Italian study demonstrated that taking 2 g/day of propionyl-L-carnitine along with 2 g/day of its cousin acetyl-L-carnitine, actually improved erectile function more than that of the a group taking testosterone. [9]  A later study showed that 2 g/day of propionyl-L-carnitine actually significantly improved erections in men who were unresponsive to Viagra alone. [10]  And, as if you wouldn’t be happy enough with these results, Carnitine has also demonstrated mood and energy improvements as well. Carnitine is abundant in animal sources:  a 3.5 oz serving of beef has a little over 90 mg, pork a little over 20 mg and chicken and dairy a little over 3 mg.  A strict vegetarian diet will have very low levels of ingested carnitine. CAUTION: : This supplement should probably be regarded as a short term solution because 1) acetyl-l-carnitine increases free radical damage (which is why it is generally coupled with alpha lipoic acid) and 2) there is some evidence that it may interfere with thyroid function.

CAUTION:  Note that this form of carnitine does not appear to be available on a retail basis. Also, carnitine has recently been implicated as a counterintuitive cause of heart disease.  It turns out that bacteria love carnitine for fuel and increase levels of TMAO in your blood.  TMAO, in turn, “enables cholesterol to get into artery walls and also prevents the body from excreting excess cholesterol.” [29] Carnitine is found in high levels in beef and pork and meat eaters should be cautious in consuming red meats such as this.

Cypionate: Weekly Versus Every Two Weeks - Peak Testosterone

So pull up the above study and show your doctor just what is going on.  And notice that it is in an endocrinology journal, so there is no excuse if he is an endo.  (You would think that endocrinologists would know about this, but, sadly, many not do not.)

REFERENCES:

1)  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

NOTE: Testosterone enanthate and cypionate share very similar half-lives and dosages. In the U.S. testosterone cypionate is typically used and enanthate rarely. However, in many other countries, the opposite is true. The general comments on this page apply to BOTH enanthate and cypionate.

This is a particularly relevant topic, because an every-two-week protocol is still practiced by most endocrinologists around the globe.  In the U.S., things are finally changing, but many countries still have the vast majority of their endos insisting on an injection every two weeks and sometimes even three or four!  This leaves many men around the globe in a terrible quandry:  should they take a horrible protocol just to get into the system or just stay hypogonadal without treatment?  Again, in the case of an every other week protocol, the cure is almost worse than the disease!

And no wonder so many endocrinologists hate HRT:  their patients hate their lame protocol.  The poor men being treated this way come back to the endo saying, “Well, I felt good for a couple of days but then I was miserable.  If fact, I felt worse than before HRT.  What’s wrong doc?”  And the endocrinologist thinks to himself:  “Well, I’ll tell you what is wrong:  HRT sucks!”

The reality is that testosterone cypionate injections are used by HRT clinics and many savvy docs with great success, but the secret is predicated on that fact that it needs to be done weekly or even twice per week!

Let’s look at some research that show just how bad cypionate (or enanthate) injections really are if done improperly.  One study looked at nine  hypogonadal Japanese males with total testosterone < 270 ng/dl or free testosterone < 10 pg/ml. [1] These are very low testosterone levels and would constitute hypogonadism with almost any lab.  The researchers then gave these men a single 125 mg dose of testosterone enathate and monitored their testosterone levels.  The results were very revealing:

What this study clearly showed is that testosterone levels are actually raised a little over baseline after a week, which explains why a weekly protocol is so often successful.  However, by the two week point, total testosterone actually collapses below these men’s already very low baseline testosterone levels. This is very ugly as HRT done this way actually makes a bad situation worse for probably four or five days!

And, for those poor guys who are put on an every three or four week protocol – well, they likely have extremely low testosterone for weeks!  One poor guy wrote in with a horror story about just this situation:

“I am 35 years old. I just started trt. My test levels were 280 ng/dl. Immediately doc put me on 2cc of 400mg of test cypionate once a month. I don’t have blood results. I just know that I really start feeling terrible after about 2 and a half weeks. I know this is vague info. But does this sound normal? Feel so down and out. Any help or opinions will be greatly appreciated.” [2]

By the way, there is something else horrible about this every four week protocol.  Look at the dose this doctor gave him:  2 cc (which is 2 ml).  Testosterone cypionate usually comes in 200 mg/cc concentrations and so this man probably got 400 mg of testosterone in one injection, which corresponds with what he wrote above.  What this means is that on days 1-4 his testosterone levels went through the roof and were VERY high.  The doc did this out of ignorance, because he figured that it would help the cypionate last longer.  However, because of its relatively short half-life, the cypionate (or enanthate) is almost all gone at about day 10 no matter how much you give him.  (Low SHBG men will clear out testosterone even more quickly.)  So that monster injection of cypionate will also send the man’s estradiol sky high which yields a completely different set of problems:  low libido, erectile dysfunction, bloating, weight gain, gyno, moodiness, etc.

2) https://peaktestosterone.com/forum/index.php?topic=121.0

Miraforte: Libido Booster - Peak Testosterone

Super Miraforte is the Life Extension Foundation’s libido, anti-estrogen and testosterone supplement. Life Extension is one of the oldest and most reputable of the supplement manufacturers out there, specializing in anti-aging in particular, and with Miraforte they have taken aim at many of the hormonal issue that so often accompany the middle age and beyond years.

What is interesting is that Super Miraforte is very often sold to bodybuilders, because of its powers to decrease estrogen and likely slightly increase testosterone.  Chrysin has a questionable history of decreasing estrogen.  However, Life Extension seems to have supercharged it with the addition of piperine for increased absorption.  This is likely the reason that Super Miraforte has been very well-received and reviewed and is used by bodybuilders in many cases.  (I have even read that some doctors are recommending it.)

Could Super Miraforte possibly increase testosterone?  One of the key things that most older men need is Estrogen Control and Miraforte does just that.  The reason that this is so critical is that, not only will estrogen “crowd out” testosterone, but it also can directly put the brakes on the testosterone output from your Leydig cells. [1][2]  This means that Super Miraforte , by decreasing estrogen, could lead to a T increase for middle-aged and beyond males that are struggling with inflated levels of the female hormones.

ARE YOU LOW SHBG? Miroforte contains Nettle and Nettle lowers SHBG. This is usually a good thing, unless you are a Low SHBG guy. Low SHBG is a fairly common condition, linked to insulin resistance, that makes HRT tough for example. Low SHBG should be cautious about using Nettle products in my opinion. I am talking about SHBG below about 18 by the way.

CAUTION: If you have any medical conditions or are on any medications, please consult with your doctor before taking any supplement.  Also, some men have such low T and E that their levels of estradiol are dangerously low.  See my link on Why Men Need Estrogen for more information.

1. Presented at the First International Congress on Ethnopharmacology, Strasbourg, France, Jun 5-9, 1990, Contributions to the clinical validation of the traditional use of Ptychopetalum guyanna.

2) J Clin Endocrinol Metab, 1978 Dec, 47(6):1368-73, “Direct inhibition of Leydig cell function by estradiol”

3) Prog Clin Biol Res, 1986, 213:359-71, “Iodothyronine deiodinase is inhibited by plant flavonoids”

Below I outline how Super Miraforte can benefit your sex life, including possibly increasing testosterone and libido and decreasing testosterone libido.

1. Chrysin. Chrysin is a known estrogen lowerer and it works by inhibiting the aromatization of testosterone to estrogen. As males age (and gain weight), an increasing percentage of their precious T is converted to E and chrysin can help.

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. [3] This could potentially lead to weight gain, which would sabotage estrogen control.

2. Nettle. Nettle is a well-known liver protector. What is not so well known is that it also fights aromatization of testosterone to estrogen as well.

4. Muira Puima. This herb is an aphrodisiac with a long history and some of its effects have even been documented in a few small studies. [1] Another study reported improved morning erections as well.

5. Maca.  This plant is another libido booster that I cover extensively in my link on The Superpowers of Maca.  Maca has actually been used as a food for centuries with an admirable safety profile.

6. Piperine. This compound from pepper, as in black, boosts the absorption of many supplements and compounds. Life Extension Foundation, by including, some piperine is essentially “supercharging” their supplement for better efficacy.

NOTE:  Increasing testosterone in men can also lead to increases in nitric oxide as well as testosterone works positively on NOS (Nitric Oxide Synthase).

REFERENCES:

How to Get Down Below 10% Body Fat and Keep Muscle Mass

Ever heard of Clarence Bass? If you’ve been in the strength or bodybuiding community for very long, then you know who he is. Clarence is a seasoned and well-respected writer and one of the few that walks the talk and talks the walk. By that I mean he has produced an incredible year round physique all the way into his mid 70’s, is still in excellent health and is able to articulate how to do all of that with great ease and readability as well. I recently read one of his books – Challenge Yourself – and wanted to cover it here, because it had such a profound impact on me.

NOTE:  Don’t miss my interview with him here: Clarence Bass: Natural Middle-Aged and Senior Bodybuilding.

First of all, the book is full of fantastic practical advice on how to lose weight, build muscle, exercise, etc. and keep doing it year after year after year.  Now, in my case, I don’t really need to be pushed to exercise, because at this point in my life, I can’t wait to get to the gym.  I feel great when I walk out almost always and I know how important it is, so I’m already a believer.  Furthermore, I am a Skinny Bastard, so putting on a spare tire has never been tht much of an issue for me either.

However, I do need to challenge myself in a key area:  I had given up on ever getting my body fat percentage below 10% while maintaining my hard-earned muscle mass.  As a 54-year-old ectomorph’s ectomorph, I don’t put on muscle that easily and I certainly don’t want to lose it all trying to get my abs.  However, I also do NOT want to do the standard low carb diets that everyone does out there to “cut.”  I have written quite a bit on those diets, as I believe they can negatively impact gut flora and cause arrhthymias in some men  when done long or even medium term.  Plus, all the saturated fat that comes with these diets would be a real erection-killer for me as well.  (I thrive on what I call  Low Fat Paleo: see my page on High Protein, Medium Carb, Low Glycemic Low Fat Diet.)

This is where Challenge Yourself comes to the rescue:  Clarence actually eats very similar to how I do, although he eats more fat and a few other modifications, but our general philosophy is very similar:  whole foods, an emphasis on plants, an emphasis on nutrient dense, high volume foods, etc.  So I could not agree more with almost everything he writes on nutrition.  Furthermore, he shows how to get your body fat below 10% – well below – and do it while eating this way, i.e. a largely plant-based, whole foods diet!  Now there’s a sermon worth listening to!

I have been told on my own Forum that the only way to get below 12% body fat is to go low carb or low carb with certain “tricks” attached to it. Right now low carb is so popular that I simply asssumed they were correct, because I read article after article praising low carb for fat loss and leaning out and virtually nothing from the other camp.  Bodybuilding articles on the necessity of “bulking” and “cutting” did not help matters and so I just gave up.  For a couple of years I have been hovering at about 14 – 15% body fat and assumed that was my final destination.

As you might guess, it was an incredible relief it was to find that there was a philosophy out there, compatible with my own, that utterly shatters the prevailing low carb mythology that it and it alone can achive low body fat percentages.   Clarernce has proven in himself and in many of his followers that, if you are willing to eat a healthy, whole-foods plant-baed diet – yes, he eats some meat and dairy as well – you can slowly lose weight with no significant loss of muscle mass AND you can do it relatively effortlessly, i.e. without a lot of hunger and counting calories, etc.

The book maps out just how to do this and this is how I plan to challenge myself.  I’d like to get my abs showing and do it in a healthy manner without losing a lot of muscle.

Just how does “Challenge Yourself” say to do this?

Well, there are literally hundreds of helpful guidelines and tips, but here are the biggees that stood out in my mind:

1.  Lose Weight Slowly. Most guys try to drop the pounds too quickly and hammer their hormones and, most importantly, lose their hard earned muscle. Losing weight in a more “sane” manner also makes it possible to lose weight without going hungry or depriving yourself of a nutrient rich diet.

2.  Measurement is the Key! How do you know if you are losing muscle as you are dropping weight?  How do you know if you are losing or gaining water weight?  Obviously, a standard bathroom scale ain’t gonna do the trick.  Sure, you can go get yourself hydrostatically weighed, but that involves some cash, scheduling and time.  A much, much more practical alternative is to get yourself a good bioimpedance scale.

I had never heard of one of these until I read about it in Clarence’s writings.  Don’t ask me how I missed it, but I was overjoyed to find that you could buy a cheap and accurate bioimpedance scale.  I got a Tanita – if it’s good enough for Clarence Bass, it’s good enough for me! – and have been using the thing religiously for about 10 days now.  I’m a numbers person and so having useful data is highly motivating for me.  That’s part of being a certified Health Geek I guess.  The Tanita gives you in less than a minute your weight, % body fat and % water weight- all the numbers you need to know to estimate water weight, lean body mass and, of course, fat mass.

3.  Do the Same Thing Every Day, 365/24/7. Now I don’t mean by this that you should do the same boring exercise or dietary routine every day.  In fact, the book talks about that.  But what I do mean is that I despise the idea of the “bulking” and “cutting” phases, as I mentioned, that so many weight lifters go through.  Clarence opposes this viewpoint and attacks the extreme form of it:  yo yo dieting as it is called.

With my personality I want to do this same thing day in and day out and I don’t want to gorge for a month and then starve for a month – that just is not my personality.  Finding Clarence’s philosophy was an incredible relief.  (Frank Zane had a somewhat similar philosophy by the way:  he just tweaked his protein/carb ratio a little.)

These three points are actually a small part of this great book that discuss his diet and recipes, his exercise philosophy and routines and almost of all of the foundation that a man needs to get started on his way to building a great physique, regardless of his age.

Arterial Stiffness and Erectile Dysfunction - Peak Testosterone

Common sense would tell us that stiff, hardened arteries are not good for us. And common sense would be dead right.  The medical term is “arterial stiffness” and one study found that “aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality.” [1] In other words, if you arteries are hardened, you have a much greater chance of dying, especially from heart-related issues.

There are several reasons for this, including the fact that stiff arteries produce a higher spike in the blood’s pulse pressure wave and that wave has more velocity.  Those spikes, over the course of years, can damage tissue (including brain and kidney) and lead to additional arterial plaque buildup just for starters.

Peak Testosterone readers know just how interrelated the heart and penis are and will not be surprised to find that arterial stiffness is also related to erectile dysfunction. [2]  We all know that you need nice, expandable arteries for blood flow into the penis, eh?

So what causes arterial stiffness and hardened arteries?  Below are some of the culprits that research has recently uncovered.

1) J Am Coll Cardiol, 2010, 55:1318-1327, “Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness”

2) https://news.georgiahealth.edu/archives/247

3) Am J Hypertens, 2007 Mar, 20(3):242-7, “Advanced glycation end-products and arterial stiffness in hypertension”

4) Hypertension, 2005, Jul;46(1):232-7, Epub 2005 Apr 25, “Advanced glycation end products are associated with pulse pressure in type 1 diabetes: the EURODIAB Prospective Complications Study”

5) Hypertension, 2005, 45:349., “Arterial Stiffness and Hypertension: A Two-Way Street?”

6) Hypertension,1999,33:1385-91, “Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure”

7) Am J Hypertens, 2007 Mar, 20(3):319-25, “Sodium, arterial stiffness, and cardiovascular mortality in hypertensive rats”

8) J. Nutr, 2011, “Sodium Intake Is Associated with Carotid Artery Structure Alterations and Plasma Matrix Metalloproteinase-9 Upregulation in Hypertensive Adults”

9) Eur J Clin Invest, 2008 Jan, 38(1):24-33, “MMP-9 haplotypes and carotid artery atherosclerosis: an association study introducing a novel multicolour multiplex RealTime PCR protocol”

10) Diabetic Med, 1992, 9:114 119, “Arterial wall compliance in diabetes”

11) J Am Coll Cardiol, 1993, 22:1881 1886, “Short and long-term effects of smoking on arterial wall properties in habitual smokers”

12) Nutrition, Sep 2013, 29(9):1122-1126, “Acute effects of beer on endothelial function and hemodynamics: A single-blind, crossover study in healthy volunteers”

NOTE:  For practical solutions, see my link on How to Partially Reverse Hardening of the Arteries.

1)  Advanced Glycation End Products (AGEs). Young, supple arteries are composed of undamaged elastin and collagen. Part of the aging process in everyone is for the bonds of these proteins to be broken and damaged for AGEs, which stiffens arterial walls like old leather. [3][4] However, many people have accelerated AGE damage.  Advanced Glycation End Products will damage your body in a hundred other ways as well:  read my link on The Dark Side of AGE’s for more information.

3)  Weight Lifting. Lifting heavy weights results in extremely transient blood pressures and one study found that long term weight lifters had higher arterial stiffness that normal. [6]  I cover this and other related issues in more detail on my link on Weight Lifting and Your Arteries.

4)  Salt. The more sodium that you consume, the higher the “plasma volume” in your arteries and vessels.  This can lead to high blood pressure, especially in sensitive individuals.  However, salt-sensitive or not, it appears that everyone is susceptible to accelerated arterial damage from high sodium consumption. [7] Researchers are not completely sure why at this point, but preliminary evidence points to an enzyme called MMP-9, [8] recently associated with arteriosclerosis. [9]

5) Diabetes. Of course, anything that raises blood sugar is going to lead to more of Advanced Glycation End Products, mentioned above, and accelerated hardening of the arteries.  Diabetes is the ultimate blood sugar raising machine and so it is no wonder that diabetes is correlated to arterial stiffness. [10]

6) Smoking. Yes, sticking burning leaves into your mouth will damage your arterial walls. [11]

7) Moderate Alcohol Consumption.  These improved arterial stiffness in one recent study. [12] Of course, moderation is the key here.

8) Blueberries.  The equivalent of one cup of blueberries per day dramatically increased nitric oxide, lowered blood pressure and decreased arterial stiffness, at least according to one study on women. However, the results would very likely be replicated in men as well.  See my page on Blueberries and Erectile Dysfunction for more information.

The bottom line is that if you want to be hard, you’ve got to keep your arteries soft.

REFERENCES:

Appetite is One of the Keys to Dropping Those Pounds - Peaktestosterone

Imagine if you could take a drug that would suppress your appetite and make you feel full and satisfied for a longer period of time.  You would, of course, eat less and much more easily maintain or even lose weight.  Well, there is no reason to take a drug for this:  the answer lies in the foods that you eat.

Many foods actually provide much greater satiefy and greatly control appetite. This is very important when you are losing weight, especially if you are not by nature a person with steely discipline when it comes to eating.  Examples abound, but below we are going to discuss some of the heavy hitters that will help you lose that health-and-hormone-harming spare tire around your midsection.

Let’s start with almonds. Almonds are a counterintuitive choice when it comes to losing weight, because they are calorie dense, i.e. they pack a lot of calories in a small volume due to their high fat content.  However, they have a huge advantage:  they are extemely satisfying of appetite and satiety.  One study of obese women, for example, found that they were able to control their weight just by eating a handful of almonds every day. [1] In other words, just one food can actually make a difference when it comes to appetitie control.

Food is not the only thing that can effect appetite:  there are significant lifestyle factors as well.  One supplement, fish oil, has been found to increase satiety and help satifsy appetite in overweight people. [6] Eliminating stress is also a critical lifestyle change as chronic stress alters appetitie in most people according to a recent study out of the Netherlands. [4] Stressed out people, especially those sensitive and vulnerable, eat even though aren’t truly hungry. And one interesting study found that women – the same is likely true for us guys as well – who eat lunch watching television end up eating more in the afternoon.  Why?  The authors speculate that one has “reduced vividness of the memory of the lunch”.  Yet another reason not to fry your brain in front of the tube, eh?

NOTE:  You may want to read my link about the Controversy Regarding Beef and Eggs.

REFERENCES:

1. North American Association for the Study of Obesity: The Obesity Society Annual Scientific Meeting 2006,”The effects of almond consumption on energy balance in adult females”

2) Eur J of Clin Nutr, Sep 1995, 49:675-690, “A satiety index of common foods.”

3) Eur J of Clin Nutr, Dec 1996, 50:788-797, “Interrelationships among postprandial satiety, glucose and insulin responses and changes in subsequent food intake.”

4) Obesity, 2008, 17(1):72 77, “Acute Stress-related Changes in Eating in the Absence of Hunger”

5) University of Copenhagen. “Dark Chocolate Is More Filling Than Milk Chocolate And Lessens Cravings.” ScienceDaily 23 December 2008. 22 March 2010

6) Appetite, 2008 Nov, 51(3):676-80, Epub 2008 Jun 14, “A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss”

Another example of this is dark chocolate.  One study out of Copenhagen showed that men who first consumed dark chocolate later consumed 15% less pizza, which adds up to a lot of calories. [5]  Participants consumed 100g of dark chocolate and, sorry, but milk chocolate did not produce the same results.  The reason?  Cacao contain compounds that slow down digestion and make you feel fuller longer as well as appetite regulators and cannabanoids.  It’s a pro-pleasure pleasing cocktail and dark has more of the chemicals that make a difference.

Other researchers did an even more thorough mapping of appetite to a wide variety of foods in a set of studies in 1995 and 1996. [2][3] The researchers in the lead study gave participants 240 calories of various foods and then queried them on appetite and satiety.  The results were very interesting and a strong key to appetite control.  In fact, they built what they called The Satiety Index that can be used by just about anyone to control overeating.  Here are some of the top foods – and notice that they are both healthy and control appetite – on the Satiety Index per this article on Diabetes Net:

In other words, most of the healthy foods are also very satisfying and keep your appetite satisfied for a longer amount of time. An important additional point about this same study is that junk foods were consistently among the worst scoring items on the Satiety Index.  In other words, not only are what I call sugar fat foods, such as cakes and doughnuts, calorie dense but they also leave you feeling less satisfied and more likely to eat again at a sooner time.

The Benefits of Testosterone Therapy (HRT)

The benefits of testosterone therapy (HRT / TRT) were absolutely incredible for me.  I was low testosterone all of my adult life and testosterone gave me morning erections for the first time; helped with some loss in erectile function and libido; and, best of all, got rid of life long dysthymia (mild depression) that I had experienced for decades.  In my case testosterone therapy produced dramatic results and really gave me a quality of life that I simply had not experienced as an adult.  It was beautiful.

And it is really very strange, if you stop to think about it, that you can increase one hormone along the pathway from cholesterol breaking down into such major hormones as DHT, estradiol and cortisol, and produce such a dramatic effect on so many things. If you increase DHT or DHEA or pregnenolone, you just don’t get those kind of profound and widespread benefits generally. (You can read about my experience if you interested in My Personal Health Story.)

Below is STEP 9 in my Testosterone Evaluation Program, which includes Over 15 Very Common, Research-Backed Benefits of Testosterone:

REFERENCES:

2)  https://peaktestosterone.com/forum/index.php?topic=2402.0

3)   https://peaktestosterone.com/forum/index.php?topic=997.04)  https://peaktestosterone.com/forum/index.php?topic=1243.60

5)   https://peaktestosterone.com/forum/index.php?topic=513.45

6)  https://peaktestosterone.com/forum/index.php?topic=433.0

7)  The Journal of Urology, May 1996, 155(5):1604-1608, “Improvement of Sexual Function in Testosterone Deficient Men Treated for 1 Year with a Permeation Enhanced Testosterone Transdermal System”; 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”

8)  https://peaktestosterone.com/forum/index.php?topic=1414

9)   https://peaktestosterone.com/forum/index.php?topic=513.120

10)  The Journal of Clinical Endocrinology & Metabolism, Aug 1 2000, 85(8):2839-2853, “Transdermal Testosterone Gel Improves Sexual Function, Mood, Muscle Strength, and Body Composition Parameters in Hypogonadal Men”

11) https://peaktestosterone.com/forum/index.php?topic=513.45

12) https://peaktestosterone.com/forum/index.php?topic=941.0

13) https://www.cnbc.com/id/48149955, “Wall Street’s Secret Weapon for Getting an Edge”, Published: 11 Jul 2012, By: Cindy Perman

14) https://peaktestosterone.com/forum/index.php?topic=513.105

15) J Androl, 2003 Jul-Aug, 24(4):568-76, “Cognitive changes associated with supplementation of testosterone or dihydrotestosterone in mildly hypogonadal men: a preliminary report”

16) Neurology, Jul 10 2001, 57(1):80-88, “Testosterone supplementation improves spatial and verbal memory in healthy older men”

Testosterone Benefits

1. Venous Leakage Reversal (Partial or Complete) and/or Erectile Dysfunction. You can have pristine penile arteries that pump out all the nitric oxide in the word, but, if you have venous leakage, you’re not going to be able to get or maintain an erection.  Basically, venous leakage is when your penis cannot trap the blood that flows into it, i.e. as much blood leaks OUT of the penis as enters in.  A common symptom associated with venous leak is a rapidly disappearing erection.  This can cause major problems in the bedroom as some men will lose their erection just walking over to get a condom or walking over to make sure a door is locked!

The most common reason for this is a surprising one:  low testosterone. It turns out that when a man’s testosterone level gets low enough, the nerves and connective tissue inside the penis begin to atrophy. Under this scenario the penis just cannot lock off the veins that carry the blood out of the penis and so inflow and outflow become very nearly equal.  In addition, low testosterone can lead to a loss of morning erections and less sexual intercourse, which decrease oxygenation of the penis.

The good news is that testosterone given to a hypogonadal male has been shown in several studies to reverse, partially or totally, venous leakage.  For details on the research, see my page on Venous Leakage.

HRT can also significantly improve erectile dysfunction itself.  Part of this for some men may be its improvement of venous leakage.  But testosterone, as I’ll discuss below, also raises dopamine, increases endothelial nitric oxide, decreases hardening of the arteries and inflammation and many other parameters that will likely greatly improve erectile strength.  See my page on Testosterone and Erectile Dysfunction for more information.

CAUTION:  Now, before I go on, I want to mention that not every hypogonadal man gets these kind of results.  On the Peak Testosterone Forum there are just as many guys that little or no benefit and some even have side effects.  I cover the dark side of HRT (TRT) in my page on The Risks of Testosterone, and I urge everyone to scan through it. Sometimes HRT-related issues can be explained by a poorly done or poorly monitored protocol.  However, that is certainly not always the case and so you have to be realistic in your expectations.  Furthermore, the root cause of your problems is not always low testosterone.  Of course, it is important to find a knowledgeable and experienced physician and run everything by him or her first.

2. Nitric Oxide.  A less well-known property of testosterone is that it activates endothelial nitric oxide.  This is a powerful anti-inflammatory and arterial protector:  Testosterone and Nitric Oxide.

3. Libido. Many women find it hard to believe that a man could ever have zero sexual desire, but low T will do just that. (So will many other things such as high prolactin, hypothyroidism, etc.) In fact, a couple of studies show that libido rises with testosterone in a dose dependent manner. To check out the research, see my page on Testosterone and Libido.

4. Restored Morning Erections. It is no secret that testosterone therapy can restore morning erections, especially if the testosterone levels are high enough.  As I mentioned, I did not have morning erections until I went on HRT.  More accurately, I did not get morning erections until my testosterone levels were consistently above about 600 or 700.  We have had other posters make the same claim, i.e. that morning erections were returned after a long period of absence due to low T. [5]

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

All of this has been verified by the research.  A number of studies have shown that nocturnal erections are increased and improved after testosterone replacement. However, it is important to note that recovery from lack of morning erections can take time. One study found that morning (and spontaneous) erections improved steadily over the course of 12 months. [7] This is likely because the body must literally rebuild tissues and receptors within the penis.

5. Decreased Anxiety. Many low testosterone men struggle with anxiety.  What is not so well-known is that as one testosterone drops, anxiety can go through the roof.  When I went on injections, that was one of the first things I noticed:  I finally felt peaceful and not so stressed out.  My boss actually made a comment to me and asked what had changed!  See my page on Testosterone and Anxiety for more information.

The reasons for this are probably numerous, but one of the most intriguing ones is that testosterone has been found to limit the cortisol response from CRH at the adrenal.  In other words, testosterone limits your body’s stress response.  See my link on Testosterone and the Adrenals for more information.

Whatever it is, look at the example below as to just how powerful this change can be for a man that increases his T from basement levels:

“I’m also much “calmer” than before and mind seems better able to focus. You would think raising T levels would make you prone to anger and violence? But it has had the opposite effect on me.” [6]

6. Fatigue. When I was low testosterone, I was excruciatingly fatigued and this is a common complaint on the forum.  Again, HRT dramatically helped with this and this is something I simply do not see in the studies.  It makes sense, though, as the studies tend to look at the more quantifiable medical conditions.

7. Desire to Workout. One of the most common comments about HRT is actually that men frequently feel like exercising and hitting the gym again. Hard workouts become the norm instead of the exception. In fact, my HRT clinic warned that men on HRT who complain about joints usually do so because now they are working out hard again and perhaps pushing themselves a little hard, as opposed to low estradiol. And I believe it based on some the comments that I see quite frequently on the forum such as these:

“At 44 yrs old this is the best I’ve ever looked or felt considering the fact that I was preparing to meet my maker 3 yrs ago! I honestly go to the gym now 5 days a week 3 hrs. a day and actually working out the whole time, and I look forward to it since I have the energy now. I’m now at 225 lbs with about 10% body fat and I’m seeing my body change in ways that I’ve never seen before. I have more energy now than when I was 17. Plus my wife is really liking it because she says that I’m acting 17 again when I comes down to our bedroom time ‘which is a lot more now day’s’ If you know what I’m talking about!” [8]

“This weekend I felt like I had to lift because I just took a T shot a day before and could not take a day time nap because I felt like I could not sit still. I went to the gym and ran a mile under 7 minutes, did hardcore ab workout with ab straps doing leg raises and knee raises, and lifted back intensely. Afterwards, I felt a weight off of my impatient feeling like a drug almost. I felt incredible. I love the fact that workouts for me does lifting of my spirit and takes a lot of stress and weight off of me. I do not mean a foggy depressed weight in my head but more so an urge to use my testosterone as a man. I told my wife at that point I had to go to the gym, not to get mad at me, this was an urge that had to be fulfilled. She understood from what she said she has read with treatments. I came back home normal and balanced. It is so nice to have this feeling that I can utilize in such a great way and come home even better than woken up.” [9]

8. Weight Loss. What is not so well known about testosterone is that quite a few studies show that you can lose weight simply by going on testosterone therapy. You don’t have to increase exercise. You don’t have to watch or cut back on calories. All you have to do is boost your testosterone (assuming you are low T of course). Now no study shows that testosterone is going to melt 50 pounds off of you. However, the studies do seem to show that HRT can help you lose a little weight, something I outline in my page on Testosterone and Weight Loss.

9. Lowered Depression. As far as I remember, I never had a morning erection in my adult life, so there is strong chance in my opinion that I was low testosterone my entire adult life.  And I struggled post-puberty with another common symptoms of low testosterone:  depression.  My depression was generally mild and was like “having the blues” or a feeling of melancholy almost continually.  The remarkable thing for me was, when I went on testosterone cypionate, the depression disappeared literally overnight. I have never felt depression a day since.

Now not everyone has this transforming kind of a change with HRT.  And it is important to realize that cypionate probably doubled my testosterone levels.  Nevertheless, many men report significant improvement in depression on The Peak Testosterone Forum and this is supported often in the research as well.  For more information, see my page on Testosterone and Depression. [Do not stop any medications without consulting with your doctor first.) In my opinion, if a man is depressed, one of the first things he should do is pull his testosterone. It’s a $25 test and can be done without a doctor’s orders: Inexpensive Testosterone Labs.

10. Sleep. As far as I know, the researchers have not really examined or quantified just how much testosterone affects sleep. Typically, they are looking at the more “sexy” parameters. However, I can tell you that I and several of the guys on the forum have had horrible sleep when they were hypogonadal. I know that I used to very commonly wake up with the sheets soaked, all of which went away once I got my testosterone levels up sufficiently. Look at what some of the other men on the forum have reported:

“I can tell you I noticed a huge improvement in my sleep quality after going on Tcyp. I sleep harder for sure and I don’t wake up at every little noise anymore, not even my wife’s snoring!” [2]

“I never slept good in my life until I got on testosterone. I sleep 7-8 hours a night usually now unless I’m really tired and then I meet sleep 11. Before that, I would get depressed and sleep 12 hours a day and still feel tired.”

11. Insulin, Prediabetes and Diabetes. This is the least sexy of the benefits of testosterone, but it is probably the most important.  Basically, as testosterone rises, insulin levels and resistance fall.  Because of this, a hypogonadal man that goes on a good TRT protocol can actually reverse his adult onset diabetes.  I discuss this in considerable detail in my pages on How to Reverse Diabetes and Testosterone and Diabetes.

12. Inflammation. Okay, I lied to you in step 10:  testosterone’s primary benefit may be it’s powerful anti-inflammatory action, especially in the arteries. I cover this in my page on Testosterone and Inflammation.

13. Marriage and Relationships. Relationships take a lot of work, especially during the more difficult times of life. Having no libido, no energy, mental fog, fatigue and mild erectile dysfunction is certainly not going to help! And we have had many men on the forum that have felt strongly that low testosterone was jeopardizing their relationship or marriage. For more information, read my page on Testosterone, Marriage and Relationships.

14. Career Building. Guess what the hottest drug on Wall Street is according to a recent ABC article?  Yep, it starts with a ‘T’. [13] For example, check out this commentary from the article:

“He said about 90 percent of his patients are guys who work in finance traders, CEOs, upper-level management. And it’s not just the little guys or executives from small companies. He s got patients from some of the biggest names in finance, including Goldman Sachs, Citigroup, Bank of America , American Express , and Morgan Stanley. The patient list at Cenegenics also reads like a Who s Who of Wall Street: Goldman Sachs, JPMorgan, Deutsche Bank, Bank of America, traders from the New York Stock Exchange and Nasdaq and a lot of hedge funds. Many complain that they used to love going to work but now they’re losing their edge. Their head s not in the game as much.”

So it’s no secret on Wall Street that testosterone can help the brain and there have been some articles and commentary lately that many executives are now on HRT primarily for the mental, career-building benefits.

15. Big Bedroom Boost. Middle-aged and senior guys will usually get the biggest bang – no pun intended – for their buck from PDE5 inhibitors, simply because usually their arteries are in much worse shape than their hormones.  However, that is not always the case and many men – especially young guys – get incredible bedroom benefits from HRT.  If you don’t believe me, check out the descriptions below.  And try not to get jealous while you’re at it!

“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.” [4]

“I make love to my wife on an average 6-8 times a week. I am taking advantage of this feeling because I never had it before and I am 34 years old. I love it. I am finally at the point where my wife has had enough in the bedroom and I am asking for more. This is the first in my life I ever felt so good and confident.” [14]

NOTE: If you read the article, it does have some information such as claiming that testosterone is expensive.  Injections and compounding are actually very reasonable and a number of men on the forum do not have insurance and use these options.

16. Anemia. Struggling with fatigue? Feel achy and drained? I sure did when I was hypogonadal. HRT seemed to slowly melt all that away. One reason that many men do not realize is that this can be partially due to anemia. In fact, it is quite common for low testosterone men to end up anemic, which of course can lead to fatigue and many other unpleasant symptoms. The reason for this is that testosterone stimulates a kidney protein that triggers red blood cell production. This is why men that go on HRT have to get their RBCs, hematocrit and hemoglobin regularly monitored. The good news is that several studies have shown that men who are anemic due to a testosterone deficiency can correct the problem through replacement therapy. [10]

17. Spatial and Verbal Memory and Function. Several studies show that low testosterone men do worse in verbal and spatial mental performance. The good news? Other studies show that men significantly improve in these areas after replacement therapy. [15][16]

18. Super Brain Power. As mentioned above, the most immediate and powerful benefits of going on HRT is often in the brain.  Now that isn’t always true, but many men have reported that the first night they can strongly feel the effects of testosterone right between the ears.  I have always described the experience of my first night on testosterone cypionate injections as “fireworks going off in my head.”  I know it sounds like I am exaggerating but look at what other men have written on the forum:

“On another note I injected Monday for the first time. Yesterday I could tell a difference just a bit. By 1 hour into my shift today I felt like the energizer bunny had hooked up to me for charge up:-)) I was completely shocked at how I felt today. I was told it will get better to in days and with the injections to come over the next weeks. I thought WOW. I felt ready to go to the gym after work to.” [12]

“Well, I have been on the 1st injection for only 48 hours and I actually do feel significantly better! Happier, full of energy, even after my lunchtime gym workout!.” [3]

“I feel better overnight than I ever was on Androgel the entire year I was taking it.” [11]

Vitamin-D and Erectile Dysfunction - Peak Testosterone

Vitamin D was once one of the superstars of the supplement world and was supposed to help solve virtually every chronic disease under the son. However, results have been lackluster to say the least, something I cover in my page on The Potential Dangers of Vitamin D. I try to keep my Vitamin D in the 40-45 ng/ml range, because of some of this research.  The fundamental issue is that Vitamin D is involved in calcium metabolism, and so overly high Vitamin D can drive calcium into soft tissues.  (Some argue that Vitamin D supplementation will overcome this dark side of Vitamin D, but, as far as I know, this has not been proven by research.)

On this page I will give you a profound reason that you do not want to go to the other extreme and let your Vitamin D sink too low:  we now have a study that shows that Vitamin D is linked to erectile dysfunction. Furthermore, the authors of this study used the rich and extensive NHANES data, i.e. it was not based on a small sample.  Their conclusion was as follows:

“After accounting for NHANES sampling, the weighted prevalence of 25(OH)D deficiency and of ED were 30% and 15.2%, respectively. 25(OH)D levels were lower in men with vs. those without ED. After adjusting for lifestyle variables, comorbidities, and medication use, men with 25(OH)D deficiency had a higher prevalence of ED compared to those with levels =30 ng/ml. CONCLUSION: In this cross-sectional analysis of a representative sample of U.S. men, vitamin D deficiency was associated with an increased prevalence of ED independent of ASCVD risk factors.” [1]

1.  Nitric Oxide. The first link has to do with that fact that Vitamin D helps govern eNOS, the enzyme that helps create your endothelial (arterial) nitric oxide.  I cover the research here:  Vitamin D and Nitric Oxide. Basically, as your Vitamin D lowers, your nitric oxide levels will generally lower as well.

It is hard to argue that there are two more important molecules to erections than testosterone and nitric oxide and Vitamin D has some control over both of them.  That said, more studywork is needed and the authors point out that “additional research is needed to evaluate whether treating vitamin D deficiency improves erectile function..” [1]

REFERENCES:

1)  Atherosclerosis, 2016 Jul 29, 252:61-67. “Associated With Greater Prevalence of Erectile Dysfunction: The National Health and Nutrition Examination Survey (NHANES) 2001-2004”

Vitamin C Cures Viruses: Dengue, Acute Hepatitis, Fever

I think this may be the most important page on my site, so, hopefully, some men out there will take notice.  Let me start out by saying that one of the members – thanks retado! – of the Peak Testosterone Forum told me I had to watch a video about Vitamin C. I have always been very interested in Vitamin C, so little persuasion was needed.  The video comes from a doctor in Colorado named Dr. Thomas Levy and kudos to him: his presentation stunned me.  Here are just a few jaw droppers from the video:

a) There is an old journal article (1949) where a doctor cured 60 out of 60 polio cases using Vitamin C. Yes, you read that right:  60 out of 60. Isn’t this every bit as impressive as what Jonas Salk did?  Yet it was completely ignored by the medical community.  The doctor (Klenner) that cured polio wrote an excellent summary of his protocols here.

b) There are also 3 separate journal articles showing that Vitamin C cures acute hepatitis (not chronic).

c) In 1950 a journal article appeared showing that Vitamin C repeatedly cured rheumatic fever. The dosage was here was actually lower than the typical high dose Vitamin C, yet it still regressed rheumatic fever nicely! You can see a summary of the physicians findings here: Vitamin C and Rheumatic Fever.

There are other journal articles cited by Dr. Levy showing that Vitamin C can defeat Dengue, West Nile Virus, and encephalitis!  (See his You Tube video here: The Great Vitamin C Suppression.)

So should you believe these old journal articles?  Let me tell why I almost immediately embraced this video: it is supported by a modern study showing Vitamin C spanking Epstein-Barr, the natry, hard-to-treat virus involved in mononeucleosis:

“The clinical study of ascorbic acid and EBV [Epstein-Barr Virus] infection showed the reduction in EBV EA IgG and EBV VCA IgM antibody levels over time during IVC therapy that is consistent with observations from the literature that millimolar levels of ascorbate hinder viral infection and replication in vitro.” [1]

There is also a recent study showing high dose Vitamin C doing quite well against cancer, obviously another immune challenging overgrowth for the body.  So should this be front page news?  Of course.  Quite simply it is clear that high dose Vitamin C is possibly the most powerful and effective antiviral on the planet. And safety seems rock solid as well, especially when compared to any modern pharmaceutical, although I do have one possible caution that I mention below.

Now I do have to caution that we don’t really know the success rates or the ideal protocols yet for high dose Vitamin C.  But in my opinion, this is definitely something that should be studied much much more than it is.  Will it cure 50% of patients?  100%?  20%?  We don’t know.  But what we do know is that it is very inexpensive and seems to have side effects to speak of.

UPDATE:  The forum poster who originally alerted me to Dr. Frye’s video is posting relevant news on Vitamin C cures and information here.

And, perhaps, right at our fignertips is a simple solution that could have saved countless lives.  My wife had a relative that contracted the very serious form of dengue in Mexico – some of the variants are deadly and some aren’t – and, thankfully, the person recovered and is doing just fine.  However, their suffering and time to recovery could have been undoubtedly greatly shortened by Vitamin C therapy.  And they could have quite easily died as well. Many of you reading this probably know someone in a similar situation who has contracted or been exposed to one of the above deadly disease.

So why would Vitamin C therapy not be considered and why hasn’t it been studied?  Well, you know the answer to that:  you can put a patent on it, so why bother, right?

NOTE: It is important to note that generally the physicians are talking about high dose Vitamin C.  You cannot generally achieve the dosages necessary to kill one of these superbugs with the standard oral Vitamin C, even Ester-C, that you buy in the store.  This can only come from IV infusions of Vitamin C or (very large) liposomal dosages of Vitamin C (assuming you have a healthy gut).  These dosages alone increase peroxide levels.

CAUTION:  Do I have any cautions?  Supposedly Vitamin C has no known toxicty.  You can literally take grams and grams of the stuff with only minor symptoms displayed at best.  Does this mean high dose Vitamin C is without any risks whatsoever?  Well, the theory is that higher dosages cause excess peroxide production in inflamed tissues – and the excess peroxide is what kills the viruses – but leaves health tissues untouched.  The this seems to be born out by Vitamin C’s excellent clinical track record.

The key is that it must leave healthy tissues untouched as, for example, some experts believe that peroxide plays a role in Alzheimer’s:

“The ability for Abeta to generate H(2)O(2), and interactions of H(2)O(2) with iron and copper to generate highly toxic ROS, may provide a mechanism for the oxidative stress associated with Alzheimer’s disease. The role of heavy metals in Alzheimer’s disease pathology and the toxicity of the H(2)O(2) molecule may be closely linked.” [2]

Bottom line:  Just keep in mind that many people will die or suffer serious damage from some of the viruses above with no known major side effects. If peroxide were really damaging neurons, you would expect that we would have heard about it.  But discuss the above with an expert or two.  And let me know what you find out!  I’m excited that we likely have a cure here that could save millions of lives.

REFERENCES:

1)  Med Sci Monit, 2014, 20: 725 732, “Effect of high dose vitamin C on Epstein-Barr viral infection”

2) Drugs Aging, 2004;21(2):81-100, “Role of hydrogen peroxide in the aetiology of Alzheimer’s disease: implications for treatment”

Testosterone and Metabolic Syndrome - Peak Testosterone

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)!

REFERENCES:

LDL: Plant Sterols to the Rescue? - Peak Testosterone

However, I have to admit that I am not quite where I would like to be when it comes my LDL. My LDL was in the upper 80’s last time that I examined my lipids.  Keep in mind that, even though LDL is a much more important number than cholesterol, LDL is just a starting point:  there are many other lipid numbers that are as or more important. However, the Plaque Reversers, Drs. Esselstyn, Gould and Davis still laser in on LDL and want it below 80, 70 and 60, respectively.  And that makes me a little above their threshold.  (I cover the Plaque Regressors at the top of the page on Articles on Improving Erectile Strength.)

So how would a guy like me pull his numbers down by 10-15%?  Well, two of the three physicians would use low dose statins to pull LDL lower.  Actually, the third write that he occasionally useds them as well. Now they probably would not give statins to me since I have 0 plaque, but the point is that they are not afraid of using a pharmaceutical solution to get that LDL number down.  However, I try to avoid pharmaceuticals as much as possible and statins are certainly no exception.  They have many issues associated with them and I doubt their long term safety for reasons I outline in my page on The Potential Dangers of Statins.

This is why my I would like to find a more natural solution and just tweak my LDL down a little. I don’t see any danger in going down the low 70’s, since this was the LDL level of the Tarahumara, who were probably the healthiest and most long-lived culture on the planet. [1] Plant stanols have been offered by some experts as a way to provide a more natural and safe alternative plan.

How do plant sterols work? They actually block some cholesterol absorption in the gut (intestines). As odd as that may sound, they are actually a natural part of anyone’s diet who eats a fair amount of plant-based foods. Researchers have studied what happens when the phytosterols (plant sterols) are removed from foods, and, as expected, it leads to a much bigger spike in cholesterol. Thus, the plant sterols in one’s diet appear to be naturally protective of your arteries and anti-atherogenic. It is estimated that humans consume between 0.15 and 0.70 grams/day. [2] Vegetarians will tend to be at the higher end of that range.

What happens if we take supplemental amounts of these plant sterols?  Can you have too much of a good thing?

To answer these questions, researchers gave participants either 0.83, 1.61 or 3.24 g of plant sterols daily. They found three key findings: [3]

I) LDL cholesterol levels were lowered by .20, .26 and .30 nmol/l, respectively, for the three different dosages.  This translates to 7.73, 10.05 and 11.60 mg/dl reductions for those in the U.S.  It should be noted that these were not hypercholesterolemic (high cholesterol) patients and, considering its mode of action, even someone with lower LDL like myself should receive roughly the same cholesterol-lowering results.

II) HDL levels were NOT significantly lowered.  This is very important, because ideally one does not want HDL, the “good” cholesterol, to be lowered.  Notice that this improved the LDL/HDL ratio for all dosages of sterols given.

III) Some nutrients were lowered.  This is because these phytosterols do not just partially block cholesterol but can also partially block certain nutrients, although it appears to be a rather short list:

“Plasma vitamin K1 and 25-OH-vitamin D and lipid standardized plasma lycopene and alpha-tocopherol were not affected by consumption of plant sterol enriched spreads, but lipid standardized plasma (alpha + beta)-carotene concentrations were decreased by about 11 and 19% by daily consumption of 0.83 and 3.24 g plant sterols in spread, respectively.” [3]

The decrease of alpha carotene caught my attention, because it has been found in one study to be so protective against prostate cancer. However, in my case, I eat many carrots every day, so even with a small decrease in alpha carotene, I should still be way above my requirements.  If you hate carrots and sweet potatoes, I guess that might be another story.

CONCLUSION:  In my case, I am considering a small dosage daily of plant sterols – maybe a a gram – in order to hopefully get my LDL just below 80.  I see little downside as this is simply a rough doubling of the amount I might get in my diet as a dang-near vegeterian.  The counterargument is that plant sterols are a relatively new supplement and may have some unanticipated side effect.  My rebuttal would be that a) I feel that the sterols will likely be healthier long term than statins and that it would appear that b) one can more than compensate for the absorption issues by eating a nutrient dense, whole foods diet.

However, as I always say, do your own homework and talk to your doc  And, when it comes to plaque regression, it usually going to be better to find yourself a doctor or a cardiologist that you can work with and help you pull and interpret all the necessary lipid numbers.  Unfortunately, it is somewhat hard to find doctors like that right now. There’s not much money in regressing someone’s plaque and, to be frank, most cardiologists make their serious money from doing procedures resulting from atherosclerosis in one way or another, so you may have to do some searching.

PRODUCT:  For those interested, I have seen a page on Pritikin’s web site that recommends a product called Cholest-Off.

REFERENCES::

1)  N Engl J Med, 1991 Dec 12, 325(24):1704-8, “Changes in lipid and lipoprotein levels and body weight in Tarahumara Indians after consumption of an affluent diet”

2) https://lpi.oregonstate.edu/infocenter/phytochemicals/sterols/

3) European Journal of Clinical Nutrition, 1999, 53(4):319-327, “Spreads enriched with three different levels of vegetable oil sterols and the degree of cholesterol lowering in normocholesterolaemic and mildly hypercholesterolaemic subjects”

Dr. Gould's Method for Plaque Reversal - Peak Testosterone

This is one of those books that should be on your nightstand and read until you have it memorized – it’s that important. Dr. Gould does something day in and day out that is supposedly impossible: reverse arterial plaque. Right now cardiovascular disease is the number one killer of men and the success of Viagra and Cialis prove that it is the number one killer of erections as well. Think about this: this entire book is essentially devoted to helping you clear out your penile arteries and increase blood flow.  Actually, he doesn’t word it that way, but that is the net effect.

Sure, testosterone and estradiol are important, but you can have pretty low testosterone and great erections if you have good blood flow and clean arteries. I have seen many men on the The Peak Testosterone Forum that can attest to this. In fact, I was very likely low testosterone all my adult life – never had a morning erection – and yet I had good erections until my late 40’s when – very likely anyway – I started developing some arterial issues down under.

And the book starts out early with a real attention-getter: study after study after study that shows that men in Western societies have significant arterial plaque (atherosclerosis) in their 20’s and 30’s.  Most of the young guys – and we have a lot of them – that show up on  The Peak Testosterone Forum assume that their issues are strictly hormonal.  Of course, sometimes they are, but that is actually a huge assumption on their part.

Let me give you just a couple of examples from the book:

1.  Trauma Victims.  76% of men with an average age of 26 had atherosclerosis. [1]

1)  Heal Your Heart, Dr. K. Lance Gould, Rutgers University Press, 5th Printing 2002, p. 44

2.  Korean War Veterans.  77% of men with an average age of 22 had atherosclerosis. [1]

Now, in fairness, he lists other studies on young men that are closer to 50%.  Regardless, these are stunning numbers:  somewhere between a half and three fourths of all young men already are building plaque in their veins.

What does that have to do with erections?  Remember that you can have a little plaque in your neck (carotid) or heart (cardiac) arteries and not feel a thing, because these arteries are so wide.  However, the penile arteries are a different story:  they are much smaller and even a little plaque can lower nitric oxide and affect erections.  Again, he has several pages of stats and studies on this and it’s a fantastic motivator in my opinion to make sure you are constantly working on your cardiovascular health.

NOTE:  You can purchase his book, Heal Your Heart: How You Can Prevent or Reverse Heart Disease , on Amazon

So just how do you reverse arterial plaque according to Dr. Gould?  Well, he goes into an extensive discussion about the subject and there are many steps.  He outlines a program of primarily diet, supplements/medications, moderate exercise and monitoring.  One thing that I really like about his program is that his starting point is a low fat diet, but he does it in such a way that it would be easy for most guys to do.  For example, he allows some low fat meats, low fat dairy and just about any low fat protein source. In fact, his emphasis on protein is something that will resonate with most men serious about their health, because, generally, they are into biking, running, weight lifting, etc. – all of which increase protein requirements above the standard baseline.  There is a lot to say about his dietary regime and so I will probably cover it in a separate page.  That point is that, even if you don’t agree with him on every point, you will get a lot of fantastic information out of it.

Dr. Gould also gives lipid guidelines for reversing plaque:  he wants total cholesterol < 140; LDL < 90; and HDL > 45.  I cover this on my site on Target LDL Levels and Target Trifecta Numbers (HDL, LDL and Triglycerides). Many men will find these numbers very challenging, but it can be easily done and the reward is incredible: getting your arteries back!  To achieve these numbers in some men, he will sometimes use a statin or niacin in a manner similar to Dr. Davis.  Now his usage of a pharmaceutical is not my favorite idea, but he very carefully explains why he often has to use them, their purpose and how he control for side effects, etc.  Again, great information even if one chooses not to go that route.  And he has an excellent discussion of the different forms of niacin, dosages, side effects, etc.

Finally, one other interesting point, which contrasts with the position of Dr. Davis from what I understand, it that he likes to use PET scans, instead of the more well-known Heart Scan or Calcium Score emphasized in Track Your Plaque.  His argument is that this gives better results regarding blood flow and we all know it’s about blood flow, eh?

Again, buy this book and read it  and reread it.  No amount of any hormone or herb or supplement can help you once those arteries clog up…

REFERENCES:

How to Get Down Below 10% Body Fat and Keep Muscle Mass

Ever heard of Clarence Bass? If you’ve been in the strength or bodybuiding community for very long, then you know who he is. Clarence is a seasoned and well-respected writer and one of the few that walks the talk and talks the walk. By that I mean he has produced an incredible year round physique all the way into his mid 70’s, is still in excellent health and is able to articulate how to do all of that with great ease and readability as well. I recently read one of his books – Challenge Yourself – and wanted to cover it here, because it had such a profound impact on me.

NOTE:  Don’t miss my interview with him here: Clarence Bass: Natural Middle-Aged and Senior Bodybuilding.

First of all, the book is full of fantastic practical advice on how to lose weight, build muscle, exercise, etc. and keep doing it year after year after year.  Now, in my case, I don’t really need to be pushed to exercise, because at this point in my life, I can’t wait to get to the gym.  I feel great when I walk out almost always and I know how important it is, so I’m already a believer.  Furthermore, I am a Skinny Bastard, so putting on a spare tire has never been tht much of an issue for me either.

However, I do need to challenge myself in a key area:  I had given up on ever getting my body fat percentage below 10% while maintaining my hard-earned muscle mass.  As a 54-year-old ectomorph’s ectomorph, I don’t put on muscle that easily and I certainly don’t want to lose it all trying to get my abs.  However, I also do NOT want to do the standard low carb diets that everyone does out there to “cut.”  I have written quite a bit on those diets, as I believe they can negatively impact gut flora and cause arrhthymias in some men  when done long or even medium term.  Plus, all the saturated fat that comes with these diets would be a real erection-killer for me as well.  (I thrive on what I call  Low Fat Paleo: see my page on High Protein, Medium Carb, Low Glycemic Low Fat Diet.)

This is where Challenge Yourself comes to the rescue:  Clarence actually eats very similar to how I do, although he eats more fat and a few other modifications, but our general philosophy is very similar:  whole foods, an emphasis on plants, an emphasis on nutrient dense, high volume foods, etc.  So I could not agree more with almost everything he writes on nutrition.  Furthermore, he shows how to get your body fat below 10% – well below – and do it while eating this way, i.e. a largely plant-based, whole foods diet!  Now there’s a sermon worth listening to!

I have been told on my own Forum that the only way to get below 12% body fat is to go low carb or low carb with certain “tricks” attached to it. Right now low carb is so popular that I simply asssumed they were correct, because I read article after article praising low carb for fat loss and leaning out and virtually nothing from the other camp.  Bodybuilding articles on the necessity of “bulking” and “cutting” did not help matters and so I just gave up.  For a couple of years I have been hovering at about 14 – 15% body fat and assumed that was my final destination.

As you might guess, it was an incredible relief it was to find that there was a philosophy out there, compatible with my own, that utterly shatters the prevailing low carb mythology that it and it alone can achive low body fat percentages.   Clarernce has proven in himself and in many of his followers that, if you are willing to eat a healthy, whole-foods plant-baed diet – yes, he eats some meat and dairy as well – you can slowly lose weight with no significant loss of muscle mass AND you can do it relatively effortlessly, i.e. without a lot of hunger and counting calories, etc.

The book maps out just how to do this and this is how I plan to challenge myself.  I’d like to get my abs showing and do it in a healthy manner without losing a lot of muscle.

Just how does “Challenge Yourself” say to do this?

Well, there are literally hundreds of helpful guidelines and tips, but here are the biggees that stood out in my mind:

1.  Lose Weight Slowly. Most guys try to drop the pounds too quickly and hammer their hormones and, most importantly, lose their hard earned muscle. Losing weight in a more “sane” manner also makes it possible to lose weight without going hungry or depriving yourself of a nutrient rich diet.

2.  Measurement is the Key! How do you know if you are losing muscle as you are dropping weight?  How do you know if you are losing or gaining water weight?  Obviously, a standard bathroom scale ain’t gonna do the trick.  Sure, you can go get yourself hydrostatically weighed, but that involves some cash, scheduling and time.  A much, much more practical alternative is to get yourself a good bioimpedance scale.

I had never heard of one of these until I read about it in Clarence’s writings.  Don’t ask me how I missed it, but I was overjoyed to find that you could buy a cheap and accurate bioimpedance scale.  I got a Tanita – if it’s good enough for Clarence Bass, it’s good enough for me! – and have been using the thing religiously for about 10 days now.  I’m a numbers person and so having useful data is highly motivating for me.  That’s part of being a certified Health Geek I guess.  The Tanita gives you in less than a minute your weight, % body fat and % water weight- all the numbers you need to know to estimate water weight, lean body mass and, of course, fat mass.

3.  Do the Same Thing Every Day, 365/24/7. Now I don’t mean by this that you should do the same boring exercise or dietary routine every day.  In fact, the book talks about that.  But what I do mean is that I despise the idea of the “bulking” and “cutting” phases, as I mentioned, that so many weight lifters go through.  Clarence opposes this viewpoint and attacks the extreme form of it:  yo yo dieting as it is called.

With my personality I want to do this same thing day in and day out and I don’t want to gorge for a month and then starve for a month – that just is not my personality.  Finding Clarence’s philosophy was an incredible relief.  (Frank Zane had a somewhat similar philosophy by the way:  he just tweaked his protein/carb ratio a little.)

These three points are actually a small part of this great book that discuss his diet and recipes, his exercise philosophy and routines and almost of all of the foundation that a man needs to get started on his way to building a great physique, regardless of his age.

Androgel versus Testim: Who Delivers? - Peak Testosterone

The bad news is that I can tell you that I get complaint after complaint about Androgel on the Peak Testosterone Forum and have covered this in my link on Testosterone and Androgel. Testim is much less widely used, because of, undoubtedly, its higher cost and smaller sales force.  To date I have not received a positive comment regarding Testim and a few to the contrary.

In spite of their issues, every man on HRT owes a huge debt to Androgel and Testim. Androgel is produced by pharmaceutical giant Abbott and its sales force pushed its way into thousands of doctors’ offices around the country. Almost overnight HRT become widely accepted and considered and this was likely in large part due to the fact that a pharmaceutical giant like Abbott was willing to back the research, funding, sales and marketing of this product.

Testim is manufactured by a much smaller company, Auxilium. However, their rather small sales force did a remarkable job of jumpstarting sales, which I am partially piggybacked on the success of Androgel. And as fyi: they have now partnered with Glaxo Smith Kline and this will only accelerate adoption of Testim. [1]

So in a war of Androgel versus Testim, who would win?  According to one study it would be Testim. [2] This study gave 50 mg of each to a group of hypogonadal men and found that “total testosterone, dihydrotestosterone, and free testosterone were greater (30, 11 and 47%, respectively) following the application of Testim compared to AndroGel .”  Approximately, 10% of Androgel is absorbed on average according to one estimate. [3] Obviously, the “PLO” or delivery system of Testim is likely somewhat higher with more than 10% being absorbed on average.

Does this mean that Testim will always deliver the most testosterone?  Well, not necessarily.  The reason is that Androgel 1% delivered only 50 mg of testosterone with four pumps. This is a lot of pumps, because you only have so much surface area on which to apply the Androgel.  (It is applied on the upper body and focuses on areas where there is little body hair.)  So 50 mg is probably the best that you are going to do with Androgel 1.0% and, again, only about 10% was probably absorbed. [5]

However, in the spring of 2011 Abbot released its Androgel 1.62% product which deliverd 42.5 mg of testosterone with only 2 pumps.  Of course, no one seems to use just 2 pumps but rather 4 like they so often did with the Androgel 1%.  Here are a few examples from the Peak Testosterone Forum post-April 2011 (when the 1.62% was approved by the FDA):

“What confuses me is that with the Androgel 1.62% I was taking 4 pumps (81mg total of testosterone) but my doc has me taking 4 pumps of Fortesta 2% which is only 40mg of testosterone. Is the difference between a 2% solution and a 1.62% solution so significant that taking 40mg less testosterone will still give me higher serum/total levels? ” [7]

You get the idea:  Androgel is very often poorly absorbed and so physicians correspondingly often prescribe 4 pumps. So how does this compare to Testim?  Testim still comes in a 1% solution as and thus one tube has 50 mg of testosterone and two tubes 100 mg.

So comparing the two standard max dosages head-to-head, Androgel 1.62% versus Testim 1% at 4 pumps versus 2 tubes, respectively, you get some interesting results.  In fact, I’ll run through the numbers below assuming the absorption rates given in the studies above.

To show this, let’s make the following assumptions based on total testosterone:

1.  Androgel 1.62%. Let’s assume that is still absorbed at 10%.  Given that 4 pumps delivers 82 mg of testosterone, this means that 8.2 mg are actually absorbed.

2.  Testim 1%.  Let’s assume, per the comparative study mentioned above, that this is absorbed at a rate of 30% more than Androgel.  If a man rubs in 2 tubes, that 100 mg at 13% absorption, then 13 mg actually makes it into his system.

Of course, this is a substantially greater quantiy, so that means that Testim is the clear winner?  Unfortunately, Testim does not seem to be doing that well on our forum.  Look at these two quotes for example:

“It was about the same time frame of being treated for cholesterol that I started with some ED issues. That’s when I finally asked about my testosterone level. It believe was 299, so he agreed to put me on testim 1%. After about 6 months to my next visit to the doctor the testim raised it to around 325, so he told me to use two tubes of testim a day. So I ll have to see how that does.” [8]

“Make sure you hook yourself up with a reputable urologist who understands how to administer T while knowing that the guy wants to have kids down the road. Testim never worked for me but there are several other alternates out there. Compounded T can be an option in a gel or a cream and formulated at a higher dose than what’s in Androgel or Testim. ” [9]

And so one cannot help but ask if Testim supposedly delivers twice the testosterone that Androgel does, why hasn’t it taken the HRT market by storm?  From what I have seen, this is anything but the case.  Testim has clearly take a back seat in sales to its supposedly weaker brother Androgel.  This is shown by raw sales numbers.  2012 Testim sales were around $245 million, whereas Androgel was around 1.3 billion. [10][11]

So the bottom line is that you can very likely get a much greater quantity of testosterone into your system using a Compounding Pharmacy. And you can likely get it at a much lower cost. Testosterone is not that expensive of a molecule and compounding pharmacies can usually beat the Big Pharma companies by almost an order of magnitude.

Who would I pick in a war of Androgel versus Testim?  As you can tell, probably neither one.

CAUTION: These topicals are incredibly convenient and popular right now.  One must be very careful not to allow the product or treated are to come into contact with women or young children.

REFERENCES:

1)   https://www.rightinginjustice.com/news/2012/05/26/ testosterone-wars-heat-up-as-testim-maker-allies-with-glaxosmithkline/

2) Biopharmaceutics & Drug Disposition, Apr 2003, 24(3):115-120, “Evaluation of the pharmacokinetic profiles of the new testosterone topical gel formulation, Testim, compared to AndroGel”

3) https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=4279

4)  https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=16411

5) https://www.abbott.com/news-media/press-releases/2011Apr29_2.htm

6) https://peaktestosterone.com/forum/index.php?topic=341.0

7) https://peaktestosterone.com/forum/index.php?topic=731.0

8) https://peaktestosterone.com/forum/index.php?topic=920.0

9) https://peaktestosterone.com/forum/index.php?topic=148.0

10) https://www.bizjournals.com/philadelphia/news/2012/08/01/area-drug-firm-gets-first-quarterly.html

11) https://www.drugs.com/stats/androgel

Inflammation and Stress - Peaktestosterone

We all know that stress suppresses immunity and, therefore, inflammation, right? For example, one of the very well-known side effects of corticosteroid medications is suppression of the immune system, which can leave patients more vulnerable to infections. It turns out that it is not that simple and now there is considerable evidence that chronic stress actually boosts “humoral immunity,” and nasty systemic inflammation along with it. [1]

Humoral immunity is the part of your immune system that deals with antibodies and fighting against foreign invaders such as germs. Of course, this is critical for our survival against infections of all sorts, but the problem is that humoral immunity is also associated with increased inflammation. For example, we know of a number of infections that likely to lead to heart disease, including urinary tract infections, influenza and possibly periodontal disease. This link between infection, inflammation and heart disease has been noted many times in the research of the last twenty years and is now widely accepted. Inflammation has also been linked to erectile dysfunction! See my page on Inflammation and Erectile Dysfunction for more information.

But a connection between stress and inflammation seems much more subtle. How could stress, especially the chronic, day-to-day kind, trigger such a silent, background process as inflammation that is designed to work against foes such as diptheria, west nile virus and malaria?

NOTE:  I have a link on How to Lower Your TNF Alpha Naturally for those interested.

The study above [2] was also instructive, because it was on medical students before and after exams.  Basically, it was covering the kinds of everyday stress that we experience as human beings in modern societies:  worrying about how we’re going to pay the mortgage; worrying about a relationship that is falling apart; worrying about medical bills that we can pay; worrying about losing your job, etc.  These kind of seeming “do or die” situations can really take a toll on us, not just psychological but physically as the above study shows us.

The same study had the foresight to study two very important psychological states that were found to really increase inflammatory cytokine levels:  1) high stress perception and 2) a high anxiety response. Some men “just roll with the punches.”  Some guys can sleep like a baby even when the pressure is on.  But most of us cannot and so, if you were one of those guys who is actually the opposite, you are probably sending these inflammatory messengers through the roof.

And the studies have looked at a little older crowd as well.  One study on seniors contrasted caregivers – those who were taking care of a very sick spouse – with those who weren’t.  What they found was incredible:  “caregivers’ average rate of increase in IL-6 was about four times as large as that of noncaregivers.” [7] Again, IL-6 can kill you in a dozen different ways and is a huge source of chronic disease. So, ironically, the task of caring and empathizing over the health of a loved one can destroy your own

So what can you do about stress?  Much, much more than you might think.  Of course, time and people management skills can help tremendously.  But one thing that many men do not realize is that there are ways to actually manage the stress (and cortisol) throught simple techniques that you can do at home..  Basically, you can teach your mind not to overreact during times of stress through a variety of techniques, which I cover on these pages:  (Non-religious) Mindfulness Meditation, Progressive Muscle Relaxation and Secular Meditation.

There are many other techniques that work.  There is a study that shows that self-hypnosis lowers the humoral immunity that I mentioned above [4] or you can go with your wife to her yoga classes, since it is a proven stress buster.  There is also guided imagery, biofeedback, Tai Chi, etc.  However, I prefer the above, because you can do them in your home in perfect privacy – no one really has to know – and they do not require another person.  You can start today after doing just 20 minutes of reading.

In addition, 1) progressive muscle relaxation almost forces your body to relax and is easy to do and 2) meditation forces you to learn how to control your mind and many men struggle with stray and repetitive thoughts under stress.  Again, read the above links and you will find that these techniques can actually 1) grow back parts of your brain, 2) lower cortisol, 3) lower blood pressure, 4) improve many psychological issues including anxiety and depression.

NOTE: The research also shows that depression is linked to inflammation.  One of the cytokines, for example, has been found to actually induce depression! [6]

REFERENCES:

1) Trends in Endocrinology & Metabolism, Nov 1 1999, 10(9):359-368, “Stress Hormones, Th1/Th2 patterns, Pro/Anti-inflammatory Cytokines and Susceptibility to Disease”

2) Cytokine, April 1998, 10(4):313 318, “THE EFFECTS OF PSYCHOLOGICAL STRESS ON HUMANS: INCREASED PRODUCTION OF PRO-INFLAMMATORY CYTOKINES AND Th1-LIKE RESPONSE IN STRESS-INDUCED ANXIETY”

3) Eur Heart J, 2007, “The role of infection in cardiovascular disease: more support but many questions remain”

4) International Journal of Psychophysiology, Aug 2001, 42(1):55-71, “Cellular and humoral immunity, mood and exam stress: the influences of self-hypnosis and personality predictors”

5) Circulation Research, 1993, 73:205-209, “Tumor necrosis factor downregulates an endothelial nitric oxide synthase mRNA by shortening its half-life”

6) Trends in Immunology, Jan 2006, 27(1):24-31, Cytokines sing the blues: inflammation and the pathogenesis of depression”

7) PNAS, Jul 22 2003, 100(15):9090-9095, “Chronic stress and age-related increases in the proinflammatory cytokine IL-6”

The answer is that the body does not really differentitate that well between a deadly superpathogen and the worry we experience night after night about your mortgage payment.  These both trigger a very similar inflammatory response as I will show below, and it can be deadly.

Has this been verified in humans? One study monitored medical students under psychological stress and found that the following inflammatory cytokines increased: [2]

NOTE: Furthermore, some students had a lower response of the immunoregulatory cytokines IL-10 and IL-4, so, basically, the brakes were removed and the accelerator pushed full throttle in some students.

The importance of the above cannot be overestimated.  Inflammation is considered the “root of all evil” by many authorities.  It has been found to be a root cause of many cancers, autoimmune diseases including diabetes and arthritis, heart disease, Alzheimers – the list goes on and on.  Almost all of the nasty chronic medical conditions that plague us in Western societies have inflammation as a root cause.  You can read about all of this in more detail in my link on The Evils of Inflammation. TNF alpha can also downregulate eNOS, which will leave you with much less nitric oxide according one one study. [5] Yes, this helps explain why an increase in inflammation can lead to a loss in erectile strength.

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.

Ginseng: Good Erectile Dysfunction Supplement for Many Men.

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”.

REFERENCES: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”

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.

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.

Are there any cautions associated with Ginseng in treating and/or helping with erectile dysfunction?  The active ingredients, ginsenosides, in Ginseng are structurally similar to both testosterone and estrogen.  In women Ginseng does have some reported estrogenic qualities.  For example, one study found that a particular line of breast cancer cells that are estrogen-sensitive were made worse with Ginseng. [5]  However, one animal study [8] and one human study on males [9] have shown an increase in testosterone with Ginseng, although still others have shown no such increase. [10]  It is likely, however, that Ginseng has minimal effect on either testosterone or estrogen since it has been used for centures with few hormone-related side effects reported.

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.

Three Engines to Improve Testosterone Production.

3) Sex. Now I’m not trying to tell anyone how to live their life, but it may be time to make up with the little woman. She may be the key to your testosterone production.  You heard that right – sex is a good way to improve your testosterone. Some of you have all but given up on the idea, but it may be time to ramp up the romance like the days of yore.  Read about How Sex Boosts Testosterone Dramatically.

I would also like to mention that there is really a fourth way if you’re not a weight lifter:  there is also significant evidence that you can Boost Your Testosterone through Weight Lifting. However, the numbers are not quite as big as the above three, but it is definitely worth considering.  Be careful not to Overtrain however as that will devastate your testosterone.

So keep in mind that you may be able to forget the pills and the gels. Of course, first talk to your physician as low testosterone can cause many conditions from osteoporosis to anemia to Metabolic Syndrome, so it may be necessary to get treatment right away. Don’t take the easy way out unless you have to. Many males have given up on all three of the above items and yet these three are usually their most powerful engines of testosterone.  You can not expect to have abundant testosterone with these three on hold. Again, if you really want to improve your testosterone, it’s lifestyle that really counts!

However, it is important to note that typically one will see testosterone increases from the above items in the 25-50% range (if you are having issues in one or more of them of course).  This may not be enough to get you where you and your physician want you to be.

By the way, another biggee is weight loss:  men can experience a doubling or more of their testosterone in some cases simply by 1) resuming normal calories (when dieting) and/or 2) losing a significant amount of weight.

The good news, though, is that there are there much more safe and reliable ways to dramatically improve your testosterone.  In fact, I call them the Big Three Ways to Improve Your Testosterone and, more importantly, almost every guy can increase his testosterone using these three:

1)  Sleep.  Remember this:  you don’t need pills, you need your pillow. Remember how mama used to put you on your bed and tell you it was good for you.  Well, mama was spot on with this one and it’s time to go back to your childhood – you’ll likely improve your testosterone levels by a good 20-30%.  Modern living leaves most of us watching TV late at night or sitting at our computers until the wee hours or a thousand other destractions that can keep us from significant testosterone improvement, around 30% or more according to some studies.  Read about How to Improve Your Testosterone through Sleep.

2) Competition. Science does not currently understand how the mind so dramatically effects testosterone levels, they just know it does. And that’s all you need to know as well. Metro just doesn’t work when it comes to testosterone:  as a guy you need challenges, victories and competition. It doesn’t have to be cage fighting – almost anything will do. You can expect testosterone improvement of 20-30% or more.  Read here for How Mental Attitute Controls Testosterone.

Cortisol and Stress Management - Peak Testosterone

This is what you need to know:  stress raises cortisol and cortisol lowers testosterone.  In addition, cortisol will also dissolve your memory and do a host of other nasty things that I document here, but let’s keep it simple for now:  stress is hard on your hormones and you need your hormones for a decent sex life.

Furthermore, all you middle-aged and beyond guys should realize something critical: a number of studies have shown that cortisol levels, in general, rise with age. [2]  This means all us older guys have less buffer to play with since our cortisol is higher and testosterone is lower.  In other words, we have to be more careful.

All of these, the Mediterranean Diet [5], Low Fat Diet [6], Exercise and Sleep (see below), have been associated with decreased cortisol levels.

Here are 13 Research-Backed Ways to Lower Stress and Stress Hormones:

1) Overtraining. Guard carefully against overtraining:  numerous studies have documented a nasty rise in cortisol with overtraining, especially once performance is affected as well. [4]  Remember that most of these studies have been done on elite athletes.  How do you think you’re handling that if you have a demanding career and/or a couple of kids?

2) Sleep. A number of studies have correlated lack of sleep with higher cortisol levels. [3] Lack of sleep is perceived by your body as a stressor and it pumps out extra cortisol accordingly. With enough caffeine you may be able to fool your brain, but you’re not fooling your body:  the cortisol is still there and wrecking physiological havoc on your system.

3) Choose Wisely. Be careful about having too many hobbies, too many investments, too much stuff, too many friends – you get the idea.  Remember this:  almost everything is good and too much good will kill you through the stress it creates.

4) Job.  Vent about any issues and problems in your job.  One study found that guys that “bottled up” negative work experiences were twice as likely to die of a heart attack or heart disease. [1]  Other studies have echoed how hard a bad work environment, or even perceived bad work environment, is on the body.

5)  Vitamin C. If you feel trapped temporarily in a bad situation, then there is a proven cortisol-lowering solution available:  Vitamin C has its issues, but it has done quite well as a cortisol reducer.  Please see this link on Vitamin C for more details (as well as cautions).

6) Fish Oil. Several studies have shown fish oil to reduce not only cortisol but the body’s overall stress response, including epinephrine and energy expenditure. [12]

7) Stress. One study from the 80’s found – and I guess it makes sense – that laughter significantly decreased cortisol and epeinephrine. [13] Maybe laughter is the best medicine?

8) Tai Chi. There’s no “theological” endorsement of Tai Chi here, but I want to point out that Tai Chi does have one study behind it showing that it significantly reduced anxiety in patients. [14]

9) Dark Chocolate. Well, this is still more good news for chocolate lovers.  All you type A’s out there, listen to this:  Nestle’s lab found that in high anxiety subjects, a small bar of dark chocolate significantly reduced stress hormones. [15]

10) Progressive Muscle Relaxation. This tried-and-true technique that involves tensing and relaxing muscle groups is a proven cortisol-buster.  In fact, one study showed that subjects lowered cortisol, perceived stress, anxiety and pulse when compared to subjects that just sat quietly for the same amount of time. [16]  (A subsequent study also showed decreased cortisol levels.) [18] Pretty impressive for a simple of investment of 15-20 minutes per day, eh?

11) Yoga. A lot of guys are scared of Yoga.  After all, most of us are sports-minded and that mean lots of kinetic movement.  The idea of painfully stretching into a Dali-esque pose is completely foreign to us.  However, the fact is that yoga works and works well when it comes to stress management.  One 2004 even showed that it lowered salivary cortisol levels. [17]

12) Meditation. Many studies have shown that meditation lowers cortisol levels and it should be noted that this goes for all the basic types of meditation. For example, both cortisol and blood pressure levels were significantly reduced in young males practicing meditation. [19] Many men, unfortunately, are intimidated by meditation, because it so often has is sandwiched in the middle of religious jargon and beliefts that antithetical to ones own personal beliefs. The solution is what is called secular meditation, i.e. non-religious meditation. I cover this in my link How to Do Secular Meditation for those interested. Other related links are The Benefits of the Relaxation Response and Mindfulness Meditation for those interested.

13) The Smell of Coffee. One animal study showed that just the smell of coffee turned on key genes that protects neurons from the damaging effects of stress. [20]   This study found that 17 genes were actually regulated by just the smell of coffee and they produced 13 proteins known to reduce the negative effects of elevated stress levels.  Time to wake up and smell the coffee, eh?  NOTE:  This is yet another example of the powerful effects of smell and aromas upon our physiology.  Another is lavender, which improves sleep.

Keep the stress levels moderate and you will be surprised what a significant difference it makes to your memory, erectile strength, libido and so on.  All of the healthy third world cultures that I talk about on this site, the Kuna, the Tokeluau, the Pukapuka, the Tarahumara, etc., live a much, much more relaxed lifestyle.  These cultures are very family and community oriented, tend to sleep when the sun goes down for about 9 hours and so on.  They walk everywhere, prepare everything by hand – it’s a radically more peaceful lifestyle.

Contrast that with us:  we get out of work a little late hungry, drive through the traffic gauntlet to pick up our kids, get them some food as we drive home, take them to practice, help them with homework, fix them a snack, etc., etc.  And so then to unwind we stay up late watching TV or reading on the computer.

My advice is always ask yourself, “What is most important?”.  Or better yet, “Is this really worth my health?”

REFERENCES:

1) Nov. 24 online edition, Journal of Epidemiology and Community Health, Leineweber, et. al.

2) Psychoneuroendocrinology, 2001, 26:225 240, “Gender differences in age-related changes in HPA axis reactivity”

3) Chronobiology Intl, May 2000, 17(3):391-404, “SLEEP IMPAIRMENTS IN HEALTHY SENIORS: ROLES OF STRESS, CORTISOL, AND INTERLEUKIN-1 BETA”

4) Psychoneuroendocrinology, 1989, 14(4):303-310, “Mood state and salivary cortisol levels following overtraining in female swimmers”

5) Clincial Endocrinology, 66(2):185-191, “Cortisol secretary pattern and glucocorticoid feedback sensitivity in women from a Mediterranean area: relationship with anthropometric characteristics, dietary intake and plasma fatty acid profile”

6) J of Parenteral and Enteral Nutrition, 1995, 19(6):482-491, “Improved Clinical Status and Length of Care With Low-Fat Nutrition Support in Burn Patients”

7) Journal of Analytical Bio-Science, 2006, 29(2):146-150, “Effects of moderate exercise on chronic stress; an analysis from salivary cortisol concentration and subjective mood data”

12) Diabetes Metab, 2003 Jun, 29(3):289-95, “Fish oil prevents the adrenal activation elicited by mental stress in healthy men”.

13) Am J Med Sci, 1989 Dec, 298(6):390-6, “Neuroendocrine and stress hormone changes during mirthful laughter”

14) J of Complementary and Integrative Medicine, Vol. 6 : Iss. 1, Article 14, “The Effect of Tai Chi in Reducing Anxiety in an Ambulatory Population,”

15) J of Proteome Res, 2009, Published online ahead of print Oct 2009, “Metabolic Effects of Dark Chocolate Consumption on Energy, Gut Microbiota, and Stress-Related Metabolism in Free-Living Subjects”

16) Biological Psychology, Jul 2002, 60(1):1-16, “The impact of abbreviated progressive muscle relaxation on salivary cortisol”

17) Ann Behav Med, 2004 Oct, 28(2):114-8, “Effects of Hatha yoga and African dance on perceived stress, affect, and salivary cortisol”

18) Applied Psychophysiology and Biofeedback, Dec 2005, 30(4):375-387, “The Impact of Abbreviated Progessive Muscle Relaxation on Salivary Cortisol and Salivary Immunoglobulin A (sIgA)”

19) Physiol Behav, Sep 1991, 50(3):543-8, “Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time”

20) J Agric Food Chem, 2008, 56(12):4665 4673,”Effects of Coffee Bean Aroma on the Rat Brain Stressed by Sleep Deprivation: A Selected Transcript- and 2D Gel-Based Proteome Analysis”

When you hit middle age, you’ve got to Choose Wisely.  You can’t do everything any more.  You’ve got to choose that One Most Important Thing.  It’s really important that you take some time to figure out what you want to do with your life and what is most important to you.  If you are headed toward another career, for example, you must plan that out carefully.

Here’s one reason I say that:  you need to no longer compromise on your health.  In fact, most of you need to repair your health.  All of us middle aged and beyond must do what I call the Big Three:

The Potential Dangers of Milk: Dairy Can Be Scary!.

It’s ironic that two favorite drinks of guys are just plain dangerous to all they hold dear as a male:  beer and milk.  I’ve already covered Beer and Testosterone, but now let’s look at that white stuff that is squeezed out of a cow’s mammaries and see if it really “does a body good.”

NOTE:  For the record, I love beer and tequila. However, I recognize that the science says that they don’t love me.

Dairy is an integral part of the typical American’s diet.  It’s added to everything in one form or another:  milk, cream, cheese, ice cream, yogurt, sour cream – the list could go on and on.  American, on average, consume about 25, 20 and  pounds of milk, cheese and ice cream, respectively per year.  That is a LOT of dairy and I’m going to show below that it is likely causing a lot of problems, both below the belt and above.

Here are five great reasons you should set down that glass of milk:

1.  Calcitrol. Most dairy products proudly discuss how much calcium they contain.  Unfortunately, it is easy for a dairy lover to actually get too much calcium, leading to lower calcitrol levels. This, in turn, signficantly increases his risk for prostate cancer. [1]  For more information, see this link on Prostate Cancer.

2.  Estrogens and Cancer. You mama weaned you off of breast milk a long time ago and for good reason:  her breast milk is chock full of estrogens. Well, so is cow’s milk and researchers have long noted that many types of hormone-related cancers, such as breast, testicular and prostate, are significantly higher in populations with high levels of milk and dairy consumption. [2]

One of the issues that affects estrogen levels in milk is the cow’s stage of pregnancy. [8] Perhaps regulation can help one day with this issue, but in the meantime, a glass of milk may give you a lot more than you bargained for.  Again, isn’t it ironic that two favorite beverages for men, milk and beer, are under fire for their estrogen-enhancing properties?

3. Inflammation. Cassein – the primary protein in milk – decreases the body’s ability to use anti-inflammatory phytochemicals in food and is likely pro-inflammatory in and of itself. [3][4]

4. Cancer. Milk increases IGF-1 and may, therefore, put one at risk for many non-hormonal types of cancer, such as colon. UPDATE:  I found many other important links and placed them in my page on Milk and Cancer. There I show that milk has growth factors linked to cancer, a gut inflaming protein and a decreasing effect on the body’s own anti-cancer molecule (calcitrol).

5. Heart Disease. There is actually more than one type of cassein molecule.  One of them, beta casein A1, has been linked to heart disease from epidemiological observations and several animal studies.  The reason?  It breaks down in the blood stream and causes inflammation in arterial walls. [5]  One 2003 animal study showed that Beta casein A1 led to increased arterial lesions (damage) and thus would like lead to increased arterial plaque buildup. [6]  NOTE:  One human study did not show any such correlation, so follow up work needs to be done. [7]

WHEY: Most of the above comments do not apply to moderate consumption of whey, which has, for example, reasonable levels of calcium. For more information, read this link on Undenatured Whey.

YOUR WOMAN: Many women consume lots of dairy in the hopes of preserving bone health.  Here’s “food for thought”:  in almost all of the supercultures of the world, dairy is used only minimally and yet there is a muchreduced rate of osteoporosis amoung women. Studies of the Okinawans reveal that the divergence occurs during middle age, i.e. at middle age those on a Western Diet begin to experience accelerated rates of bone loss. [11] Scientists are unsure exactly why, but it is likely a combination of the 1) high magnesium, 2) abundant exercise and the 3) low animal and dairy product consumption.

In the meantime, your woman’s consumption of dairy may be increasing her risk of breast cancer and uterine fibroids.  Uterine fibroids are benign tumors that afflict almost all women.  However, some experts think that dairy, due to the elevated estrogens, accelerate fibroid growth. When fibroids become large enough, they can cause heavy menstrual bleeding, severe cramping and painful intercourse. Yes, that means you have a miserable woman who is less interested in sex.

MYTH: One belief about milk that is probably largely myth is its “mucus producing” properties. There is little to no evidence that milk promotes asthma, allergies or mucus, except of course in sensitive individuals with a true food allergy. [9]  Of course, milk is one of the most common food allergies and may be as high as 8% of the population. [10]

REFERENCES:

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

2) https://news.harvard.edu/gazette/2006/12.07/11-dairy.html

3) https://www.futurepundit.com/archives/005578.html

4) J of Isfahan Med School, 25(87), “Association between Dairy Consumption and Circulating Levels of Inflammatory Markers among Women”

5) https://news.bbc.co.uk/2/hi/health/1268481.stm

6) Atherosclerosis, 2003 Sep, 170(1):13-9, “A casein variant in cow’s milk is atherogenic”

7) Br J Nutr, 2006 Jan, 95(1):136-44, “Effect of dietary supplementation with beta-casein A1 or A2 on markers of disease development in individuals at high risk of cardiovascular disease”

8) Domest Anim Endocrinol, 2002 Jul, 23(1-2):125-37, “Mammary secretion of oestrogens in the cow”

9) J Am Coll Nutr December 2005, (24suppl)(6)547S-555S, “Milk Consumption Does Not Lead to Mucus Production or Occurrence of Asthma”

10) Journal of Allergy and Clinical Immunology, July 2001, 108(1):133-140, “Population study of food allergy in France”

11) https://www.okicent.org/study.html

Arginine Dangers - Peak Testosterone

Many men do not realize that their best efforts to raise nitric oxide by increasing their body s internal Arginine levels may actually be risky to their long term health. Many men are now taking L-Arginine and/or L-Citrulline in order to boost blood L-Arginine levels, which in turn increases the amount of all-important nitric oxide in the blood. (See my links The Benefits of Citrulline for more information.)

However, what is not commonly realized is that increasing Arginine levels, through Arginine or Citrulline, could feed and fuel certain herpes viruses and actually damage one’s long term health. You may be saying, That s okay I ll take a few cold sores in order to get improve my erections! Unfortunately, it s not that simple. There are actually many herpes viruses and they cause a wide variety of long term health issues and nasty medical conditions. In fact, I would argue that a high percentage of people struggling with major health issues – both men and women by the way – have one of these herpes viruses as a root cause.

1)  https://www.cdc.gov/std/herpes/stdfact-herpes.htm

2) Am J Pathol, 1986 Jan, 122(1):62 70, “Virus-induced atherosclerosis. Herpesvirus infection alters aortic cholesterol metabolism and accumulation”

3) Eur Heart J, 1993 Dec, 14(Suppl)K:12-6, “Infection and inflammation as risk factors for myocardial infarction”

4) Nature, 1970, 228:1056-8, “Epstein-Barr virus in Burkitt’s lymphoma and nasopharyngeal carcinoma. [ii] EBV DNA in biopsies of Burkitt tumours and anaplastic carcinomas of the nasopharynx”

5) J Clin Virol, 2006 Dec, 37 Suppl 1:S24-6, “Clinical parameters and HHV-6 active replication in relapsing-remitting multiple sclerosis patients”

6) https://www.traditionaloven.com/tutorials/l-lysine_rich_foods.html

1. HSV-1 and HSV-2. HSV-1 is the herpes simplex virus known for causing cold sores and HSV-2 genital herpes.   (In the U.S. about 16% of people aged 14 to 49 have HSV-2 and a much higher percentage HSV-1.)  [1] Of course, cold sores and genital herpes can be annoying, but these herpes viruses also likely accelerate arteriosclerosis.  That’s right – these viruses can actually lead to arterial plaque by damaging the lining of the arteries.  When the artery is damaged, even slightly, repair is initiaed and the body “repairs” or “protects” arteries by coating them with a nice layer of plaque.

Researchers noted this in an animal study on chickens where they infected the poor birds with MDV, a type of avian herpes virus, and observed greatly increased arterial “lesions” as they are called.  These lesions are what leads to arteriosclerosis. [2] Later study work verified that HSV can lead to increase arterial lesions as well. [3]

Of course, what this means is that doing anything to make life easier for any HSV in your system could wreak havoc with your arteries, which is always a bad idea for your sex life and life in general.

3.  HHV-6 (Human Herpes Virus 6).  This not-as-well-known herpes virus is known to negatively affect neurological tissues. It has been implicated as one of the root causes of Mulitple Sclerosis. [5] Therefore, increasing Arginine levels may possibly lead to increased risk for certain autoimmune disorders as well.

4. Herpes Zoster (Shingles). The herpes virus behind childhood chicken pox can surface later in life as shingles, where it infects and attacks the nerves. Shingles can be very painful and irritating and can lead to bright red patches and swelling on the face and body. In some cases, it can cause joint pain, hearing loss, drooping facial muscles and many other nasty symptoms.

So it becomes clear that, whatever we do, we do not want to cause an outbreak of any of the above viruses. Futhermore, it is quite likely that most men will have two or more these herpes viruses and so more than one outbreak could occur.

Are there any reasonable solutions? Well, I asked Naturopathic Doctor and Christopher Pick from the U.K. to give us some insights. Below are some questions are answers that I received from him. (You can read Chris’ profile in this link or visit his web site at Erectile Dysfunction Help Information.)

Q. I’m wondering if Citrulline, which seems much more powerful than Arginine, can cause even more problems for men with latent viruses? What’s your take on this?

A. It is estimated that around 95% of the US population over the age of 35 are infected with EBV. As you will know Herpes, EBV, shingles, chickenpox & lyme disease are all related. The immune system under normal conditions can keep these problems under control and in most cases it ONLY JUST manages this. Any type of additional immune stress such as hard exercise, general stress, lack of sleep, sun exposure, etc will overwhelm the immune system and an outbreak occurs.

A. Now, we know that arginine fuels the herpes virus and must deduce that it will also fuel similar viruses by the same mechanism. We also know that citrulline is a precursor to arginine. So, more citrulline equals more arginine equals more fuel for herpes type viruses. In the instance of certain dormant infections citrulline must be loosely considered as an immune system stressor.

You mentioned Lysine as a solution? Do you think a man can simply take a few grams of Lysine per day to counteract the effects of the Citrulline on any herpes viruses? In other words, can you get the best of both worlds by taking both Citrulline and Lysine?

A. Lysine is a solution for some. But as it antagonises arginine the down side may be a total or partial reduction in any vasodilation properties that were exhibited. This will vary considerably from person to person. Basically supplementing any amino in large quantities (over that found in foods) can up-regulate or down-regulate the metabolic pathway utilisation. Of course, this can create negative or positive effects.

I know that the Citrulline is a big help to some guys in the erectile department. Is there any chance that they can “take 2 grams of Citrulline per day and 3 grams of Lysine per day for safety”? What would you advise?

A.  The bottom line. Taking 2 grams of Citrulline and 3 grams of lysine may work for some and not for others. It would need individual experimentation. This is probably not the best route. Considering the infection rate it would be better to seek other alternatives for increasing nitric oxide for vasodilation requirements. For those who are willing to experiment, it may well be worthwhile.

It has always been a problem for me when I try to advise on supplementation & the metabolic pathway interactions. People do not want to hear it &rightfully so if it is not their interest. They just know from advertising that this cures that or this effect can be had etc. Further, the majority of manufactures & sellers of supplements have no knowledge of interactions. They can follow the research of an effect of a single ingredient on a particular issue & sell it on. Rarely does the research on a single substance follow the metabolic pathways to see what else may occur the expense would be astronomical.

Q. So right now there is no way good way to keep the EBV/HPV/HSV’s in check other than the body’s own immune system plus, in some people, extra L-Lysine?

A. Correct again. The drug Aciclovir is effective for cutting down on break outs. Some people have been on it for years. But whether it is Citrulline or Aciclovir, there are checks a balances.

So what’s a fella to do?  Well, there are several options:

1. Avoid Citrulline and Arginine Supplementation. Erectile function may still be restored through an Erectile Strength Diet, exercise and a few choice supplements. This requires patience and experimentation of course.

2. Supplemental L-Lysine. A man could take some a gram of Citrulline in the a.m. upon waking, Lysine at lunch and another gram of Citrulline in the early evening, since that is the prime love-making time. In addition, one could try to get Arginine from food instead, which will also provide some Lysine for protection. For example, the meats, such as chicken and beef, provide an approximate 1:1 ratio of Lysine to Arginine. However, many plant foods actually provide more Arginine than Lysine. Oats, for example, have about twice as much Arginine as Lysine and peanut butter over 3 times. [6]

3. Citrulline Only. Of course, one can also just take Citrulline. Short term studies, at least to date, have shown no side effects from Citrulline usage (at levels in the 0.5-3 grams/day range). This is a certainly a promising sign, but if there are long term risks that come to light through activation of the Arginine pathway, these would not have come to light in the these studies. And keep in mind that usage of Citrulline as an erectile supplement is quite new.

Which of these safest? I cannot answer that for you, of course, for many reasons, but one of which is that every man’s situation is different.  Do you have any of the above viruses?  Have you had symptoms that seem to tie into of the herpes viruses?  Unfortunately, you must do any your own self-assessment, research and discuss things (with hopefully knowledgeable) physicians that can give you good advice along the way.

REFERENCES:

Cocaine, Heroin and Erectile Dysfunction - Peak Testosterone

It will probably not surpise most of you that most drugs are very hard on your penis considering how hard they are on your body.  Well, consider your suspicions confirmed.  Most guys using recreational drugs do not wake up in the morning saying, “Today, I’m going to trade a half hour of pleasure for my sex life.”  But that is exactly what most recreational drug users aren doing without even realizing it.  It may take a week or two or  may take a year or two, but almost always one of the first things to go out the window are the ol’ erections.

1)  Drug and Alcohol Dependencies, Apr 1 2008, p. 12-18

2) Med J Australia, 2002, 177(5):260-262

3)  Cardiology, 88(3):191

4) NEJM, Apr 24 1975, 292:882-887

5) J of Postgraduate Med, 2006, 52(1):51-56

Let’s start with the opiates, such as heroin, methadone and so on.  All of these are very hard on male erectile strength, sabotaging it in many different ways.  Some of these drugs should be called Erection Killer, Anti-Viagra, Castratanol or something similar.  One study  looked at heroin addicts in treatment with methadone or buprenorphine and found that almost half reported erectile dysfunction, 24% saying mild to moderate and 18% severe. [1]  Of course, that assumes that you survive: cocaine also is a fantastic clot builder and artery spasmer and heart attacks are not

NOTE:  Don’t think you are immune if you’re abusing prescription drugs.  The DEA estimates that in America there are “nearly 7 million Americans are abusing prescription drugs more than the number who are abusing cocaine, heroin, hallucinogens, Ecstasy, and inhalants, combined”. Furthermore, the problem is bound to get worse as one recent study in the Journal of Adolescent Health found that one in five adolescents lends or borrows prescription drugs.  Prescription drugs are just as powerful and damaging as those on the street.

But how does cocaine lead to erectile dysfunction?  One journal points out that it basically greatly accelerates the aging of the arteries, leading to accelerated plaques and calcification. [2]  Another study found that chronic cocaine use lead to chronically elevated CRP levels, which good Peak Testosterone readers know is one of the leading risk factors for heart disease. [3]  Methadone and heroin destroy just about every marker of gonad function that researchers can think of.  It lowered ejaculatory volume, seminal vesicular and prostatic secretions by over half! [4] Those Nirvana lyrics “Half the Man I Used to Be” really apply here. But the nightmare doesn’t stop there:  baseline testosterone levels were 43% lower in methadone users for example.  Interestingly enough, methadone (a controlled substance given at clinics) produces the worst results in all markers, but heroin is not far behind.

Next we will cover marijuana.  This supposedly benign plant that everyone wants to use for medicinal purposes should be called The Great Sterilizer. Please read this link on How Marijuana Can Destroy Your Hormones, Fertility and Lead to Impotence.

REFERENCES:

Salt (Too Much) Lowers Body Temperature - Peak Testosterone

Quite a few men on the Peak Testosterone Forum have complained of a low body temperature. The general assumption is that men with low body temperature have “adrenal fatigue” or hypothyroidism. What few men (and perhaps physicians) realize is that recent research has shown that too much salt will also lower body temperature and may explain at least a part of their issue.

More importantly, what researchers have discovered is that it is this decrease in body temperature that is the root cause for salt sensitive hypertension.  I recently found out that I was salt sensitive and that it is quite common:  estimates that I have seen are around a fifth of the general population. [1] I tell the story as to how I dropped by blood pressure by 10-15 points by eliminiating extra added amounts in my diet on this page:  Salt Caused My Prehypertension.

To understand what is happening salt sensitive people like myself, you have to realize what happens when you ingest a bunch of added salt.  Salt, after all, is not something that Paleo man ran across nor his hominid ancestors before that. The body basically says, “What in the heck is all this salt?”  It finds itself going through the following metabolic roller coaster:

1) Diabetologia, 1995 Dec, 38(12):1443-8, “Increased prevalence of salt sensitivity of blood pressure in IDDM with and without microalbuminuria”

2) Hypertens Res, 2011 Jun, 34(6):753-7, “Effect of acute salt ingestion upon core temperature in healthy men”

b) Your arteries initially will dilate in order to handle the extra volume of water entering your cardiovascular system.

c) Heat loss then increases and body temperature will start to fall due a) and b).

This is when it gets interesting, especially for salt sensitive individuals.  Salt sensitive individuals experience a greater drop in body temperature and then the following happens:

RESEARCH: A recent study gave strong evidence that this was really the case and to test their theory gave salt sensitive individuals and controls 11 grams of salt.  It was spread out in short intervals but was given pretty much all at once. [12]

Of course, this is a LOT of salt.  However, it is not completely off the rails considering that the typical American consume 3.4 grams per day on average.  (Many of us consume significantly more.)  They went on the high side, though, to prove a point:

What they found was what I stated above:  salt sensitive people had a significantly greater loss in body temperature that the non-salt sensitive folks verifying the ideas presented in a) through d) above.

I would add that the average lowering of body temperature was close to a degree (Fahrenheit) with that 11 grams of salt.  So, if you are 2 degrees below 98.6, I doubt that salt coupled with salt sensitivity explains it.  However, we should all keep in mind that excess salt could be playing a partial role in lower body temperature.  And, regardless, what is the point in shoving a bunch of extra water into your arteries?!

CAUTION:  Let me just mention that I recognize that athletes need more salt and also that extra salt does not seem to affect most men in the general population.  However, for those of you that are salt sensitive like me, reading this and some of my other pages on salt will be a godsend.

REFERENCES:

Exercise & Nitric Oxide - Peak Testosterone

One thing that I see quite often in emails is that some men seem to be only seeking a pharmaceutical or supplement solution to their health and/or bedroom issues. What they do not realize is just how powerful lifestyle changes, such as exercise, can be. Our history here on planet earth involves lots of movement and walking in particular – almost nonstop – and the Western lifestyle is the polar opposite.  But some men still struggle to exercise because they see no short term motivators.

Well, here is one big short term reason for you to exercise:  boosting nitric oxide.  Yes, exercise is a huge nitric oxide and blood flow booster and we’ll show you just how much with some of the key studies below.

1. Restore Youthful Blood Flow. If you are a senior or middle-aged and are seeing possible signs of endothelial dysfunction, such as erectile issues or high blood pressure, then there is one study in particular that should really grab your attention. In this study the authors found that sedentary younger men (22 to 35 years old) had 25% less forearm blood flow (to a standard stimulation test) than that of sedentary older men (ages 50 to 76).  That’s no shock – youth has its advantages after all.

However, the interesting part of the study came when looked at endurance-trained men, i.e. men that did cardio.  The endurance trained senior men had virtually equal blood flow to endurance trained younger men to the same stimulation test. In other words, this study points to the fact that the age-related loss in blood flow “responsiveness” can be reversed with exercise and that you can, indeed, make your arteries young again.. And, by the way, this exercise was primarily “home-based” and walking. It was NOT any spectacular triathlon or marathon training.  The authors concluded that “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.” [1]

1) Circulation, 2000, 102:1351-1357, “Regular Aerobic Exercise Prevents and Restores Age-Related Declines in Endothelium-Dependent Vasodilation in Healthy Men”

2) Circulation, 2003; 108:530-535, “Effect of Different Intensities of Exercise on Endothelium-Dependent Vasodilation in Humans: Role of Endothelium-Dependent Nitric Oxide and Oxidative Stress”

3) Med Sci Sports Exerc, 2008 Jul, 40(7):1336-43, “Effect of intensity of aerobic training on VO2max”

4) Journal of Applied Physiology, Mar 1 1997, 82(3):760-764, “Both physical fitness and acute exercise regulate nitric oxide formation in healthy humans”

5) Arteriosclerosis, Thrombosis, and Vascular Biology, 1999 19:2782-2787, “Exercise Training Increases Basal Nitric Oxide Production From the Forearm in Hypercholesterolemic Patients”

6) Circulation, 1999, 100:1194-1202, “Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive As Well As Hypertensive Subjects”

7) J Am Coll Cardiol, 1995,25(2s1):298A-298A, “Exercise Increases Systemic Nitric Oxide Production in Men “

8) JAMA, 2004, 291(24):2978-2984, “Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men A Randomized Controlled Trial”

2.  High Blood Pressure Patients. A study in Circulation found that men with with hypertension got a nice increase (25%) using the same stimulation as in the study above. [6] This is important, because it shows that you should begin where you are and not assume that you are so damaged that you cannot get a boost in blood flow or nitric oxide.

CAUTION:  If you have existing an existing medical condition, especially heart disease, consult with your doctor first before undergoing an exercise program.

3.  High Cholesterol Patients. One study looked at high cholesterol patients and found that they got a nice bump in nitric oxide through exercise. [5] Again, this is yet another study showing that, even if you are a high risk patient, you can significantly improve things.

CAUTION:  If you have any cardiovascular issues, clear exercise through your doctor first.  This sounds like an overly cautious statement, but many men have had heart attacks during exercise and it is simply because they went too fast for their damaged cardiovascular systems.  Go easy and talk to a doc if you have atrial fibrillation, angina, heart medications, high blood pressure, etc.

Exercise Intensity Levels for Best Nitric Oxide Levels

What is the best exercise intensity level to increase blood flow?  The more intense the better, right?

Actually, one study shows that moderate intensity exercise is probably the best way to go.  They evaluated this by splitting up a group of healthy, younger men into 3 exercise groups (5-7 times per week) based on the percentage of VO2max in their sessions.  Specifically, their definition was “mild, 25% V̇O2max; moderate, 50% V̇O2max; and high, 75% V̇O2max.” [2]  (VO2max is a standard measure of intensity used in many studies and refers to the maximum ability of an individual’s body to use oxygen during exercise.) [3]

Now it kind of makes sense that very mild exercise would not stimulate nitric oxide much.  But why did the intense exercise not increase nitric oxide and blood flow even more than moderate and mild intensity levels?  The answer lies in the fact that intense exercise increased oxidative stress, i.e. raised free radical production so much that it overwhelmed the body’s ability to adapt.

Now does this mean you should not push yourself and just “coast” in your workouts?  No, not really.  Another study showed that trained individuals had 32% more baseline nitrate levels, a measure of nitric oxide, than less trained individuals. [4] So as you slowly build up your ability to exercise and train, you should see your baseline nitric oxide, i.e. resting plasma nitrate levels increase over time.

Exercise As An Erectile Dysfunction Cure?

One natural question is the following:

“If exericise can do such a nice job boosting nitric oxide, can it be used to “treat” erectile dysfunction?”

Well, yes and no.  First of all, practically speaking, you can’t really exercise and then try to grab your wife or girlfriend while you still have the elevated nitric oxide levels.  Well, if YOU can do that, it just might work, because one study showed that nitric oxide levels increase by well over double post-exercise (~125% increase) in both trained and untrained individuals. [7]  That is an incredible boost from just one lifestyle change.

There is just one problem though:  after two hours nitric oxide levels returned to baseline.  So that gives you maybe an hour-and-a-half to drive home from the gym, kick the kids out of the house, shower and convince the little woman that “now is the time!”  Well, this isn’t too practical obviously and so you may be wondering just how practical exericse really is.

Well, before you give up on exercise, remember the study above:  trained individuals have 32% more baseline nitric oxide levels than untrained.  Yes, you can increase your baseline nitric oxide levels through regular and diligent workouts. In other words, these research results point out that exercise should be part of a total “Nitric Oxide Program” that helps maintain and/or restore youthful nitric oxide levels, thus helping any erectile dysfunction you may be experiencing. (Of course, there are other non-endothelial reason for erectile dysfunction, including Venous Leakage and Neuropathy for example. But, usually, a loss of nitric oxide-induced blood flow is a primary culprit.

And one study (in obese men) has already found that exercise can improve erectile dysfunction. [8] And no doubt more studies will follow.

CAUTION:  Few lifestyle factors are harder on the body than being sedentary, something I discuss in my link How Sitting Will Kill You. You may also want to read my article on Erectile Dysfunction and Exercise for some additional information.

REFERENCES:

Wheat Belly Review: How Modern Wheat Can Kill.

I’m sorry to be sensational, but I can’t help myself:  Wheat Belly by William Davis is one of those books that can save your life – this book is that importat. The first 40 pages of this book, in particular, are just packed with mind-bending information that can literally save your life. I had already become cautious about eating wheat and reading this book confirmed my suspicions.  In fact, because of reading this book, I rarely eat wheat now.

One of the things that made me very cautious about wheat was the fact that I have eaten it in significant quantities before sleeping on several occasions and woken up in the middle of the night feeling horrible, almost as if I have a cold or the beginnings of a flu.  Of course, it may be coincidence or some other factor, but it got me to investigating.

Regardless, it should strke you as a bit odd that I would be warning you about wheat:  aren’t a grain-lovin’, plant-based health fanatic?  Yes, indeed – but I know rely on other grains and only eat wheat during certain social situations. That may sound a little fanatical to some, but let’s go into some of the reasons that Dr. Davis outlines so well in his book:

However, Dr. Davis says that the reactions to wheat go way beyond these known issues.  At the time the book was written, he was a working cardiologist in Milwaukee and he says his patients were cured of all sorts of diseases and conditions by going off of wheat. He mentioned near-miraculous cures of Irritable Bowel Syndrome, asthma, rheumatoid arthritis – all immune-related diseases.

And besides noticing the profound effect of going off of wheat, he makes some convincing genetic arguments that it is actually the genetic modifications that have turned wheat into a Frankengrain.

DISCLAIMER: From what I can tell, Dr. Davis is a Paleo Diet advocate.  As you may know, I am not a big fan of Paleo Diets, because it is so easy for men to get themselves into trouble by eating meat.  It is possible to eat meat successfully, but not easy and I’ve summarized my concerns in this link on The Risks of Eating Meat.

2.  Weight Loss. Another interesting insight given in this book is that Davis has found that many people can lose weight dramatically simply by cutting wheat out of their diet.  The reasons are many, but one is that it is ubiquitiously in foods, many of them “bad” and high calorie foods and so eliminating wheat gets rid of a big source of calories for many people.  It creates an easy-to-follow dietary program for most people.

However, the other reason is that wheat is a high-glycemic food and can lead to insulin and glucose spikes/crasheds and visceral fat gain as well. So dropping wheat can melt of that “beer belly” that has been plaguing you as well according to Davis.

3.  Blood Sugar Levels and Diabetes. Wheat is a grain with a very disturbing property, and one that concerned Davis to a great deal as a cardiologist:  it has a Glycemic Index (GI) higher than table sugar!  That’s right – both whole and regular wheat breads will actually elevate your blood glucose significantly higher than good ol’ sucrose. Now this is no secret, but what Davis does a nice job of explaining is why:  adiponectin.

It runs out that wheat is very high in amylopectin-A, which is rapidly converted by the digestive enzyme amylase, into glucose.  Table sugar is half fructose, which slows down post-meal blood sugar rises to a certain degree.  But the main point here is that eating wheat means you are likely going to get a tissue-damaging boost in glucose – yes, glucose is the sugar they give you in a lab to spike your blood sugar – and this is undoubtedly contributing to the epidemic of prediabetes, Metabolic Syndrome and Diabetes that we see in our society today.

NOTE: Although fructose doesn’t spike blood glucose significantly, that’s where the good news ends.  Fructose has it’s own risks, which you can read about in my links on The Dangers of Fructose.

Of course,  has been out for awhile and is available on Amazon:  Wheat Belly: Lose the Weight.  So why do I want to highlight this book?  Well, many men turn to Erection Friendly Grains, when they start trying to get their health back and that is a good thing.  However, wheat has morphed in recent history into a frankenfood that now has very questionable health values.  There are many other excellent grains with much better health properties – Quinoa, millet, oats, etc. – that should be considered first in my opinion.

And this isn’t easy for me to say: I ate wheat literally at every meal growing up.  However, I have found that it’s quite easy to give up and don’t regret it one bit.  Anyway, hats off to Dr. Davis for writing a great review of a food that, until recently, everyone assumed was a near superfood and excellent addition to a health diet.

1.  GMO-based Wheat Reactions. As you hopefully know from poking around my site, there are three grains that have been heavily genetically engineered in the last half century:  soy, corn and, yes, wheat. These have received heavy attention for both altruistic reasons – feeding a growing planet ad solving world hunger – and not so altruistic, i.e. profit.

Davis explains that it was the Rockefeller Foundation that established an agricultural center east of Mexico City a little after World War II to study ways to modify wheat in order to increases its yield and increase its durability.  Unfortunately, they have been incredibly successful and have made literally hundreds of changes to the wheat genome. Furthermore, they have come up with literally thousands of variations of wheat that are sold around the globe.

Some of you may be saying, “So what?”  Well, to that I can only say that you must read this book:  Davis builds a convincing case that all these modifications are responsible for many of the nasty immune responses that men are getting from consuming modern wheat. It is no secret that many people have “wheat intolerance”, “gluten intolerance” and celiac disease.

Erectile Dysfunction and Inflammation - Peaktestosterone

What does inflammation have to do with erectile dysfunction?  Possibly everything according to some experts. Probably the most foundational aspect of an erection is endothelial health and, it turns out, endothelial health has everything to do with inflammation (or the lack thereof).  In fact, one study found that ALL of the following inflammmatory markers were associated with erectile dysfunction: [1]

This list could continue, but the important point is that inflammation hammers the endothelium, the lining of your afteries and blood vessels, which then hammers your erections. This has caused some researcher to believe that inflammation is the true root of most erectile dysfunction. [2]

There are other indictions that this could be the case.  infections with Chlamydia pneumoniae or cytomegalovirus have been associated with erectile dysfunction as indicated by increased inflammatory markers. [3] The same has held true for gum disease as well. [4]

So how does chronic inflammation affect the endothelium in such a negative manner? First of all, it lowers nitric oxide availablity.  This has been observed in several populations, one of the most notable being apnea sufferers, who have elevated inflammation for chronic sleep interruptions. [5]  One of the ways inflammation controls nitric oxide is by affecting eNOS, the stuff of Viagra. [6] Yes, inflammation is the ultimate anti-Viagra in this sense.

Affecting NOS negatively is potentially dangerous in the long term as well, because nitric oxide decreases the damage done to arterial walls.  So as chronic inflammation turns off your nitric oxide, additional damage occurs to the endothelium, which in turn leads to decreased nitric oxide and so on.

The bottom line:  to avoid erectile dysfunction, you have to get this Enemy #1 in control.  Remember, this will also decrease your cancer and cardiovascular risks as well. Read my links on How to Decrease Inflammation and Juicing and Inflammation for starters.

REFERENCES:

1) European Heart Journal (2006) 27, 2640–2648, “Unfavourable endothelial and in?ammatory state in erectile dysfunction patients with or without coronary artery disease”

2) Eur Heart J, 2007, “Is erectile dysfunction a low-grade systemic inflammatory condition?”

3) Eur J Clin Invest, 2006 Jul, 36(7):497-502, “Infection induced inflammation is associated with erectile dysfunction in men with diabetes”

4) https://www.foxnews.com/health/2011/06/28/bad-gums-linked-to-erectile-dysfunction/

5) Circulation, 2008, 117: 2270-2278, “Inflammation, Oxidative Stress, and Repair Capacity of the Vascular Endothelium in Obstructive Sleep Apnea”

6) ENDOTHELIAL DYSFUNCTION AND INFLAMMATION, Progress in Inflammation Research, 2010, 65-80, “Post-translational regulation of eNOS activity in inflammation”

Compounded Testosterone - Peak Testosterone

This is where a compounding pharmacy comes in.  A good compounding pharmacy takes the same bioidentical testosterone and puts into a gel or cream at the dosage the doctor specifies.  (Again, this is MUCH cheaper than either Testim or Androgel as testosterone is a relatively cheap molecule to manufacture.)  Many guys who cannot seem to get past the 200’s or 300’s with Testim or Androgel break those barriers easily with compounding.  (Most docs will try to get you right around 500 from what I have seen.)

WHAT ABOUT INSURANCE?  I was actually able to get compounded testosterone through insurance because Androgel did not work for me. However, compounded testosterone is so inexpensive that my copay was not that much below the cost of just paying cash!

Besides cost and effectiveness what are the other big advantages to using compounded testosterones?

2) Diurnal Rhythm. If you apply the cream in the morning every day, you will be somewhat mimicking the body’s natural diurnal rhythm of higher testosterone levels in the morning that then taper off in the evening.  This may be important for physiologically in some way that we do not yet understand.

3) Increased DHT Levels. This is a pro or con depending on how you look at it.  All topicals will tend to raise DHT levels more than other delivery systems.  This can be good for middle-aged and older men from the libido standpoint.  You do have to be careful in my opinion as you can go supraphysiological, i..e well over the top of the lab range, which is true for any compounded or brand name cream or gel.  You can pull your DHT levels here:  Inexpensive Testosterone Labs.

4) Control Over Concentration. With the name brand name products, you get what you get when it comes to concentrations.  For example, Androgel is 1.62% and virtually all men using Androgel use this concentration.  Want 3% Androgel?  Too bad – it’s not offered.  But with a compounded cream or gel, your physician can order almost any reasonable strength.

Compounded Testosterone Dosage

Figuring out the dosage of the prescription that your doctor wrote is not as difficult as it might seem.  Think of 1,000 mg of water, or the cream, as the starting point.  Let’s say you mixed in 10 mg of testosterone into that 1,000 mg.  That would be considered a 1% compounded solution. A 2% solution would be 20 mg mixed into the 1,000 mg.  Common prescriptions are anywhere from about 3% to 20%.

So why can’t you go above 20%?  Technically, you can go get about 30% into a cream or gel from what I have heard.  However, it starts to get “gritty” at that levels and so 20% seems to be the maximum out there in the real world.

“I’m now using about 1.5 grams of 5% compounded T cream. I mix it with a splash of water to make it spread out. I then apply to shaved shoulders, shaved armpits and any remainder to shaved scrotum/thighs. I spread it thin and rub it in vigorously. It takes a bit to dry. Works like magic. Last T levels were at 700. I’ve been low T for a very long time, so I have a good “feel” for when it’s right and when it’s not. I cannot use Androgel. Even with massive doses, it simply does not work for me.” [1]

Cujet also thins his out with a little water.  He said, otherwise, it is like trying to spread “peanut butter.”  For both cujet and myself, compounded testosterone was a life saver.  (Androgel never raised my testosterone a nonogram.)

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

Compounded Testosterone Costs

My monthly supply of testosterone was about $50!  This was quite a few years ago and now costs tend to be about $75 per month usually from what I have seen.  Compare that to a month of Androgel, which is about $250 the last time I checked.  In my opinion this is a ridiculously high price for something that has been around for decades.  It is like Good Year suddenly declaring  that only their tires are safe and then charging the consumer $500 a tire! Remember: bioidentical testosterone, which is in all topicals, is not an expensive molecule to manufacture and compounders were safely dispensing testosterone creams for years before the large pharmaceutical companies got involved.

Compounded Testosterone Delivery System

The reasons that compounding can deliver so much more testosterone has mostly to do with the increased concentration.  The delivery systems from what I have read are comparable in absorption rates to Androgel, or at least close.  The most common system used is called PLO(Pluronic Lecithin Organogel), “penetration enhancer”.  Many drugs are delivered in PLO, which helps the drug pass through the stratum corneum, a big name for the upper layer of your skin.  PLO is usually made from soy but can be made from eggs as well.  It is composed primarily of lecithin, isopropyl palmitate and Pluronic F127.  Isopropyl palmitate helps the testosterone penetrate the skin and is also a solvent.  It can definitely cause skin irritation, clogged pores, etc. and this is one of the potential downsides to PLO.

The Pluronic F127 is a “surfactant”, which means that it spreads the product out evenly so that it does not bind or coagulate together.  These two chemicals are considered safe and they are pretty widely used.  Isopropyl palmitate is a low hazard expection compound according to the Environmental Working Group for example. [4]  And the Pluronic F127 is in mouthwashes and toothpastes for what that is worth. Again, this has not bee tested long term as far as I know.

The only other disadvantage that I know with compounded testosterone is that its effect on family members is undocumented.  After reports of children being affected through their father’s topical application of testosterone therapy, the FDA asked for the manufacturers to do additional testing to make sure this wasn’t an issue with their product.

Personally, I doubt that Testim or Androgel has unusual potent penetration capabilites as a significant percentage of guys find they get little to no penetration.  Plus, again from what I have heard, these cases are usually from fathers who are being careless. Androgel, for example, is applied to the chest and upper arms.  Some dads go shirtless or forget to wash off the product before doing physical things with their family.

If you thoroughly wash the area of application, your family members should be safe, i.e. your wife and kids should not be overabsorbing supplemental testosterone.  However, you should realize that the FDA is only working with the mainline manufacturers and not with compounding pharmacies. Talk to your doc, of course, about all of the above. CAUTION: Be careful about love make sessions with your woman unless you’ve thoroughly washed the product off:  her testosterone is just a fraction of yours!

1) https://www.peaktestosterone.com/forum/index.php?topic=8082.0

2) https://www.peaktestosterone.com/forum/index.php?topic=7881.0

3) https://www.medpagetoday.com/MeetingCoverage/ENDO/50372

4) https://www.ewg.org/skindeep/ingredient/703207/ISOPROPYL_PALMITATE/

Packed with chemicals that block vitamin,mineral absorption.

Grain-bashing is a popular pastime right now in the blogosphere, but make no mistake:  whole grains – and I emphasize whole – are good for your penis and erections.  Grains are excoriated for being a relatively new invention of modern man and, therefore, neither truly natural or healthy.  Supposedly, they are packed with chemicals that block vitamin and mineral absorption, raise insulin and are the Freddie Kruegar of the dietary world.

But the truth is that these beliefs are strictly “religious” in nature and are simply unfounded for whole grains.  Study after study has not only exonerated whole grains but shown that grain-based diets are very high performers and deserve nothing but the utmost respect from the nutritional community.  Don’t listen to the grain-haters:  your penis will thank you.

So let’s go through the accusations one by one.  First of all, grains supposedly destroy your sugar and insulin metabolism according to the Paleolithic proponents.  Well, one study looked at a diet high in unrefined carbohydrates, i.e. grains, and found that it actually improved insulin sensitivity.  In fact, the title of the study is revealing:  “A Mediterranean and a high-carbohydrate diet improve glucose metabolism in healthy young persons”. [1] This undoubtedly shocked the Low Carb blogophiles:  glucose metabolism AND insulin sensitivity is actually improved by lots of carbohyrdates.

NOTE:  Did you know that quinoa, a grain from South America growing steadily in populariy, has a perfect protein just like an egg? It’s also as easy to fast and cook as rice.

CAUTION:  I am not a big fan of modern wheat. Along with soy and corn, it has been highly genetically engineered:  read my Review of Wheat Belly for some of the negative properties of modern wheat.

Remember that a https://www.peaktestosterone.com/ also has significant unrefined carbs.  The conclusion of the researchers was that substituting either unrefined carbs or monounsaturated fats for saturated fats improved insulin sensitivity. This is a very unappealing concept to the carnivore-or-die crowd, who want to believe lots of carbs will overwhelm our digestive and metabolic systems.  And don’t forget that Metabolic Syndrome is very hard on the penis and a leading cause for erectile dysfunction.

Their reasoning goes like this:  1) high carbs are broken down into high levels of blood glucose, 2) high levels of blood glucose require high levels of insulin to be produced, 3) years of high insulin levels eventually exhaust the body and 4) insulin resitance and diabetes follow shortly thereafter.  But all of these are completely unfounded myths.

The fact is that grains do the opposite of what all the naysayers say:  grains actually are diabetes-preventative. For example, one major study found that a higher intake of fruits, fish and grains was actually associated with a lower risk of diabetes. [2]  Another major study, in this case of women, said it clearly:  “Whole grain intake is inversely associated with risk of type 2 diabetes, and this association is stronger for bran than for germ. Findings from prospective cohort studies consistently support increasing whole grain consumption for the prevention of type 2 diabetes”. [3]

Furthermore, researchers recently found out that the high glutamic acid, the primary amino acid plant protein, content in plant products, such as grains in particular, led to a drop in blood pressure. [4]  A later study found that those who ate a significant amount of whole grains, over about 46 grams/day, were 19% less likely to develop hypertension. [6]  And, as Peak Testosterone readers well know, a drop in blood pressure almost always means expanding arteries and expanding arteries is what allows blood flow into the penile chambers.  Remember also that hypertension is bad for the penis and erections and is a major cause of erectile dysfunction.  This may explain some of the powers of the Ornish, DASH and https://www.peaktestosterone.com/ Diets to lower blood pressure.

Another criticism of grains is that they are nutritional weaklings.  In other words, low carb folks basically often claim that eating fruits and vegetables are much higher in value than grains and so why not stick to them instead?  Again, science has found the opposite.  One 2009 study by the American Chemical Society found that grains had as many antioxidants as fruits and vegetables. [5] Again,  this may be yet another explanation for why the Mediterranean and Low Fat Diets have done so well in the studies.

Many of the grains also directly boost Nitric Oxide, a fact that I cover in more detail in my https://www.peaktestosterone.com/ program. Boosting Nitric Oxide, of course, is what Viagra and Cialis are all about and will help your penis achieve its maximum hardness factor.

The truth is that grains prime your system with vitamins, mineral and phytochemicals and do it without destroying your metabolic health.  There simply are few better all around foods for your general and sexual health. Grains are penis protective – it’s that simple.

ln fact, the poster children for grains are the Ikarians, residents of a Greek Island where one in three residents live to be 90! (This is in market contrast with America, with its expensive health care system, where about 1 in 9 do.)  One of their secrets is a Mediterranean Diet, with lots of grains, fruits, vegetables and olive oil.  Oh, and AARP reports that most Ikarians over 90 are probably sexually active, which means that grains can’t be too bad for the ol’ penis, eh?

REFERENCES:

1)  Diabetologia, 2001, 44(11): 2038-2043

2) Ann Intern Med, 2002, 136(3):201-209

3) Pub Library of Science, Aug 2007, Med 4(8): e261

4) 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”

5) American Chemical Society (2009, August 19). Whole Grain Cereals, Popcorn Rich In Antioxidants, Not Just Fiber, New Research

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

Low Fat Book Emphasizing Healthy Fat Healthy Carbs.

Do low fat diets work?  In spite of what you may have read, they are generally incredibly successful if done correctly and many of the healthiest cultures in the world consume them.  I cannot tell you the number of times that I have read that low fat diets are evil since their backbone is carbs and thus they will cause prediabetes and diabetes.  In reality, the results are the exact opposite according to this book co-authored by the Chief Medical Officer of the Pritkin Institute, a cardiologist named Dr. Robert Vogel.  His experience is that men and women entering the Pritikin Institute, a low fat-based medical clinic experience the following:

—74% of Type II diabetics get off of their oral medications

—44% of Type II diabetics get completely off of insulin

—83% of those with hypertension completely normalize their blood pressure.  (And high blood pressure is one of the hallmark symptoms of the prediabetic state called Metabolic Syndrome.)

In other words, the realities of a well-done Low Fat Diet are the exact opposite of what you have (likely) read.  The keys are outlined in this book and, of course, include using healthy carbs, fats and proteins.  For those of you who, like me, got tired of consuming mountains of industrial meat, eggs and dairy, this is great news!

1. He hammers home the point over and over that low fat diets maximize blood flow.  And I don’t know any guy that can argue with blood flow.  He also makes many great points about maximizing nitric oxide.

2. He hammers home the point that no diet lowers inflammation like a properly done low fat diet.  And, we all know that  Inflammation is the Root of Evil.

3. He has a very realistic approach toward low fat diets that many men would feel comfortable with, such as recommending fat levels at 15-20% of total calories in order to displace some carbohydrates in the diet and yet still good arterial outcomes.  (This is about the level of the elite supercultures in John Robbins’ Healthy at 100.

Most men think of low fat diets as completely vegan.  It is true that some of the leaders are squarely in that camp, such as Dr. Esselstyn and Dr. Barnard.  However, Pritikin himself and now Dr. Vogel clearly allow some meat, especially if it is healthy and low fat.  One of the best sections in the book may be a table of different types of fish that are low mercury and these include herring, mackerel, mussels, oysters, salmon, sardines, trout, sole/flounder and trout.  And he actually recommends these fish up to one serving daily.

This is the highest amount of fish that I have seen recommended from an expert, but, of course, it depends on getting the low mercury versions. Many types of fish have up to 20-30 times the amount of mercury in the above fish.

Other great tips and info in the book include:

–It is the diterpenes in coffee that increase LDL.  (I had always wondered why decaffeinated coffee increased LDL.)

–I often hear the argument that fat has decreased in the American Diet and yet chronic disease has only gotten worse, therefore fat is not the issue.  However, Dr. Vogel points out that while the percentage of fat has gone down a little in the last few decades, calories have gone up so much that total fat has actually increased.  Thus, the argument is completely misleading.

–He emphasizes the calories per pound of food as being what really counts in the battle against obesity.  Let’s take the case of bananas, which get some criticism from class Paleo and Low Carb folks for being too “sugary.”  One banana is 420 calories per pound.  However, industrial beef is 1,235 calories per pound!

Weight loss, healthy fats and carbs, tips on how to get protein and a bunch of great arterial information – this book is a must read for any man’s health library.

(NOTE:  The great majority of men who try low fat do not use whole foods and fail miserably.  You can’t eat a bunch of wheat and white rice and dried fruit and call that low fat.)

So why would a man want to go on a low fat diet?  Well, there are many, many reasons and I outline a dozen of them here:  The Incredible Benefits of a Low Fat Diet. But Dr. Vogel hammers home some of the key ones in the book, which I mention below:

Vitamin D Can Boost Nitric Oxide - Peak Testosterone

Vitamin D is really a hormone, has its own independent receptors and affects dozens of systems and tissues. Furthermore, deficiencies in Vitamin D are extremely common and can result in lowered testosterone levels. Correcting a deficiency can raise your testosterone by about 30% and make you feel a lot better with increased alertness and energy. (For the studies, see my link on Testosterone and Vitamin D.) One not-so-well-known property of Vitamin D is its ability to boost nitric oxide and endothelial function in some men. Below we’ll quickly summarize some of the research showing this and just how Vitamin D works its magic.

1)   The Journal of Physiology, Oct 1 2011, 589:4777-4786, “Vitamin D insufficiency is associated with impaired vascular endothelial and smooth muscle function and hypertension in young rats”

2) Mol Endocrinol, 2014 Jan, 28(1):53-64, “Vitamin d is a regulator of endothelial nitric oxide synthase and arterial stiffness in mice”

3) Circulation, 1997, 96:1755-1760, “Active Serum Vitamin D Levels Are Inversely Correlated With Coronary Calcification”

4) Nature Reviews Cardiology, Oct 2009, 6:621-630, “Vitamin D status and arterial hypertension: a systematic review”

5) The Journal of Steroid Biochemistry and Molecular Biology, May 2004, 89-90:387 392, “Vitamin D: a negative endocrine regulator of the renin angiotensin system and blood pressure”

Researchers began noticing that men (and women) with Vitamin D deficiencies had a host of symptoms that appeared to be related to decreased nitric oxide output: “hypertension, left ventricular hypertrophy, increased arterial stiffness, and endothelial dysfunction in normal subjects and in patients with chronic kidney disease and type 2 diabetes.” [2]  This was verified by a fairly recent animal study showing that Vitamin D deficient rats in the womb and early life were much more likely to develop hypertension and had a decreased ability to create nitric oxide. [1] A 2014 study on mice showed that mice that have a genetic defect that causes them to produce insufficient Vitamin D have a reduced expression of eNOS. [2] This is the enzyme that Viagra and Cialis affect and this explains why the animals have decreased nitric oxide and increased arterial stiffness.

Of course, us guys like nitric oxide due to its artery-expanding and erection-improving abilities.  The goal is that as the arteries – penile or otherwise – expand, blood pressure is lowered and blood flow is increased.  Vitamin D can actually positively influence both blood flow and blood pressure throught a completely different system:  the kidneys.  Vitamin D also includes “renoprotective effects and suppression of the renin angiotensin aldosterone system.” [4] Animal studies back this up showing that lack of Vitamin D results in “elevated production of renin and angiotensin (Ang) II, leading to hypertension.” [5]

Help for Low Testosterone: Readers Write - Peak Testosterone

Low testosterone can be a lonely road to walk and help difficult to find.  Below I’m going to show you some of the difficulties that men face when they try to first get assistance for testosterone-related issues.  These are real emails from guys struggling to get their life back.

First of all, men can struggle with major issues. This reader lost his girlfriend:

READER: “About 10 months ago I had a serious rude awakening when my girlfriend left me as a result of my inability to get or maintain an erection. I’ve since spent the past few months frantically worrying about what was wrong with me and how I was going to deal with it. I’ve spent lots of precious time and money on various pills, potions and therapies to somehow get to the root of the problem and regain my sense of manhood.”

This is all too common:  women very often interpret struggling with an erection as lack of interest. Usually nothing could be further from the truth:  the guy just needs some physical help.

READER:  “I am hoping you can help me with some health questions. I am also very health conscious: I am at the gym 4 days a week where I lift weights and run 3 miles. For the last 2 years I have kept a very strict diet eating mostly lean proteins and fats, vegetables, yogurt, and some fruits. I take in about 2200 calories a day.

In the past I could count on losing some weight with this regime but as of the last 2 years my weight hasn’t moved. I carry most of my weight in the upper body, i.e. belly, chest, arms. Out of frustration I asked my doctor to check my testosterone level. In June it measured 354, this past month it measured 319.

My doctor says its normal and not to worry. I disagree. I believe my inability to lose flab is related to my T-level.”

Besides that, though, more often than not, I get emails from men who have low testosterone and the symptoms and still the doctor won’t treat them.  Look at the frustration behind this reader’s email:

READER: “I just had my test results read to me and they said I am in range and am OK at a level of 242,(I did the test in the morning, and, I am more carnivore than omnivore), the nurse did agree that I MAY be a little low.(Ya think!) Anyway as you might imagine, I am dealing with nearly ALL of the symptoms you describe and will see my doctor very soon to demand HRT. ”

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

Of course, the decisiion to go on HRT is an involved one and can only be done on the advice of the doctor.  That said, it is difficult to understand the reluctance of many doctors at this point to provide help for men clearly at very low testosterone levels with significant issues.

Look at this guys description as to how good he felt when his testosterone was at youthful levels only to find that his doctor wanted to dramatically reduce his therapy:

READER: “I reached 800 after injections of 1mg every two weeks for about two months. The doctor had me take a blood test and she freaked out when she saw the 800 number. I was feeling better than I’ve felt in ages! She then wanted to put me on once a month, and then I talked her into every three weeks.

Just got a blood test today after being on every three weeks for two months now, I see her next Friday to get the results. I don’t feel as well as when I was on every two weeks. I think she wants me to be about 350-400.”

Even more scary is the fact that many men will never receive help, because they are asymptomatic.  The reader below just happened to ask for a testosterone reading simply because of his cousin and then found that he, too, had low testosterone.

Why not periodically get your testosterone checked. If nothing else, it could be a huge help to you later in life because you have, at least, established a baseline.

READER:  “I went in for a physical last week, and asked the doctor if he could check my testosterone level. He smiled a bit and asked me why I wanted to know. The truth is that I have a cousin  mwho recently went to the doctor and had his T level checked and it came out low, 275ng/dl to be exact. He suggested that next time I went in for a physical to ask my doctor to do the same, so I did.

Well I just got my blood work results back and although everything else looks great, my testosterone level, no so much. The doctor said it was 245ng/dl. This is even lower that my cousin’s!”

IGF-1, Cancer and Animal Protein - Peak Testosterone

One thing that many bodybuilders and gym rats assume prima facie is that the natural (sans steroids) bodybuilding lifestyle is the ultimate and ideal in healthy living.  There is definitely much truth to this as muscle is a great calorie-burner, improves appearance and self-image and many other important physiological factors.  However, there is a dark side to bodybuilding that few discuss:  animal protein and its impact on IGF-1.

The rule of thumb for bodybuilding is at least 1.0 g of protein per pound of weight.  Thus, an 180 pound guy would need to consume about 180 g of protein per day.  That’s a lot of protein and – let’s face it – that’s probably anything but “natural”.  And, as I document in Muscle Madness link, eating meat, casein and soy can easily lead to cancer and heart disease (from the Saturated Fat)), inflammation and brain shrinkage.

REFERENCES:

1)  Arch Pathol, 1968, 85:133 7, “The effect of dietary protein on carcinogenesis of aflatoxin”.

2) Eur J Clin Nutr, 2009 Sep, 63(9):1076-83, Epub 2009 May 27, “Differential effects of casein versus whey on fasting plasma levels of insulin, IGF-1 and IGF-1/IGFBP-3: results from a randomized 7-day supplementation study in prepubertal boys”

3) “The Inter-Relationship Between Growth Hormone,

Even worse, there is a substantial body of research that shows that animal protein leads to increased levels of IGF-1. IGF-1 is Insulin-like Growth Factor and is one of those things, like folate, in the human body that stimulates growth and tissue development. This may sound good, except that both IGF-1 and folic acid have numerous studies linking them with cancer.  Yes, they stimulate growth of both good and bad cells and that can lead to an early and painful death if one is not careful.

One of the leading researchers in this area is T. Colin Campbell, author of the famous China Study, and he showed conclusively that casein, the main protein in milk, activates an enzyme complex along with increasing IGF-1 levels that can accelerate and lead to various cancers. [1]

NOTE: This is one of the dangers of Growth Hormone injections:  they bypass the body’s natural feedback mechanisms and directly increase IGF-1 levels beyond the patient’s physiological norm.  Many researchers are concerned that this will lead to increased risk for cancer.

So can one embrace the bodybuilding lifestyle in a healthy way without increasing their risk of cancer through artificially raised IGF-1 levels?  Well, every person must research this for themselves and discuss with their doc, but I believe that there is a way around this issue:

1.  Whey.  Many studies have shown that casein, the primary milk protein, increases IGF-1 and inflammation, both of which are deadly.  However, whey, the other milk protein, appears to be the white sheep of the family.  One study, for example, specifically looked at whether it was casein or whey that caused increased IGF-1 levels and found that only casein was the culprit:  whey left IGF-1 levels untouched. [2]  Whey is also known for its immune-boosting powers, which should be an asset in fighting cancer as well.  However, keep in mind that the typical whey is loaded with dangerous excitotoxins and I document that in my link called No Whey! The alternative is Undenatured or Biologically Active Whey..

2.  Fruits, Vegetables and a Low Fat Diet.  I have shown in my links on Cancer Protection and the Ornish Diet that these two are powerful protectors against cancer.  Of course, there’s no guarantees in life, but these definitely decrease the odds according to the research.

3.  Exercise.  It’s no secret that exercise, especially with intensity, increases Growth Hormone levels. IGF-1 is a metabolite, i.e. a byproduct, of Growth Hormone in the liver.  So then the more you exercise, the more IGF-1 and the more cancer risk, right?  Wrong!  Researchers have found that exercise increases the sensitivity of IGF-1 receptor sites and so athletes consistently have lower IGF-1 levels. [3]

Again, you must decide yourself whether consumption of animal protein is worth the risk.  Jack LaLanne is an anecdotal example of doing this successfully:  he ate abundant fruits and vegetables, lifted and exercised intensely all his life, and ate copius amounts of egg whites.  However, I think that the above four factors can overcome these concerns.

Testosterone and HDL: Does HRT Raise or Lower It?

Well, one concern with HRT (or TRT as some prefer) is that it could lower HDL levels.  HDL is the “good cholesterol” that is responsible for cleaning up the “bad cholesterol” in your arteries.  It does this via a mechanism called RCT, or Reverse Cholesterol Transport.  RCT is a process – and HDL is the main player – that removes cholesterol from “foam cells” and then transports it to the liver for elimination.  Most of the plaque reversing gurus like to see respectable HDL levels and you can see my link on HDL, LDL and Triglyceride Levels To Reverse Atherosclerosis for their actual thresholds.  (Low HDL levels are also associated with a “pattern B,” pro-atherosclerotic lipid patterns.)

Although a surprisingly complex subject, clearly HDL is an important facet of arterial protection, including your penile ones.  So let’s start with a older study on Seventh Day Adventists and Mormons, who were chosen because of their avoidance of alcohol and cigarettes, that found that “testosterone has a strong negative association with HDL-C in men.” [1] In other words, the higher the testosterone levels in these men, the lower their HDL levels.

Other observations and research have shown similar results, i.e. cases where increased testosterone has led to lower HDL:

a) Men on steroids have significantly lowered HDL.  Yet another reason not to do steroids, eh?

b) Men taking the “old school” oral testosterones lead to lower HDL per one study. [6]

1. Oral Testosterone Undecanoate (Used in Andriol).  This type of oral testosterone is different that the one mentioned above, because it effectively bypasses the liver.  And one study showed that 120 mg/day led to no signficant decrease in HDL. Furthermore, the authors concluded, since the testosterone also lowered LDL and triglycerides, that “we conclude that TU [testosterone undecanoate] may be an effective drug for protecting coronary heart disease in healthy elderly men with lowered TT [total testosterone] and FT [free testosterone] levels.” [7]

2. Injected Testosterone Undecanoate (Used in Nebido / Aveed). One study noted that this resulted in a significantly improved total cholesterol/HDL ratio, which should, the authors noted, improve CVD risk.

3. HCG Monotherapy or HRT. Researchers gave hypogonadal men – non-Klinefelter (HCG), Klinefelter (HRT) – testosterone-raising treatments based on their underlying status concluded that “triglyceride, LpA-I:A-II, Lp(a), HDL cholesterol, HDL3 cholesterol, and apolipoprotein (apo) A-I concentrations did not change significantly after treatment.” [9]

4. Androgel. A study using 1% Androgel likewise showed no increases in HDL nor HDL’s “efflux capacity,” i.e. it’s ability to help macrophages get rid of their cholesterol. [10]

Just as important, I would argue that most men will have to self-monitor.  Get an HDL (and other basic lipids) read before HRT and then afterwards and see if your HDL has changed.  The studies deal with averages and you may be one of the unlucky ones that has their HDL lowered by HRT – who knows?  For example, keep in mind the relationship of blood pressure to testosterone.  Most studies that I have seen show a drop in blood pressure with HRT.  However, some men have the side effect of elevated blood pressure and even have to go off of testosterone because of it.  So there is no one-size-fits-all when it comes to HRT.

You may be thinking that your doctor is very unlikely to test this before or after unless you are covered via a physical or annual wellness check.  I would agree with you.

The good news is that, at least here in the U.S., you can pull your lipid numbers very easily without a doctors orders in most states.  (Thank God for freedom, eh?)  I have a list of labs that Peak Testosterone Forum members have used. See my page Testosterone Labs for more information.

1)  Metabolism, 1983 May, 32(5):428-32, “Relationship of plasma HDL-cholesterol to testosterone, estradiol, and sex-hormone-binding globulin levels in men and women”

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 Clin Invest, May 15 2003, 111(10):1579 1587, “HDL-associated estradiol stimulates endothelial NO synthase and vasodilation in an SR-BI dependent manner”

6) Medscape, Clin Lipidology, 2012;7(4):363-365, Katya B Rubinow, Stephanie T Page, “Testosterone, HDL and Cardiovascular Risk in Men: The Jury Is Still Out”

7) Jpn Heart J, 1997 Jan, 38(1):73-82, “Beneficial effects of testosterone undecanoate on the lipoprotein profiles in healthy elderly men. A placebo controlled study.”

8) International Journal of Endocrinology, 2014, “Effects of Five-Year Treatment with Testosterone Undecanoate on Metabolic and Hormonal Parameters in Ageing Men with Metabolic Syndrome”

9)  J Clin Endocrinol Metab, 1996 Sep, 81(9):3372-8, “Effects of gonadotropin and testosterone treatments on Lipoprotein(a), high density lipoprotein particles, and other lipoprotein levels in male hypogonadism”

10) J Lipid Res, Jul 2012; 53(7): 1376 1383, “Testosterone replacement in hypogonadal men alters the HDL proteome but not HDL cholesterol efflux capacity”

Inflammation: Lower in Vegetarians -Peaktestosterone

REFERENCES:

1)   Nutrition, Oct 2004, 20(10):863-866, “Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk”

2) European Journal of Clinical Nutrition, 2008, 62:138 144, “Total cardiovascular risk profile of Taiwanese vegetarians”

3) Bratisl Lek Listy, 2005, 106(11):345-347, “C Reactive Protein and Nutrition”

A number of key studies show that vegetarians enjoy improved longevity, i.e. experience significantly decreased death rates, especially in the area of ischemic (blood flow-related) heart disease.  This is something I cover in my page on Vegetarian Longevity. NOTE: It is worth nothing that Vegetarians Enjoy Equal or Superior Testosterone Levels according to one study.

So what confers these health benefits in the cardiovascular arena to plant-based diets?  Vegetarian diets, in general, have many advantages in this area:

1. Lowered blood pressure.

2. Increased antioxidant status.

3. Decreased inflammation

I want to focus here on #3, i.e.decreased inflammation. All men everywhere should have a laser-focus on controlling their inflammation levels and the reason is simple:  inflammation appears to the root of most chronic illness in Western societies, including cardiovascular disease, autoimmune disease, cancer and dementia/Alzheimers. (Insulin insensitivity would be a close second.)

NOTE:  For more information, see these links on Controlling Inflammation.

Below I want to outline how vegetarians have been shown in a number of key studies to have lower inflammation levels than the general populace and meat-eaters:

1. Sex-Matched Long Term Vegetarians.  This study concluded that “a long-term vegetarian diet is associated with markedly higher fasting plasma AA concentrations and lower concentrations of TAG, UA, and hsCRP. Long-term vegetarians have a better antioxidant status and coronary heart disease risk profile than do apparently healthy omnivores.”   Notice the decreased hsCRP levels, a key marker of the body’s overall inflammation levels.  hsCRP stands for “highly sensitive C-Reactive Protein.

2.  Taiwanese Study.  This study noted that “”Taiwanese vegetarians have lower total cholesterol, LDL-C and hs-CRP levels, and higher homocysteine levels than omnivores.”

3.  Slovakian Study. This study showed dramatically reduced hsCRP levels. Authors praised the increase fruit and vegetable consumption of vegetarians as a likely reason for cardiovascular improvements.  The difference in CRP scores was remarkable:  .72 mg/l in vegetarians versus 1.62 in meat-eaters.

All evidence shows that one of the big benefits from a vegetarian, plant-based lifestyle is greatly reduced inflammation levels.  Again, the important of this cannot be overestimated.  Keep in mind that inflammation is the primary component that damages your arteries, leading to decreased nitric oxide output, weakened erections and increased arterial plaque.

Androgel Story: Libido Booster from a T of 160

NOTE:  Topicals, such as Androgel, may have a unique issue associated with them.  See my on Testosterone (HRT) Risks for more information.

GUEST INTERVIEW: Regulus

Q. What were your starting total testosterone levels and can you describe any of the low testosterone symptoms that you were having?

A. When I finally got tested for it, my total testosterone level was about 160. I had a second test where I actually hit the 140’s. I am certain that I had been low for at least 20 years. Brain fog, inability to concentrate, daily anxiety attacks, depression, lack of energy and difficulty controlling my emotions. Severe social anxiety, inability to deal with conflict. I thought that I was on the spectrum of autism actually. Low libido (though no ED until things got really bad.) Also, inability to gain muscle mass (despite weight training attempts), lack of body hair, difficulty losing body fat, and no morning wood (didn’t know that was a symptom … I thought that was just a puberty thing, and so I took no note when it stopped happening in my early 20’s. Could have had a couple much more productive decades if had known about that.)

Things got progressively worse over the years, and finally the libido got so low that I started experiencing ED, and found my anxiety and depression getting so bad I was having trouble functioning at all. I’d wake up in the middle of the night crying for no reason. Based on internet searching I found that these were symptoms of low testosterone. If you had asked me I would have assumed that my testosterone levels were low, but I never realized that you could do anything about it or that it could be the cause of anything other than a lack of alpha-male characteristics.

I have juvenile diabetes and so I regularly see an endocrinologist. I inquired about low testosterone and he blew it off, gave me a Cialis prescription and told me to see a shrink. The Cialis did nothing, and I didn’t want to see a shrink, and so next visit I prevailed on him to order the test. When the results came back he called me and told me I absolutely needed TRT.

Honestly, the doc in question was generally speaking a pill-pusher, and so his choice of Androgel probably was mostly a matter of a recent visit from an Abbott sales rep. He didn’t offer or even mention any other options. I personally researched other options, but decided that the gel seemed most convenient way to start. Insurance covered it, and that’s what my doc was recommending, so try it out, see if it helps, and then maybe try something else down to road.

I’ve since fired that endo, but both my primary care physician and my new endo agree that since Androgel is working for me, that’s the way to go.

Q. What dosage did you start out with on Androgel and how much did it raise your testosterone levels?

I originally started at the minimum dose (4 pump depressions) of the 1% gel. That got my total T up to about 350. I must have been very low for a very long time because at 350 I felt like Superman. I gradually increased up to the max dose (eight depressions). That’s a lot of gel to spread around, and when 1.62% hit the market I went to that. Currently on max dose of that (four depressions) on which I’ve consistently tested between 600 and 850.Q. What is your current dosage with Androgel and what are your testosterone levels?

Q. How do you apply Androgel and to what part of body? Any tricks you’ve learned to increase absorption?

A. I apply it to my shoulders, always about five minutes after getting out of the shower. I do have problems with absorption when my skin is very dry. It varies seasonally. I have found that lotion (Lubriderm) or grape seed oil spread on the skin greatly increases absorption when skin is dry (based on how I feel when doing so).

I also have to occasionally shave my shoulders. I don’t grow much hair there, but if it grows too long it gets in the way I think.

Q. Have you had any side effects with Androgel? If so, what have you done about them?

A. Initially I had some interesting side effects. Basically, I went through puberty in my forties. My voice got deeper, started growing body hair, etc. Harmless stuff, but strange to happen at midlife! I experienced some breast swelling and nipple tenderness and for a while was showing signs of high estradiol, but I’ve dealt with that through diet and no longer have those symptoms. It took me a while to convince my doc to test estradiol (very resistant to doing so, I think because she didn’t want to be asked to prescribe anything off-label) but when I finally did get it tested it was on the low end of normal. (20)

I have experienced some testicular shrinkage, which took a while to get used to. But it’s not a big deal.

Q. How long after you started on Androgel before you started noticing improvements?

A. Honestly, within a day or two. I felt about a foot taller almost immediately. I don’t think I fully stabilized for about a year though.

Q. What symptoms has Androgel improved and by how much?

A. The biggest changes for me have been the cognitive ones. I can concentrate, I’m not fighting daily anxiety attacks, I can deal with interpersonal relationships and handle conflict constructively instead of avoiding it at all costs, I can sleep at night. I was able to hold things together over the years, and actually have been pretty successful in both my personal life and in my career, but I accomplished a lot less in life and in my career because of all the energy that got sucked up just by holding it together. With that energy freed up for actually accomplishing things, I’m actually accomplishing things.

I have also made huge changes in my physique. I always tried to be active, and worked out both cardio and strength training, but never lost much weight or built much muscle. I have lost 50 pounds and am now almost down to normal weight for my height, and have make staggering increases (off a very low base) in the amount of weight I can lift. I’m still in transition there. I’ve gotten from Stay-Puff Marshmallow Man to The Before Picture. Probably still a year or two of efforts left to get to my goal, The After Picture. May not get all the way there; I’m motivated by the sense of well being, and not so much the vanity.

The ED I experienced was solely due to a complete crash of libido. Once the libido came back, it took a little while to get rid of the performance anxiety that about a year of ED created, but that was 100% in my head.

Q. Of course, you have to really watch the topicals and make sure that none of the product is transferred to women or children? How do you handle this?

A. I apply the gel around 6 or 7 am every morning. It’s a pretty rare situation where my wife would be having any contact with my bare shoulders, or even any contact with them covered, earlier than 12-15 hours after that. If you look at the studies and do the math, the risk of any meaningful transfer risk under those circumstances is nil.

In the event of very extensive contact (like a shoulder massage) even after that time period I’d probably take a shower first to eliminate anything left on the skin surface. In the event of afternoon delight, just keep a shirt on.

I do have two kids (roughly at the age of puberty) but there are simply no circumstances where either of them would have contact with my unclothed shoulders. Still, they’ve both been clearly instructed that if Dad doesn’t have a shirt on, don’t touch him. It hasn’t been an issue.

In all the studies I’ve seen, transfer problems are rare and only occur when there is extensive contact with the application site within a few hours of application. The risks posed by transfer to women and kids are serious and have to be taken very, very seriously. We of all people should appreciate what happens when your hormones get messed up. But, I have not found it at all difficult to take reasonable, honestly even excessive, precautions to avoid it.

In short, you have to be very careful about this, but for most guys I don’t think the care you need to take would be all that difficult. That said, if those precautions are a problem, topicals aren’t for you.

Q. Would you recommend Androgel to other men interested in HRT?

A. I would not recommend any form of HRT to anyone who is just “interested” in it. If you don’t NEED it, if you can get your hormones in better shape by other means (lose weight, hit the gym, etc.) do that. It’s an inconvenience, an expense, and it’s something you become dependent on for life. If you go off, you’re shut down, and it will take a while for you to get back to even your previous lows.

That said, if you do need HRT, I really think Androgel is a good choice, provided (a) you are part of the 85% of men who absorb it OK, (b) the expense is not an issue (with my insurance it’s actually the cheapest option … go figure), and (c) you are not in a position where transfer to women and children is a risk.

Injectables, even if done frequently, put you through up-down swings far greater than you get with the gel. And the gel is reasonably convenient if you have consistent daily habits (showering every morning at roughly the same time.) I will consider Nebido/Aveed once it hits the market, as it provides more stable long term levels than other injectables, but for me at least Androgel or a similar topical is a very good fit.

Progesterone: Normal Levels in Men - Peak Testosterone

Progesterone is one of those “forgotten” hormones for men in the sense that it is undermonitored and undermanaged by most physicians. It’s important for anxiety reduction, erectile strength and possibly lipid management as well (according to the work of Dr. Dzugan). It is also important to monitor in TRT (testosterone replacement therapy) according to one school of thought, because progesterone levels can fall unnaturally after 3+ months on TRT (without HCG).  I am likely a great example as my progesterone levels were the following in January of 2016:

Progesterone <0.5 ng/ml [range < 1.6 ng/ml]   Sonora Quest

Notice that my range is somewhere between 0.0 and 0.5 ng/ml and thus on the low side after being on testosterone cypionate for several years.  (I discuss my solution with the help of Dr. Saya of Defy Medical here: DHEA and Pregnenolone.)  And my case brings up an important question:  just what are normal, adult male progesterone levels?  I asked that of Dr. Saya, and his reponse was

NORMAL MALE PROGESTERONE LEVELS: Progesterone 0.0 – 1.2 ng/ml  LabCorp

Notice that there is a little dispute as to the top of the range if you compare Sonora versus LabCorp, but that both are fairly close and could be explained simply by differences in equipment and methodology.

NEWS FLASH:  There has been considerable heartburn on the Peak Testosterone Forum, because Lab Corp has updated their progesterone test for men and the new range is 0 – 0.2 ng/ml! In other words, the top of the range is now a fraction of the old top of the range.  One of our posters was dismayed with this situation and posted the following:

“So, I have been taking 20mg dhea and 30mg pregnenolone in a compounded tablet through defy medical. Also, taking HCG 250units EOD. Then, .10ml Tcyp EOD. My dhea went up to 293 from 170. That’s good maybe want to go higher though. My progesterone though went from .4 to .1!!!! This seems crazy!!!”

And this poster is not the only one.  I asked Dr. Saya about this new situation as well, and he said the following via email, which I post with his permission:

“Of course since LabCorp inexplicably changed their progesterone reference range about 3 weeks ago to basically zero (previously 0.0 -1.2 changed to 0.0 – 0.1) virtually ALL patients have shown “high” for progesterone on their LabCorp reports simply due to the ridiculously low reference range. I’ll be sending LabCorp execs a thank you card for Christmas to show my appreciation for the lost productivity attributed to having to explain this very fact to every single patient with NORMAL progesterone levels…I’m frustrated beyond belief with the irrational change in reference range for progesterone from LabCorp. I’ve got an email in to the medical directors, but likely won’t receive a response. According to their new “reference range”…95% of the NORMAL male population will have “high” progesterone levels. I literally have to explain to EVERY patient why their 0.2 or 0.4 or 0.6 progesterone level is completely normal and it’s just smoke and mirrors due to the lab report.“

Adding to the confusion is some great detective work by one of our senior posters that LabCorp may have changed the reagant and that this led to the incorrect reference range.  If you want to check out the technica details, see reference 2 below. [2]

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=11416.0

2) https://www.peaktestosterone.com/forum/index.php?topic=11421.msg98904#msg98904

Consider the Risks of Testosterone Therapy (HRT)

Testosterone Risks

I have had a great experience with HRT (TRT) overall.  It has been a life changer – positively of course – and helped me in my relationship with my wife, my career and I am convinced my general health and personal psychology.  That said, I had absolutely no idea what I was doing when I got on testosterone and no doctor ever told me about any of the risks associated with it.  I personally was blindsided by an issue, for example, that I will discuss below.

Why do physicians not give full disclosure?  Well, many of them simply know very little about testosterone therapy and are on end the early stages of the learning curve.  Still others feel financially and time constrained.  Finally, it is clear to anyone following the industry that there are many out there who just want to grab your money before they tell you about any potential issues.  Many of you have seen very aggressive advertisements from testosterone manufacturers and HRT clinics for example.

NOTE:  HRT has its risks, but it also has incredible potential rewards.  I cover those in my page called The Benefits of Testosterone.

So “eyes wide open” as I always say and please scan through the STEP 10 of my Examining Your Testosterone Program, which includes these Ten Significant Risks of Testosterone Therapy and then discuss with a (hopefully knowledgeable) physician:

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

1. What if Have to Go Off of HRT? I was stunned one day by my HRT clinic.  They were the ones that started me on testosterone cypionate and cypionate powerfully changed my life for the better:  it vanquished my dysthymia (mild depression) and gave me morning erections for the first time in my life. My libido went through the roof; my boss commented how much easier I was to work with; and my erectile strength improved, etc.

However, everything came crashing down when my HRT clinic told me that I had a PSA read of 6.3 – my baseline was 1.4 or 1.5 – and that I had to immediately quit testosterone until I got urological clearance. I was horrified.  Not only might I have prostate cancer, but, even if I didn’t, I had to have a prostate biopsy and no T for an indefinite period of time.  One month after quitting HRT, my testosterone was 111 ng/dl!  That was probably about an eighth of my average testosterone over the last year.  I was miserable when my testosterone was in the low 300’s and I could not bear the thought of living with levels in the 100’s and 200’s for months and months..

The story has a happy ending.  I was able to go back on HRT – they found inflammation and no cancer during the biopsy – and all seems to be well as my PSA has since dropped down to 1.9.  But it was a very sobering experience and very stressful.  (You can read about the details in my page on High PSA But No Cancer.)

On the Peak Testosterone Forum, this is not a very common issue, but it certainly can happen. Furthermore, considering that prostatitis can raise PSA very significantly, the percentage of men on TRT facing the issue over many decades can probably be significantly magnified. In addition, there are other issues that I have seen take men off of HRT: high, persistent hematocrit / hemoglobin and high blood pressure. Some men cannot get these in line even if they donate blood and thus are forced off of HRT due to stroke/heart attack risk concerns.  Still other men find that testosterone raises their blood pressure and/or pulse.  So discuss these kind of risks with your physician before you go on HRT and find out how he or she handles it.

2. What If I Feel Nothing? Being forced off of testosterone therapy (#1) is not all that common.  However, I quite often get asked the following question:  “when will I feel something?”  A significant percentage of men have one of two scenarios happen:

a) After three months, they notice little change from HRT, i.e. no real benefit.

b) They had some improvements for a few days or weeks, and then the honeymoon phase was over and they have felt nothing for several months.

Sometimes these can occur because of a lousy protocol.  However, that is certainly not always the case.  There are many other reasons that HRT can have little effect, but I would guess the most common is that more than one issue is going on.  If a man has gut issues, sleep disorder, high prolactin, insulin resistance, hypothyroidism, etc., these can override any benefit that a man might get from increasing testosterone.

Other reasons are low SHBG, which makes HRT much more difficult to dial in.  In addition, some men just don’t need high levels of HRT.  We had one younger man on the Forum who really struggled with HRT and then just decided to go off of it.  He felt fantastic almost immediately!

3. Possible Decrease in HDL? There are a few studies that show that testosterone can lower HDL.  On the other hand, there are more studies that show no change, except perhaps at supraphysiological levels, i.e. > 1200 ng/dl.  Testosterone improves many cardiovascular parameters, so some say this concern can be dismissed.  I think a more prudent approach is to take an HDL read before and after HRT and see if it is an issue for you individually.  It probably won’t be, but you never know until you check.  You can use my page Testosterone Labs for inexpensive self-testing if you need to.

4. Partial Shutdown of Various Hormones. Exogenous (outside-the-body) testosterone therapy will partially turn off signaling at the hypothalamus.  And this, in turn, turns off (partially) the signaling that goes to the pituitary. Theoretically, only the testosterone cascade should be affected by this.  For example, we do indeed see the sister pathway shutting down fertility in men.

But can this shutdown affect other hormones, such as DHEA, progesterone and cortisol?  These should not be affected, but some men have reported decreases in the hormones.  Furthermore, one of the most well-known HRT physicians out there has reported that DHEA often shuts down and thus prescribes the same for most of his men on testosterone.

I know that I have been on cypionate for a couple of years and my DHEA was quite low – basically at the bottom of the scale.  I can also tell you that I feel very good, though, and I would never have known it if I hadn’t taken the measurement simply out of curiosity.  But on the Peak Testosterone Forum we have seen men experience nice improvements in libido and/or morning erections using DHEA, so this could definitely be an issue.  Low cortisol can also be a very negative issues, leading to tremendous fatigue.

5. Can I Get My Old Testosterone Level Back? Let’s say one has to go off of HRT.  We all assume that, after a few months of pain and suffering during the rebound period, we will get our old baseline testosterone levels back, right?  For example, I was always in the lower 300’s before I went on HRT.  So, if I quit HRT for some reason, I would expect to go below 300 for several months and then come back to the lower 300’s at my old baseline level.  Unfortunately, this appears not to be a given.  Some men, especially older, never bounce all the way back apparently.

NOTE:  This probably can be avoided by simultaneously going on HCG, which keeps the testes active and restores volume.

6.  Existing Hypertension. I do not have a study to prove this, but I have spoken to a doctor and, separately, an HRT clinic that stated that some men with hypertension will actually experience a rise in blood pressure after receiving testosterone therapy. In fact, the doctor was quite upset, because she had heard that some of the HRT clinics were not monitoring blood pressure and that taking vitals is an obvious and necessary protocol during any medical exam.  And she had a point:  perhaps some clinics will get themselves into trouble by ignoring this easy step.  The bottom line:  if you have high blood pressure, this is something to discuss with your doctor if you are considering going on HRT and something to be monitored during your therapy.  And, by the way, I have seen this many times on Peak Testosterone Forum.

7. Blood Clots. This interview of Dr. Glueck discusses a potential (and controversial) issue with TRT: blood clots. As testosterone increases, estradiol increases and many men are put on an aromatase inhibitor (or sometimes a SERM), all of which can increase the risk for a DVT / clot. according to Dr. Glueck  He states that as many as 1-2% of men may be at risk. Dr. Glueck recommends that a man have four tests before undergoing HRT.  (Discuss with your doctor, but I don’t know of any large studies that show this to be an issue.)

8. Feeling Worse on TRT. Some men just never feel good on TRT.  And, oddly enough, when they go off of testosterone therapy, they feel much better and are glad they got off of it.  Now one could argue that this is because they had a lousy protocol.  On my page Feeling Worse on Testosterone Therapy, I discuss some examples where, in my opinion, it likely was not the protocol that was the root cause of the problem: these guys probably should have never been on testosterone in the first place.

9. Negative Psychological Effects and Even a “Freak  Out”. Testosterone really affects the male brain.  Generally, the changes are very good as mood and libido are lifted and depression, anxiety and mental fog are decreased.  However, sometimes the changes are overwhelming and can induce very disturbing emotions and psychological states.  Some men actually get more depressed and find that their mood is negatively impacted.  This may be from high estradiol – many doctors mistakenly do not manage or monitor this ultracritical hormone that rises with HRT – or from the above shutdown process.  But this is not always the case.

I also want to mention that every once in awhile a man will have a really “bad trip” from HRT.  It’s not common, but it does happen.  Look at what this poster wrote after receiving testosterone pellets:

“On the day 5 after insertion in the evening I suddenly felt an agitated state of mind, and tension. It almost feel like I have intoxication and high blood pressure. I woke up at night with heart palpitations, uneasy feeling in heck/head, and feeling of being depersonalized, as if things were happening not in this reality. I never felt anything like that before. It was scary/horrifying. This night I slept maybe 3 hours total. In the morning I started to feel that it is getting worse. In fact, symptoms resembled heart attack. So I went to GP, she measured blood pressure – 122/74, normal. Pulse rate was elevated to about 100. So it appeared to be an anxiety/panic attack.”

“I called the urologist and asked him what is happening. His reaction was – it cannot be Testopel. He said it has been less than 10 days, you cannot even feel the effect of it yet. But I insisted on checking levels of testosterone and estrogen. The test came back as testosterone – 500, estrogen – 39. Urologist said, T level is good, and E is in the range. So everything is going like it should. But I have experienced during these days series of mood swings, where I go from super-focused, clear-minded to crying spells for no reason, feeling sad and extremely down. Mind fog, depersonalization/derealization also visited me a few times. Also, my sleep pattern changed drastically. I could sleep 4 hours a night, wake up at 5 am, and not be tired all day. ”

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

Which Estradiol Test is Best? - Peak Testosterone

Pull your estradiol with the best test available. (Always discuss everything with your doctor first.)

A lot of men (and physicians) do not realize that low and high estradiol can cause just as many of the classic symptoms that men deal with, such as erectile dysfunction, low libido, anxiety, depression, etc.

One big issue with men on HRT (Testosterone Therapy) is dialing in their estradiol to the correct level.  Nothing is quite as frustrating as finally convincing your physician to put you on testosterone, feeling better after he does and then finding out a few weeks later that all the benefits have gone.  You no longer feel as good; your libido has tanked; and your erectile strength is right back where it started.

More often than not, the reason for this has to do with estradiol.  When a man goes on HRT, his estradiol rises and, in some men, it can go too high to the point where the extra estradiol cancels out the benefit of his newfound testosterone.  And, from what I’ve seen, this effect usually takes a couple of weeks to kick in.

After that, yet another estradiol problem can arise.  Many doctors and HRT clinics will put a man with high estradiol on an aromatase inhibitor – usually Arimidex – and some guys are quite sensitive to it.  Their estradiol crashes to an abnormally low level and they feel miserable.  Often their joints will ache with an accompanying loss of libido and erections.

So getting estradiol tuned right is extremely important for a man on HRT and most clinics shoot for 20-35 pg/ml, although a few will go a little above or below that.  (This is controversial, so discuss with your doctor.)  Of course, estradiol is very important for men not on testosterone therapy, but, from what I’ve seen, very few doctors look at it.  You’re lucky if you can get a blood draw for testosterone out of them much less one for estradiol!  (In the last year there have been two studies on the important of estradiol in HRT, so, hopefully, it will hit the mainstream doctors sometime soon.)

CAUTION: You have to be extremely careful in lowering your estradiol. If you go too low for too long, you can end up with osteoporosis. In addition, setting an estradiol target is more difficult now, because the big labs are no longer using the old assays but rather a more accurate technology called LC-MS/MS. However, this test lowered the range and so more research needs to be done to correlate the old versus the new values.

So how do you find out your estradiol level?  You just get a blood draw similar to testosterone, right?  Wrong!  Estradiol is much more problematic.  A man’s estradiol levels are, of course, much lower than a pre-menopausal woman and so it’s actually trickier to read our estradiol levels.  There are potentially 4 kinds of estrogen/estradiol-related tests.  Here in the U.S., Labcorp is the biggest lab and so we’ll use them as an example:

NOTE: To make matters more confusing, Quest has an “ultrasensitive test” that is actually the LCMS technology. So, again, you should probably get the test number from your doctor and research exactly what kind of test it is. I wouldn’t go by the name. Get the actual number and look it up on the lab’s site for verification. Remebmber that most of these tests you can get for yourself: Inexpensive Self-Testing Testosterone and Estradiol Labs.

First of all, we will throw out #4 as this is just the wrong test, because it includes the other estrogens (estrone, estriol) in addition to estradiol.  However, I mentioned it, because I have seen (on the Peak Testosterone Forum) physicians who have mistakenly ordered this test.

That leaves us with three legitimate candidates for male estradiol testing. Here are the current ranges for an adult male for these LabCorp tests:

Now let me go to some comparisons of Labcorp’s Sensitive Test versus their regular test.  And the reason I am doing this is to emphasize that, at least in my opinion, the regular estradiol test is not very safe or accurate in many situation and illustrate that with some practical lab results.  As an example, one of our forum posters has actually had both of these estradiol tests pulled on the same day and same time and here are his results:

NEWS FLASH: These results are no longer valid as this test has now changed to LCMS.The first thing to notice is that he was easily in the range of both tests. Therefore, both tests should have provided reasonably accurate results. Yet there is a 73% difference! The standard test is almost double the value of sensitive test.

And here is what is so dangerous:  estradiol too high or too low has been shown in several studies to be dangerous to a man’s health, due to (primarily) increased cardiovascular risks.  Therefore, if you choose the wrong test, you could potentially be putting yourself at risk for heart disease or stroke.  Life Extension Foundation sites studies that show:

“The men in the balanced quintile with the fewest deaths had serum estradiol levels between 21.80 and 30.11 pg/mL. This is virtually the ideal range that Life Extension has long recommended male members strive for. The men in the highest quintile who suffered 133% increased death rates had serum estradiol levels of 37.40 pg/mL or above. The lowest estradiol group that suffered a 317% increased death rate had serum estradiol levels under 12.90 pg/mL.” [1]

Even worse in many cases, is the fact that low estradiol can easily slowly lead to osteopenia and eventually osteoporosis, a potentially crippling and painful condition.  Look at the man’s standard reading above of 33.  His doc could potentially decide to put him on some Arimidex (if he was on HRT) to get him closer to 20 pg/ml.  Yet, using the sensitive test, he would probably have estradiol of 12 or 13!

Making matters worse is the fact that many doctors are trying to save money by using the less expensive standard test and think to themselves, “Well, my patient is probably in range, so this is fine.”

Here is an example from another forum poster.  In this case, his doctor used the lab’s sensitive test and he the same morning pulled the regular estradiol test.  His numbers, which includes total testosterone, were:

Total Testosterone=1080; Estradiol regular = 34.8  pg/ml

Sensitive: TT=1252; Estradiol sensitive = 25 pg/ml

Again, notice the identical pattern:  he is in range more than likely on both tests but the regular estradiol test reads significantly higher (40%) than the sensitive.  Since that time we have had several other posters end up with similar results.

The important things:

Stay in range for any lab test you do.

The gold standard should probably be the LCMS technology, but you will probably find some knowledgeable doctors still using the sensitive test.  Deciding on the best test is something, in this case, that you have to do with your physician, but make sure that he/she is knowledgeable and not just prescribing the cheaper test to save money.

1) https://www.lifeextension.com/

Acne from Testosterone Therapy (DHT) - Peak Testosterone

Remember those post-puberty glory days and the change in facial terrain that followed?  Well, some guys find themselves observing the same phenomenon after boosting their testosterone via Hormone Replacement Therapy!  Yes, that’s always fun to explain to the wife and kids, eh?  Actually, sometimes it is not as visible to the general public.  I have noticed on The Peak Testosterone Forum that many guys get acne on their neck, back and shoulders.

How does testosterone do it?  Many studies have shown that increasing testosterone levels increases DHT (dihydrotestosterone) levels, which in turn fires up the sebaceous glands. [8]

However, one thing most guys don’t realize is that diet alone can help very significantly with acne and I’ll cover that below and some of the key dietary scientific findings, mostly from the last four years (as of this writing) that can help or even cure this issue.  I even through in a standard cosmetic treatment that may help as well.

1. Low Glycemic Diet.  A couple of studies have shown significant decreases in acne through a diet based on low-glycemic carbohydrates, such as most whole grains, fruits and veges. [1] One of these studies was based on fairly high protein (25%), medium carbohydrate (45%) and medium-high fat (30%). [2] Care should be taken to avoid too much saturated fat in order to avoid erectile issues, which means the protein would need to come probably mostly from egg whites. See my page on The Potential Dangers of Saturated Fat In Men (particularly in men over 40) for more information.

2.  Fish Oil. Multiple studies have indicated that increased consumption of fish and sea food, and thus most likely fish oil, is associated with decreased acne. [3]

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

3.  Red Light Therapy. A recent study showed that red light therapy appears to be an excellent solution for acne.  Acne is primarily caused by bacteria that live within skin pores where red light therapy specializes in penetrating. [4] You may recall from my page on Skin and Eye Treatments that red light therapy is also very effective aginst the wrinkling that occurs around the eye, a difficult are to treat in general.

4.  Dairy. Some people reports good results with acne simply by giving up dairy. [5] This is anecdotal but is easy and worth a try. I would recommend taking some supplemental calcium to make sure that you get enough.

5. Stress. Watch your stress levels:  cortisol accelerates acne by altering hormone levels that jump start sebaceous gland oil production.  Read my link on How to Reduce Stress for research-backed ways to decrease cortisol levels.

6. Diary and Milk Products. Finally!  Dermatologists have for yours denied a link between diet and acne.  However, a recent review recently overturned this assumption and found a consistent link between dairy consumption and acne. [6]

7. High Glycemic Meals. The same study mentioned in #6 above also found a link between high glycemic eating and acne. [6] The key concept to understand is “glycemic load”.  Some foods are high glycemic foods, such as carrots, but you would have to eat so much of them that it they never spike insulin or blood sugar significantly. For the sake of your skin, watch your glycemic load.  Yes, we need carbs, but they need to be whole food, high fiber.

8. Clearasil.  Although not exactly natural, some of the over the counter treatments pretty low in side effects.  (Discuss with your doc or pharmacist of course.)  And I’m not really advocating one brand, but the point is that sometimes you can use the standard “high school” over the counter treatments to get things under control.  One poster on the The Peak Testosterone Forum wrote: “I started using Clearasil Stayclear twice a day and it is already noticeably clearer.” [7] In addition, there are a lot of over-the-counter preparations that help with acne and they usually contain various combinations of salicylic acid and benzoyl peroxide. Clearasil’s most potent formulation is 10% behzoyl peroxide: Clearasil Acne Control Vanishing Cream, 1 oz is an example.  Other Clearasil products contain salicylic acid, generally 2% in strength.  (I have not seen greater than that.)  Both of these ingredients are proven acne fighters, but sometimes you need with proven wrinkle-fighter Retin-A. (If you put it on your face, you have to be very careful with sun exposure.  Discuss with the doc that writes the prescription.)

1) J Am Acad Dermatol, 2007 Aug, 57(2):247-56, “The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial”

2) Am J Clin Nutr, 2007 Jul, 86(1):107-15, “A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial”

3)  Arch Dermatol, 1961 Dec, 84:898-911, “Adolescent acne and dietary iodine”

4) Photodermatology, Photoimmunology & Photomedicine, Published Online: 11 Sep 2008, 24(5):244-248, “Non-invasive diagnostic evaluation of phototherapeutic effects of red light phototherapy of acne vulgaris”

5) Prevention., April 2010, p.4.

6) Journal of the Academy of Nutrition and Dietetics, 2013, 113(3):416-430, “Acne: The Role of Medical Nutrition Therapy”

7)  https://www.peaktestosterone.com/forum/index.php?topic=1060.0

8) Journal of Investigative Dermatology, 1992, 99:509 511; “Control of Human Sebocyte Proliferation In Vitro by Testosterone and 5-Alpha-Dihydrotestosterone Is Dependent on the Localization of the Sebaceous Glands”

Miraforte Review (Chrysin and Nettle) - Peak Testosterone

Super Miraforte is the Life Extension Foundation’s libido, anti-estrogen and testosterone supplement. Life Extension is one of the oldest and most reputable of the supplement manufacturers out there, specializing in anti-aging in particular, and with Miraforte they have taken aim at many of the hormonal issue that so often accompany the middle age and beyond years.

What is interesting is that Super Miraforte is very often sold to bodybuilders, because of its powers to decrease estrogen and likely slightly increase testosterone.  Chrysin has a questionable history of decreasing estrogen.  However, Life Extension seems to have supercharged it with the addition of piperine for increased absorption.  This is likely the reason that Super Miraforte has been very well-received and reviewed and is used by bodybuilders in many cases.  (I have even read that some doctors are recommending it.)

Could Super Miraforte possibly increase testosterone?  One of the key things that most older men need is Estrogen Control and Miraforte does just that.  The reason that this is so critical is that, not only will estrogen “crowd out” testosterone, but it also can directly put the brakes on the testosterone output from your Leydig cells. [1][2]  This means that Super Miraforte , by decreasing estrogen, could lead to a T increase for middle-aged and beyond males that are struggling with inflated levels of the female hormones.

ARE YOU LOW SHBG? Miroforte contains Nettle and Nettle lowers SHBG. This is usually a good thing, unless you are a Low SHBG guy. Low SHBG is a fairly common condition, linked to insulin resistance, that makes HRT tough for example. Low SHBG should be cautious about using Nettle products in my opinion. I am talking about SHBG below about 18 by the way.

CAUTION: If you have any medical conditions or are on any medications, please consult with your doctor before taking any supplement.  Also, some men have such low T and E that their levels of estradiol are dangerously low.  See my link on Why Men Need Estrogen for more information.

1. Presented at the First International Congress on Ethnopharmacology, Strasbourg, France, Jun 5-9, 1990, Contributions to the clinical validation of the traditional use of Ptychopetalum guyanna.

2) J Clin Endocrinol Metab, 1978 Dec, 47(6):1368-73, “Direct inhibition of Leydig cell function by estradiol”

3) Prog Clin Biol Res, 1986, 213:359-71, “Iodothyronine deiodinase is inhibited by plant flavonoids”

Below I outline how Super Miraforte can benefit your sex life, including possibly increasing testosterone and libido and decreasing testosterone libido.

1. Chrysin. Chrysin is a known estrogen lowerer and it works by inhibiting the aromatization of testosterone to estrogen. As males age (and gain weight), an increasing percentage of their precious T is converted to E and chrysin can help.

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. [3] This could potentially lead to weight gain, which would sabotage estrogen control.

2. Nettle. Nettle is a well-known liver protector. What is not so well known is that it also fights aromatization of testosterone to estrogen as well.

4. Muira Puima. This herb is an aphrodisiac with a long history and some of its effects have even been documented in a few small studies. [1] Another study reported improved morning erections as well.

5. Maca.  This plant is another libido booster that I cover extensively in my link on The Superpowers of Maca.  Maca has actually been used as a food for centuries with an admirable safety profile.

6. Piperine. This compound from pepper, as in black, boosts the absorption of many supplements and compounds. Life Extension Foundation, by including, some piperine is essentially “supercharging” their supplement for better efficacy.

NOTE:  Increasing testosterone in men can also lead to increases in nitric oxide as well as testosterone works positively on NOS (Nitric Oxide Synthase).

REFERENCES:

15 Common Erection Killers-https://www.peaktestosterone.com

As I often state, an erection is actually a very complex phyical process that involves multiple bodily systems.  This is why optimal general health is so critical for optimum bedroom performance (and libido).  Furthermore, few men realize that many of the things, lifestyle and otherwise, are very significant erection killers.  This can be in the short term or even lead to longer term erectile dysfunction as we will discuss below.

Most of the list below is common sense. However, a lot of times when you are in the battle, it is hard some of the important details that could be causing you issues. Plus, many things that can hurt your general and sexual health are culturally acceptable and so it simply never crosses our minds. So, if you are experiencing erectile difficulties, scan through the list of 15 Erection Killers below to see if any may apply and then discuss with your physician:

CAUTION: Do not alter any medications without talking to your physician first.

1. Low Testosterone. Okay, this is no big shock. However, I put it first because many men do not realize that it can lead to Venous Leakage, an intimidating condition where a man has great difficulty maintaining an erection

2. Loss of Morning Erections. Okay, this is no big shock. For more information, see my link on The Basics of Morning Erections, an intimidating condition where a man has great difficulty maintaining an erection. It doesn’t matter how much nitric oxide you have if your penis cannot “lock and hold” the blood flow into the corpus cavernosum. If you are not getting morning erections, you need to make sure you get regular erections somehow, some way as this is critical for the health of the penis.

1) International Journal of Clinical Practice, Feb 2005, 59(2):225 229, “Endothelial dysfunction links erectile dysfunction to heart disease”

2) The Journal of Urology, Jun 2003, 169(6):2262 2264, “Laboratory Evaluations of Erectile Dysfunction: An Evidence Based Approach”

3) International Journal of Experimental Pathology, Aug 2000, 81(4):219 230, “Cigarette smoking, endothelial injury and cardiovascular disease”

3. High Blood Pressure. High blood pressure is significantly associated with erectile dysfunction and the reasons are many. First of all, it is actually a root cause of endothelial damage, because higher pressures can lead to damaged arterial walls. However, hypertension is also a symptom of the Metabolic Sndrome, a suite of symptoms that includes insulin resistance and elevated triglycerides as well. For more information, see my link on Erectile Dysfunction and High Blood Pressure.

4. All Cardiovascular Risk Factors. Almost anything that is hard on the heart and cardiovascular system is going to lead to erectile dysfunction. The reason is simple: erectile dysfunction is strongly related to endothelial dysfunction where the delicate lining of your arteries becomes damaged and does not output nitric oxide like it should. This means that things like elevated homocysteine, which have only been found to indirectly lead to erection problems, will likely soon be found to be linked to impotence. We will give numerous examples below. to erectile dysfunction. And, yes, this is the primary reason that lifestyle is so critical: exercise, weight management and diet all powerfully affect all of these. Don’t believe me? Just look at the title of this study: “Endothelial dysfunction links erectile dysfunction to heart disease” [1]

9. Estradiol (E2). Low testosterone can negatively impact erections, so why not too much estradiol, the “bad” estrogen? This definitely has been shown to be the case in clinical practice, where many HRT clinics find that they not only need to raise T sufficiently but keep estradiol in the 20-30 range. Many men go on injections and cannot figure out why they are struggling even though their testosterone has doubled or tripled. The reason, more often than not, is that estradiol has also been driven up proportionately and is sabotaging the results. If this is your situation, find a knowledgeable physician that will monitor both your T and E2.

10. Overweight. Okay, this is no big shock: those extra pounds can hammer erections in even the most mighty Weekend Warrior. Being overweight does every nasty thing that you can think of: it lowers testosterone, increases estrogen, raises inflammation, boost insulin levels – the list goes on and on. To see just what extra body weight does to you, check out these links on How Being Overweight Affects Erections and What Those Extra Pounds Do To You.

11. Smoking. Interestingly enough, smoking seems to raise testosterone just a little. But that’s the last of the good news: cigarette smoke is VERY hard on the endothelium. In fact, nicotine is a vasoconstrictor, i.e. narrows your arteries allowing less blood to flow to the penis.  However, it is the smoke that really causes the damage.  One research study explained that “Nicotine and carbon monoxide are much less damaging than is whole smoke. However the free radical components of cigarette smoke have been shown to cause damage in model systems.” [3]

12. Medications. Many, many medications will kill erections. Some lower testosterone. Some raise prolactin. Some have a sedating effect by raising seratonin levels. Some alter dopamine function. The bottom line is that if you are on a medication and having erectile difficulties, this is one of the first places that you should look. I have some starter information in my links on Testosterone and Drugs and Erectile Dysfunction and Drugs.

13. Depression. Being depressed is miserable. In fact, it’s actually painful and anyone that has experienced it knows just what I am talking about. Unfortunately, to add insult to injury, it is also very hard on erections. You can read about it here in my links on Testosterone and Depression and Erectile Dysfunctiona and Depression.

14. Recreational Drugs. A lot of men do not realize that even something as relatively benign as marijuana use can affect their sex life. Don’t believe me? Check on my link on Testosterone and Marijuana. Of course, painkillers of all shapes and sizes as well as cocaine and herone can really kill erections. See these links on Cocaine and Heroin and The Problem with Painkillers.

REFERENCES:

Skin Sag: Legitimate Skin Tighteners - Peak Testosterone

Ever look in a mirror and want to put your fist through it? Well, one of the likely culprits is skin sag.  Skin sagging occurs for many reasons including aging, fat, sun damage, smoking and even long term jogging. All of these damage collagen, which is the prime culprit in skin sag. Of course, they say a little of the weather-beaten look makes a guy look a little more chiseled and distinguished, but I’ve got a feeling that’s just to make us feel better, eh?

Almost all middle-aged and beyond guys could use at least some help with facial sagging in order to improve their physical attractiveness and appearance.  This is where skin tightening can come in.  Unfortunately, quality skin tightening is not as simple or inexpensive as Wrinkle Reduction for Males tends to be.

CAUTION: First of all, we should probably cover how NOT to do skin tightening.  One seemingly easy solution to skin tightening is a simple, topical solution of DMAE.  What could be more convenient than just putting on some lotion once a day and getting legitimate skin tightening results, right?  Unfortunately, DMAE has some very serious health concerns associated with it and very likely results in cell damage and dysfunction. [1] You also want to avoid CO2 lasers as they are known for producing scarring and spotting, i.e. the cure can be worse than the disease.

The only real answers for (mild to moderate) facial sagging are cosmetic procedures.  However, the good news is that these are relatively non-invasive. So, if you can get yourself over the fear of making an appointment with a cosmetic surgeon and driving to his office, the procedures below are generally simple, fast and relatively affordable.  Of course, I probably don’t need to tell you that if you have major facial sag, your only solution will be a lift of one sort or the other.

Below are some legitimate cosmetic procedures that will help wind back the clock potentially a decade or two for some guys. They all work by doing a little micro damage to the outer layer of skin, whereby the body, in the process of healing itself, manufactures new collagen. For this reason, most of these procedures can be used all over the body including the face and eyes.

1)  Infrared Laser. This replacement technology for the more risky CO2 lasers of prior years are potentially an excellent choice for guys.  There are almost no side effects and the results seem very promising.  One study using a Titan laser had particularly admirable results that lasted in some participants up to one year. [2]  Again, the beauty for guys is that this generally only produces a little redness for a couple of hours and you’re back in business at work the next day without anyone noticing.  Furthermore, typical costs are $350 per treatment and so for the normal three treatments (for results of about a year), you are only risking a grand.

2) Radiofrequency. Thermage, and other radiofrequency treatment options such as Accent, can provide significant significant skin tightening effects as well.  A typical treatment on the face takes only about 45 minutes.  Results take a few months to manifest but then can last over a year in some cases. Thermage generally has more side effects, i.e. redness and bumps that infrared and most guys will not want to plan on going to work the next day. It should be mentioned that some guys get redness for up to a week with Thermage.  In other words, Thermage is basically a little “bigger gun” than Infrared Laser but is also more costly, around a $2,000 – $3,000, with a little bit more downtime.

NOTE: One important comment is that both of the above generally only produce about a 25% improvement in sagging, which can improve appearance substantially of course.  Furthermore, a big block of people, say a third or so, experience no discernible difference whatsoever.  However, if you’re one of the “lucky ones”, you may be able to shave years off of your face with an hour or two of your time.

3) Ultherapy. None other than Dr. Oz recently popularized this new procedure which uses ultrasound for skin tightening.  It is apparently FDA-approved for the face and neck, but is particularly suited for the sagging skin in the neck area.  According to the information on the show, this procedure produces remakable results for a non-invasive procedure by stimulating collagen growth.  Results occur two to three months after treatment as your skin’s inner tissues rebuild.

Why is this a perfect procedure for men?  It takes 30 minutes and has no downtime.  In other words, you can leave the office without anyone knowing the difference. The only negative is the cost:  about a  $1,000 per treatment.

REFERENCES:

1)  https://www.smartskincare.com/ingredients/dmae_safety.html, “Is DMAE Safe for Your Skin?”

2) https://www.medscape.com/viewarticle/561994_2

Hibiscus Tea: Will Help Most Men With Erectile Dysfunction

As I write this, I am actually drinking hibiscus tea. There is no doubt that it is Mother Nature’s gift to every man on the planet (especially if you are over about 40). It’s quite bitter, but then so is beer, eh? My experience is that you get used to the bitterness and actually enjoy the taste after a few days.

So what’s all the hibiscus hype?  Well, it’s not hype and let me prove it to you with a number studies from the research that should get your attention. Remember that erections are all about your arteries – nitric oxide in your arteries and nice low blood pressure levels (which indicates higher blood flow):

1. Increased eNOS Activity and Nitric Oxide. We get most of our arterial nitric oxide from the endothelium and this is governed by the eNOS enzyme.  It turns out that the polyphenols in hibiscus tea activate this enzyme and cause your endothelium to produce more nitric oxide. [6]

Now you may object and say, “Well, this was in the lab and not in actual human subjects.”  That is true. However, one of the big tests for any possible NO-increasing compounds is whether or not it can produce big drops in blood pressure.  As you’ll see below, this has been demonstrated in at least five studies, three of which I have documented below.

Also, I do not need to point out that boosting arterial nitric oxide, which is what we are talking about here, will generally help significantly with mild to moderate erectile dysfunction. No one can promise you it will solve it, but you have little to lose, eh?  Hibiscus tea is very easy to find and prepare, something I discuss here:  How to Make Hibiscus Tea.

2. Endothelial Function.  Remember this formula:

1) Journal of Human Hypertension, 2009, 23, 48 54, “The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes”

2) Journal of Hypertension, Apr 2009, 27(4):774 781, “Black tea consumption dose-dependently improves flow-mediated dilation in healthy males”

3) J Ethnopharmacol, 1999 Jun, 65(3):231-6, “The effect of sour tea (Hibiscus sabdariffa) on essential hypertension”

4) J. Nutr, Feb 2010, 140(2):298-303, “Hibiscus Sabdariffa L. Tea (Tisane) Lowers Blood Pressure in Prehypertensive and Mildly Hypertensive Adults”

5) Phytomedicine, Feb 2010, 17(2):83 86, “The effectiveness of Hibiscus sabdariffa in the treatment of hypertension: A systematic review”

6) https://ddd.uab.cat/pub/tfg/2015/143857/TFG_victorfarrealins.pdf

7) Mol. Nutr. Food Res, 2014, 58:1374 1378, “Hibiscus sabdariffa extract lowers blood pressure and improves endothelial function”, https://onlinelibrary.wiley.com/doi/10.1002/mnfr.201300774/pdf

Erectile function = Endothelial function

The endothelium is the thin layer of cells on the inside of your arteries that are responsible for controlling their expansion and contraction and the nitric oxide that governs the process.  Researchers refer to this ability to relax the arteries as “endothelial function,” and, generally speaking, endothelial function governs how well and how fast your erections are.  (There are exceptions, of course, as low dopamine, venous leakage and other systems can negatively impact erections as well.) In any event, you can probably guess where I am headed:  hibiscus tea has been shown to significantly help with endothelial function:

“Diuresis and inhibition of the angiotensin I-converting enzyme were found to be less important mechanisms than those related to the antioxidant, anti-inflammatory, and endothelium-dependent effects to explain the beneficial actions. Notably, polyphenols induced a favorable endothelial response that should be considered in the management of metabolic cardiovascular risks.” [7]

Notice that these researchers boldly told physicians to consider using hibiscus in their practices.  Amen!  Oh course, how many physicians actually consider natural solutions to chronic disease, even though 99% of the time, chronic disease results from unnatural lifestyles?

Again, an improvement in endothelial function will help the solid majority of men with mild to moderate erectile dysfunction.  This is especially true if coupled with a high nitric oxide-based lifestyle, something I explain in great detail my my book: The Peak Erectile Strength Diet.

3. Hypertensive Type II (Adult Onset) Diabetics. This study did a black tea versus hibiscus tea study.  (Black tea is known for also improving endothelial function, although this study found the opposite.)  The results were very impressive for hibiscus tea:

A 20+ point drop in systolic blood pressure should get everyone’s attention.  Of course, this means that the participants arteries relaxed or dilated and blood flow increased.

Admittedly, the number of patients was small (60) and another study found that black tea decreased blood flow in a dose dependent manner [2] instead of restricting it.

4. Moderate Essential Hypertension. Patients with essential are often the toughest to treat, because they have no known cause.  In a small study, hibiscus provided solid results in just this situation:

“Statistical findings showed an 11.2% lowering of the systolic blood pressure and a 10.7% decrease of diastolic pressure in the experimental group 12 days after beginning the treatment, as compared with the first day. The difference between the systolic blood pressures of the two groups was significant, as was the difference of the diastolic pressures of the two groups. Three days after stopping the treatment, systolic blood pressure was elevated by 7.9%, and diastolic pressure was elevated by 5.6% in the experimental and control groups.” [3]

5. Prehypertion and Mild Hypertension.  Again, this was a fairly small study (65 participants) but provided solid results:

“A standardized method was used to measure BP at baseline and weekly intervals. At 6 wk, hibiscus tea lowered systolic BP (SBP) compared with placebo (-7.2 11.4 vs. -1.3 10.0 mm Hg). Diastolic BP was also lower, although this change did not differ from placebo (-3.1 7.0 vs. -0.5 7.5 mm Hg).” [4]

This group is particularly relevant in my opinion, because we clearly have quite a few prediabetic men on the Peak Testosterone Forum.

CAUTION: Do not drink too much hibiscus tea.  One of the men on the forum said that Dr. Greger advises less than a quart to make sure you don’t get too much manganese.  The bottom line is that more is not always better.  Also, if you have low blood pressure or are on blood pressure medications, please discuss with your doctor first.

6. Protection Against Arterial Plaque. One thing that can lower your nitric oxide and endothelial function over time is a buildup in plaque in your arteries.  Why?  Because plaque represents actual damage and “scarring” of the lining of your arteries.  Keep in mind that blood supplied to your penis is done so via the pudendal artery and you have actual penile arteries as well.  Things simply are not going to work right in the bedroom if you have significant atherosclerosis.  I have a page that covers the association between the buildup of plaque and the loss of erectile strength:   Evidence That a Loss in Morning Erections Is Due to a Buildup of Arterial Plaque.

SOUR GRAPES: Meta-Analysis.  Oy vay is all I can say for what these researchers concluded:

“Results Four trials, with a total of 390 patients, met our inclusion criteria. Two studies compared Hibiscus sabdariffa to black tea; one study compared it to captopril and one to lisinopril. The studies found that Hibiscus had greater blood pressure reduction than tea but less than the ACE-inhibitors. However, all studies, except one, were short term and of poor quality with a Jadad scoring of <3 and did not meet international standards. Conclusion The four randomized controlled studies identified in this review do not provide reliable evidence to support recommending Hibiscus sabdariffa for the treatment of primary hypertension in adults.” [5]

The authors above know that no one except large pharmaceutical companies can afford massive, large scale trials.  So, sure, it’s obvious that hibiscus tea has not been held up to FDA-style scrutiny, and it never will.  But it’s been a solid performer in multiple studies on multiple subpopulations, so why not just try it?  It’s a common drink in many countries, and so it’s safety profile should be considered stellar compared to virtually any phamraceutical.

CONCLUSION:  Hibiscus tea provides solid results for increasing blood flow and lowering blood pressure and should be considered by men with erectile dysfunction as a potential significant help.  It should also be consumed in my opinion regularly to help prevent atherosclerosis.

REFERENCES:

Arginine Dangers - Peak Testosterone

Many men do not realize that their best efforts to raise nitric oxide by increasing their body s internal Arginine levels may actually be risky to their long term health. Many men are now taking L-Arginine and/or L-Citrulline in order to boost blood L-Arginine levels, which in turn increases the amount of all-important nitric oxide in the blood. (See my links The Benefits of Citrulline for more information.)

However, what is not commonly realized is that increasing Arginine levels, through Arginine or Citrulline, could feed and fuel certain herpes viruses and actually damage one’s long term health. You may be saying, That s okay I ll take a few cold sores in order to get improve my erections! Unfortunately, it s not that simple. There are actually many herpes viruses and they cause a wide variety of long term health issues and nasty medical conditions. In fact, I would argue that a high percentage of people struggling with major health issues – both men and women by the way – have one of these herpes viruses as a root cause.

1)  https://www.cdc.gov/std/herpes/stdfact-herpes.htm

2) Am J Pathol, 1986 Jan, 122(1):62 70, “Virus-induced atherosclerosis. Herpesvirus infection alters aortic cholesterol metabolism and accumulation”

3) Eur Heart J, 1993 Dec, 14(Suppl)K:12-6, “Infection and inflammation as risk factors for myocardial infarction”

4) Nature, 1970, 228:1056-8, “Epstein-Barr virus in Burkitt’s lymphoma and nasopharyngeal carcinoma. [ii] EBV DNA in biopsies of Burkitt tumours and anaplastic carcinomas of the nasopharynx”

5) J Clin Virol, 2006 Dec, 37 Suppl 1:S24-6, “Clinical parameters and HHV-6 active replication in relapsing-remitting multiple sclerosis patients”

6) https://www.traditionaloven.com/tutorials/l-lysine_rich_foods.html

1. HSV-1 and HSV-2. HSV-1 is the herpes simplex virus known for causing cold sores and HSV-2 genital herpes.   (In the U.S. about 16% of people aged 14 to 49 have HSV-2 and a much higher percentage HSV-1.)  [1] Of course, cold sores and genital herpes can be annoying, but these herpes viruses also likely accelerate arteriosclerosis.  That’s right – these viruses can actually lead to arterial plaque by damaging the lining of the arteries.  When the artery is damaged, even slightly, repair is initiaed and the body “repairs” or “protects” arteries by coating them with a nice layer of plaque.

Researchers noted this in an animal study on chickens where they infected the poor birds with MDV, a type of avian herpes virus, and observed greatly increased arterial “lesions” as they are called.  These lesions are what leads to arteriosclerosis. [2] Later study work verified that HSV can lead to increase arterial lesions as well. [3]

Of course, what this means is that doing anything to make life easier for any HSV in your system could wreak havoc with your arteries, which is always a bad idea for your sex life and life in general.

3.  HHV-6 (Human Herpes Virus 6).  This not-as-well-known herpes virus is known to negatively affect neurological tissues. It has been implicated as one of the root causes of Mulitple Sclerosis. [5] Therefore, increasing Arginine levels may possibly lead to increased risk for certain autoimmune disorders as well.

4. Herpes Zoster (Shingles). The herpes virus behind childhood chicken pox can surface later in life as shingles, where it infects and attacks the nerves. Shingles can be very painful and irritating and can lead to bright red patches and swelling on the face and body. In some cases, it can cause joint pain, hearing loss, drooping facial muscles and many other nasty symptoms.

So it becomes clear that, whatever we do, we do not want to cause an outbreak of any of the above viruses. Futhermore, it is quite likely that most men will have two or more these herpes viruses and so more than one outbreak could occur.

Are there any reasonable solutions? Well, I asked Naturopathic Doctor and Christopher Pick from the U.K. to give us some insights. Below are some questions are answers that I received from him. (You can read Chris’ profile in this link or visit his web site at Erectile Dysfunction Help Information.)

Q. I’m wondering if Citrulline, which seems much more powerful than Arginine, can cause even more problems for men with latent viruses? What’s your take on this?

A. It is estimated that around 95% of the US population over the age of 35 are infected with EBV. As you will know Herpes, EBV, shingles, chickenpox & lyme disease are all related. The immune system under normal conditions can keep these problems under control and in most cases it ONLY JUST manages this. Any type of additional immune stress such as hard exercise, general stress, lack of sleep, sun exposure, etc will overwhelm the immune system and an outbreak occurs.

A. Now, we know that arginine fuels the herpes virus and must deduce that it will also fuel similar viruses by the same mechanism. We also know that citrulline is a precursor to arginine. So, more citrulline equals more arginine equals more fuel for herpes type viruses. In the instance of certain dormant infections citrulline must be loosely considered as an immune system stressor.

You mentioned Lysine as a solution? Do you think a man can simply take a few grams of Lysine per day to counteract the effects of the Citrulline on any herpes viruses? In other words, can you get the best of both worlds by taking both Citrulline and Lysine?

A. Lysine is a solution for some. But as it antagonises arginine the down side may be a total or partial reduction in any vasodilation properties that were exhibited. This will vary considerably from person to person. Basically supplementing any amino in large quantities (over that found in foods) can up-regulate or down-regulate the metabolic pathway utilisation. Of course, this can create negative or positive effects.

I know that the Citrulline is a big help to some guys in the erectile department. Is there any chance that they can “take 2 grams of Citrulline per day and 3 grams of Lysine per day for safety”? What would you advise?

A.  The bottom line. Taking 2 grams of Citrulline and 3 grams of lysine may work for some and not for others. It would need individual experimentation. This is probably not the best route. Considering the infection rate it would be better to seek other alternatives for increasing nitric oxide for vasodilation requirements. For those who are willing to experiment, it may well be worthwhile.

It has always been a problem for me when I try to advise on supplementation & the metabolic pathway interactions. People do not want to hear it &rightfully so if it is not their interest. They just know from advertising that this cures that or this effect can be had etc. Further, the majority of manufactures & sellers of supplements have no knowledge of interactions. They can follow the research of an effect of a single ingredient on a particular issue & sell it on. Rarely does the research on a single substance follow the metabolic pathways to see what else may occur the expense would be astronomical.

Q. So right now there is no way good way to keep the EBV/HPV/HSV’s in check other than the body’s own immune system plus, in some people, extra L-Lysine?

A. Correct again. The drug Aciclovir is effective for cutting down on break outs. Some people have been on it for years. But whether it is Citrulline or Aciclovir, there are checks a balances.

So what’s a fella to do?  Well, there are several options:

1. Avoid Citrulline and Arginine Supplementation. Erectile function may still be restored through an Erectile Strength Diet, exercise and a few choice supplements. This requires patience and experimentation of course.

2. Supplemental L-Lysine. A man could take some a gram of Citrulline in the a.m. upon waking, Lysine at lunch and another gram of Citrulline in the early evening, since that is the prime love-making time. In addition, one could try to get Arginine from food instead, which will also provide some Lysine for protection. For example, the meats, such as chicken and beef, provide an approximate 1:1 ratio of Lysine to Arginine. However, many plant foods actually provide more Arginine than Lysine. Oats, for example, have about twice as much Arginine as Lysine and peanut butter over 3 times. [6]

3. Citrulline Only. Of course, one can also just take Citrulline. Short term studies, at least to date, have shown no side effects from Citrulline usage (at levels in the 0.5-3 grams/day range). This is a certainly a promising sign, but if there are long term risks that come to light through activation of the Arginine pathway, these would not have come to light in the these studies. And keep in mind that usage of Citrulline as an erectile supplement is quite new.

Which of these safest? I cannot answer that for you, of course, for many reasons, but one of which is that every man’s situation is different.  Do you have any of the above viruses?  Have you had symptoms that seem to tie into of the herpes viruses?  Unfortunately, you must do any your own self-assessment, research and discuss things (with hopefully knowledgeable) physicians that can give you good advice along the way.

REFERENCES:

Cheapest Testosterone Tests - 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)

Enanthate-How Much Testosterone Enathate Should I Take?

Testosterone enanthate is used in many non-U.S. countries, whereas the cypionate ester is used almost exclusively here in America.  These esters are quite similar, however, both providing about 70% testosterone by weight. [1] (The ester weighs 30% or so.)

So how much do you want to take?  Well, first of all, the great majority of guys will do much better with weekly enanthate shots simply because weekly injections minimizes the fluctuation in testosterone and estradiol levels.  So everything I say below assumes that you are going to get your shot weekly and not every two or three weeks.

Let me cover a few important assumptions first that you should go over with your doctor:

1.  Physiological Levels. I think it is wise to not exceed “physiological levels” of testosterone, i.e. to not go over about 1200 ng/dl – the maximum that you would see in a healhty, young male during his peak years.

2.  Estradiol Monitoring and Management. If you go to a peak of 1200 ng/dl, you will probably need some sort of aromatase inhibitor to keep your estradiol from going to high.  At a minimum, you will need to be monitored to make sure that this is the case.  In the U.S., low dose Arimidex (anastrazole) is commonly used for this purpose.

Based on these two assumptions, here are the typical weekly dosages that I have seen on the Peak Testosterone Forum and elsewhere:

“Hey guys a question about clomid, so my Doc has put me on 100mg of enanthate each week. When I asked him about clomid he looked looked at me like what is that! When I told him about it his response was that no one on TRT needs that.. yes I’m looking for an Endo. So my question is is it bad for me to just take like .25mg once in a while for a few day to make sure my E doesn’t get out of hand. When I asked to make sure we test me E level he just said they don’t test that and not to worry, so I will get my own blood tested independently I think.. Any input would be awesome .” [2]

“To determine the relative efficacy of several dosage regimens of testosterone enanthate in the treatment of male hypogonadism, we treated men who had primary hypogonadism with the following dosage regimens: 100 mg once a week, 200 mg every 2 weeks, 300 mg every 3 weeks, and 400 mg every 4 weeks, each for 12 16 weeks. Twenty-three men completed 37 dosage regimens.” [4]

And this makes sense:  100 mg of testosterone cypionate weekly is a very common HRT regimen and, again, enanthate is roughly equivalent to cypionate.  Typically, when you see physicians wanting to give you 200+ mg of enanthate, it means they want to put you on an every-two-week or every-three-week schedule, which is not ideal in my opinion.  Yes, it is a little more convenient, because you do not have to worry about as many injections.  But this advantage is quickly negated by problematic fluctations in testosterone and estradiol.  For more information, you can read my page on Testosterone Cypionate.

CAUTION:  Always work with a knowledgeable doctor when it comes to testosterone therapy.  Regular monitoring of T, PSA, hematocrit/hemoglobin, blood pressure and estradiol should all be done at a minimum on a regular basis. In addition, good injection technique and safety is critical.

REFERENCES:

1)   https://forums.steroidal.com/anabolic-steroids-forum/50-steroid-remaining-after-ester-removed.html

2) https://peaktestosterone.com/forum/index.php?topic=3010.msg26513#msg26513

3) https://www.guideline.gov/content?id=16326#top , “Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline.”

4) J of Endocrinology and Metabolish, 51(6), “Treatment of Male Hypogonadism with Testosterone Enanthate”

Testosterone and DHEA - Peak Testosterone

On the Peak Testosterone Forum I see certain men’s health solutions that have a pretty solid track record. HRT (TRT) does pretty well with a good protocol and on the erectile side, things like pomegranate juice and Citrulline have a decent batting average. DHEA is brand new, but we now have several men who have recently experimented with it with some short term successes at least. For example, look at what this man wrote:

“Before that i was experimenting with 50mgs of DHEA, after a week or two, I noticed morning erections, that were rock hard, the last time i had this was when i was a teenager.” [1]

And it also helped out this guy who was on HCG Monotherapy in several ways:

“I started on 50mg DHEA daily about a week ago and I think it’s helped my mood and libido considerably. I am on HCG mono and my T levels look great, but I needed some additional help. My DHEA was in the low 200s so I thought I’d give it a try and I can say I’m actually thinking it’s working.” [2]

Just how does DHEA work its magic in some men?  Well, one thing that we can say is that it is NOT from increasing total testosterone.  Multiple studies in men – it definitely can raise T and DHT in women! – have shown no effect in total testosterone and this is what we will cover below.  We will also look at what DHEA does to free testosterone.

1)  https://www.peaktestosterone.com/forum/index.php?topic=6099.0

2) https://www.peaktestosterone.com/forum/index.php?topic=6182.0

3) The Journal of Clinical Endocrinology & Metabolism, Published Online: July 01, 2013, 78(6), “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age.”

4) Urology, Mar 1999, 53(3):590 594, “Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study”

5) https://www.peaktestosterone.com/forum/index.php?topic=6186.0

6) American Journal of Physiology – Endocrinology and Metabolism, 1 Jan 1995, 268(1): “DHEA administration increases rapid eye movement sleep and EEG power in the sigma frequency range”

7) ) Metabolism Clinical and Experimental, 2006, 55:858-870, “Endocrine effects of oral dehydroepiandrosterone in men with HIV infection: a prospective, randomized, double-blind, placedbo-controlled trial”

8) Clin Endocrinology, 1998, 49:421-432, “The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age advanced men and women”

9) Journal of Andrology, Nov-Dec 2008, 29(6):610 617, “Reference Ranges for Serum Dehydroepiandrosterone Sulfate and Testosterone in Adult Men”

NOTE:  If you are interested in whether or not testosterone therapy (HTR / TRT) impacts DHEA, skip to the bottom of this page.

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.  This small study had a six month study period and found that there was difference in either testosterone or DHT in the men. [8]

c) ~600 mg in HIV Positive Men.  Probably the ultimate verification that supplemental DHEA does not change total testosterone came from a study of HIV positive men where a very large dosage (600 ng/dl) was administered on a daily basis. [7]

1.  Boosting Free Testosterone When Combined With Intense Exercise. Now some of you may know that DHEA can be a precursor to testosterone. So you may be thinking, “Aha!  I know why DHEA sometimes does these things:  it’s boosting testosterone!”  However,that typically is not the case, at least in terms of total testosterone.  Many studies in men have shown no significant change in total testosterone.  Plus, if DHEA routinely increased total testosterone, every bodybuilder on the planet would be taking it.

While it does not appear to consistently boost total testosterone, it may actually boost free testosterone quite significantly if combined with HIIT in some men.  See my page How to Increase Testosterone Naturally for the study.  As a verification, this same study showed no significant difference in total testosterone levels – only free.

2.  Raising Levels Decreased by HRT (Testosterone Therapy). I have not seen proof of this, but one of the well-known online HRT physicians, has stated that HRT generally lowers DHEA levels.  We saw this in one of our own guys whose DHEA levels on HRT were about 500 and then rose to 600 when he quit. [2][5] For this reason, some HRT docs and clinics recommend supplemental DHEA.

4.  Brain Booster. In my opinion, HRT works not because it can (sometimes) improve erectile function or restore morning erections, but instead because it is such a brain booster for hypogonadal men.  For a man who has low testosterone, Testosterone Can Restore Brain Dopamine and increase brain-benefitting estradiol and DHT levels as well. Therefore, libido and mood usually increase on a well-done HRT program. Depression scores improve. And even mental performance can improve – working and verbal memory for example. Basically, this is not always the case, but usually in my opinion testosterone is a great “brain tonic” for a man that is deficient.

Now let’s go back to DHEA.  Does it exert similar brain-boosting characteristics?  The answer is that it probably does not for most men, simply because there are quite a few studies who found that in men no increased libido, mood or memory.  (Women do a little better in the studies.)  However, there was one study that found that it “was associated with a remarkable increase in perceived physical and psychological well-being for both men (67%) and women (84%).” [3] Unfortunately, there was no increase in libido. Like most of the studies, the participants were give 50 mg per day.  The bottom line is that some men, for reasons unknown, may get a boost in well-being, mood and the like, but don’t expect it.  This brain boost may be responsible for some of the good reports I am getting.

5. Sleep Aid. DHEA can lower cortisol and is considered a “stress tonic” by some.  Perhaps for this reason, DHEA seems to help with sleep in the sense that it increases REM sleep. [6] Interestingly enough, morning erections generally occur during the REM sleep phase, so perhaps this explains why the man above enjoyed improved morning erections? (A very large dose, 500 mg, was given in this study and it was on healthy young men.  So more study work needs to be done in this area.)

6. Cortisol Reduction. DHEA can lower cortisol as well in some men.  Generally, this is not the case though according to a number of studies

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

CAUTION: DHEA should not be given in my opinion if you are not low in DHEA.  It should also not be given in higher dosages. See my page Potential DHEA Dangers for more information.  While DHEA levels plummet with aging, it is important to get a DHEA read before.  You can pull your DHEA inexpensively here:  Testosterone Labs.

Testosterone Therapy (HRT / TRT) and DHEA

Above I documented the studies that show that DHEA does not significantly increase total testosterone on average but likely does increase free testosterone in many men. But what about the other way around? What if a man significantly boosts his testosterone through HRT (TRT)? Will that raise or lower his DHEA?

Unfortunately, my answer to that question is anecdotal:  there are several knowledgeable HRT physicians who have stated that decreased DHEA is a common side effect in the medium and long term testosterone therapy.  The reason given for this is that testosterone tends to shut down the body’s HPA (hypothalamus-pituitary-adrenal) axis, and the theory is that this “shutdown” can leave some men with lower DHEA.

Can I prove this or back it with some references from the medical journals?  No, I cannot.  However, I can tell you that my DHEA was every low after being on testosterone cypionate for a couple of years.  My DHEA-S was right around 100 ug/dl last year (2014) and a typical range for a man my age would be about 109-208 (25th, 75th percentile). [9]

On a practical level, it would be prudent for men on TRT to measure their DHEA-S before and after TRT.  For more information on DHEA, see my Index Page on DHEA.

REFERENCES:

HRT: Testosterone Therapy and Class Action Lawsuits

NEWS FLASH(ES): There have been a number of studies that have shown that HRT can improve many cardiovascular parameters, so many experts were skeptical of the results of these studies.  Sure enough, two very positive HRT cardiovascular studies followed immediately after the ones on this page.  See my page The Recent Positive Testosterone Therapy Cardiovascular Studies for more information.  The one except is a sutdy I discuss on the following page:  Possible Testosterone Injection Dangers or Just a Bad Protocol?. Also, the climate has completely changed since I wrote this page, and a federal judge recently threw out the most recent case that testosterone manufacturers increased their risk of cardiovascular issues. [5] My, how things change in a year or two! (Please consult with your physician, however:  it is his or her job to stay up on the latest research and evaluate any medical conditions you may have.)

1.  NEJM 2010. The first anti-HRT study was in published in 2010 in the prestigious New England Journal of Medicine. [1] This study look at testosterone administration to a group of “community dwelling” seniors. I’m not sure why they picked that group, but the results were ugly:  almost four times as many men in the testosterone had cardiovascular events versus the control group! The authors wrote that “during the course of the study, the testosterone group had higher rates of cardiac, respiratory, and dermatologic events than did the placebo group. A total of 23 subjects in the testosterone group, as compared with 5 in the placebo group, had cardiovascular-related adverse events. .”

2. JAMA 2013.  Then just a few years later, the equally prestigious Journal of the American Medical Association also found increased cardiovascular risk in men given testosterone.  This study was also widely criticized.  Life Extension Foundation wrote a particularly scarthing and insightful rebuttal that, in my opinion, tore apart this study piece by piece.  In fact, I would argue that this study mostly showed that the mainstream medical boards have a very low level of understanding of even the basics as to how to administer and monitor testosterone successfully.  For example, one of the things that the article points is that no mention of estradiol was ever given in the study! This is inexcusable as abundant data has made clear that estradiol is VERY important to arterial health.  The LEF writer, which included an M.D. and two N.D.’s, stated:

“In the paper published by Vigen, there was no report of the subjects’ estradiol levels. If estradiol was not monitored during testosterone administration, this oversight means that the men receiving testosterone could have experienced a concurrent rise in estradiol levels. This may have compromised their cardiovascular health and could partially account for the increased risk observed in the testosterone-treated group.” [3] The study was on vets and some of them probably were on the old big cypionate dose every two weeks.  These big dosages using this kind of “old school” protocol send both testosterone and estradiol through the roof for 4-5 days, which could put some men at risk.

1.  Men with hypertension.

2. Men with certain clotting disorders.

3. Men with kidney disease.

I cover these three cases in my page on The Potential Risks of Testosterone.

And I think that few have any doubts that the attorneys will likely have a field day with all of this. One of the big things that they have going for them is the fact that heart disease is the number one killer of men and an epidemic in our Western culture. This ensures that will be a huge pool of men with heart attacks, angina, angioplasties, strokes and so on that have been on HRT just due to the odds. Of course, that also means a potentially larger class in their class action law suit.

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

To file a law suit, attorneys need only net around 40 men with heart disease and on a particular type of HRT.  This, of course, should be easy and I think we will see a multitude of suits forming around the country.  A few quick searches on the internet will pull up literally hundreds of law firms already requesting names and information to forum such suits.

The End Result of the Lawsuits

There will some positive and negative outcomes from all of these lawsuits and class action suits. Many men with risk factors will be excluded from treatment. No doctor can afford to prescribe testosterone with the threat of a lawsuit hanging over him. So do you really think that if you have had a DVT, or an embolism, or angina, or an angioplasty or perhaps even hypertension, that a doctor is going to give you testosterone. I have my doubts.

So the best thing you can do for yourself, if you are would like to be on HRT is take care of your heart and arteries.  I have a lot of pages on the subject on my site, including How to Clear Your Arteries, Increase Your Nitric Oxide Naturally, and Erectile Dysfunction and Arterial Plaque for example. So start working on things like lowering your blood pressure and clearing out arterial plaque. Otherwise, you may find that your doc takes you off of HRT sometime down the road as the lawsuits hit.

And believe me: doctors are completely willing to drop you off of HRT in a heartbeat. My clinic recently dropped me almost instantly over a high PSA reading. I was off of HRT for a month and my testosterone dropped to 111!  It turns out that I did not have cancer, but it taught me a sober lesson: I need to carefully guard my health in order to be allowed to stay on testosterone. So get on a good clean, heart friendly diet. Lose those extra pounds. Drop the weight. It will pay off in the end…

1) N Engl J Med, 2010 Jul 8, 363(2):109-22. “Adverse events associated with testosterone administration”

2) https://www.zrtlab.com/blog/entry/testosterone-elixir-or-dangerous-drug

3) JAMA, 2013, 310(17):1829-1836, “Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels”

4) https://www.lef.org/featured-articles/ Response-to-Media-Reports-Associating-Testosterone-Treatment-with-Greater-Heart-Attack-Risk.htm, “Flawed Testosterone Analysis Spurs Misleading Media Headlines”, By Blake Gossard, Kira Schmid, ND, Luke Huber, ND, MBA, Steven V. Joyal, MD

5) https://www.courthousenews.com/2015/11/12/pfizer-dodges-claims-over-testosterone-drugs.htm

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”

Weight Lifting and Testosterone - Peak Testosterone

Increasing Testosterone Through Weight Lifting and Weight Training Iron.  That’s what you need to take to increase your testosterone.  No, I’m not talking about the mineral – I’m talking about something you lift off of the mat in order to build Muscle. There are actually studies that show that testosterone can be increased simply by lifting weights.Now, before I go on, let me mention that there is a transient boost in testosterone that occurs whenever you lift weights or do strength training.  The bodybuilding magazines love to make a big deal of this.  But they shouldn’t since this “increase” in testosterone is for the most part nothing more than a subtle increase in “hemoconcentration” of your bodies testosterone.  In other words, during a workout your body is not flooding your system with testosterone as these magazines would lead to believe – quite the opposite.

So then why do I say that weight lifting leads to an increase in testosterone?  Because there are several studies out there that show that patient and consistent – I emphasize the year-after-year kind – weight lifting slowly raises baseline testosterone.  And I hope that grabs your attention, because it is baseline testosterone that we want to increase.  Baseline testosterone can be thought of as your testosterone “smoothed out” and probably the best measure of it is early morning testosterone.  Your testosterone, unless you’ve got a nasty sleeping disorder, peaks in the early morning hours and then tapers off until evening where it hits its low.

One fairly recent short term study of 8 young men with an average age of 17 showed significant increases in baselines testosterone (7.5%) in only 11 weeks. [1] This is a nice increase in testosterone when you consider that it occurred in less than three months!  What did these young pups do to increase their already abundant testosterone?  They simply engaged in “explosive strength training” for these 11 weeks.

Are there any studies showing that this exprapolates to longer time frames?  Yes!  One study of nine elite weight lifter over a two year period showed significant increases in testosterone, leutenizing hormone and the ratio of testosterone to SHBG. [2]  The authors concluded that “the present results suggest that prolonged intensive strength training in elite athletes may influence the pituitary and possibly hypothalamic levels, leading to increased serum levels of testosterone”.

Yet another study showed that elite weight lifters had significantly higher testosterone levels than elite cyclists. [5]  In other words, the body seems to adapt to the kind of exercise placed before it.  In everyday language that means that weight lifting and weigh training very likely lead to increases in testosterone over time.  Remember that testosterone seems to be increased by any competitive challenge in the short term.  The amazing news is that hitting the weights seems to imprint itself in our glands and force them to spit out more of the precious stuff.

As a side note, 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. [4] 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. So weight lifting should pay huge dividends in more than just increased testosterone levels.

CAUTION: Before, I got on I have to issue a caution here:  you must be careful not to Overtrain or you will whack your precious testosterone instead of increasing it.

Also, one question that may have crossed your mind is if these results translate to other sports and methods of training?  Well, we don’t fully know the answer to that question.  What we do know, though, is that long endurance sports such as cycling seem to lower testosterone in the same way that weight lifting and weight training seems to increase it.  For example, one 2003 study “that basal testosterone levels were significantly lower in cyclists than age-matched weightlifters or untrained controls”. [3] In fact, some researchers have actually concluded that this is an adaptation that gives cyclists and other endurance athletes a competitive advantage since, after all, testosoterone and it’s ensuing muscle mass would probably slow them down.

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

So should you lay off of all endurance sports?  Well, I would be cautious in making any such rule. Remember the incredible Power of Exercise. Exercise decreases heart attack risk, improves your risk of dying from all causes, lowers inflammation, improves your erectile strength, protects your brain (in a dozen ways) and, above all, gives you endurance in the bedroom.  So, if your testosterone is in a halfway decent location, you will almost for sure not have to worry about a small drop in testosterone that comes with any endurance sport.

If, on the other hand, your testosterone is low anyway, then you need to be very cautious about lowering it any further with a triathlon or marathon.  Remember:  the Symptoms of long term low testostone are nothing but ugly and dangerous. Rememember you want to increase your testosterone if need be in order to increase your mental outlook and attitude as well as build your lean body and muscle mass.  Testosterone does all that for you:  there is no substitute!

NOTE:  Taking Cialis (or probably any of the erection-boosting PDE5 inhibitors) increases testosterone post-exercise in healthy male subjects. [6] So should you pop this pill before going to the gym?  Well, not so fast:  the study also showed that Cialis amplified cortisol significantly more than normal as well. The last thing most of us guys need is more cortisol, which leads to muscle tissue breakdown, visceral fat deposition and other ills. In addition, you should read the following links that cover The Dangers of Recreational Use of Viagra and Side Effects of Viagra, Cialis

REFERENCES:

1) Eur J of Applied Physio, 2004, 91(5-6):698-707

2) J Appl Physiol, 1988, 65:2406-2412

3) J of Strength and Conditioning Res,Feb 2003, 17(1):129-39

4) Brit Med J, 2008, 337:a439

5) J of Sports Sciences, 2004, 22(5):465-478

6) 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”

Reverse Diabetes & Arteriosclerosis While Losing Weight.

So can you be Low Fat and reverse diabetes? The standard propoganda from the Low Carb crowd goes something like this:

“Of course not!  A Low Fat Diet is a high carb diet and carbohydrates will always raise blood sugar and make diabetes worse.”

The logic here may seem sound to some, but, as is so often the case, the human body often operates counterinuitively.  First of all, what really affects insulin sensitivity is, surprisingly, a high fat diet.  So, generally speaking, someone eating a Low Carb Diet will have to consume very high fat levels in order to get enough calories during their maintenance phase.  If this happens, insulin resistance is often induced.  In fact, this property of Low Carb Diets is used all the time with lab animals:  researchers will put animals on a high fat diet in order to study insulin resistance and, unfortunately, humans are no different.

Now it is true that if someone cheats and eats a Low Fat Diet with a bunch of refined carbs and high glycemic foods, he is bound to get into trouble.  Cheaters never win, eh?  However, there is a Low Fat researcher who has shown something remarkable:   you can actually reverse diabetes with a Low Fat Diet!

What is the secret?  It is very simple:  you simply eat low fat and low glycemic at the same time.  This is not as hard as it sounds as many low fat foods are low glycemic, such as beans, legumes, vegetables, many fruits, etc. We’ll discuss this a bit more below but think of the significance of this for many middle-aged and senior men:  they can likely reverse their diabetes and partially reverse their arteriosclerosis at the same time.  This is a chance to actually get their life back.

And one other huge benefit of going on this type of diet:  easy weight loss! Most men will steadily (and effortlessly) lose weight on a Low Fat Diet initially.  The reason is simply:  starchy foods are generally bulky, low fat, high fiber foods that fill you up.  These kind of foods are low calorie simply because a carb is only 4 calories per gram whereas fat is 9 calories per gram.

I get men writing in and asking, “How can I get enough calories on a Low Fat Diet?”  The issue with a Low Fat Diet is actually NOT to lose weight.  My answer, by the way, is to add some supplemental protein.  In my case, I add in undenatured whey, egg whites and rice proteins to round out my diet. And, practically speaking, most clinicians would agree that anything below 7% is a reversal of diabetes. If you have more questions, please visit the Peak Testosterone Forum.

Most men who have arrived at the stage of Type II (adult onset) diabetes have gotten there slowly over time, having passed long ago throught the prediabetic stage.  During this long and unhealthy transition period, significant damage to their cardiovascular and endothelial systems has ensued, leaving them (very likely) with a substantial buildup of arterial plaque.  With one simply dietary regimen, they can very likely get their life back and reverse both conditions.

NOTE: Of course, if you are diabetic or on medications, you need to work with your doctor as an lifestyle change can modify the need for medication which alter blood sugar levels.

A great guidebook on the mechanics of doing this is Dr. Neal Barnard’s Program for Reversing Diabetes.  Dr. Bernard has done a number of classic studies on Low Fat diets in diabetics and found that:

1) Insulin sensitivity improved by 24% in 14 weeks. [1]

2) A1C was reduced from 8.0 to 6.8 in 22 weeks.  [1] A1C is a marker called “glycated hemoglobin” that essentially measures your average blood glucose over the last three months.

Now some may object that, according to the 2009 standards set up by the International Expert Committee of the American Diabetes Association, an A1C of 6.5% is technically the official marker of diabetes. [2] Their reasoning was that at this level, diabetes complications such as retinopathy are quite uncommon.  However, Bernard’s achievements of lowering down to 6.8% in just a few months is remarkable.

Futhermore, with additions such as weight loss, exercise and possibly HRT (for low testosterone men) going below 6.5 could often be achieved.  One example of this is a study that combined a low fat, high fiber, high complex carbohydrate along with exercise and found that “this decrease in fasting glucose was achieved along with the discontinuation of oral hypoglycemic agents in 24 of 31 patients and of insulin in 13 of 18 patients;.” [3]

NOTE:: Low testosterone greatly increases the risk for developing diabetes, because it raises insulin levels and eventually reduces insulin sensitivity.  Furthermore, many men with Type II diabetes can actually completely eliminate their need for insulin with properly done HRT.  See my links on Testosterone and Diabetes and Testosterone and Insulin.

These men also very likely experienced many other key aspects of going on a Low Fat Diet, including a) increased blood flow, b) increased nitric oxide and c) decreased blood pressure.  Of course, all of these are good for erectile strength and you can read more here in my link on The Many Benefits of Low Fat Diets.

Again, though, the key is that one must eat low glycemic foods.  For those who may not be familiar with the term, the glycemic level of food is simply a score as to how much a given food raises blood sugar levels for a given weight of food.  Of course, refined carbs will almost always elevate your blood sugar rapidly.  There are many foods which are low fat, cheaps carbs and sugars for example, that will do just this.  Again, though, this is NOT the spirit of a whole foods, high fiber, Low Fat Diet.

And it’s not that hard.  For some of the details check out Dr. Bernard’s book above.  The books by Drs. Ornish and Esselstyn are also excellent.

One last recommendation:  get yourself an inexpensive blood glucose monitor if you do not have one.  You want to watch to make sure that your blood glucose levels do not rise too rapidly after a meal and this is an relatively inexpensive way to do some self-monitoring.  (If you are diabetic, please follow your doctor’s monitoring instructions of course.)

CAUTIONS:  There are many ways to do a Low Fat Diet.  Dr. Bernard’s methodology outlined in this book includes both soy and wheat.  Personally, I am very cuatious about both for the reasons outlined here in my links on Soy and Men and a Review of Wheat Belly.

REFERENCES:

1) Dr. Neil Bernard’s Program for Reversing Diabetes, Neil Bernard, p. 19-20.

2) Diabetes Care, 2009 July; 32(7): 1327 1334, “International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes”

3) Diabetes Care, May/June 1983, 6(3):268-273, “Long-Term Use of a High-Complex-Carbohydrate, High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM Patients”

Biochem: How About a Whey That Won't Fry Your Neurons

Biochem Whey ReviewI am always on the hunt for good and safe sources of protein. You might as well not even lift weights if you’re not going to consume a lot of extra protein. Most men who can’t put on muscle in the gym have too little protein to blame.

So what’s the answer?  How about a protein that is one of nature’s true superfoods!  Whey is not only a good protein but is just plain powerful stuff – it’s one of Mother Nature’s little miracle workers. As I cover in link on Good Whey, it does something very important:  it boosts glutathione, the master detoxifier and one of the body’s core antioxidants.

Unfortunately, someone along the way got the bright idea of boiling the crap out of whey to save a few bucks in the manufacturing and processing of the end product. This has a surprisingly negative impact that I document in my link Whey of Death: it essentially releases multi-grams of free glutamine (and free aspartates as well) in a standard serving. Technically, this free glutamine acts just like MSG, and this much can overexcite, or “fry” in the vernacular, your precious neurons.  (They may also increase risk for various cancers and/or lead to Excitotoxin Syndrome .)

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

What is the answer? Well, instead of boiling the whey into oblivion, one could gently filter it instead. Who would do such a good deed? Biochem will – that’s who. I recently stumbled on Biochem Whey Protein in a local vitamin store, where I noticed that it stated clearly on the label that 99% of the peptides were left unaltered. So I recently contacted a representative of Country Life, the parent company of Biochem, about their Vanilla Whey Protein powder in order to verify that their whey was, in fact, almost entirely undenatured.

NOTE: As far as I know, all wheys by Biochem are undenatured but check the label to make sure. The containers I have seen all say something about how 99% of the peptides remain intact, i.e. undenatured.

Thek representative clearly stated that:

“The isolation method is not chemical or heat but it is instead membrane filtration. The raw whey is passed through a series of two filtration steps: 1) it first retains the fat and releases the protein and 2) the protein is retained but allows things like falactose to release out. At the end of the process, it yields a 99% undenatured whey protein isolate that still maintains important biological fractions such as lactoferrin and IGG.”

So the bottom line is that you can have your cake and eat it too when it comes to whey. Isn’t it nice to know that there are few companies out there who care for their buyers enough not to attack their neurons? It kind of makes you tear up, doesn’t it?  Well, I think so, and, to make matters even better, Biochem has no added ingredients, such as soy compounds, and is pretty inexpensive compared to most of the other undenatured wheys out there: Biochem Ultimate 100 % Whey Protein, Natural .

Vitamin C Cures Viruses: Dengue, Acute Hepatitis, Fever

I think this may be the most important page on my site, so, hopefully, some men out there will take notice.  Let me start out by saying that one of the members – thanks retado! – of the Peak Testosterone Forum told me I had to watch a video about Vitamin C. I have always been very interested in Vitamin C, so little persuasion was needed.  The video comes from a doctor in Colorado named Dr. Thomas Levy and kudos to him: his presentation stunned me.  Here are just a few jaw droppers from the video:

a) There is an old journal article (1949) where a doctor cured 60 out of 60 polio cases using Vitamin C. Yes, you read that right:  60 out of 60. Isn’t this every bit as impressive as what Jonas Salk did?  Yet it was completely ignored by the medical community.  The doctor (Klenner) that cured polio wrote an excellent summary of his protocols here.

b) There are also 3 separate journal articles showing that Vitamin C cures acute hepatitis (not chronic).

c) In 1950 a journal article appeared showing that Vitamin C repeatedly cured rheumatic fever. The dosage was here was actually lower than the typical high dose Vitamin C, yet it still regressed rheumatic fever nicely! You can see a summary of the physicians findings here: Vitamin C and Rheumatic Fever.

There are other journal articles cited by Dr. Levy showing that Vitamin C can defeat Dengue, West Nile Virus, and encephalitis!  (See his You Tube video here: The Great Vitamin C Suppression.)

So should you believe these old journal articles?  Let me tell why I almost immediately embraced this video: it is supported by a modern study showing Vitamin C spanking Epstein-Barr, the natry, hard-to-treat virus involved in mononeucleosis:

“The clinical study of ascorbic acid and EBV [Epstein-Barr Virus] infection showed the reduction in EBV EA IgG and EBV VCA IgM antibody levels over time during IVC therapy that is consistent with observations from the literature that millimolar levels of ascorbate hinder viral infection and replication in vitro.” [1]

There is also a recent study showing high dose Vitamin C doing quite well against cancer, obviously another immune challenging overgrowth for the body.  So should this be front page news?  Of course.  Quite simply it is clear that high dose Vitamin C is possibly the most powerful and effective antiviral on the planet. And safety seems rock solid as well, especially when compared to any modern pharmaceutical, although I do have one possible caution that I mention below.

Now I do have to caution that we don’t really know the success rates or the ideal protocols yet for high dose Vitamin C.  But in my opinion, this is definitely something that should be studied much much more than it is.  Will it cure 50% of patients?  100%?  20%?  We don’t know.  But what we do know is that it is very inexpensive and seems to have side effects to speak of.

UPDATE:  The forum poster who originally alerted me to Dr. Frye’s video is posting relevant news on Vitamin C cures and information here.

And, perhaps, right at our fignertips is a simple solution that could have saved countless lives.  My wife had a relative that contracted the very serious form of dengue in Mexico – some of the variants are deadly and some aren’t – and, thankfully, the person recovered and is doing just fine.  However, their suffering and time to recovery could have been undoubtedly greatly shortened by Vitamin C therapy.  And they could have quite easily died as well. Many of you reading this probably know someone in a similar situation who has contracted or been exposed to one of the above deadly disease.

So why would Vitamin C therapy not be considered and why hasn’t it been studied?  Well, you know the answer to that:  you can put a patent on it, so why bother, right?

NOTE: It is important to note that generally the physicians are talking about high dose Vitamin C.  You cannot generally achieve the dosages necessary to kill one of these superbugs with the standard oral Vitamin C, even Ester-C, that you buy in the store.  This can only come from IV infusions of Vitamin C or (very large) liposomal dosages of Vitamin C (assuming you have a healthy gut).  These dosages alone increase peroxide levels.

CAUTION:  Do I have any cautions?  Supposedly Vitamin C has no known toxicty.  You can literally take grams and grams of the stuff with only minor symptoms displayed at best.  Does this mean high dose Vitamin C is without any risks whatsoever?  Well, the theory is that higher dosages cause excess peroxide production in inflamed tissues – and the excess peroxide is what kills the viruses – but leaves health tissues untouched.  The this seems to be born out by Vitamin C’s excellent clinical track record.

The key is that it must leave healthy tissues untouched as, for example, some experts believe that peroxide plays a role in Alzheimer’s:

“The ability for Abeta to generate H(2)O(2), and interactions of H(2)O(2) with iron and copper to generate highly toxic ROS, may provide a mechanism for the oxidative stress associated with Alzheimer’s disease. The role of heavy metals in Alzheimer’s disease pathology and the toxicity of the H(2)O(2) molecule may be closely linked.” [2]

Bottom line:  Just keep in mind that many people will die or suffer serious damage from some of the viruses above with no known major side effects. If peroxide were really damaging neurons, you would expect that we would have heard about it.  But discuss the above with an expert or two.  And let me know what you find out!  I’m excited that we likely have a cure here that could save millions of lives.

REFERENCES:

1)  Med Sci Monit, 2014, 20: 725 732, “Effect of high dose vitamin C on Epstein-Barr viral infection”

2) Drugs Aging, 2004;21(2):81-100, “Role of hydrogen peroxide in the aetiology of Alzheimer’s disease: implications for treatment”

Three Engines to Improve Testosterone Production.

3) Sex. Now I’m not trying to tell anyone how to live their life, but it may be time to make up with the little woman. She may be the key to your testosterone production.  You heard that right – sex is a good way to improve your testosterone. Some of you have all but given up on the idea, but it may be time to ramp up the romance like the days of yore.  Read about How Sex Boosts Testosterone Dramatically.

I would also like to mention that there is really a fourth way if you’re not a weight lifter:  there is also significant evidence that you can Boost Your Testosterone through Weight Lifting. However, the numbers are not quite as big as the above three, but it is definitely worth considering.  Be careful not to Overtrain however as that will devastate your testosterone.

So keep in mind that you may be able to forget the pills and the gels. Of course, first talk to your physician as low testosterone can cause many conditions from osteoporosis to anemia to Metabolic Syndrome, so it may be necessary to get treatment right away. Don’t take the easy way out unless you have to. Many males have given up on all three of the above items and yet these three are usually their most powerful engines of testosterone.  You can not expect to have abundant testosterone with these three on hold. Again, if you really want to improve your testosterone, it’s lifestyle that really counts!

However, it is important to note that typically one will see testosterone increases from the above items in the 25-50% range (if you are having issues in one or more of them of course).  This may not be enough to get you where you and your physician want you to be.

By the way, another biggee is weight loss:  men can experience a doubling or more of their testosterone in some cases simply by 1) resuming normal calories (when dieting) and/or 2) losing a significant amount of weight.

The good news, though, is that there are there much more safe and reliable ways to dramatically improve your testosterone.  In fact, I call them the Big Three Ways to Improve Your Testosterone and, more importantly, almost every guy can increase his testosterone using these three:

1)  Sleep.  Remember this:  you don’t need pills, you need your pillow. Remember how mama used to put you on your bed and tell you it was good for you.  Well, mama was spot on with this one and it’s time to go back to your childhood – you’ll likely improve your testosterone levels by a good 20-30%.  Modern living leaves most of us watching TV late at night or sitting at our computers until the wee hours or a thousand other destractions that can keep us from significant testosterone improvement, around 30% or more according to some studies.  Read about How to Improve Your Testosterone through Sleep.

2) Competition. Science does not currently understand how the mind so dramatically effects testosterone levels, they just know it does. And that’s all you need to know as well. Metro just doesn’t work when it comes to testosterone:  as a guy you need challenges, victories and competition. It doesn’t have to be cage fighting – almost anything will do. You can expect testosterone improvement of 20-30% or more.  Read here for How Mental Attitute Controls Testosterone.

Pycnogenol - Peak Testosterone

Pycnogenol is one of several supplements that has good evidence for its ability to improve erectile dysfunction.  Pycnogenol, a patented water extract from the bark of specific type of pine tree in southwestern France, is a Nitric Oxide “booster”.  Of course, many foods are erection-promoting Nitric Oxide boosters. Pycnogenol, while not a food, is an example of another plant-based blood flow builder.

1) J Sex Marit Ther 2003 May-Jun; 29(3):207-213

2) J Inflamm (Lond),2006 Jan 27,3:1

3) Biomed Pharmacother,2006 Jan,60(1):5-9

4) J Phytotherapy Research, April 2008, 22(4)

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

6) J Reprod Med, 2004, (49)10:828-832

7) Hypertension Res, Oct 2007, 30:775-780

8) Cardiovascular Toxicology, March 2007,7(1):10-18

9) Clin and Appl Thrombosis/Hemostasis, 2004, (10)4:373-377

10) Urologe A, 1989 Jan, 28(1):48-53

11) Clin and Appl Thrombosis/Hemostasis, 2006, (12)211) Clin and Appl Thrombosis/Hemostasis, 2006, (12)2:205-212. See also Phytomedicine, 2000 Oct, 7(5):383-8.

12) Journal of Cardiovascular Pharmacology, Jul 1996, 28(1):158-166, “Effects of In Vivo and In Vitro L-Arginine Supplementation on Healthy Human Vessels”

13) J Am Coll Cardiol, 1996; 27:1207-1213, “Dietary supplementation with L-arginine fails to restore endothelial function in forearm resistance arteries of patients with severe heart failure”

14) https://www.prelox.com/pdf/prelox_research.pdf

According to history, Pycnogenol got its start from a group of French sailors who were nursed back to health from pine bark prepared by the local natives (I believe along the St. Lawrence in Canada).  Regardless of how true the story is, the natives were probably centuries ahead of their time as pine bark is loaded with antioxidants and other remarkable phytochemicals.  Pycnogenol has had stellar research results, including its ability to pump up your erectile strength. (See also How To Improve Erectile Dysfunction Naturally through foods.)

The study that put pycnogenol on the map in the fight against erectile dysfunction was one where a cohort of men (with erectile dysfunction of course) were given a combination of 1.7 G L-Arginine per day along side 2X40 mg doses of Pycnogenol. [1] L-Arginine is also a Nitric Oxide booster and the study showed that the two in combination significantly improved the erectile dysfunction of most of the men involved in the study. Several follow up studies have shown that varying combinations of Pycnogenol (40-120 mg daily) and L-Arginine (1.7 – 3.0 grams daily) result in 70-90% of men having restored erections and with no side effects. [14]

So how does Pycnogenol work its magic and improve erectile dysfunction??  It’s primary pathway is probably by directly boosting Nitric Oxide as mentioned above.  A 2007 study found that 180 mg daily of pycnogenol increased arterial expansion by 42 percent in young healthy males that were actually given an inhibitor of L-Arginine. [7] This means that Pycnogenol led to significant release of Nitric Oxide and that is exactly what you need to improve your erectile dysfunction.

Second of all, one recent study showed that patients taking 200 mg of Pycnogenol per day for just five days reduced several key markers of inflammation. [2]  A study from the same year found that Pycnogenol inhibited the COX-1 and COX-2 inflammatory enzymes. [3]

It is worth noting that COX-2 inhibition was the goal of the NSAID drug Vioxx that was pulled off the market by Merck:  it did cardiovascular damage to around 140,000 seniors during its infamous tenure by causing increased fluid retention and high blood pressure. Many of these individuals could have taken Pycnogenol which is now a clinically proven osteoarthritis-fighter. [4]  156 patients with knee osteo-arthritis were given 100 mg of Pycnogenol for three months and experienced an average 56% reduction in symptoms including pain reduction, improved ability to exercise and decreased edema.

Fourthly, sometimes venous insufficiency – a sort of Leaky Vein Syndrome – is one of the root causes for erectile dysfunction. One study found just that:  12% of patients studies had documentable venous insufficiency. [10]  Pycnogenol has been found to greatly help those with, at least, advanced venous insufficiency.  In fact, it was so powerful that at a daily dose of 150 mg, it actually beat out a medication typically prescribed for this condition. [11]

Also, if you already have high blood pressure, Pycnogenol has been found to help protect you from the damage that it does to your heart. [8]  High Blood Pressure is very hard on many parts of the body, including the brain and various organs including the heart. Pycnogenol has also been shown to protect people with Blood Pressure from the edema that sometimes results from their medications. [9] In other words, Pycnogenol may not only help you to improve your erectile dysfunction, but it may buy you time to get to the root of your Blood Pressure problems.

The only downside to Pycnogenol is that it is patented, which tends to keep the price higher than many supplements. This is good, because the company apparently very carefully watches quality control which shows in their stellar research results. You can also save quite a bit by going through an online discounter such as Amazon: TwinLabs Pycnogenol Capsules, 50 Mg, 60-Count Bottle.

If you want to follow what was done in the studies, just couple between 1 and 3 of the above tablets daily (50 mg – 150 mg daily) with about 1.5 grams of L-Arginine. You can get L-Arginine very reasonably at either Walmart or Amazon: L-Arginine (500mg).

I do also want to mention that Pynogenol is very likely skin protective as well.  Collagen is the backbone, if you will, of your skin and Pycnogenol has been shown to protect and even reconstruct collagen fibers in aging or damaged connective tissue.  Pycnogenol also reportedly protects Vitamin C, which is also a collagen rebuilder.  So Pycnogenol will not just help improve your sex life through improving your erectile dysfunction – it will also very likely improve your already dashing good looks while it is at it.

By the way, a hot tip that you can pass on to the woman in your life and score a few points is that pynogenol has been found to relieve the symptoms of menstruation at least in one recent study.  Much of the pain associated with menstruation is believed to be associated with inflammation and Pycnogenol, 30 mg twice daily in this case, helped significantly with this woman’s issue. [6]

CAUTION:  The only caution that I have about Pycnogenol is that the studies all couple it with L-Arginine, which has some potential issues.  However, the dosages of L-Arginine used in the Pycnogenol erectile-dysfunction studies are all relatively low dose (1.5 g – 3.0 g).  Read my link on L-Arginine for more details.

NOTE:  Some studies have shown L-Arginine helps directly.  Still other research with L-Arginine have produced lackluster results.  For example, one study of healthy males showed no increased blood flow from 20 g/day, which is a very large dosage [12].  Similar results were achieved in patients were discovered in patients with heart failure as well. [13] So the bottom line seems to be that L-Arginine, to work effectively, need a solid Nitric Oxide booster.

REFERENCES:

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]

Aphrodisiacs: Male Libido Supplements - Peak Testosterone

Or maybe you’re a male who just wants to enhance your sexual desire using some scientifically-backed male libido supplements?  Well, we have good news:  there are several legitimate, scientifically-verified such supplements that seem to work quite well on the male brain.. Yes, it’s Christmas at Peak Testosterone.

However, one should keep in mind that there are several medical conditions that can cause waning libido, almost all of which should be checked by a doctor.  For example, no male libido supplement on planet earth can help stimulate you if you are low in testosterone.  Testosterone is simply too intimately tied to male libido.  Read this link on Low Testosterone Symptoms if you think that might be an issue.  Lack of sleep, depressed immunity, depression, stress, relationship issues and many other things can do the same.

1)  Maca.  We have already covered Maca’s sperm and erection enhancing properties in our discussion of Maca and in our Erection Supplementation Guide. But what you may not know is that Maca has had a reputation for centuries among Peruvians for its libido-increasing powers among male tribal members.  And animal studies bear out the ancient wisdom. [1]

In fact, one animal study turned rats into rabbits.  Don’t believe me?  It all started when researchers studied rats and put one male rat in with two virgin female rats.  Rat heaven, eh?  Researchers were astonished to find that each male rat entered, i.e. penetrated the female rats over fifty times in a three hour period! [2] When is the last time you did that, mate?  This greatly exceeded the number of penetrations performed by the Maca-less rats. Those rats just couldn’t get enough.

2) Muira Puama. Maca comes from Peru. Muira Puama comes from the same continent in Brazil. Most of the studies on Muira Puama’s aphrodisiac qualities have been done by a Frenchman. But, then, who better to study an aphrodisiac than a Frenchman, right?  One of his studies on human subject showed that about 2/3 of low libido participants were helped by taking Muira Puama. [3]

3) Tribulis Terristris. Tribulis is tremendulis and fantabulis. We have covered this herb elsewhere, including How to Improve Testosterone and Super Sexual Herbs, but made scarce mention of the fact that Tribulis Terristris also has evidence of being a decent male libido supplement at least in animals. [4] It seems to work this magic by increasing DHEA and Nitric Oxide.

4) Ginseng. Korean Ginseng was shown in one study to improve erectile strength and function in a number of ways, including boosting the beloved Nitric Oxide. [5]  This same study found that Ginseng boosted libido and other animal studies have implied that sexual desire is enhanced by this herb as well.

5) A specific extract of the food and spice Fenugreek has been shown to be a significant libido and orgasm booster.  For more information, see my link on The Benefits of Fenugreek. (There are a couple of Cautions with this herb as well.)

CAUTION 2: One male libido supplement that gets some press is Damiana.  However, it’s powers are poorly documented and debatable in males anyway.  In addition, it has been shown to be estrogenic, the last thing most of us guys need. [6]

CAUTION 3:  Some pills are what I would call an anti-aphrodisiac. Beta blockers (for high blood pressure/arrythmias) are notorious libido reducers.  Cimetidine (Tagamet) for stomach acid is another interesting case, because it can actually cross the blood-brain barrier and somehow interferes with sexual desire in many patients. [7] Dopamine is, in general, associated with an increased sex drive and seratonin with the opposite.  For this reason, almost all common antidepressants can lead to a loss of libido. In fact, the research shows that a great many of the antidepressants lead to loss of libido, erectile dysfunction and delayed orgasm. [8]

1) J Ethnobiology, 1981, 1:208-212

2) Urology, Apr 2000, Qun Yi Zheng

3)  Ethnopharmacology, Mar 1995, Male Sexual Asthenia – Interest in a Traditional Plant Derived Medication

4) Ann Acad Med (Singapore), Jan 2000, 29(1):22-26

5) Int J Impot Res,Sep 1995,7(3):181-6, “Clinical efficacy of Korean red ginseng for erectile dysfunction”

6) Journal of Ethnopharmacology. 120:387-393, “Anti-Aromatase Activity of the Constituents from Damiana (Turnera diffusa)”

7) Can Med Assoc J, Aug 18 1979, 121(4):404 405, “Diminished libido with cimetedine therapy”

8) Indian Journal of Medical Sciences, 2001, 55(3):139-148, “Antidepressants induced sexual dysfunctions”

DHEA: Possible Dangers? - Peak Testosterone

Testosterone Replacement Therapy (TRT) has been a large success to date and improved the lives of many hypogonadal men (such as myself), so why not some of the other hormones? DHEA is an example of a hormone with considerable promise. One study shows, that when combined with HIIT (High Intensity Interval Training), it can boost free testosterone levels substantially. (See my page How to Increase Your Testosterone Levels Naturally for details.) And, as I mentioned in my page on How to Increase DHEA, we had one man claim that DHEA restored his morning erections. And DHEA seems to have very powerful anti-diabetes, anti-Metabolic Syndrome properties.

So DHEA definitely has some excellent properties, but is there a dark side?  I think the argument is weak against DHEA, assuming it is taken within physiological dosages.  To protect against taking too much, what I see the savvy doctors doing is the following:

a) Testing a man’s DHEA-S first and making sure he is in the lower part of the lab’s range.  Many men are actually high in DHEA-S, so taking DHEA makes no sense in that case.

b) Giving a man low dose (usually oral) DHEA-S in order to hit a DHEA-S target that is usually in the upper mid range of DHEA-S.

c) Making sure with continuted monitoring that the man does not go too high in DHEA-S on an ongoing basis.

I believe the above precautions will avoid almost all problems, but, of course, it’s always best to consult with a physician or naturopath first.

NOTE:  A combination of DHEA and pregnenolone got rid of my lifelong struggle with some anxiety.  Read more about here:  Low Dose DHEA and Pregnenalone.

1.  Arrhythmia. Ray Sahelian has stated that many users of DHEA, especially in medium and higher dosages, have experienced arrhythmias. [1] It is too early to tell in what subpopulations and circumstances this occurs.  Adding to the confusion is the fact that one study showed that the higher the (non-supplemented) levels of DHEA, actually DHEA-S, the lower the risk of atrial fibrillation, which is the most common kind of arrhythmia. [5] However, the fact that someone naturally has high levels of DHEA does not necessarily equate to the same physiological situation as someone being low and then supplementing.  An underlying, predisposing condition could remain.  Or it could be that those who are already high and supplement occasionally have an arrhythmia.

2. Negative Brain Effects?  Ray Peat warns against overly elevated DHEA levels:

“One study has found that the only hormone abnormality in a groupt of Alzheimers patients’ brains was an excess of DHEA. In cell culture, DHEA can cause changes in glial cells resembling those seen in the aging brain. These observations suggest that DHEA should be used with caution. Supplements of pregnenolone and thyroid seem to be the safest way to optimize DHEA production.” [2]

Again, holding DHEA-S levels to mid range values should alleviate these kind of concerns, but keep in mind that there are no long term studies with DHEA that I know of.

3.  Possible Increasing PSA?. In general, DHEA is thought to be anti-cancer.  However, there are reports of men taking DHEA who have spiked their PSA’s. [3][4] Is this coincidence?  Well, without some study work, it is difficult to say.  But you may want to take your PSA before and after to make sure.  And, if you have had issues with your PSA, discuss with your doctor.  Again, this should not be an issue with the lower dosages that I am used to seeing.  See my page on DHEA Dosages for more information.

4. Possible Gynecomatia. The steroid boards have quite a few posts of men getting gyno from taking larger doses of DHEA.  However, from what I can tell, this is from taking very large dosages of DHEA – 500 mg +.

5. Increased IGF-1. DHEA has done fairly well in the cancer studies from what I have read. However, one distrubing property:  it increases IGF-1.  IGF-1 is the growth factor that is ground zero for a lot of anti-aging research, i.e. elevated IGF-1 levels are associated with accelerated aging.  In addition, abundant research shows that higher levels tend to fuel epilthelail cancers and adult onset diabetes. Of course, one would not want to go too low since IGF-1 is anabolic and supports many key metabolic processes. In any event,  there are several studies that show that DHEA supplementation increases IGF-1 in men. [6] The good news is that it seems to minimally raise IGF-1, assuming one is using a reasonable dose <= 25mg.  I discuss that the research that shows in my page on DHEA and IGF-1.

FINAL COMMENT: Many experts point out that the great majority of side effects with DHEA occur at higher dosages. For this reason, they recommend much lower dosage of DHEA, such as Ray Sahelian who believes 5 mg is the most appropriate dosage considering our bodies only make 10-15 mg/day probably..

NOTE:  Keep in mind that most people who take DHEA do not test to see if they are low. You can test your DHEA levles very inexpensive here:  Inexpensive Testing Labs (Mostly U.S.). I make this comment, because boosting a little very low DHEA levels is probably a different thing that a man with high levels pushing his DHEA even higher. Deficiencies usually need correcting and pushing yourself supraphysiological is often not a good thing when it comes to hormones.

REFERENCES:

1)   https://www.tldp.com/issue/175-6/Caution.html

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

3) https://www.nasw.org/users/nbauman/dhea.htm

4) https://www.medhelp.org/posts/Prostate-Cancer/Sudden-PSA-Rise–Hormonal-changes/show/1781895

5) Eur J Prev Cardiol. 2014 Mar;21(3):291-8, “Dehydroepiandrosterone sulfate levels and risk of atrial fibrillation: the Rotterdam Study”

6) The Journal of Clinical Endocrinology & Metabolism, Published Online: July 01, 2013, “Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age.”

Hair Testing Analysis for Men - Peak Testosterone

4. Chelation. If you are high in mercury – and between 1% and 5% of the population are – then some chelation is likely in order assuming that you do not still have the metal fillings in your mouth.

Dr. Cutler states that ALA (alpha lipoic acid) is an excellent and safe chelator.  ALA is available in any vitamin store as well as many retail chains.  He recommends a protocol with ALA every few hours for a few days and then stopping for a few days.  Sometimes DMSA or DMSP are added in order to bind up the extra mercury and make the process a little safer during the chelation process.  I hope to cover Dr. Cutler’s chelation protocol on another page.

NEWS FLASH: Dr. Cutler – and a number of alternative physicians as well – have been reporting miraculous results. The reason is that mercury overload can cause schizophrenia-like, ALS-like and autistism-like symptoms, resulting in many misdiagnoses.  However, many of them when chelated using Dr. Cutler’s simple and inexpensive protocol, are in large part and sometimes totally cured.  Dr. Cutler believes that a significant percentage of children diagosed with autism undoubtedly have a heavy metal issue and his book relates some very moving stories of children who have started speaking again and become fully functional through chelation.  Just do a search on “Cutler protocol mercury” or something similar and you’ll pull up many interestin stories.

CAUTION: As mentioned above, chelation with ALA should not be attempted with mercury amalgams still in your mouth.  The reason is that the fillings are leaking mercury into your system and then chelation usually moves some mercury, and so this may not lead to unsafe levels.

Hair Testing for Mercury, Heavy Metals and Some Nutritional Deficiencies. In my opinion, getting a hair test done is a no brainer for a man that is experiencing many of the typical symptoms that I see all the time on Peak Testosterorne Forum.

Of course, many other symptoms could be listed as well, but the key thing to notice is that a lot of the symptoms of low testosterone overlap with mercury another heavy metal overloads. And hair testing does a good job of picking up on these type of toxic overloads.  Better yet, here in the U.S. anyway, it’s cheap and there are excellent materials from the labs and in books to help you understand your results.  (Of course, you should go to a doctor or naturopath who works with this day an dnight to get the actual interpretation of your results in my opinion.)

NOTE: Let me say that I am indebted to the Dr. Andrew Hall Cutler’s two books on the subject:  Hair Test Interpretation and Amalgam Illness, Diagnosis and Treatment.  .

Here are the simple steps that one can take based on what I have gleaned from these books:

Step 1. Mercury Fillings. First of all, have someone look in your mouth (if you don’t know) and see if you have any metal (mercury amalgam) fillings.  These are not as widely used as there were a few decades ago, but many of us have some of them.  (My wife had five removed and I still have two in my mouth!)

Step 2.  Hair Test.  Get a hair test done.  I used Direct Labs, who mailed us out a hair test kit. The test was called “Hair Toxic & Essential Elements-DD KIT” and was $100 on sale. We cut samples of my wife’s hair and mailed it back where it ended 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.  Conveniently, Doctor’s Data is what Dr. Cutler uses in his books and case studies.  (I have no affiliation with either.)

3a. Results – Mercury. Evaluate your results for mercury overload.  This can be done with a protocol outlined by Dr. Cutler in his Hair Test Interpretation book in great detail.  The reason that this requires special consideration is that the great majority of men with mercury overload will not actually show up high mercury, because mercury usually gets trapped deep within tissues including neurons behind the blood brain barrier. So mercury is actually stored and plasma mercury  levels then fall and can be quite low even though the person is quite toxic.

And how do you tell if someone has too much mercury stored and if is causing issues?  The answer lies in something Dr. Cutler describes as “abnormal mineral transport”.  What happens is that mercury attaches to a large number of enzymes in your body and disrupts their normal function.  One of the direct effects of this is that your body often loses its ability to handle, detoxify and clear various minerals and metals. Dr. Cutler shrewedly came up with a way to identify this condition and has outlined Five Rules of Dysfunction Minteral Transport in his book Hair Test Interpretation. I will show an example of this in my page on Hair Testing and Mercury.

3b. Results – Other (Non-Mercury) Heavy Metals. Your hair test results will also cover a wide variety of other metals – lead, antimony, tin, silver, arsenic, etc.  If any of these are high, this can cause ugly issues and should be addressed by either removing the source of exposure and/or chelation.  It should be mentioned, however, that these can be high due to high mercury levels causing transport issues.

By the way, a case in this category that really caught my attention was that of one of our senior posters (EH) on the forum.  EH is a smart and well-educated man that works as a scientist and he got a hair test that showed that he had high levels of cadmium. Cadmium is not something you want a lot of – it essentially acclerates aging in the body.  EH’s high levels of cadmium struck him as odd, so he did some research.  He found out that Consumer Reports had done an expose showing that most cocoa sold today had been contaminated with cadmium, and he had been consuming large amounts of cocoa powder before his test. You can read his thread here if you are interested:  Cadmium and Cocoa.

The point is that if he had not had this test, he probably would still be consuming large amounts of cocoa and in a year would have started feeling lousy with no idea as to why.

3c. Results – Mineral Deficienies / Adrenal and Thyroid Deficiency. While hair testing will not give you an exhaustive nutritional analysis, it does still cover a lot of key markers.  Furthermore, since magnesium, calcium, potassium and sodium are measured in the hair test, valuable information about adrenal and thyroid function can be extrapolated as well.

The Benefits of Low Dose HCG for Men on TRT - Peak Testosterone

Overtraining can make you sick, lower your erectile strenght and libido, lead to a collapse of adrenal hormones and even lower testosterone, something I discuss in my page on Overtraining and Testosterone. And there have even been cases, if OTS (Overtraining Syndrome) goes on long enough, that is has quite literally destroyed the individual’s health.  You might as well sign up as a prisoner of war in some remote corner of the planet – it’s essentially “anorexia for men.”

As men we are trained to ignore pain, much less the more subtle issues that arise from something like overtraining.  And, unfortunately, some of the best measures of overtraining are fairly subtle and subjective.  These include “poor performance in competition, inability to maintain training loads, persistent fatigue, frequent illness, disturbed sleep and alterations in mood state.”  [4] Unfortunately, if a guy can ignore major pain and discomfort, he will probably also easily ignore these kind of “soft” tests for overtraining as well.

Plus, a problem that I have seen a number of times on  The Peak Testosterone Forum is that guys who are overtraining can become like addicts.  They will even sometimes self-medicate with caffeine or energy drinks.  Poor sleep may come on slowly to where they almost forget what a good night’s sleep is like.  I have even known a marathoner who basically walked around with a cold all the time and said it was “allergies.”

So on this page I want to laser in some of the more objective measures of overtraining in the hopes that perhaps the hard numbers will get some guys to think a bit that maybe, just maybe they are overdoing it a little and that they could be compromising their long term health by doing so.

1. Hematocrit and Hemoglobin. Various markers of iron status have been found by many experts to be good markers for overtraining syndrome.  One of our posters explained why:

“There is lots of evidence here to suggest over-training. For example, a paradoxically and persistently low hemoglobin with no other explanation is consistent with a phenomenon called “march hemoglobinuria and hemolysis” due to excessive trauma to the feet and red blood cells. Trail marathons and long runs that last 3-4 hours are also excessive for most people. The author of the post also mentions that he notices a “reduction over time in my libido levels and muscle recovery after long runs or lifting.” [4]

What should you look for?  First of all, let’s look at the normal ranges for the latter two in men:

Hemoglobin:  14-18 g/dl

Hematocrit:  42-54%

Consider this statement from a research review that explained common signs of overtraining:

“Low levels of haemoglobin that remain within the normal range and iron deficiency are commonly recorded conditions among some groups of professional athletes, both female and male. These types of deficiency may result from an unbalanced diet, gastrointestinal (GI) bleeding during and after long distance running and, possibly, chronic low-grade systemic inflammation.” [5]

In other words, just because you are in range does not mean you are “out of the woods.”  Again, being in the low end of the range is often a sign – more on that below:

2. Ferritin. Related to iron status above is ferritin, which is a measure of the body’s iron stores.  Think of hematocrit and hemoglobin as a snapshot of current plasma iron levels, but ferritin a measure of the actual iron that gets stored in the body.  Ferritin is a great marker, because many athletes have been known to get low ferritin from overtraining. [5] Does this occur because of the low hematocrit and hemoglobin mentioned above?  This probably plays a role, but the actual driving force behind the low ferritin is actually much more insidious:

a) Excessive exercise leads to high levels of inflammatory cytokines. [6]

b) These cytokines cause increased levels of hepcidin, a hormone that controls iron.

c) Rising levels of hepcidin decrease iron absorption in the gut.

The bottom line is that if you have ferritin levels below about 25 ng/ml, you may be overtraining.

3. Low IgA. Because of the seemingly high incidence of URTI [UpperRespiratory Tract Infections] among athletes, much attention has focused on the mucosal immune system response to intense exercise training, using salivary IgA concentration as a marker. Low resting salivary IgA concentration has been reported in some elite athletes. Salivary IgA levels decline during prolonged periods of intense exercise training and IgA concentration is lower in overtrained compared with well-trained swimmers. Low salivary IgA concentration is predictive of the subsequent appearance of symptoms of URTI over the short and long term.””

4. A/G (Albumin/Globulin Ratio). Many men know overtraining can literally make you sick and increase the risk of upper respiratory infections.  However, some men just don’t get sick very easily.  So what is an early warning sign, ideally a lab test, that might show issues in this area?  One of them is a high A/G ratio, which basically shows immunosuppression, i.e. an immune system that is functioning suboptimally.  It is important to talk to your doctor about this, because it can in rare cases be a sign of something serious, such as leukemia.

However, a high A/G ratio can also tie into overtraining. It turns out that overtraining is known for suppressing the immune system – it’s kind of “Cancer Lite” if you will on your immune system, something I alluded to in #3 above. One study stated it this way: “A tentative trend may be discerned whereby light to moderate exercise may increase immune responsiveness but high-level competition sport, especially if it involves extensive endurance training, may lead to a degree of immunosuppression.” [1]  Thus, overtraining can suppress immunoglobulins (IgA) and can lead to an elevated A/G ratio as well. Check out these three interesting studies done in one paper as an example:

“Study 1: Recreational joggers ran on a treadmill for 40 min at 55% and 75% VO2peak and competitive distance runners ran for 90 min at the same intensites. In both groups, IgA secretion rate did not change significantly after exercise at either intensity.

Study 2: Competitive runners ran on a treadmill for 90 min at 75% VO2peak on 3 consecutive days. IgA secretion rate decreased 20 to 50% after exercise (p < .001). Post-exercise IgA secretion rates were significantly lower (p < .05) on days 2 and 3 compared with day 1.

Study 3: Elite swimmers were followed over a 6 month season, with IgA concentration measured at 5 times. Throughout the season, IgA concentration was significantly (p < .05) lower in stale compared with well-trained swimmers.” [2]

The latter comment is particularly interesitng, because swimmers that were not improving, perhaps the key marker of overtraining, also tied with low IgA concentrations.  This indicates that IgA is very valid sign of overtraining.

NOTE:  I hope you noticed this common theme in the research:  light to moderatre exercise is incredibly good for you.  More intense and long gets questionable very quickly.

High BUN and Creatinine. These numbers are often high in endurance athletes (and bodybuilders). The reason?  Both of these tend to be high from to the breakdown of muscle that occurs in these sports.  Endurance athletes also tend to be dehydrated, which further elevates these values.

Recently, I was looking at the lab work of a marathoner that had some of the classic signs of overtraing, such as irritability and reactive hypoglycemia in the middle of the night.  (It was effecting his erections as well.)  Here were his results (from LabCorp):

BUN  20  mg/dl  Range:  6 – 24 mg/dl

Creatinine 0.9 mg/dl  Range: 0.76 – 1.297 mg/dl

Should he be concerned?  The rule of thumb that I have heard is that, if you are near the top of the range for an exteneded period of time, you could be putting a lot of wear and tear on your kidneys. The exact value where that occurs probably anyone’s guess.

One thing to notice is that his BUN/creatinine ratio is high (22) which probably indicates dehydration, again a comon problem in athletes.  (It can also indicate something more serious, so run it by your doc to play is safe.)

NOTE:  Taking creatine can raise BUN a little as well, but long term studies have shown no kidney issues in those with no kidney disease.

1)  Br Med Bull. 1992 Jul;48(3):518-33, “Sport and the overtraining syndrome: immunological aspects”

2) Int J Sports Med, 1994 Oct, 15 Suppl 3:S179-83, “Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining”

3) Immunology and Cell Biology, 2000, 78:502 509, Special Feature for the Olympics: Effects of Excercise on the Immune System, “Overtraining effects on immunity and performance in athletes”

4) https://www.peaktestosterone.com/forum/index.php?topic=8652.msg75359#msg75359

5) J Sports Sci Med, 2013 Jun, 12(2):249 258, “Do High Blood Hepcidin Concentrations Contribute to Low Ferritin Levels in Young Tennis Players at the End of Tournament Season?”

6) Med Sci Sports Exerc, 2000 Feb, 32(2):317-31, “Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress?”

Anxiety & Testosterone - Peak Testosterone

Anxiety can be one of the most miserable and incapacitating of all the low testosterone symptoms. For reasons I explain in my My Personal Health Story, I am pretty sure that I have been low testosterone all of my adult life. And I can remember thinking after my first testosterone injection, “Wow! So this is what it feels like to be a normal person!” Testosterone has a profound effect on the male brain – you can read more about it in my link on Testosterone and the Brain actually – and I felt it in an unbelievable way. I was always a pretty high anxiety person prior to going on Testosterone Cypionate Injections and it was T that finally came to the rescue. My manager, who still does not know I am on HRT of course, even commented on how much better I was doing.

And I am not alone. One of the most common complaints of men with low testosterone on the Peak Testosterone Forum is anxiety. This is just one of the reasons that it is so cruel for physicians to ignore men with low testosterone and say, “It’s all in your head” or “you’re testosterone is fine” The reality is that the anxiety can be incapacitating. Look at how much these guys are suffering with it:

“Im not sure were to start but here we go, and forgive me if it get lengthy, but I feel it’s important to see the whole picture.  I am 39 years old and have been suffering from anxiety, depresion to one degree or another since 1999.  Up until that point I had never had any issues with anxiety/depression.  I was healthy fit and vibrant, and loving life.” [1] (NOTE:  His testosterone levels were a very low 221 ng/dl!)

“I have suffered from anxiety for 11 years. I have tried almost every mental health drug out there and Benzos, nothing works except I get a heap of side effects. I am currently on Klonopin 1.0mg per day, Valium 11mg per day and Citalopram (Celexa) 40mg per day. I still cant lead a normal life. I feel tired, irritable, very low sex drive, poor erections, abdominal weight gain, poor concentration etc. I asked my Dr for my Testosterone levels to be checked, they came back at 8.5 (Levels range from 7.8-35.5) which is around 210 in the States (I am in the UK) so they are very very low.” [2]

“I started to have a little anxiety when I was 30 years old. It was mild and started from really no where that I could think of. I went to the Dr and had my blood work done. That was when I first noticed I had low T. My T then was around 222 to 250. I didn’t do anything about it and lived my life. I am now 43 yrs old and still have low t. My anxiety got a little worse, still on the mild side. I started weekly injections a few weeks ago of Cypionate and I have made an appointment to see Dr. Shippen in Feb. I was wondering if the low t and the anxiety have anything in common?” [3]

So how do we know that low testosterone can cause or worsen anxiety?  Well, of course, one obvious signpost is the fact that so many patients report it as a symptom.  Plus, many men like me, are significantly helped once on HRT.  Researchers were clued in with other lines of evidence as well.  For example, prostate cancer patients, who usually undergo androgen blockers, often have increased anxiety. [5] And animal studies were showing that low testosterone causes anxiety. [6]

When they looked at it in human studies, there were a few that showed the opposite however.  Nevertheless, many studies did still indicate the relation between hypogonadism and being anxious and we outline some of them below by year:

2000.  Contradicting the above was a case study of a high-anxiety young male, a 34-year-old, with “mental exhaustion, irritability, insomnia, poor concentration, and decreased libido.” [7]  His doc had tried relaxation techniques and medications, but nothing seemed to help.  And no wonder as his testosterone was a nasty 185 ng/dl!  So they put him on 200 mg injections and – lo and behold! – the patient experienced a miraculous recovery.  Of course, there were many such similar stories from men on HRT, but notice that this study almost expressed shock that testosterone could do this and stated “with this case report, we suggest including anxiety in the list of psychiatric manifestations of hypogonadism that improve with testosterone replacement therapy.”

2003.  A few years later a study looked at testosterone and anxiety in young males and found that “for boys, lower levels of testosterone and testosterone levels that decreased more slowly across the day were related to higher levels of anxiety–depression and attention problems.” [4]

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

2003. Yet another study mentioned that anxiety is a standard symptom in men over 50 with low testosterone. [9] So far so good.  However, then the researchers, in spite of studies #1-3 above, were very cautious and wrote that “the relationship between andropause and psychological symptoms such as depression is far from clear.”  We think that studies #1-3 are pretty clear!

Unfortunately, the current state of affairs is, as far as I know, that no researchers are advocating testosterone therapy as an anxiety cure or help in hypogonadal men. Perhaps this will change in time as it did for depression. [10])

In the meantime, additional evidence for the testosterone-to-anxiety link as science has uncovered many means of “biological plausability”, i.e. actual physiological ways that  giving a low T man HRT decreases anxiety.  Here are a few examples:

1. DHT in the Hippocampus.  Researchers found that in rats, it was DHT (or a related metabolite) that actually was the cause of reduced anxiety. [11] Of course, DHT is converted from testosterone in the male and so this is why increasing testosterone lowers anxiety. The researchers noted that the rats with reduced anxiety were more “exploratory”.  In other words, as anxiety goes down, creativity can increase. This is going to be good for your career and relationships.

2. Decreased Fear.  Although fear is considered a little different psychological animal than anxiety, it is obviously a related characteristic.  And, in general, as testosterone increases, fear is reduced. [12]  ‘

3. Reduced Amygdala Activity. The amygdala is the key area of the brain involved in your fight or flight response and reacting to fearful situations.  Testosterone has been found in several studies to dampen the activity of the amygdala to fearful situations and thus is an anxiety tonic under certain circumstances. [13]

So if low testosterone is a cause of anxiety, does testosterone always cure anxiety?   Of course not.  It doesn’t take much thought to come up with many different reasons for heightened anxiety, including past trauma, elevated adrenal hormones such as cortisol, chronic stress, major life events or even a bad mother-in-law or evil boss.  To really heal anxiety, it is important to take a holistic approach that looks at a multi-pathed solution.

WARNING: High estradiol can cause anxiety and other similar symptoms in men.  If you are on HRT, make sure your doctor monitors and manages your estradiol levels.  Some men get no relief from HRT and this is one of the more common reasons why.

1) https://peaktestosterone.com/forum/index.php?topic=1167.0

2) https://peaktestosterone.com/forum/index.php?topic=547.0

3) https://www.peaktestosterone.com/forum/index.php?topic=963.0

4) Development and Psychopathology, June 2003, 2:431-449″Salivary testosterone diurnal variation and psychopathology in adolescent males and females: Individual differences and developmental effects”

5) International Journal of Impotence Research, 2008, 20:157–161; “Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction”

6) Hormones and Behavior, Dec 2002, 42(4):448–460, “Testosterone Rapidly Reduces Anxiety in Male House Mice (Mus musculus)”

<p7) am=”” j=”” psychiatry,=”” 2000=”” ,157:1884-1884,=”” “testosterone=”” replacement=”” therapy=”” for=”” anxiety”<=”” p=””>8) Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Aug 1999, 19(8):951-956, “Testosterone and Andropause: The Feasibility of Testosterone Replacement Therapy in Elderly Men”

9) Ann Endocrinol (Paris), 2003 Apr;64(2):162-9, “[Testosterone and depression in men aged over 50 years. Andropause and psychopathology: minimal systemic work-up”

10) J Clin Psychiatry, 2002 Dec, 63(12):1096-101, “Testosterone therapy in late-life major depression in males”

11) Psychoneuroendocrinology, Jun 2005, 30(5):418–430, “Testosterone’s anti-anxiety and analgesic effects may be due in part to actions of its 5α-reduced metabolites in the hippocampus”

12) Biological Psychiatry, May 2006, 59(9):872–874, “A Single Administration of Testosterone Reduces Fear-Potentiated Startle in Humans”

13) Psychoneuroendocrinology, Jun 2009, 34(5):687–693, “Amygdala activity to fear and anger in healthy young males is associated with testosterone”

Diabetes and Erectile Dysfunction - Peak Testosterone

The classic first signs of diabetes are extreme thirst and hunger coupled often with excessive urination and inability to heal.  However, if you let it get to that point, those symptoms are just the beginning of your problems: significant damage has likely been done to your arteries and endothelium and that’s bad news for your health and your sex life.

Diabetes is a plague in almost every modern industrialized society.  In America, for example, studies have shown that 14% of males have diabetes. That is about one out of every seven guys struggling with a major illness that is literally eating their arteries and organs from the inside out.  And this does not even take into account all the males, probably an additional 3-6%, depending on age, that have diabetes and do not even know it.

Diabetes is a huge risk factor for erectile dysfunction and one study estimates that as high as 50% of men with diabetes have significant erectile dysfunction. [1]  The study explains that “in addition to the disease’s effect on small vessels, it may also affect the cavernous nerve terminals and endothelial cells, resulting in deficiency of neurotransmitters Additionally, in diabetics, corporal smooth muscle relaxation in response to neuronal- and endothelial-derived nitric oxide (NO) is impaired, possibly due to the accumulation of glycosylation products .” [2]

REFERENCES:

1) Population Health Metrics, 2009, 7:16, “Diabetes prevalence and diagnosis in the US states: analysis of health surveys”

2) Urol Clin North Am, 2005 Nov, 32(4):379-95, “Physiology of penile erection and pathophysiology of erectile dysfunction”

3) Diabetes Care, Apr 2003, 26(4)1093-1099, “Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?”

4) Eur Heart J, 2004, 25 (21):1861-1862, “The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe”

In other words, diabetes is very hard on erections in almost every way possible, attacking the endothelium, nitric oxide, nerves and neurotransmitters.  What is left when those are damaged or depleted after all?  Even worse, diabetes is known for resulting in even more severe erectile dysfunction than normal. [3]  Diabetics score worse in almost every major category including erectile function, intercourse satisfaction, sexual desire, overall satisfaction, and psychological impact.

NOTE: Yes, testosterone has miraculous effects on male insulin levels, i.e. it lowers them significantly, a fact I cover in my book Low Testosterone by the Numbers.  This effect of this appears to be much more powerful than I realized.  I recently spoke to to a worker in an HRT clinic and she said that ALL of their Type II diabetic patients were able to totally eliminate their need for insulin.  This is astonishing.  Yes, a few had to keep taking Metformin, but nevertheless, this is a remarkable reversal.  This clinic increases testosterone via weekly injections ito around 1000 ng/dl.

And it’s no wonder:  diabetes is brutally hard on the heart and arteries.  Diabetics suffer significantly more strokes, heart attacks and high blood pressure than non-diabetics.  Much of this has to do with the fact that arteriosclerosis is accelerated with diabetes due to elevated inflammation, oxidation, fibrinogen, arterial plaque and weight around the midsection.  Diabetes raises almost every risk factor for cardiovascular disease and, as I often mention, the Heart and the Penis are intimately linked.  Even worse, diabetes can be a silent killer:  one European study found that about one third of heart attack patients were diabetic and didn’t know it. [4]

Diabetics can get into trouble even with relatively normal LDL levels because their LDL molecules are the smaller, more deadly kind.  They also usually have worse HDL and triglyceride levels to go along with it.  In other words, the whole lipid profile is skewed negatively.

All of this is generally leads to severe erectile dysfunction.  Yes, diabetics can get some relief from PDE5 inhibitors such as Viagra and Cialis according to the studies, but the studies also show that the results are not as long-lasting.  And who wants to be dependent on a pill for their sex life?

So the bottom line is to keep your blood sugar and glucose under control and do everything within your power to avoid diabetes in the first place. This is especially important if you have a family history of diabetes.

What’s a fella to do?  Fear not:  I’ve got a great list of preventative measures in my link on Metabolic Syndrome Solutions. But start now:  don’t wait until the damage has already been done.  In addition, read my link on Natural Ways to Prevent Diabetes and consider the book Reversing Diabetes, an M.D.’s program to dramatically help and sometimes even completely things.

Maca and Its Effects - Peak Testosterone

However, Maca’s superpowers go well beyond simple reproductive effects.  Maca seems to it definitely helps with some of the things that plague us in our modern lifestyles and middle age, including energy, libido, vitality, stress management and so on.  And for guys that take care of themselves with diet and exercise as well, it can give you that old I-want-to-rip-her-clothes-off feeling.

So how does Maca work its powerful effects?  One would immediately expect it to be a testosterone or leutinizing hormone increaser, but studies have not shown that to be the case.  The answer probably lies in its effect on our central nervous system.  For example, a 2010 study in vitro, i.e. “test tubes”, and on rats found that maca was neuroprotective. [1]  Furthermore, it has (at least in women) been found to overcome SSRI-induced sexual dysfunction. [2]  SSRI’s, the largest and most popular class of anti-depressant drugs currently on the market, are famed for their “relaxing and calming” effect, which, unfortunately, can translate to an overly tranquilizing effect on sexual desire.  Maca, again at least in women, helps overcome this neurotransmitter soup and reignites passion.

CAUTION:  We’ve had a couple of posters on the Peak Testosterone Forum have pretty negative experiences with Maca. One man said that it gave him E.D. and another lower testosterone levels. Please read this thread for more information. I’m not sure what to think as I have had many positive comments and it is a widely used supplement, but I want to include this information.

In addition, Maca also increased glucose tolerance in these rats and definitely lowered glucose levels in their blood.  This means Maca may help with Metabolic Syndrome, which is one of the biggest enemies of our sexual lives and a common source of erectile dysfunction.  Maca may also partially do its work by improving some of the basic risk factors that plague modern, industrialized lifestyles.  For example, the same study on rats fed high-sucrose diets found that Maca lowered bad cholesterol, total cholesterol and triglycerides. [3]

I also noticed something very interesting once I started taking Maca:  I instantly started gaining muscle..  It is unlikely that Maca did this through increasing testosterone levels, but there is another possible mechanism:  Maca has been reported to very significantly lower cortisol levels, at least in animals, [4] and cortisol is a known mucscle-destroyer.

Of course, all of these impressive qualities need to be better verified in human studies, but the results so far are remarkable by all counts.  Maca may be on track to be the next Pycnogenol, which is well-known for lowering multiple heart disease risk factors all the while improving inflammation, blood pressure and erectile strength.

Almost all Maca has the advantage of being organic, so you do not have to worry about some of the issues that plague other plants.  It is grown at such a high altitude in the Andean mountains that it has no real competitors and spraying is simply not necessary.  I take it in its most natural form from Navitas: Navitas Naturals Organic Raw Maca Powder and I always cook it as that is how the Peruvians have almost always eaten it as well.  (For cautions regarding Maca, see the bottom of this page on The Power of Maca.)

Of course, do not make any changes without talking to your doc, hopefully a good and knowledgeable one.

REFERENCES:

1) Annals of the New York Academy of Sciences, Published online Apr 29 2010, “Neuroprotective effects of Lepidium meyenii (Maca)”

2) CNS Neuroscience & Therapeutics, Aug 13 2008, 14(3):182-191, “A Double-Blind, Randomized, Pilot Dose-Finding Study of Maca Root (L. Meyenii) for the Management of SSRI-Induced Sexual Dysfunction”

3) Journal Plant Foods for Human Nutrition (Formerly Qualitas Plantarum), Jun 2007, 62(2), “The Influence of Maca ( Lepidium meyenii ) on Antioxidant Status, Lipid and Glucose Metabolism in Rat”

4) International Journal of Biomedical Science, Feb 15, 2006, 2(1):15-29, “Short and Long-Term Physiological Responses of Male and Female Rats to Two Dietary levels of Pre-Gelatinized Maca (Lepidium Peruvianum Chacon)”

Low Fat Diet: The Mind-blowing Bedroom Benefits

A Low Fat Diet is, quite simply, looking like the most powerful and promising diet on the planet right now. It is particularly important for most middle-aged and senior men to consider, because modern living is so hard on the endothelium and prostate and, as we’ll show below, some of the big benefits of a Low Fat Diet deal with these.  NOTE:  This diet is sometimes called the Ornish Diet, because it was popularized in several studies from famed researcher Dr. Dean Ornish.

1) Lancet,1990,336:129-33;Am. J. Cardiol,2003,91:1316-22

2) https://findarticles.com/?noadc=1

3) Circulation, 1992, 86:1-11

4) The Lancet Oncology, 9(11):1048-1057, “Increased telomerase activity and comprehensive lifestyle changes: a pilot study”

5) https://www.sciencedaily.com/releases/ 2011/10/111025135931.htm

6) Ann Med, 2005, 37(5):347-56, “Fat in the liver and insulin resistance”

7) Am J Med, 1985 Jan, 78(1):23-7, “Effects of a high-complex-carbohydrate, low-fat, low-cholesterol diet on levels of serum lipids and estradiol”

Really the Low Fat Diet might better be called The Last Chance Diet as it offers a final chance for healing to all those who have destroyed their health through a Western diet and lifestyle. Think I’m exagerrating?  Judge for yourself. Below are some of the key benefits – and they are huge – of a Low Fat Diet:

NOTE:  One diet that has done poorly in the research, contrary to popular opinion, is the Atkins (or Low Carb) Diet. This type of diet is okay for weight loss, but for most people will likely lead to issues. Read about it here.)

14 Powerful Reasons To Go On a Low Fat Diet

1. Testosterone-to-Estrogen (Estradiol) Ratio. It is true that for some men, they may experience a slight reduction in total testosterone levels by going on a Low Fat Diet depending on how they have been eating. However, what most men do not know is that they will likely experience a very significant improvement in their all-important testosterone-to-estrogen ratio. This is what many of your tissues really care about: how many “male” hormones you have floating around versus “female”. The more male hormones you have proportionately, the more those receptors will get activated after all. (See my link on the Testosterone-to-Estrogen Ratio for more details.)

And what a difference a Low Fat Diet can make!  One study examined the hormones of 21 males who went on a Lowf Fat Diet and found that there estradiol (the “bad” estrogen or E2) dropped from 47.2 to 23.8 pg/ml on average.  This is a reduction of over 50% and effectively halved their estradiol levels. [7] And the remarkable thing is that their testosterone stayed constant at 510 ng/dl!)  This means that their testosterone-to-estrogen ratio was effectively doubled just by this simple dietary change.

CAUTION:  Low testosterone or hypogonadal men generally should not reduce their estrogen any more or they can go too low and be at risk of low estrogen.  See my link on Why Men Need Estrogen for more information.

2. Reversing Arteriosclerosis. One of the curses of modern living is accelerated arterial plaque buildup.  In addition, men with low testosterone are even more at risk for arteriosclerosis (likely due to increased insulin levels).  One of the huge benefits Dr. Ornish’s research showed was that one could actually partially reverse the plaque buildup in the arteries.  Just as important, a Low Fat Diet stabilizes the plaque, because it is the unstable plaque breaking off that generally leads to most heart attacks.

So what’s the big deal about removing a little arterial plaque?  Remember that this plaque is covering your precious endothelium, which is supposed to be pumping out nitric oxide to lower your blood pressure and give you erections.  A diet that can actually partially reverse arteriosclerosis is proving that not only can you stop the normal plaque buildup from aging, but you can actually heal and repair your arteries and blood vessels.  What middle-aged guy would not want the chance to de-age his arteries, especially the ones inside his penis??

And remember that for a normal sedentary person on a Western Diet, arterial plaque just keeps building and building at a rapid rate.  Many men, by their late middle age or early senior years have 80% or 90% blockages. So it would be a remarkable accomplishment to halt this relentless process much less reverse it.

Also, consider the a Low Fat Diet does what no other technology or diet has ever been able to do.  For example, Big Pharma tried to reverse arteriosclerosis by throwing various drugs at the situation and have had very limited success.  Astra-Zeneca, for example, funded a study on patients with high C-Reactive Protein (CRP) levels.  Patients were given a placebo or a huge dose of their statin drug called Crestor, or rosuvastatin by its generic name, and did successfully reverse heart disease.  However, this was a massive dose and I probably don’t need to tell you about the https://www.peaktestosterone.com/.

In other words, Big Pharma has pulled out their biggest guns and still cannot do what the Low Fat (or Ornish) Diet does.  The Low Fat (or Ornish) Diet, as you will see below, does much, much more than just simple reduction of arterial plaque ad all without any known long term side effects!

3.  Reduced Liver Fat.  Decreasing arterial plaque is incredibly impressive, but just as impressive and critical to ones health is the fact that a Low Fat Diet can reduce liver fat.  Fat storage in the liver has become recognized as one of the leading causes of heart disease and, undoubtedly soon, of erectile dysfunction. A Low Fat Diet can put the brakes on liver fat and even decrease it according to the latest reserach. [6] For more information, read my links on The Liver and Inflammation and https://www.peaktestosterone.com/. (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.)

4. Blood Pressure and Hypertension. Besides cleaning out your arteries, a Low Fat Diet usually very significantly lowers high blood pressure. 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 Low Fat (or Ornish) Diet.  This is a nice drop and put people with very serious medical condition(s) just a hair above normal! Similar results were found in individuals with ‘1,245 participants who had coronary heart disease (55%), diabetes, and/or at least three other risk factors (hypertension, hyperlipidemia, and obesity)’. [2] High blood pressure is a huge risk factor for both erectile dysfunction and stroke.  (You can also read about healthy the How Incredibly Healthy Grains For the Penis.)

How does a Low Fat Diet lower blood pressure?  First of all, a Low Fat Diet is primarily plant-based and plant-based diets generally lower blood pressure, because they are high in 1) glutamic acid (NOT the excitotoxin), 2) flavanoids, 3) linolenic acid and 4) nitrates. I cover this more in my book The Peak Erectile Strength Diet. Put all these compounds together and you can make a very significant difference.

By the way, cleaning out the arteries may decrease blood pressure a bit in and of itself.  The less narrow the arteries, the less pressure.

5. Erections and Erectile Dysfunction. Low Fat Diets will help many men with their erectile dysfunction simply because of #1 and #2.  In this link on Low Fat Diets and Your Sex Life, I discuss how there is a direct and almost linear relationship between cholesterol and erectile strength.  And, as we’ll discuss below, a Low Fat Diet is the most powerful diet for lowering cholesterol.

NOTE: Have you heard that Low Fat Diets hammer testosterone? I have!  The truth is that there are several studies that show either zero change or very little change in testosterone. For more information, see my link on Low Fat Diets and Testosterone.

6. Prostate Protection. Most meat eaters hammer their prostates for decades with risky heterocylic amines, the delicious black charred stuff on your meat from high temperature cooking. These HCA’s as they are called slowly injure the cells in the prostate, leaving men much more prone to cancer. Couple that with rising estrogen levels from weight gain and you have a deadly combination that leads almost all men down a path of prostate cancer.  (Most men in Western societies, if they live long enough, will have at a minimum some of the slower-growing prostate cancer cells residing in their prostate.)

7.  Morning Erections. You must give this a few weeks or even months, but, anecdotally, some men will experience increased morning erections as your endothelial function is restored by the Low Fat Diet.  As your arteries are cleared out and your blood pressure is lowered, you may notice some pleasant surprises.

8. Telomerase. One of the key theories of aging deal with telomeres, the shortening of one’s chromosomes, and the enzyme, telomerase, that controls this process.  As your body ages, most tissues have a certain number of cell divisions that they can undergo before they begin to “wither” and become dysfunctional.

As it turns out, research by Dr. Ornish showed that a Low Fat Diet increased telomerase activity in immune cells. [4] For more information, read my link on Telomeres and Telomerase.

9. Cholesterol. Many men suffer with chronically elevated cholesterol levels.  They have tried everything they can think of, including medications, and just cannot get their cholesterol under control.  What they and their doctors have missed:  some men are very sensitive to saturated fat.  Even small amounts of saturated fat in their diet sends their cholesterol through the roof.  A Low Fat Diet is famed for its cholesterol lowering abilities.

Vitrually all men that go on a Low Fat Diet will find their cholesterol below 150.  Remember that 150 is the magic number at which no heart disease occurs. Research has shown – read the China Study by Campbell for details – that cultures with cholesterol below 150 have dramatically reduced heart disease.

10. Mood. A Low Fat Diet has been found to boost mood in a couple of  studies. For example, one study looked at dieting via Low Carb or Low Fat and found that Low Fat was clearly superior in the area of mood and cognitive function. See also How to Control Appetite and Boost Mood through Diet.

11. Unbeatable with Exercise. If you couple a Low Fat Diet with exercise, the combination appears to be unbeatable.  For example, researchers studied just this scenario:  they put patients with mild heart problems – and a high percentage of middle-aged and beyond me on a Western Diet would be in that category – on a Low Fat Diet (not as strict as the Ornish however) along with intense exercise.  What did they find?  You guessed it:  drastically reduced heart disease and dramatically reduced injury to the arterial walls. [3] This stuff works.

The Tarahumara are yet another example of this.  This native people in northern Mexico eat a Low Fat Diet and have cholesterol levels in the 120’s!  They also exercise intensely, both in normal daily mountain living, and in ultramarathon sporting events that are part of their culture.  This society has NO heart disease and almost imperectible rates of hypertension in both young and old.  They also are known for incredible longevity and energy.  Again, a Low Fat Diet and exercise are a powerful combination.

12.  Weight Loss. Another big benefit of a Low Fat Diet is weight loss.  I have had me write into me on a Low Fat Diet and ask how they can get more calories.  The reason is that Low Fat foods, such as whole grain, vegetables, beans/legumes, etc. are almost all high volume foods that fill you up with minimal calories.  Remember that fat is the much more dense calorically than either protein or carbohydrate.  So most men find that it gives a lean, muscular fit look that you had back in your early twenties.  And, by the way, that’s what most women want! I talk about this more in my link on Muscle Madness.

13. Save Money.  A Low Fat Diet can be a great money saver. Let’s face it:  the most expensive items in your diet are, by far, meat.  Brown rice, beans, etc. – these are pennies on the dollar relatively speaking.

14. Reduced Supplement Costs.  The Low Fat Diet is so powerful that you will likely be able to throw away many supplements. Some of you are dropping a hundred bucks or more a month, trying to fix your erectile dysfunction and other issues. You may be able to completely eliminate almost all of that.

NOTE:  All the signs point to the Low Fat (or Ornish) Diet being very good for erectile strength.  Read this link on How the Low Fat Diet is Good for your Sex Life.

So are there any cautions?  Just a few and I include them below:

CAUTIONS:

1. You have to let your colon adjust for a few days. All those veges and beans and fiber can make your belly feel like the Hindenburg.  But, trust me, the pressure dies down quickly as your GI tract adjusts as well.

2.  Grains are a common source of food allergy. If you have any issues – usually in adults it is a feeling the throat tightening or possibly nausea – then you may want to get tested.

3.  Depending on your dietary pattern before going on a Low Fat Diet, there is some chance that it could lower your testosterone a little.  Usually, one is more than compensated by the improved endothelial function, blood flow and nitric oxide, but it may be something watch out for.  However, if you have heart disease and erectile dysfunction, then you should – ask your doctor first of course! – go on the Ornish Diet anyway to partially reverse your problems. Remember that erectile dysfunction is primarily a cardiovascular problem.  The Low Fat Diet will help the great majority of guys out there with this issue.

REFERENCES:

Nitric Oxide Boost Verified by Spinach Meal - Peak Testosterone

Can eating spinach help erections? Absolutely! And the way it performs this bedroom-enhancing phenomenon is primarily by being one of the higher-nitrate superfoods. Few foods have more nitrates than spinach – no one can beat arugula lettuce however! – and this is the reason that researchers recently studied spinach’s ability to raise nitric oxide and lower blood pressure. They took 26 healthy men and women between the ages of 38 and 69 and gave them enough spinach to get 200 mg of food-based nitrates and then matched them against a non-nitrate diet. [1]

The results were impressive:

Now what is so impressive is that they achieved these results in healthy men and women.  Many studies show that those with prehypertension and hypertension get much bigger drops in blood pressure from treatments both natural and pharmaceutical.  And this is exactly what I have seen on the  Peak Testosterone Forum, i.e. big improvements in men struggling with medical issues such as erectile dysfunction – which usually has an arterial / cardiovascular component – and higher blood pressure.

And, of course, it is also impressive that they achieved these results with just one dietary modification:  adding some spinach to their meals.  Plant foods have many other properties that increase blood flow and blood pressure, and this is the subject of my book The Peak Erectile Strength Diet. Again, many plant-based diets, such as the DASH Diet and a Low Fat Diet, have been shown to yield nice drops in blood pressure.  In fact, one study showed that even flavonol-rich apples resulted in a nice increase in salivary nitrites. [3] Spinach outperformed the apple in this study, but the primary point is that a diet rich in plants will maximize all the parameters that you need for erectile strength.  I can only say to just try it if you’re not eating a lot of vegetables and fruits (and brown rice) and you’ll likely immediately notice a difference.

1)  Nitric Oxide, 2013 Nov 30, 35:123-30, “Effects of a nitrate-rich meal on arterial stiffness and blood pressure in healthy volunteers”

2) https://www.berkeleytest.com/scientific-articles.html

3) Free Radic Biol Med, 2012 Jan 1, 52(1):95-102, “Flavonoid-rich apples and nitrate-rich spinach augment nitric oxide status and improve endothelial function in healthy men and women: a randomized controlled trial”

4) Atherosclerosis, 1972 Jan-Feb, 15(1):87-92, “Effect of spinach and wakame on cholesterol turnover in the rat”

5) Journal of Medicinal Food, Jul 15 2011, 14(7-8), “Dietary Spinach Saponin-Enriched Lipophilic Fraction Inhibits Platelet Aggregation and Blood Coagulation”

6) https://usatoday30.usatoday.com/news/health/diet/2002-05-03-spinach-stroke.htm , USA TODAY05/02/2002, “Spinach may reduce stroke risk”, By Kathleen Fackelmann

Spinach also may provide some long term protection against arteriosclerosis according to one animal study. [4] It also likely protects against clots and evidence also shows that it reduces the risk of stroke. [5][6] In other words, spinach looks very good as a general Artery and Cardiovascular Healer.

I can also tell you anecdotally that eating high nitrate foods has dropped my blood pressure by 10+ points.  In my page on How I Boosted My Nitric Oxide, I discuss an arugula-eating experiment that I did. Beets will also work and beetroot juice in particular has been in the health news lately. Beets are also high nitrate foods and the juice is particularly easy to consume. For this reason, researchers have studied beets in detail and the results have been quite impressive, something I document in my link The Benefits of Beetroot Juice.

These are impressive results from drinking a mere 8 oz. of beetroot juice and were documented in the presitigious journal Hypertension.  Again, the results achieved are not too far off those from standard medications. For another great blood pressure-lowering nutraceutical solution, see my page on Garlic and Vitamin C.

REFERENCES:

Some Common Tests That Men Pull - Peak Testosterone

Unfortunately, there are many physicians out there still new to diagnosing and testing low testosterone and often important items get overlooked.  For this reason, until the medical community gets better up to speed as a whole, it is important for men to know the fundamentals of testosterine testing in order to ask important questions.

For this reason I have compiled what I call the 15 Common Tests for Men with Suspected Low Testosterone. These testosterone tests are very important, because they can have such a strong and direct bearing on either a) testosterone levels or b) safe administration of Testosterone Therapy (HRT):

NOTE:  If you suspect you might have low testosterone, check out my pages on the Standard Hypogonadal Symptoms and Classic Hypogonadism.

1.  Total Testosterone. This testosterone number is the most widely studied and heavily researched number.  While it is true that one can debate whether free or bioavailable testosterone is a better indicator, total testosterone gives doctors a very good snapshot as to general testosterone status.

If you’ve been around my site much, you know that most men begin to experience strong low testosterone symptoms in the 300’s (and a few even in the 400’s).  Furthermore, you hopefully know that in the 300’s, a man’s risk factors for many serious medical conditions (diabetes, osteoporosis, Metabolic Syndrome, erectile dysfunction, etc.) begin to increase signficantly, something I document in my book Low Testosterone By The Numbers. (NOTE: Some men seem to do fine and are symptom-free in the 300’s and 400’s, however.)  Total testosterone, and all the tests on this page for that matter, are generally pulled through a blood draw and should be done as early in the morning as possible (since a man’s testosterone falls throughout the day).

[4]NOTE: Non-U.S. readers should use a conversion factor of 29.4 to convert to nmol/l.

Notice that all of these reference ranges are between 241-286 ng/dl. Let’s say that your lab results show up with the 241 number and your actual total testosterone is 242. Many physicians will simply say, “Sorry, fella, but you are clearly normal.  You are clearly within the normal range.”  Meanwhile, you could be limping through life with erectile dysfunction, horrendous memory and concentration, a non-existent libido and a complete loss of morning erections. But, by golly, that doc is absolutely certain that your issues have NOTHING to do with low testosterone because of that lab result and the range listed right beside it.

Fortunately, many doctors are now realizing that the 200’s are abyssmally low numbers for most men.  Furthermore, the biggest lab, LabCorp, has now bumped up the lower end of their total testosterone range for males over 18 years old to 348-1197 ng/dl. [5] Of course, the lower end of this range for normal testosterone, 348 ng/dl, is higher than past ranges.  Even better, I have seen this figure quote by several on the Peak Testosterone Forum. [6][7] Essentially, LabCorp is arguing that our current definitions of hypogonadism are much too low and, perhaps, doctors will listen.

2. Free Testosterone. Free testosterone, which can be thought of as the testosterone that can actually do work on your tissues and receptors, runs about 2% of total testosterone. An acceptable range for testosterone is often give as 1.5-2.5%.  To read in more detail, see this page on  Free Testosterone and SHBG.

Plasma levels of LH are useful primarily for diagnostic purposes, because there are two “categories” of low testosterone:  primary and secondary hypogonadism.  In the case of primary hypogonadism, usually LH and FSH are overly high and this indicates that the problem is in the testes.  Basically, the pituitary tries to compensate for the testes’ lack of production by trying to pump out more LH in order to normalize testosterone production.  LH just keeps climbing and climbing with no significant change in testosterone.

In the case of secondary hypogonadism, both LH and FSH are generally low or low normal and, in this case, the problem is somewhere rooted in the pituitary or the hypothalamus rather than in the testes themselves. Thus, with secondary hypogonadism the problem is not in the testes but in the brain’s signaling to the testes.

Knowing whether you are primary or secondary can help a doctor know best how to treat you, or, at least, a knowledgeable one  Some treatment methods, such as Clomid, are designed to work on men with secondary hypogonadism as a root issue.

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

4.  Follicle Stimulating Hormone (FSH. FSH is also produced by the pituaitary and, coupled with testosterone, is responsible for sperm production.  Doctors will pull this number primarily for fertility purposes.

5.  Estradiol (E2). There are actually several estrogens in the blood stream of both men and women.  Estradiol is the most well-known and “potent” estrogen and is responsible for most of its properties, both good and bad for us males.

Estradiol is one of the most important, and often ignored, hormones that should be pulled in men who are experiencing sexual or erectile dysfunction issues.  The reason is that estradiol has a relatively tight range that men should, ideally, fall within. If estrogen goes too high (in men), it can cause many of the same issues associated with low testosterone:  erectile dysfunction, low libido, fatigue, etc.  Furthermore, it is a) fat-promoting, b) cancer promoting (in the prostate) and c) potentially fuels gynocomastia (“man-boobs”).

Overly high estradiol can cause issues, but, more often that not, low estradiol is the culprit in men with lowered libido and erectile strength.  It is very important that you get the right estradiol test, which is an LC-MS/MS test designed for the low levels that men have.  Low estradiol can lead to bone less and eventually osteoporosis, but an important new study shows that low estradiol causes virtually the exact same symptoms associated with low testosterone.

Tests to Find the Root Cause of Low Testosterone

6.  Zinc Status. Every doctor should, in my opinion, test for zinc status.  There are several tests that are applicable including the zinc taste test and zinc plasma levels.  And the reason is that, if you are low in zinc, restoring proper zinc levels can double or more your testosterone levels.  See this page on Zinc Deficiencies and Low Testosterone for more details.

7.  Vitamin D. One of the most important low testosterone tests is actually Vitamin D, due to the fact that Vitamin D deficiencies are so widespread.  The standard for Vitamin D monitoring is called “25-hydroxy” test and can be obtained from a simple blood draw.  Therefore, it can be pulled at the same time that you have your testosterone tested.  Most labs and physicians now consider 30 ng/ml to be the threshold for a deficiency.  However, many experts recommend that Vitamin D be maintained somewhat above that level.

What does your Vitamin D reading have to do with testosterone?  It turns out Vitamin D is actually correlated with testosterone and appears to be partially causative.  In other words, keeping your Vitamin D levels up to healthy levels may give you a boost in testosterone.  (Some experts even consider Vitamin D much more a hormone than a vitamin.) For more information, see my link on The Benefits of Vitamin D.

8.  Prolactin. If this hormone goes too high, it drive down testosterone levels by negatively impacting dopamine.  The net effect is usually significantly lowered libido and sexual function.  I cover this in more detail in my link on Prolactin and Prolactinomas.

9.  Thyroid Stimulating Horomone (TSH). If this is high, then you may have hypothyroidism.  TSH actually comes from the pituitary and not the the thyroid gland. In general, when the pituitary senses that your thyroid hormones are falling too low, it pumps out more TSH in order to compensate, similar to elevated Leutinizing Hormone (LH) in men with primary hypogonadism.  However, TSH is just the beginning and free T3, free T4 and reverse T3 should also be pulled at a minimum.

What does this have to do with testosterone?  Well, researchers have found that hypothyroidism is associated lower testosterone levels and it is no wonder since it usually comes with fatigue, weight gain and a slowed metabolism and libido, i.e. symptoms that are very similar to those of hypogonadism.  Furthermore, correcting hypothyoridism can lead to a nice boost in testosterone often, something I discuss in my page on Testosterone and the Thyroid.

10.  T4 and T3. These two thyroid hormones, which are triggered by TSH coming from the pituitary, can be low as well.  Somewhat like testosterone, these can come as total T4 and/or T3 and free T4 and/or T3. When these are below the reference ranges, you will usually find that your physician will consider you hypothyroid.

Tests to Establish a Baseline Before You Go On TRT (If You Do)

11.  PSA. Physicians will generally monitor your prostate before administering TRT, HCG Monotherapy or Clomid over concern regarding prostate enlargement (BPH) and prostate cancer as a side effect.  Several large studies have hsown these not to be a concern, but, as I always say, you have to discuss with your doctor and do your own research.  Regardless, it is prudent to pull your PSA before TRT in my opinion.  The PSA has been under sharp criticism in the last ten years, because it does not just show an increase in cancer but also an increase in prostate size and inflammation.  In fact, the latter is the most common reason for a significant rise in PSA.  (It happened to me.)

12.  Red Blood Cell Count/Hematocrit/Hemoglobin. Testosterone actually governs male red blood cell counts in your blood and this is the reason that we have more red blood cells in our plasma than our wives and girlfriends. A good physicians will always monitor your RBC count, as it is called, to make sure that you are neither too high or too low.  However, the key is that, if you are anemic from low testosterone, then something probably needs to happen.

Again, men with low testosterone often see their RBCs fall significantly and can even end up anemic.  This is yet another reason that men can experience fatigue with hypogonadal testosterone levels.

There is another reason to get RBC Counts/Hematocrit/Hemoglobin:  if a man is on the high side of these numbers before TRT, he may struggle while on TRT trying to keep his levels in check.  You cannot let your levels go too high or it can increase the risk of stroke or an MI.  (Some of the Tour De France riders have almost died from this condition due to doping). [8] One of our forum posters actually found himself in this condition, for example, even though his most recent testosterone reads were 290 and 301 ng/dl. [9]

So what are acceptable RBC counts?  Different labs have a little different ranges, but the range given as normal is generally around 4.3-5.7 million cells/mcl.  Notice, however, that this forum poster’s range was 4.1-5.6 and thus differently slightly. [10]  I have seen higher levels as well, say, at 4.7-6.1.

Also, some men may wonder why testosterone increases red blood cell counts.  The reason actually ties into a kidney hormone called erythropoietin which induces red blood cell production in the stem cells of the bones. Testosterone actually increases erythropoietin production and, therefore, actually causes an increase in red blood cells due to its downstream influences.

13. SHBG. This is the binding protein that attaches itself to a little over half of our testosterone and effectively takes it out of commission.  If you are low SHBG, you may struggle with TRT and require a little different protocols.  This is also possible with high SHBG as well.  Low SHBG men may also be insulin resistant, something I discuss in my page on Low SHBG.

14. Other Hormones. If you end up on TRT, just trust me:   you’ll be glad that you pulled your DHEA-S, progesterone and cortisol and established some kind of a baseline.  There is one school of thought out there that TRT can slow down these hormones over time, so pull these while you can to see if you have changed over time.  And, by the way, all of these can affect sexual function and energy levels.

15. Liver Function.  This is an important test for low testosterone men,. because testosterone is metabolized in the liver.  A good physician at a minimum will check to make sure that you do not have any existing liver disease or disorders.  In addition, some of the injectables (cypionate, enanthiate, etc.) actually have to be broken down into testosterone.  The topicals (Androgel, Testime, etc.) have a good liver side effect profile but should be checked regardless from time to time as occasional issues do occur.

1)  Quest Diagnostics, Table 1, Testosterone Reference Ranges in Adults, https://www.questdiagnostics.com/hcp/ intguide/EndoMetab/Gen_Misc/Testosterone/Table%201.pdf

2) https://peaktestosterone.com/forum/ index.php?topic=114.msg1641#msg1641

3) https://peaktestosterone.com/forum/index.php?topic=179.15

4) https://peaktestosterone.com/forum/index.php?topic=213.0

5) Labcorp, Technical Review, “Testosterone: Aiding in the diagnosis of androgen dysfunction and hypogonadism”

6) https://peaktestosterone.com/forum/index.php?topic=290.msg2580#msg2580

7) https://peaktestosterone.com/forum/index.php?topic=175.msg2161#msg2161

8) Dtsch Arztebl Int, Jan 2008, 105(4):62 68, “Congenital and Acquired Polycythemias”

9) https://peaktestosterone.com/forum/ index.php?topic=346.msg3221#msg3221

10) https://peaktestosterone.com/forum/ index.php?topic=221.msg1733#msg1733

11) https://www.lef.org/magazine/mag2010/ may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

Phthalates and Testosterone - Peak Testosterone

REFERENCES:

1) https://www.sciencedaily.com/releases/2009/11/091116085040.htm

2) International Journal of Andrology, 29(1):172-180, Published Online 7 Feb 2006, “Possible impact of phthalates on infant reproductive health”

3) Toxicological Sciences, 2008, 105(1):153-165, “A Mixture of Five Phthalate Esters Inhibits Fetal Testicular Testosterone Production in the Sprague-Dawley Rat in a Cum7) J Appl Toxicol, 1989 Aug, 9(4):277-83, “Mechanism of testicular atrophy induced by di-n-butyl phthalate in rats”. Part 1.

4) Toxicological Sciences, 2008, 105(1):153-165, “A Mixture of Five Phthalate Esters Inhibits Fetal Testicular Testosterone Production in the Sprague-Dawley Rat in a Cumulative, Dose-Additive Manner”

5) Environ Health Perspect, 2003, 111:1164-1169, “The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay”

6) Human Reproduction, 19(5):1121-1126.”Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy”

8) Biological Psychiatry, 15 Nov 15 2009, 66(10):958-963, “Phthalates Exposure and Attention-Deficit/Hyperactivity Disorder in School-Age Children”

9) European Journal of Endocrinology, 2006, 154(5):599-611, “Environmental chemicals and thyroid function”

10) https://www.medicalnewstoday.com/articles/247857.php

11) Environ Health Perspect, 2007 June, 115(6): 876 882, “Concentrations of Urinary Phthalate Metabolites Are Associated with Increased Waist Circumference and Insulin Resistance in Adult U.S. Males”

Phthalates are not the nastiest chemical in our environment, but they are everywhere.  They are added in large quantities in most plastic products you buy and are used in hundreds of agricultural, commercial, residential and consumer products. They are in shampoos, pesticides, soaps, nail polish, lotions, cosmetics, vinyl and fragranced detergents.  Even worse, they are used as the coating of some pills and supplements and in air fresheners sprayed throughout homes and businesses.

What’s a few phthalates amoung friends?  Well, if you’re a male, it’s bad news:  phthalates are nasty xenoestrogens now associated with a host of ills.  Hardly a month goes by now without some new study showing the negative effects of phthalates on both us and the environment.

Phthalates are particularly damaging to children.  If you have kids or know anyone with children, I hope you’ll encourage them to only use glass and stainless steel for cooking.  (Also I urge you to keep your use of canned products to an absolute minimum around any boy pre-puberty. See this link on Bisphenol-A for more details.)

What is so tragic is that scientists have known for 30+ years of the dangers of phthalates, yet no one has done anything about it.  One 1982 study for example showed that phthalates shunted testosterone-boosting zinc away from the testes. [6]  A study a few years later verifed this and noted actual testicular atrophy (shrinkage). [7]

Lest you think I am exagerrating, let me point out just a few of the studies showing problems with phthalates:

1.  Effeminization. A recent study demonstrated that the higher the levels of phlthates in the mother’s urine, the less likely their boys were to play with regular male toys, i.e. they appeared to be effeminized. [1] Extra estrogens during these critical years can permanently alter the young male brain. Animal studies clearly show that phthalate exposure can alter SHBG, testosterone and LH (leutinizing hormone) levels. [2]

2. Testosterone. These are potent endocrine disruptors that every hormone-luvin’ male should avoid like the plague. One study examined dosages of 100, 80, 60, 40, 20, 10, 5, or 0% of the mixture.on fetal rates and found a dose-dependent decrease in testosterone, meaning the more phthalates, the less the testosterone. [4]  Needless to say, this is very, very bad for males in the fetus or young children.

3.  Fertility. Further proof of phthalates’ gonad-killing properties are linked to lowered sperm quality [5] and DNA damage [6].  See my link on Male Fertility for additional information.

4.  ADHD. The decreased testosterone and other attributes of phthalates actually alter the male brain and one study showed a link to ADHD. [8]  For more information, see my link on Environmental Causes of ADHD.

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

5.  Thyroid. Many studies have verified that phthalates alter thyroid function.  This is particularly dangerous for the little ones and one study warned “even small changes in thyroid homeostasis may adversely affect human health, and especially fetal neurological development may be vulnerable.” [9]

6. Insulin Resistance and Diabetes.  These chemicals seem to wreak havoc with the body’s blood glucose systems and have been implicated in several studies (on both men and women) as a contributor to insulin resistance, metabolic disorder, prediabetes and diabetes. [10][11][12] The reason?  Testosterone, as I document in my book Low Testosterone by the Numbers, regulates insulin sensitivity in men.

This list could go on and on.  Again, one should be as cautious as one’s budget will allow, buying organic – many pesticides are phthalates – and using only stainless steel/glass for cooking and natural means for pest control.

Cortisol and Laughter - Peak Testosterone

When it comes to health benefits, there are many counterintuitive examples and laughter is right near the top.  Few guys would ever guess just how important humor and laughter could be to their future.  As it turns out, those you who are serious about your health – well, you may just want to not be so serious.  A little levity, it turns out, may go a long ways.

Laughter is, quite simply, as powerful and potent as any drug and all without side effects.  Here are four key benefits laughter can provide for you:

1) Growth Hormone. One of the most powerful “fat-burning” hormones is HGH (Human Growth Hormone).  There is also evidence that HGH aids muscle growth somewhat as well. Laughter, according to one older study, strongly increases (by 80%) HGH levels. [1] That means that “laughing your ass off” may be quite literally true.

2) HDL.  Good cholesterol, unless your are on a Low Fat (Ornish) Diet, is critically important to your heart health.  HDL is also a potent stimulator of Nitric Oxide.  Another just-downright-amazing benefit of laughter is that it increased HDL levels in diabetic patients by an impressive 26%. [2]

3) C-Reactive (Inflammation) Levels. C-Reactive protein, a measure of system inflammation, is a well-known risk factor for arterial disease.  The reason?  Inflammation is one step in the process that damages arterial linings and, in the aftermath, leaves the infamous plaques that causes arteriosclerosis. Research has shown that elevated C-Reactive protein levels also leads to penile arterial disease, i.e. erectile dysfunction and impotence. [3]  Laughter, it turns out, is a powerful anti-inflammatory tonic and significantly lowers C-Reactive protein levels by an astonishing 66%. [4]

4) Cortisol. The same study that found laughter’s boost in growth hormone also found that laughter significantly reduces cortisol as well. [1]  Elevated cortisol levels damage the brain, increase visceral fat and lower testosterone.

So, as odd as it may seem, laughter is likely a huge protector of all you hold dearest as a male: your sex life, your hormones and your brain. What other benefits do you need, eh?

REFERENCES:

1) Am J Med Sci, 1989 Dec, 298(6):390-6, “Neuroendocrine and stress hormone changes during mirthful laughter”

2) Presented at the 122nd Annual Meeting of the American Physiological Society, Apri 18-22 New Orleans Experimental Biology 2009 scientific conference, “Mirthful Laughter, As Adjunct Therapy in Diabetic Care, Increases HDL Cholesterol and Attenuates Inflammatory Cytokines and hs-CRP and Possible CVD Risk”, Birk, Tan.

3) International Journal of Impotence Research, 2003, 15:231 236, “Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction”

4) Presented at the 122nd Annual Meeting of the American Physiological Society, Apri 18-22 New Orleans Experimental Biology 2009 scientific conference, “Mirthful Laughter, As Adjunct Therapy in Diabetic Care, Increases HDL Cholesterol and Attenuates Inflammatory Cytokines and hs-CRP and Possible CVD Risk”, Birk, Tan.

Glutathione:Protection Against Testosterone-Killing Mercury

Remember also that mercury attacks your precious testosterone, so glutathione is one of your body’s natural testosterone protectors. Glutathione is involved in dozens of other critical systems and even protects your body’s Vitamin C.  And we know Vitamin C provides critical collagen protection, including that in your skin.

So how do we raise glutathione levels naturally?

2. Maca. This Peruvian aphrodisiac was found to increase the all-important natural super-antioxidants SOD and glutathione. [3]

3. Avoid Alcohol.  Alcohol consumption decreases glutathione.  Why?  Because alcohol creates a toxin that glutathione must detoxify. [1]

5. Exercise. Exercise increases the important form of glutathione. [6]  However, it should be kept in mind that this is the body’s natural response to the increased oxidative load that exercise places upon it.

6. Glucose/Sugars/High Glycemic Foods. A number of in vitro study of human epithelial cells showed that increased glucose led to decreased glutathione levels. [7][9]

7. Resveratrol. Resveratrol increased glutathione in lung epithelial cells that were “smoke depleted”. [8]  Good sources of resveratrol are red wine, peanuts and cocoa. nuts and cocoa.

8. Grape Seed Extract. This potent and relatively cheap supplement can help improve blood flow – always good for erections – and arterial clotting and inflammation. And, just as important, one study found that it raised plasma glutathione levels by 52%! [10] Admittedly, this was in type II diabetics, but it should help virtually any middle-aged or senior male.

9. Nanodelivery Glutathione. Again, glutathione, if taken by itself, is very poorly absorbed. LEF (Life Extension Foundation) has a product with a nonodelivery system that supposedly greatly improves absorption. The product is called “Lipoceutical Glutathione” if you are interested.

10. Magnesium (Deficiency). There is some evidence that correcting a magneisum deficiency could boost glutathione levels. [12] And there is also evidence that increasing glutathione can increase magnesium in some tissues as well. [11]

1) Alcohol and Alcoholism, 21(1):81-84, “ALCOHOL ENHANCES VITAMIN C EXCRETION IN THE URINE”

2) Arzneimittel-Forschung, 1992, 42:829-831

3) Journal Plant Foods for Human Nutrition (Formerly Qualitas Plantarum), Jun 2007, 62(2), “The Influence of Maca ( Lepidium meyenii ) on Antioxidant Status, Lipid and Glucose Metabolism in Rat”

4) Eur J Clin Invest, 2001 Feb, 31(2):171-8, “Oral supplementation with whey proteins increases plasma glutathione levels of HIV-infected patients’

5) Toxicol Ind Health, May 2009, 25(4-5):325-328, “Whey proteins influence hepatic glutathione after CCl4 intoxication”

6) J Appl Physiol, 1993 Feb, 74(2): 788-92, “Blood glutathione status during exercise: effect of carbohydrate supplementation”

7) Journal of Molecular Endocrinology, 2004, 33:797-803, “High glucose decreases intracellular glutathione concentrations and upregulates inducible nitric oxide synthase gene expression in intestinal epithelial cells”

8) American Journal of Physiology, Lung Cellular and Molecular Physiology, 294(3):L478 88, “Resveratrol induces glutathione synthesis by activation of Nrf2 and protects against cigarette smoke-mediated oxidative stress in human lung epithelial cells”.9) FEBS, 2 Jan 2 1998, 421(1):19-22 “High concentration of glucose causes impairment of the function of the glutathione redox cycle in human vascular smooth muscle cells”

10) Diabetic Medicine, May 2009, 26(5):526 531, “Effects of grape seed extract in Type 2 diabetic subjects at high cardiovascular risk: a double blind randomized placebo controlled trial examining metabolic markers, vascular tone, inflammation, oxidative stress and insulin sensitivity”

11) Hypertension, 1999, 34:76-82, “Effects of Glutathione on Red Blood Cell Intracellular Magnesium”

12) Inflammation Research, Jun 2008, 57(6):279-286, “Effects of magnesium supplementation on the glutathione redox system in atopic asthmatic children”

Plant-Based Nutrition: The Male Fantasy - Peak Testosterone

REFERENCES:

1)   https://www.sciencedaily.com/releases/2011/10/111011171553.htm

2) Am J Clin Nutr, Dec 2006, 84(6)1489-1497, “Fruit intake vegetable intake metabolic syndrome cardiovascular disease risk factors inflammation”

3) https://www.dole.com/LiveRight/Prevention/ PreventionDetails/tabid/837/Default?contentid=4228

4) Am J Clin Nutr, Nov 2005, 82(5):1052-1058, “A 4-wk intervention with high intake of carotenoid-rich vegetables and fruit reduces plasma C-reactive protein in healthy, nonsmoking men”

What is the number one thing most men can do to boost their sex life? Well, exercise is right up there along with sleep and stress management.  However, the king in this category is undoubtedly plant-based nutrition for many reasons. One huge tragedy in most modern societies is that meat is synonymous with manliness. And, for this reason in my opinion, meat-based lifestyles (Low Carb, Atkins, the high fat Americanized version of Paleo, etc.) are incredibly popular, much moreso than any other dietary regimen here in the U.S. Again, though, this is ironic, because guys are all about sex and impressing their woman and it is plants that are going to help them most in this category.

Yes, plant-based nutrition should be called the True Manly Diet in my opinion and, hopefully, below I can give you many benefits and reasons just why this is so.  I myself am a lacto ovo vegetarian, meaning I don’t eat meat but do eat egg whites and non-fat yogurt to decrease carbohydrates and for additional protein.  (I’m into buidling and maintaining muscle so want extra protein sources.)

By this definition I would be “plant-based” since I get over 90% of my calories from plants.  However, the general definition that I see out there for plant-based is basically 100% vegan or plant foods but ONLY whole plant foods.  Plant-based vegan pride themselves, as well they should, on only eating whole natural plant foods.

Regardless of what label you put on yourself, here are 8 Huge Benefits of Going On 90+% Plant-Based Diet or Even a True Whole Foods 100% Plant-Based Diet::

1. Blood Flow.  Many plant-based foods will lower blood pressure. If you’ll notice in my link on How to Lower Blood Pressure, there are probably a dozen plants that have been shown in the research to lower blood pressure.  Of course, this is very important, because high blood pressure is a risk factor for erectile dysfunction, stroke and heart disease for starters.  (It is also part of the modern plague called the Metabolic Sydrome that cripples so many men in middle age and beyond.)

NOTE: Personally, I would avoid wheat for reasons I outline in my Review of Wheat Belly by Dr. William Davis.  I would also avoid corn, because it is highly GMO’d with a pesticide called BT toxin (at least here in the U.S.).

2. Testosterone. There are indications that plant-based systems of eating tend to have testosterone levels as high or higher than their meat-eating equivalents.  One study showed that vegetarians had testosterone 6% higher than their meat-eating counterparts. (See my link on Testosterone and Vegetarianism for more information.) And what will be really counterintuitve for many men is that vegans – vegetarians that do not eat any dairy or eggs – had 16% higher testosterone than the equivalent carnivores in the study.  And the Okinawans, who eat only small amounts of meat, maintain high testosterone levels decades part the typical man in a Western society.

Yes, gone are the old myths that meat eaters are the only ones with decent testosterone.  It appears that the opposite may be the case.  And it makes sense:  many of the more vegetarian, plant-based diets emphasize monounsaturated fats, which are known to be pro-testosterone.  Furthermore, these types of diets are high in antioxidants and anti-inflammatory phytochemicals that will tend to act in a protective manner against the age-related losses of testosterone.

3. Nitric Oxide.  It’s no secret that all the big nitric oxide-boosting foods and drinks are plants.  This is one of the primary subjects of my book, The Peak Erectile Strength Diet.

4. Mortality. Wanna stay alive?  A plant-based lifestyle has been shown to do just that.  Multiple mortality studies on vegetarians have shown improved mortality rates.  What this means is that those who eat vegetarain generally die less frequently. See my link on Mortality Rates for additional information.

5. Change Your Genes. Have “bad genes”?  Fruits and vegetables have been shown to overcome this in some cases.  For example, one massive study found that ample servings of fruits and vegetables overcame the negative effects of the 9p21 gene that strongly influenes cardiovascular outcomes. [1]

6. Inflammation Protection. The number one thing that you want your natural lifestyle to do is fight inflammation. Why? Because inflammation is the Root of All Evil. It is the root cause for most of our heart disease, diabetes, autoimmune disease, cancer and erectile dysfunction. And, yes, many studies have shown that fruits and vegetables dramatically lower inflmmation. For example, a 2003 study that in just one month participants who ate a diet high in fruits, vegetables and nuts lowered this C-Reactive Protein levels by 28%. [3] Yet another study found that eating fruit lowered CRP levels by about 20% from lowest to highest consumption and vegetables by almost 30%. [2] Not bad for just one component of ones diet!  Studies on just healthy males alone have shown the same thing. [4] For additional, read my link on How to Lower Inflammation and Inflammation and Juice.

7. Metabolic Syndrome. Fruit and vegetable consumption is associated with decreased risk for developing the epidemic plague in modern societies called The Metabolic Syndrome. [2] Both fruits and vegetable consumption was tied to a reduction in risk of about a third.

8. What About Grains?? One bias that many men have is against whole grains due to the prolieration of and misinformation from many Low Carb and Paleo sites of late. This is unfortunate because WHOLE grains are every bit as outstanding for health as fruits and vegetables. Common sense tells you this, because grains are a substantial component of many of the healthiest diets around the world including the Mediterranean, the cultures in Healthy at 100 and the  Tarahumara.

As I show in my link on Grains and Your Penis, whole grains do everything you could possibly want as a man, lowering blood pressure, increasing nitric oxide and flooding your system with anti-inflammatory and antioxidant compounds. It’s literally a dream-come-true.

Of course, the key is that grains are only healthy if they are whole grains.  I also caution against too much wheat consumption, whole or not, due to its heavy GMO modifications in the last fifty years.  See my Review of Wheat Belly for details.

Arterial Stiffness and Erectile Dysfunction - Peak Testosterone

Common sense would tell us that stiff, hardened arteries are not good for us. And common sense would be dead right.  The medical term is “arterial stiffness” and one study found that “aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality.” [1] In other words, if you arteries are hardened, you have a much greater chance of dying, especially from heart-related issues.

There are several reasons for this, including the fact that stiff arteries produce a higher spike in the blood’s pulse pressure wave and that wave has more velocity.  Those spikes, over the course of years, can damage tissue (including brain and kidney) and lead to additional arterial plaque buildup just for starters.

Peak Testosterone readers know just how interrelated the heart and penis are and will not be surprised to find that arterial stiffness is also related to erectile dysfunction. [2]  We all know that you need nice, expandable arteries for blood flow into the penis, eh?

So what causes arterial stiffness and hardened arteries?  Below are some of the culprits that research has recently uncovered.

1) J Am Coll Cardiol, 2010, 55:1318-1327, “Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness”

2) https://news.georgiahealth.edu/archives/247

3) Am J Hypertens, 2007 Mar, 20(3):242-7, “Advanced glycation end-products and arterial stiffness in hypertension”

4) Hypertension, 2005, Jul;46(1):232-7, Epub 2005 Apr 25, “Advanced glycation end products are associated with pulse pressure in type 1 diabetes: the EURODIAB Prospective Complications Study”

5) Hypertension, 2005, 45:349., “Arterial Stiffness and Hypertension: A Two-Way Street?”

6) Hypertension,1999,33:1385-91, “Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure”

7) Am J Hypertens, 2007 Mar, 20(3):319-25, “Sodium, arterial stiffness, and cardiovascular mortality in hypertensive rats”

8) J. Nutr, 2011, “Sodium Intake Is Associated with Carotid Artery Structure Alterations and Plasma Matrix Metalloproteinase-9 Upregulation in Hypertensive Adults”

9) Eur J Clin Invest, 2008 Jan, 38(1):24-33, “MMP-9 haplotypes and carotid artery atherosclerosis: an association study introducing a novel multicolour multiplex RealTime PCR protocol”

10) Diabetic Med, 1992, 9:114 119, “Arterial wall compliance in diabetes”

11) J Am Coll Cardiol, 1993, 22:1881 1886, “Short and long-term effects of smoking on arterial wall properties in habitual smokers”

12) Nutrition, Sep 2013, 29(9):1122-1126, “Acute effects of beer on endothelial function and hemodynamics: A single-blind, crossover study in healthy volunteers”

NOTE:  For practical solutions, see my link on How to Partially Reverse Hardening of the Arteries.

1)  Advanced Glycation End Products (AGEs). Young, supple arteries are composed of undamaged elastin and collagen. Part of the aging process in everyone is for the bonds of these proteins to be broken and damaged for AGEs, which stiffens arterial walls like old leather. [3][4] However, many people have accelerated AGE damage.  Advanced Glycation End Products will damage your body in a hundred other ways as well:  read my link on The Dark Side of AGE’s for more information.

3)  Weight Lifting. Lifting heavy weights results in extremely transient blood pressures and one study found that long term weight lifters had higher arterial stiffness that normal. [6]  I cover this and other related issues in more detail on my link on Weight Lifting and Your Arteries.

4)  Salt. The more sodium that you consume, the higher the “plasma volume” in your arteries and vessels.  This can lead to high blood pressure, especially in sensitive individuals.  However, salt-sensitive or not, it appears that everyone is susceptible to accelerated arterial damage from high sodium consumption. [7] Researchers are not completely sure why at this point, but preliminary evidence points to an enzyme called MMP-9, [8] recently associated with arteriosclerosis. [9]

5) Diabetes. Of course, anything that raises blood sugar is going to lead to more of Advanced Glycation End Products, mentioned above, and accelerated hardening of the arteries.  Diabetes is the ultimate blood sugar raising machine and so it is no wonder that diabetes is correlated to arterial stiffness. [10]

6) Smoking. Yes, sticking burning leaves into your mouth will damage your arterial walls. [11]

7) Moderate Alcohol Consumption.  These improved arterial stiffness in one recent study. [12] Of course, moderation is the key here.

8) Blueberries.  The equivalent of one cup of blueberries per day dramatically increased nitric oxide, lowered blood pressure and decreased arterial stiffness, at least according to one study on women. However, the results would very likely be replicated in men as well.  See my page on Blueberries and Erectile Dysfunction for more information.

The bottom line is that if you want to be hard, you’ve got to keep your arteries soft.

REFERENCES:

Chemicals and Testosterone - Peak Testosterone

I am a science fanatic, but one of the curses that the scientific age has brought upon us is a tidal wave of chemicas, many extremely common in every day life, that can pull the rug right out from under your hormonal hindquarters. Read the list of chemicals below and you’ll be ready to hide under the mattress (instead of doing something constructive on top of it) in order to save your precious testosterone. Maybe the Amish were right after all!

The good news is that, for the most part, these chemicals can be avoided with a few simple lifestyle changes:

1) Excitotoxins. Animal studies show that fetal exposure to excitotoxins, such as MSG in food and aspartame in diet drinks, can lead to reproductive and hormonal abnormalities in puberty and beyond. Read more about Testosterone and Excitotoxins and find out more.  SOLUTION:  Buy nothing in it with MSG, aspartame, monosodium glutamate, autolyzed yeast extract, Equal or any of the other ingredients I list in Testosterone and Excitotoxins.

2) Mercury. Mercury, specifically methylmercury, is a testosterone (and other hormone) killer.  See my link on How to Protect Your Testosterone From Mercury for more details.

1) Toxicological Sciences, 2008, 105(1):153-165, “A Mixture of Five Phthalate Esters Inhibits Fetal Testicular Testosterone Production in the Sprague-Dawley Rat in a Cumulative, Dose-Additive Manner”

2) Toxicology, 1 June 2006,223(1-2):144-155, “Mechanisms underlying the anti-androgenic effects of diethylhexyl phthalate in fetal rat testis”

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

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”.

5) Infertility, 1978, 1(1):33-51, “Hypogonadism in chronically lead-poisoned men”

6) https://www.consumerlab.com/reviews/    Omega-3_Fatty_Acids_EPA_and_DHA_from_Fish_Marine_Oils/omega3/

3) Pesticides. The FDA has gotten rid of some of the worst testosterone-whacking pesticides, such as DDT, but many still remain.  Read about Testosterone and Pesticides for some of the sobering details. SOLUTION:  Avoid the dirty dozen fruits and vegetables mentioned in Testosterone and Pesticides for being particularly overly sprayed.  You may even want to buy organic when possible.

5) Phthalates. I hope you didn’t sound like you were coughing up a fur ball trying to say this one, but it’s actually quite easy: just don’t say the “ph”. That’s right – phonetically these are “thal-its” and they are just as nasty to your testosterone as they are to say.  These are potent endocrine disruptors that every hormone-luvin’ male should avoid like the plague. One study examined dosages of 100, 80, 60, 40, 20, 10, 5, or 0% of the mixture.on fetal rates and found a dose-dependent decrease in testosterone, meaning the more phthalates, the less the testosterone. [1] Low testosterone can be just as devastating for a male infant. Researchers have found evidence that phthalates, a common family of chemicals used in air fresheners and to soften plastics that lower testosterone [6] are linked to effeminizing behavior in boys.  See number 10 in my link on Child IQ for more details. Animal studies have shown nasty effects from phthalates as well, including permanent reproductive disorders [2] and a recent human study showed lowered sperm counts as verification. In other words, the damage seems to be permanent.  SOLUTION:  Use only glass and stainless steel for cooking and don’t let anyone freshen your air.

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

6) Bisphenol-A. The chemical, used (in America) in almost every canned good, is a proven endocrine disruptor.  Read more about Bisphenol-A to find out how the levels that we are commonly exposed to are enough to have a clinically negative effect. SOLUTION:  Avoid canned goods.

7) Lead.  China is by now means the only source of lead in our environment but has been implicated frequently in a number of recent studies and exposes.  Our children are particularly exposed to the onslaught of this chemical we once thought we had purged from our environment. Lead is a known testosterone-lowerer. One study, for example, found that lead exposed and poisoned men, who had complained of lowered libido and intercourse, had reduced Leutinizing Hormone and, therefore, testosterone levels. [5]  This is just the beginning, however, as lead attacks many systems in the body, including the brain and kidneys. Since we’ve eliminated lead in our gasoline and paints, we’re safe, right?  Read this Consumer Report’s article on the many products they found with lead. SOLUTION:  This is the toughest one as there is no inexpensive, easy way to detect and avoid lead products.

REFERENCES:

Ways to Raise Free Testosterone - Peak Testosterone

Some researchers believe that free testosterone is the only testosterone that really counts, since it is the testosterone ready and able to actually “work” on your tissues. And there is a lot of truth to this. The reason is that about two thirds of non-free, or bound testosterone is actually chemically bonded to a protein called Sex Hormone-Binding Globulin (SHBG) and about 1/3 to a protein called albumin.  Therefore, according to one school of thought, only a small percentage (about 2 percent) is actually free to supercharge our brains, blood, muscles, sex lives and all the other things we associate with testosterone.

Well, kind of.

It turns out that the testosterone bound to albumin is actually only bonded loosely and is readily available to do work on your tissues.  In fact, researchers have come up with the following formula:

And they point out that it is really bioavailable testosterone that is the true free testosterone.  Furthermore, still other experts counter that total testosterone is really the better number, because it acts as reserve or bank to build from.

Well, I will leave that debate for the men in white, but, in the meantime, it’s best to realize that free testosterone is an incredibly important number for men to monitor and maintain.

So what then controls your free testosterone?  It turns out that your level of albumin is relatively fixed with minimal fluctuation in most men.  However, SHBG can vary widely and lab results clearly show that as SHBG goes up, the percentage of free testosterone as a percentage of total goes down and, as SHBG goes down, the percentage of free testosterone goes up.  Thus, it is SHBG that has tremendous control over free testosterone.

Normal aging, as many of us know all too painfully, leads to substantial drops in androgens such as testosterone and a corresponding rise in SHBG.  Think how ugly this is:  decreasing testosterone leads to increasing SHBG which leads to decreased free testosterone.  And, practically speaking, low free testosterone levels will yield low testosterone symptoms just as surely as low total testosterone will.

There are also many other reasons for low and high SHBG, including liver dysfunction, estradiol levels, thyroid function and much more.  I cover these in my links on Low SHBG and https://www.peaktestosterone.com/.

So how do you know if your free testosterone is low?  It starts with a simple test from your doctor.  You sometimes have to ask for this, as some doctors just stick with total testosterone.  Generally, free testosterone is given as a percentage of total testosterone, the typically acceptable range according to the lab listed as 1.5%-2.5%.

NOTE:  Men on HRT (Hormone Replacement Therarpy or testosterone therapy) will often have an elevated free testosterone percentage, because HRT tends to lower SHBG. Also, some men have low SHBG even before starting HRT. These men often have great difficulty with achieving successful results from testosterone therapy for reasons that are not totally understood.

Let me give you 10 Natural Ways to Lower SHBG and Raise Free Testosterone:

1) Testosterone and Lowering Estradiol. On this page, I’ll show some ways to uniquely raise free testosterone levels.  However, the most straightforward way to raise free testosterone levels is by raising total testosterone levels. In general, as you raise total testosterone, free testosterone tends to rise with it.  I have already created a page with 40+ Ways to Raise Testosterone Naturally. Again, though, on this page we’ll look at some ways to raise your percentage of free testosterone (out of total testosterone).

Similarly, if you can lower your estradiol levels, you can generally get a boost in total and free testosterone.  Research shows that normal aging as well as an increase in adipose – that’s a nice way of saying fat – tissue leads to ever increasing levels of the estrogens. And here’s the key:  increasing estrogen leads to increasing SHBG, which will lower your free testosterone as a percentage of your total.  Please read the important link on How to Control Estrogen.

2) Protein-to-Carbohydrate Ratio. The protein/carbohydrate ratio has an interesting effect on free testosterone and SHBG. Several studies have shown that increasing carbs versus protein boosts total testosterone. However, before you start pounding granola bars, one study found that increasing the protein/carb ratio not only increased total testosterone but also SHBG. [4] This means that free testosterone may not have been increased significantly because of SHBG’s opposing effects. (Increasing the protein to carbohydrate ratio also increased cortisol, a fact I cover elsewhere on this site.)

3) DHEA.  Researchers examined untrained young and middle males and found that giving them 50 mg of DHEA daily raised their free testosterone significantly.  They also noted that normally HIIT substantially lowers testosterone, but with the DHEA no such decrease in free testosterone at least occurred.  [7] There are warnings out there that DHEA can increase estradiol disproportionately, but I have seen no actual research evidence of this.  The real concern with DHEA is more brain-related. Ray Peat, in particular, has noted:

“One study has found that the only hormone abnormality in a groupt of Alzheimers patients’ brains was an excess of DHEA. In cell culture, DHEA can cause changes in glial cells resembling those seen in the aging brain. These observations suggest that DHEA should be used with caution. Supplements of pregnenolone and thyroid seem to be the safest way to optimize DHEA production.”  In spite of this, DHEA seems to be widely used in the alternative and anti-aging communities.  Do your own research and talk to your doc is all I can say.

CAUTION:  Low SHBG men should not lower their SHBG further.  See my page on The Risks and Causes of Low SHBG for more information.

REFERENCES:

1) J Korean Diabetes Assoc, 1998 Sep,22(3):328-337

2) Planta Med, 1995 Feb, 61(1):31-32; Fortschr Med, Nov 10 1996, 114(31):407-411; Z Naturforsch [C], 1995 Jan-Feb,50(1-2):98-104

3) Clin Endocrinol (Oxf), 2009 Dec 29, [Epub ahead of print], “Association of vitamin D status with serum androgen levels in men”

4) Life Sciences, May 4 1987, 40(18)1761-1768, “Diet-hormone interactions: Protein/carbohydrate ratio alters reciprocally the plasma levels of testosterone and cortisol and their respective binding globulins in man”

5) Phytomedicine, 2003, 10(5):405-15, “Modulatory effect of Urtica dioica L. (Urticaceae) leaf extract on biotransformation enzyme systems, antioxidant enzymes, lactate dehydrogenase and lipid peroxidation in mice”

6) https://robthoburn.wordpress.com/2011/02/02/boron-increases-testosterone-again/

7) Eur J Appl Physiol, 2013 Jul, 113(7):1783-92, “Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training.

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

9) Br J Sports Med, 2003, 37(5), “THE ERGOGENIC EFFECTS OF EURYCOMA LONGIFOLIA JACK: A PILOT STUDY”

10)  https://www.prosource.net/content/articles/Articles-by-ProSource/tribulus-real-anabolic-alternative

Bioavailable Testosterone = Albumin-Bonded Testosterone + Free Testosterone

HRT (Hormone Replacement Therapy) Can Lower Cholesterol.

However, a 2011 book called The Magic of Cholesterol Numbers by Dr. Dzugan found a way to turbocharge these results and apparently even exceed that which is seen with standard TRT.  It may also make results even more consistent.

The importance of Dr. Dzugan’s works is incredibly profound, and I think, unfortunately, largely ignored.  I believe that implementing his ideas could save literally tens of millions of lives every year and billions in health care costs on top of that.  That is how important this is, and so I hope, after you read this article, you will spread the word.  Dr. Dzugan’s protocol can greatly lower cholesterol levels even with no changes in your diet.  (I highly encourage you to improve your diet if you have not of course!  Check out my pages on https://www.peaktestosterone.com/.)

Here is a summary of what he Dr. Dzugan did in a couple of studies from the above (must-read) book:

1.  He measured pregnenolone, testosterone, DHEA-S, cortisol, vitamin D  and progesterone.  (p. 170)

3. He only used bioidentical hormones, i.e. hormones identical to the ones the body naturally produces.

Hormonodeficit Hypothesis of Hypercholesteremia. Now why does he concentrate on the above hormones?  Why not melatonin or T3/T4 or prolactin., etc.?  The answer lies in the following “Hormone Production Lines:”

Cholesterol ==> Pregnenolone ==> DHEA ==> Testosterone ==> Estradiol and DHT

Cholesterol ==> Pregnenolone ==> Progesterone ==> Cortisol

Note that both of these hormonal pathways start with cholesterol at the top.  Now let’s say that, for whatever reason, one of the downstream hormones resulting from cholesterol is low, i.e. pregnenolone, DHEA, testosterone, progesterone or cortisol.  The Hormonodeficit Hypothesis of Hypercholesteremia posits that the body will do what it needs to do to try to boost that hormonal deficiency, i.e. it will boost cholesterol production in order to try to jack up all downstream hormones.  .

Check out the results of his two studies:

1.  Study on Adults of All Ages with High Cholesterol.  The above protocol dropped cholesterol levels 30% in men from 253 mg/dl to 191! (p. 171)

2.  2002 Study.  This study looked at 12 early senior aged men and found their total cholesterol dropped an average of 22% from 228 to 177 mg/dl.

Study #2’s results were particularly profound, because HDL remained unchanged.  Statins will lower both HDL and cholesterol, but by restoring hormones, you appear to get nothing but benefits.

This may partially explain some of the very impressive results that we have seen in the TRT cardiovascular studies lately.  The most recent study showed that in men that were low testosterone and had severe heart disease, TRT lowered cardovascular incidents by 80%!  This is much better than a statin, although statins are given to those with any testosterone level.  For details, see my on The Latest Testosterone Therapy Cardiovascular Studies. I would add that cholesterol-lowering is not the only cardiovascular benefit from TRT, something I cover in depth here:  Testosterone and Heart Disease.

CONCLUSION:  Current standards of practice are often decades behind the research and Dr. Dzugan’s work is one example of this.  Patients with cardiovascular issues are typically prescribed statins and maybe a baby aspirin and sent on their way.  Of course, lifestyle changes are the most important, but, clinically, it is clear that checking for certain hormonal deficiencies is nearly as critical.  Again, I recommend reading Dr. Dzugan’s book above and checking out the details of his protocols and findings.  He methodically and thoroughly describes the underlying issues and solutions.

One interesting and practical story having to do with with all of this is the famous low fat plant-based plaque regresser Dr. Esselstyn, who I cover on this page:  https://www.peaktestosterone.com/. Dr. Esselstyn commented that his diet will almost always lower cholesterol below 150 mg/dl but there are a certain percentage of men that he has to give a statin to in order to achieve that target cholesterol value. These men may very well be deficient in one of these hormones and just need bioidentical hormone therapy in order to avoid having to take a statin. (They could also be hypothyroid which wil artificially raise total cholesterol levels.)

This, by the way, is not is not a criticism of Dr. Esselstyn, whose work has undoubtedly saved literally tens of thousands of lives.  I am just pointing out that some men have stubborningly high cholesterol and hormonal issues is probably often the problem.  Why is this important?  Because statins are rife with side effects, something I cover here:  https://www.peaktestosterone.com/.

1)   The Magic of Cholesterol Numbers by Dr. Sergey Dzugan and Konstantine Dzugan

apoB closely tied to IMT scores - Peak Testosterone

However, there is a problem with LDL-P:  most doctors will not pull it for you and it is currently pretty expensive to pull yourself.  Many physicians do not yet understand the importance of LDL-P and are not interested in “unnecessary testing”, i.e. testing you before develop angina or drop dead from a heart attack!  In my opinion, LDL-P should a part of every man’s yearly physical.  Unfortunately, if a man tries to pull LDL-P himself, the cheapest cost from what I have seen is in the $125-$150 range.

The good news is that there is another marker out there that one can use in place of LDL-P:  apolipoprotein B (apoB). From all I have read – of course do your own research – this number essentially parallels LDL-P and it is MUCH cheaper.  For example, you can get this at Health Tests Direct for $35, assuming you don’t live in one of the states that doesn’t allow testing.  See my page on Testosterone Labs for more information.

Like LDL-P, apoB has been closely tied to IMT scores, i.e. the development of arterial plaque, in multiple studies.  One paper noted that apoB is also tied to cardiac events, i.e. angina, heart attacks, etc.:

“Although LDL cholesterol (LDL-C) is associated with an increased risk of coronary heart disease, other lipoproteins and their constituents, apolipoproteins, may play an important role in atherosclerosis. Elevated levels of apolipoprotein (apo) B, a constituent of atherogenic lipoproteins, and reduced levels of apo A-I, a component of anti-atherogenic HDL, are associated with increased cardiac events.” [4]

So why should a man be interested in managing his arterial plaque?  Well, besides the fact that he could drop dead from a heart attack, plaque is also tied to nitric oxide production and erectile function.  Yes, as plaque builds up in those penile arteries, things will softer and slower in the bedroom.

Apolipoprotein B (apoB) Levels to Arrest or Reverse Arterial Plaque

The burning question in my mind is always what I can do to keep arterial plaque from increasing and possibly even reverse it. To do this, let’s look at some of the targets that may achieve just that for us:

That said, it’s better safe than sorry and so you may want to shoot for this target.  However, keep in mind that Dr. Davis recommends LDL-C levels below 60 mg/dl and I have seen other reliable sources recommend between 70 and 80 for plaque reversal.

2.  Go For The Top Five Percent.  According to some Lipid Center data, if you want to be in the top five percent of apoB scores, you would need to have a level of 62 mg/dl or below. [1] This is probably a reasonably solid number as about 5 percent of Americans have no atherosclerosis and notice that it corresponds fairly closely to Dr. Davis’ 60 threshold.  If you want to be in the top 2 percent, you would have to be well below that at 54 mg/dl according to the same report.

3.  ~100 mg/dl in Higher Cholesterol Patients?. There is an interesting study out there that put patients with higher cholesterol on either a statin or high dose niacin.  You may recongize these as the two agents that the Plaque Regressers Dr. Gould and Dr. Davis use on most of their patients.  A statin works primarily by lowering the over LDL numbers and niacin by moving the LDL away from a “pattern B,” i.e. less small particle LDL and triglcyerides. What is interesting is that both strategies decreased narrowing of the arteries in a multiyear study even though their apoB levels were not really that low.  ApoB levels were 103 and 111 mg/dl in the lovastatin and niacin groups, respectively and yet they still experienced plaque regression. [3] Is it easier for higher cholesterol patients to regress plaque?  I don’t know, but I would aim for lower apoB numbers to play it safe.

4 Verify with an LDL-P Blood Draw. You can also pull your LDL-P (LDL Particle Count) and verify using that as mentioned above.  To get an idea for levels to reverse plaque using this marker, see my page https://www.peaktestosterone.com/l and LDL-P Particle Count Levels.

DIET ALONE? Can you achieve a satisfactory apoB score with just diet alone.  I can tell you that I am currently on a low glycemic, low fat diet and exercizing and hour per day.  Doing just this I have been able to get my apoB down to 68 mg/dl without niacin or a statin.  This is a good start in my opinion, but I’d like to drop it below 65 if at all possible.

REFERENCES:

1)  https://www.lipidcenter.com/pdf/AACC_Position_Statement_on_LDL_P.pdf

2) Track Your Plaque, by Dr. William Davis, iUniverse, p. 93.

3) N Engl J Med, 1990; 323:1289-1298, “Regression of Coronary Artery Disease as a Result of Intensive Lipid-Lowering Therapy in Men with High Levels of Apolipoprotein B”

4) J Intern Med, 2004 Feb, 255(2):188-205, “Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy.”

The Benefits of Dark Chocolate - Peak Testosterone

We all know that anything that tastes or feels good is bad for you, right?  Wrong!  We’ve already covered how Sex Is Good For Males. Well, dark chocolate is yet another example.

Dark chocolate is relatively low on calories and high on flavanoid-rich cocoa.  Dove is the gold standard, but almost any true dark chocolate will do.

The merits of dark chocolate are coming out in the studies almost every month, but here’s a few of the most important:

REFERENCES:

1) J Nutr, 2008;138:1939-1945, “Regular consumption of dark chocolate is associated with low serum concentrations of C-reactive protein in a healthy italian population”

2) J of Alzheimer s Disease, 18(4), in-press, A Diet Enriched in Polyphenols and Polyunsaturated Fatty Acids, LMN Diet, Induces Neurogenesis in the Subventricular Zone and Hippocampus of Adult Mouse Brain.

3) J of Proteome Res, 2009, Published online ahead of print Oct 2009, “Metabolic Effects of Dark Chocolate Consumption on Energy, Gut Microbiota, and Stress-Related Metabolism in Free-Living Subjects”

4) J Nutr, Jun 2006, 136(6):1565-9, “Long-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in women”

5) University of Copenhagen. “Dark Chocolate Is More Filling Than Milk Chocolate And Lessens Cravings.” ScienceDaily 23 December 2008. 22 March 2010

6) Journal Agric Food Chem, 2008, 56 (18):8527 8533, “Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders”

7) Circulation: Heart Failure, 2010; 3:612-616, “Chocolate Intake and Incidence of Heart Failure: A Population-Based Prospective Study of Middle-Aged and Elderly Women”

8) Physiol Behav. 2011 Feb 12;103(3-4):255-260, “Consumption of cocoa flavanols results in an acute improvement in visual and cognitive functions”

9) BMJ, 2012, 344: e3657, Published online 2012 May 31, “The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model”

10) https://esciencenews.com/articles/2012/05/31/ dark.chocolate.could.prevent.heart.problems.high.risk.people

11) HYPERTENSION, AHA, Published online before print August 14, 2012, “Benefits in Cognitive Function, Blood Pressure, and Insulin Resistance Through Cocoa Flavanol Consumption in Elderly Subjects With Mild Cognitive Impairment”

12) Am J Clin Nutr, 2005 Mar, 81(3):611-4, Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons”

13) https://www.eurekalert.org/pub_releases/2014-02/foas-wdc022714.php, “Why dark chocolate is good for your heart New research in the FASEB Journal suggests that consumption of dark chocolate lowers the augmentation index, a key vascular health predictor, and reduces adhesion of white blood cells to the vessel wall”

1)  Heart Health. Cocoa, the main ingredient in dark chocolate, is very good for the heart.  It lowers blood pressure among other things. See #4 here.

2)  Kuna.  Imagine a world with no heart disease.  Well, the Kuna live in such a world and cocoa is one of their secret weapons. Read here to find out about the Kuna and the unique lessons we can live from this third world people.

3)  Nitric Oxide. Dark chocolate increases Nitric Oxide, the stuff of erections.  Yes, it increases blood flow into the penis and that’s just what you need for a healthy sex life.  For other examples of foods that do the same, consider the Peak Testosterone Erectile Strength Diet.

4)  Inflammation. A 2008 study showed that small amounts, one or two squares, of dark chocolate reduced inflammation, which is implicated in heart disease and a host of other ailments. [1]  See my link on Inflammation for more details.

5) Delay In Dementia and Alzheimers. The polyphenols in dark chocolate will very likely delay and prevent Alzheimers and dementia according to one recent study. [2]

6) Appetite Suppression.  Dark chocolate is highly satisfying to the appetite and can actually help you to lose weight. Researchers in Copenhagen showed that men who first consumed dark chocolate later consumed 15% less pizza, which adds up to a lot of calories. [5]  In other words, dark chocolate can actually prevent you from overstuffing the ol’ pie hole.

7) Stearic Acid.  The primary fat in chocolate is a saturated fat, but has much less negative effects on your blood lipids than most other kinds of saturated fat.

8) Stress Reduction. Well, this is still more good news for chocolate lovers.  All you type A’s out there, listen to this:  Nestle’s lab found that in high anxiety subjects, a small bar of dark chocolate significantly reduced stress hormones. [3]

9) Skin. Consumption of 2 tablespoons of high-flavanoid cacao for 12 weeks resulted in skin that was smoother and more moist, which is important for a more youthful look. [4]

10) Heart Failure Protection. One 2010 study (of women) showed substantial protection against heart failure hospitalization or death in those who ate just an ounce of chocolate – not necessarily dark in this case – once or twice per week. [7] Note that eating over one serving per day was associated in a loss of all protective benefits.

11) Brain and Vision.  High flavanol dark chocolate was found to significantly increase short term cognitive and visual brain functions. [8]  For example, it improved choice reaction time, spatial memory, visual contrast sensitivity and motion detection for starters. In other words, chocolate is not just a sex booster – it’s a brain booster.

12) Medicine. Yes, researchers have actually suggested that dark chocolate could be used as medicine!  As I always say, “Food is clinical” and dark chocolate is a perfect example of this.  Researchers studied people with high blood pressure (hypertension) and Metabolic Syndrome and found that  dark chocolate actually saved lives and decreased mortality. [9] The researchers emphasized that it needs to be 1) dark chocolate with 2) at least 60-70% cocoa. [10]

13) Brain Booster. The studies keep rolling in showing that cocoa is a brain builder.  For example, a 2012 study in the journal Hypertension, shows that older people with mild cognitive impairment were significantly helped by consuming high-flavonol cocao. [11] It is important to note that this study showed the benefit ONLY occurring with the higher flanonol cocoas, so your dark chocolate must be of high quality and low processing.

14) Insulin Sensitivity. One of the huge battles for most men (over the age of about 40) is managing their blood glucose and insulin levels. Of course,  prediabetes and often Metabolic Syndrome occur when men lose their insulin sensitivity.  (This can be triggered by Inflammation.) Again, high quality cocoa can come to the rescue as one study found that it increased insulin sensitivity. [12] Is there anything this wonder plant can’t do???

“What are you waiting for?”  That’s my only question for those of you who don’t eat dark chocolate. It is simply one of those things in life that is too good to be true but really is.

15) Serotonin. Chocolate also contains significant amounts of both serotonin and tryptophan, which are important in the production of serotonin. They believe this explains the calming effect of chocolate on many people. (Magnesium actually helps tryptophan into serotonin.)

16) De-Stiffens Arteries. A recent study found that dark chocolate de-hardened arteries in overweight, middle-aged men.  And they also found that it kept white blood cells from sticking to arterial walls, which should help with arteriosclerosis prevention. [13]

CAUTION:  You may want to read my link on Does Chocolate Have An Ideal Dosage?  There are some strong indications that there is such a thing as too much chocolate.

CAUTION 2:  You may want to read my link on TNF Inhibitors as well. Cocoa may stimulate TNF-alpha production in some cases and this inflammatory cytokine is a root cause for diabetes, arthritis, arteriosclerosis and many other ills. However, it should be pointed out that The Kuna, who are heavy consumers of cocoa, show no ill effects.

CAUTION 3: The only “side effect” that I know related to dark chocolate is that it can relax the valve between stomach and esophagus in some sensitive people, leading to heart burn.  Also, if you happen to be the type that actually knows what to do in the kitchen and are using cocoa in your recipes, you will generally want to avoid Dutch-processed cocoa or cocoa “processed with alkali”.  Alkali processing is used to lower the naturally acidic pH of raw cocoa but, unfortunately, strips out most of the flavanol content.  One study, for example, showed that alkali processing lowered the flavanol content from an average of 34.6 to 13.8 and 7.8, respectively, for lightly and heavily processed cocoas. [6]  My understanding is that the standard Hershey’s and Nestle’s cocoa that you buy in the supermarkets (in the U.S.) use a processing called Broma that leaves the flavanol content largely untouched.

How to Add Some Mass to Your Ass and Look Younger - Peak Testosterone

Modern living does something nasty to our appearance:  it flattens our butt.  Aging does the same thing. Remember erosion in your geology class?  Well, the same thing is happening to those firm glutes dealt to you in youth.

We all know that one of the biggest signs of the “grandpa look” is a flat butt. That’s not going to score you any points with your honey.  Put on some muscle, especially in your rear, and you’ll immediately take a few decades off the appearance of your body.

The good news is that you don’t have to say bye bye to your butt.  No, indeed, you can actually grow your rear as much as you want to. What’s the secret?  All you have to do is the oldest exercise in the book:  squats. Generally speaking, guys will do a weight lifting workout and you’ll never hear them complaining about how sore their butt muscles are.  Well, that’s a sure sign they didn’t do their squats.

This works – trust me.  I’m a Skinny Bastard and my wife noticed and made comments about you-know-what.  That happened when I was 49 years old, so you can do it too.

Here’s another secret:  don’t just do regular squats, but concentrate on wide stance squats.  Italian researchers recently looked examined muscle activation in the legs and rear and found something interesting:  the width of the squat affected only the glutes (butt muscles). [1] By width of the squat, I mean how far apart you put your feet.  A normal squat is done with the feet fairly close together, but these researchers found that the putting the feet farther apart actually hammered the gluteal muscles much harder.

It’s interesting, but I had discovered this principle on my own.  I have one knee that bothers me and I found that wide stance squats are a little easier on my knee.  The next day I could really feel it in the ol’ hind quarters if you know what I mean.

“But isn’t squatting hard on your knees and back?”, I hear you ask.  First of all, if you have a medical condition, talk to a good doc of course.  However, for the great majority of you, squats are an excellent health-promoting, butt-building exercise and, if done correctly, will not hurt your knees or back. Of course, if you don’t know how to do a squat correctly, get a good trainer.

Here are three tips that will help as well:

1) Do not put your knee over the end of your foot when squatting.  This can put unneeded stress on your knees.

2) You do not have to go past 90 degrees to hit your thighs and glutes. In fact, I never go to 90 degrees (as if I was sitting in a chair).

3) You don’t have to use a lot of weight.  If you feel more comfortable with less weight, then just increase the number of reps that you do.  You’ll still feel it the next day.

It doesn’t matter so much how much weight you use – what matters is that you do it. And don’t let fear of falling or tipping stop you:  that’s what Smith Machines are for.

REFERENCES:

1) J Strength Cond Res 23(1): 246-250, “The Effect of Stance Width on the Electromyographical Activity of Eight Superficial Thigh Muscles During Back Squat With Different Bar Loads”

Testosterone Therapy: The Positive Cardiovascular Studies, 2015

Nevertheless, there is great reason for the TRT community to celebrate these findings, and I summarize the results and studies below for those who wish to dig into more detail.

CAUTION:  Always consult with your doctor when it comes to any medical condition including heart disease.  He or shoe knows your specific situation and medical background:  the studies just deal with averages and can have their own issues.

1. Men with Severe Heart Disease. This study looked at 755 senior men between the ages of 58 and 78 with very advance arterial plaque levels – many were diabetics, smokers, etc. – and split them up into three groups:  those who got no testosterone; those got a lower dose of testosterone; and those who got a higher dose of testosterone.  The latter group end up with testosterone > 742 ng/dl. I highly suggest that you look up the study and read it for yourself, but a quick summary is that the researchers measured a quantiy called MACE, Major Adverse Cardiovascular Events.  This will include things like a heart attack, stroke and probably angina.  What they found was the “the men who did not receive testosterone as part of their treatment were 80 percent more likely to suffer an adverse event, such as a heart attack, than those taking T.” [7][8]

2. Senior Men Receiving Injections. This study found that “older men who were treated with intramuscular testosterone did not appear to have an increased risk of MI [heart attack]. For men with high MI risk, testosterone use was modestly protective against MI.” [4] Injections, in particular, have been criticized – more on that below – as posing some additonal cardiovascular risk but notice that testosterone actually lowered the risk of heart attack in those who need it most.

3.  NORMALIZATION Greatly Improves Risk of Heart Attack, Stroke and Mortality.  This recent study in The European Heart Journal pointed out that the major component missing from the two negative CVD studies were normalization of testosterone levels, i.e. proof that the patients actually had their testosterone boosted significantly.  The authors of this study used a VERY large set of 83,000+ veterans data and found results that were so positive it has silenced virtually all TRT critics from what I have seen: [6]

a) A 47% reduction in all cause mortality!

b) An 18% reduction in heart attacks

c) A 30% reduction in strokes.

These are incredible numbers and, as I often point out, it is no wonder considering that testosterone lowers insulin levels and improves insulin sensitivity, something that is a major issue for most 45+ men in modern societies.  (See my pages on Testosterone and Diabetes and Testosterone and Metabolic Syndrome for more information.) Again, just because a man goes on TRT does not necessarily mean that anyone has proven that his testosterone has normalized.  He may not have been compliant and some delivery systems just do not work in some circumstances.

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

In my layman’s opinion, the research overall shows that testosterone therapy significantly improves cardiovascular outcomes in the average hypogonadal man placed on standard TRT.  This is actually remarkable considering that some rather lousy protocols are used out there, something that I highlight in my page on Potential Testosterone Injection Dangers. In addition, some men with clotting disorders may be at risk and you can read about this on my page called The Potential Risks of Testosterone Therapy. So talk to your doctor and do your own research as I always say, but it would appear that testosterone therapy still has a bright future ahead of it.

NOTE:  Before I go on, I want to be clear that I am not a doctor or a researcher but simply another guy out there enjoying the benefits of testosterone therapy.  That said, I am probably more interested in the subject that the great majority of physicians out there, simply because testosterone therapy has been such a life changer for me and greatly improved my health from all I can tell.  I also have a wife and three kids and certainly do not want to do anything reckless, and so I want to know the strengths and weaknesses of what I am doing.

I HEARD THERE WERE STUDIES SHOWING TRT INCREASES CVD RISK?  Within just a few months (Oct 2013 to Jan 2014) testosterone replacement therapy appeared to be on the ropes with two back-to-back studies showing increased cardiovascular risk for men on TRT. [1][2] These studies were controverisal and widely criticized in the TRT community however.  And one of the reasons is that, in general, testosterone therapy has done very well in the cardiovascular research, and so this was quite a shock.  In my opinion Dr. Morgentaler did an incredible job of showing the issues with these studies in two papers that you can read here and here. Although his discussion is not exactly an easy read, I see no point in rehashing it here, and I highly encourage you to read what he wrote. Below is a quick recap by Dr. Morgentaler of the key problems:

“However, methodological flaws and data errors invalidate both studies as credible evidence of risk. One showed reduced adverse events by half in T-treated men but reversed this result using an unproven statistical approach. The authors subsequently acknowledged serious data errors including nearly 10% contamination of the dataset by women. The second study mistakenly used the rate of T prescriptions written by healthcare providers to men with recent myocardial infarction (MI) as a proxy for the naturally occurring rate of MI. Numerous studies suggest T is beneficial, including decreased mortality in association with TTh…” [6]

Although one of our posters pointed out that Dr. Morgentaler has disclosed considerable financial ties to the testosterone manufacturers, Dr. Morgentaler’s position seemed completely vindicated by the above three ensuing major studies showing that testosterone therapy actually IMPROVES cardiovascular risk. [3] [7]

1) PLoS One. 2014 Jan 29;9(1):e85805, “Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men”

2) JAMA, 2013, November 6, 2013, 310(17), “Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels”

3) https://www.peaktestosterone.com/forum/index.php?topic=6369.0

4) Ann Pharmacother, 2014 Jul 2;48(9):1138-1144, “Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy”

5) Asian J Androl, 2015 Jan-Feb, 17(1):26-31, “Testosterone deficiency and cardiovascular mortality”

6) European Heart Journal, published August 6, 2015, “Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men”

7) JACC, Apr 5 2016, 67(13), “CLINICAL EFFECTS OF TESTOSTERONE SUPPLEMENTATION AMONG HYPO-ANDROGENIC MEN WITH PREEXISTING SEVERE CORONARY ARTERY DISEASE: THE INTERMOUNTAIN HEART COLLABORATIVE STUDY”

8) https://www.medicaldaily.com/testosterone-shotsheart-attack-risk-coronary-artery-disease-381236

Cell Phone Dangers - Peak Testosterone

Sometime in 2012 the world will hit 4.5 billion cell phone users. That’s 4.5 billion people who take an electromagnetic device and press it almost every day against their cranium without ever thinking that it might possibly have a dangerous effect on their brain, ears, mouth and other structures in close proximity. The cell phone industry has grown so fast that issues of health and safety have never crossed anyone’s mind.

That is until recently…

In the last decade one study after another has come out showing just how toxic cell phones are to humans. Is it any wonder?  Humans are, after all, primarily a vast electrochemical neuronetwork and a phone seems almost diabolically designed to interfere with our “wiring.”

The argument from the industry is that the output from a cell phone is simply not enough to damage DNA and, therefore, cell phones must be safe. That is a debatable theory as it turns out, but, regardless, there is much, much more to us than just DNA.  Cell phones affect us in many nasty ways that have nothing directly to do with DNA damage.

Think pesticides are bad? Cell phones may be even more deadly.  Read below and I’ll give you non-DNA 15 reasons to take that silly device in your pocket and drop it into the nearest fishtank:

1.  Upregulation of Genes. An animal study showed clearly that exposure to cell phone radiation upregulated genes. [2] So, while experts wrangle over whether cell phone radiation can alter DNA, it is somewhat a moot point: cell phones can clearly affect genetic material through upregulation anyway. The cells affected were neurons by the way.

2.  Free Radical Damage and Fertility. Recent studies have shown that cell phone radiation can alter DNA throught a surprising pathway:  increasing oxidative (free radical) load within cells, a huge health danger it goes without saying. [3] We all know that antioxidants are, in general, a good thing and help protect health.  The study above showed that cell phones accelerate the opposite phenomenon and actually damage the DNA within sperm and decrease male fertility.

It does this within the mitochondria of sperm cells and this leads to a frightening question:  “Does cell phone exposure accelerate mitochondrial damage in other cells as well?”  If so, this would be downright dangerous.  Mitochondria are so important to health that there is an entire theory of aging built around these cell structures.  Anything that negatively affects them will lead to health issues.

3.  Testosterone. Strangely enough, a study showed that cell phone exposure increased testosterone. [4] Again, this may seem like a good thing, but can anything that is frying your sperm be doing your body good? It may affect testosterone positively, but what other hormones does it affect negatively?

4.  Blood Brain Barrier. A number of animal studies have documented that cell phone radiation alters the permeability of the blood brain barrier, i.e. lets more molecules in the blood stream pass into the brain. (See my link on Electrosmog for more details.)  This is incredibly dangerous as it could potentially allow toxins, including excitotoxins, to more easily cross the only line of defense that your brain has. This research shows yet another way that cell phone EMF’s can affect cell functioning and processes.  Childhood leukemia and brain cancer have been on the rise. [6] Could this be contributing?

5.  Brain Glucose Metabolism. One study looked at PET scans of the brain before and after cell phone usage.  What they found was scary indeed:  after just 50 minutes of cell phone usage, the areas of the brain around the ear had altered glucose metabolism. [7] Again, this demonstrates that cell phones change activity on the cellular level.

NOTE:  I also give coverage to the very ugly health issues of “dirty electricity” here in my link on The Dangers of Electrosmog .

6.  Brain Tissue Damage. There is some evidence that cell phones may actually damage brain tissue, indicating yet another danger associated with long term usage. [8][9]

7. Mouth Cancer (Heavy or Rural Users). Many studies have shown that cell phone usage does not significantly increase cancer risk.  However, still other studies have. One disturbing example is a study of rural users.  The reason that rural users are of particular concern is that cell phones in this situation emit more radiation to reach more distant towers.

One study found, for example, that cell phone users in these regions were much more likely to get cancer of the salivary gland. [10] One 2009 meta-analysis explained that, although cancer and cell phone usage has been studied often, there are a number of important issues with almost all of the studies and the study periods have generally not been of sufficient length to come to a definitive conclusion. [11] Cell phone usage may very well lead to brain cancer over decades, for example.

8. Bone Loss. One recent study found that cell phones – many people carry them in their pocket – lead to increased bone loss in the hip area. [12] Although the bone density loss did not come close to that of someone with osteoporosis, this is yet another example of cell phone usage affecting tissue on a cellular level.

9. Behavior Problems in Children. Cell phone usage may pose a danger to the brains of our children as well.  One study showed that it affected behavior and mood in over 13,000 kids. [13] The most significant factor was in-the-womb exposure, which has a signficant relationship to childhood emotional problems and hyperactivity.  Again, this is another sign that cell phone exposure does in fact affect structures within the brain.

10. Tinnitus. Hearing also appears to be affected according to some studies which show a relationship between cell phone use and ringing in the ears. [14] Again, it’s the tissues that are closest to the cell phone that are affected.

11. Eye Damage. One study showed that electromagnetic radiation similar to cell phones was capable of damaging the eye. [15] While some recent studies have shown no increased risk of eye cancer from cell phone usuage, this study showed that it is very possible that a “bubbling” could be initiated on the surface of the lens, which fortunately appears to be reversible.  Nevertheless, who wants to take a chance?

12.  Headache, Fatigue and Sleep. One Saudi study found an association between cell phone use and “headache, sleep disturbance, tension, fatigue and dizziness.”  The incidence of headache was particularly high.  Of course, this is just one study but inicates possibly brain function issues could be associated with cell phone usage. [16]

13.  Erectile Dysfunction. A recent study shows that those with erectile dysfunction were 2.6 times more likely to carry a cell phone in their front pocket. [17] Ouch! Again, this is scary when coupled with the bone loss study above for the same. (See #8.)

REFERENCES:

1)  https://www.cellular-news.com/story/29824.php

2) Neuroscience Letters, Jan 22 2007, 412(1):34-38, Exposure to cell phone radiation up-regulates apoptosis genes in primary cultures of neurons and astrocytes”

3) PLOS, 2009, “Mobile Phone Radiation Induces Reactive Oxygen Species Production and DNA Damage in Human Spermatozoa In Vitro”

4)  https://www.sciencedaily.com/releases/2011/05/110519113022.htm

5) https://www.medicinenet.com/script/main/art.asp?articlekey=125152

6) https://www.kurzweilai.net/cell-phone-use-affects-brain-glucose-metabolism

7) https://www.kurzweilai.net/cell-phone-use-affects-brain-glucose-metabolism

8) Electromagn Biol Med, 2008, 27(2):103-26, “Radiofrequency and extremely low-frequency electromagnetic field effects on the blood-brain barrier”

9) https://www.huffingtonpost.com/scott-mendelson-md/your-cell-phone-will-not_b_416588.html

10) https://www.telegraph.co.uk/news/uknews/1579028/ Heavy-mobile-phone-use-a-cancer-risk.html

11) Environ Health Perspect. 2009 March; 117(3): 316 324, “The Controversy about a Possible Relationship between Mobile Phone Use and Cancer”

12) https://www.webmd.com/osteoporosis/news/20091027/cell-phone-on-hip-may-weaken-bone

13) Epidemiology, Jul 2008, 19(4):523-529, “Prenatal and Postnatal Exposure to Cell Phone Use and Behavioral Problems in Children”

14) PLOS ONE, Received: November 23, 2008; Accepted: March 4, 2009; Published: March 27, 2009, 4(3): e5026, “Association of Tinnitus and Electromagnetic Hypersensitivity: Hints for a Shared Pathophysiology”

15) The Open Ophthalmology Journal, 2008, 2:102-106, “Non-Thermal Electromagnetic Radiation Damage to Lens Epithelium”

16) Saudi Med J, 2004 Jun, 25(6):732-6, “Association of mobile phone radiation with fatigue, headache, dizziness, tension and sleep disturbance in Saudi population”

17) https://www.healthcentral.com/erectile-dysfunction/c/215658/158881/dy/

tion/ Understanding IIEF E.D. Scoring - Peak Testosterone

Many erectile dysfunction studies use IIEF scores to show improvments over control or placebo, making a basic understanding of this questionnaire and the scores underlying it critical for evaluation and comparison purposes.  The IIEF (International Index of Erectile Function) questionnaire comprises 15 questions aimed at assessing sexual function, and is divided into five domains . The questionnaire was devised for use in clinical trials when Viagra was under development.

The most often quoted domain is the IIEF-EF domain, where EF refers to Erectile Function. Within the IIEF-EF domain there are six questions, and you gain up to five points per question. The questions refer only to the previous four weeks and ask the following. (i) How often during sexual activity did you gain an erection? (ii) How often were erections hard enough for penetration? (iii) When you attempted penetration how often did you succeed? (iv) How well did you maintain the erection after penetration? (v) How well did you maintain the erection to orgasm? And (xv) how high was your confidence that you could get and keep an erection? The more positive/confident your answers: the more points.

Most Questionnaires define a score of at least 25 as no dysfunction . 19-24 is mild . 13-18 is mild to moderate. 7-12 is moderate, and 1-6 is severe. Some Questionnaires, more realistically, define a score of at least 26 as no dysfunction ; 22-25 as mild ; 17-21 as mild to moderate ; 11-16 as moderate and 1-10 as severe .

The IIEF questionnaire was developed for a purpose: to understand the effect of Viagra on men taking part in clinical trials, – and those men were expected to report in a scientific manner. In a random group of men, not taking part in a properly organised clinical trial, the questionnaire is far from ideal.

Some questions need explanation. In question 1, for example, does masturbation count as sexual activity? (The answer is yes. But suppose you don t masturbate?) Does a semi count as an erection? (The answer is again yes, as does any slight stiffening.) Does being drunk, tired and just eaten a heavy meal when you failed allow you not to lose so many points? Or being nervous with a new partner?

There are slightly different versions of the questionnaire, which employ slightly different phraseology.

When I filled in the questionnaire in November 2012 I wasn t given any guidance. Confusion in patients and doctors minds may partly explain why the charts and graphs in many trials appear irrational and contradictory.

The first five questions award no points only if you ve not attempted sexual activity in the previous four weeks. If you make the attempt (as you would if taking part in a clinical trial) have always failed, and have very low confidence, you get one point per question. So, even without a penis, you would score six points. On the other hand you may be a stud, who s had no sex activity for a month, and only score five points.

The IIEF-EF questionnaire misses some important questions. For example it does not give marks for speed of erection. You could take an hour to achieve an erection, need p**nogr*phy even to achieve that, and generally orgasm within five seconds of penetrating a hired hooker, but with such desperate performances on a regular basis you could score the maximum 30 points.

The final question awards at least one point (for having the lowest level of confidence) and so the technical range of possible scores spans from one to 30, but the useful clinical-trial range spans from 6 to 30.

You gain two points, in question 1, simply for occasionally eventually getting some slight increase in penis size, with ideal sexual stimulation. A man who never has a proper erection, can gain a just a very weak response only occasionally, and sustain it for only a few seconds, could score 7 points, and hence be in the moderate category. Whereas in reality his condition would be far from moderate.

The other four domain scores can help give a better perspective on the IIEF-EF score. These domains relate to Intercourse Satisfaction , Orgasmic Function , Sexual Desire and Overall Satisfaction . Intercourse Satisfaction is scored from 3-15 and the others 2-10 (assuming you made the relevant attempts in the previous four weeks).

The Intercourse Satisfaction domain seems a more useful, though slightly vague, guide. Strangely, it awards five points just for making at least eleven attempts in the previous four weeks, no matter how unsatisfactory they might have been. The other ten points more reasonably relate to how much enjoyment and to how much satisfaction you had. (Sounds almost like the same question asked twice.) Perhaps Overall Satisfaction is the most easily understood and useful domain, though half of the possible points relate to your relationship with your partner, which might be outside your control

Research with a random group of 111 normal men in Washington, found an average IIEF-ED score of 25.8. By some versions of the questionnaire that is mild dysfunction. Perhaps 50% had some level of e d, and 50% didn t? The published facts relating to the amount of erectile dysfunction in the world vary enormously, from around 10% of men, to more than 50% in the 40-70 age group.

There is usually significant increase in IIEF score in the placebo or sham group of men on clinical trials. This might just be wishful thinking by the guinea pigs, but perhaps these men were talking to, being more open with and relaxed with their partners; and that may cause genuine increase in scores (especially in the so-called psychogenic cases of dysfunction).

Increases in IIEF-EF score of 4, 5 or 6 are by most trials considered significant . Viagra trials tended to report increases in EF score of around 8 to 11 points, and PDE5i seems generally to offer the greatest beneficial effect. However, when judging questionnaire results, one might perhaps deduct the sham treatment group s increase score from the treated group s increase, to get a more realistic idea of average sustainable improvements.

The S H I M. There is a simplified version of the full questionnaire called the Sexual Health Inventory for Men, or the IIEF-5 Questionnaire . This, more realistically, covers the previous six months, and is more rational for a man not on a clinical trial. There are five questions and possible scores of 1 to 5, for each. Hence the minimum score is 5 and the maximum is 25.

The questions are (i) how did you rate your confidence to get and keep an erection? (ii) How often were they hard enough for penetration? (iii) How well did you maintain the erection after penetration? (iv) How well did you maintain the erection to completion? (v) How often was intercourse satisfactory for you?

Questions 1 and 2 include masturbation; and q1 must include any slight stiffening (or q2 would be redundant). Answers to questions 4 & 5 could depend on how self-centred or easily satisfied you are.

22-25: No erectile dysfunction; 17-21: Mild erectile dysfunction; 12-16: Mild to Moderate erectile dysfunction; 8-11: Moderate erectile dysfunction; 5-7: Severe erectile dysfunction

Cortisol and Depression - 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

Cypionate: The Kind of Therapies? - Peak Testosterone

Cypionate injections actually had a very lackluster history in its early years and it is very important for any man interested in injections to understand why.  In fact, it’s not an overstatement to say that many men have had quite miserable experiences, but in the great majority of cases, you can’t blame cypionate!  Blame the docs who usually just did not know any better. Let me give you some examples from the Peak Testosterone Forum:

NOTE: For reasons unknown, in some countries testosterone enanthate is used almost exclusively over testosterone cypionate.  The two have similar half lives and virtually everything on this page that applies to cypionate also applies to enanthate as well.

1.  Time Between Injections. Ten or even five years ago, most doctors made the patient wait a ridiculous amount of time between injections – between two and four weeks in some cases!  Here are some examples of the suffering this can incur:

The problem is that testosterone cypionate has a half-life of 8-12 days!  So, after a couple of weeks, you have very little in your system.  Notice that this man said that he felt terrible for two-and-a-half weeks, which of course corresponds to the time period when he had very little testosterone left.  Basically, the doc gave him just enough testosterone to tease him!

Now most doctors do not do monthly schedules, but I get men all the time writing in via email or on the forum on two and three week regimens.  These are little better.  Even a two week regimen leaves a man hypogonadal for a few days at the end of the cycle.  Just when life seems good, the rug gets pulled out from under you.

2.  Roller Coster Rides.  Men on cypionate injections every two or three weeks usually have other issues.  The docs know that the patient is going to be low for the last week or two and so the tendency is to give more testosterone.  The thinking is basically to give a big initial dose knowing that the man will go close to zero so that the average is in a more “reasonable” zone.

Elevated estradiol can also lead to some of the symptoms that are associated with HRT, such as fluid retention and prostate enlargement.  For example, check out this poor guy whose doctor put him on a four week cycle:

“This progressed (after the first T injection) into heavier swelling, fatigue and bouts of shortness of breath along with several instances of dizziness leaving me in a position that I have now been out of work for nearly a month.” [2]

Again, it is likely his physician gave him a massive dose to try to compensate for the very long time between injections.

3.  Unmanaged Estradiol. Something related to #2 is the fact that some men are overweight and some are “high converters,” meaning that they will change a lot of their precious testosterone into estradiol and end up with overly high estradiol levels while on testosterone replacement.  Because of this, many HRT docs and anti-aging clinics try not to allow estradiol levels go too high or too low and generally keep men in the 20-30 pg/ml range for not only heart health but also to make sure that libido and mood do not crash as well.  (See my Estrogen (Estradiol) Links for Men for more information.)

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

One more important point:  some men seem very sensitive to estradiol.  A matter of just 3-5 points can help or hurt erectile strength and morning erections according to many reports.  This may seem like a placebo effect, but keep in mind that a healthy male has a very high ratio of testosterone-to-estradiol and so a small amount of estrogen must be matches by a lot of testosterone to make up for it.

Besides erectile and libido issues, men going too high with estradiol can be at risk for “water retention”, i.e. swelling of the feet, etc.  This can be frightening but is generally from estradiol going too high.  In fact, look at the post above where the man experienced swelling from HRT.

High estrogen can also lead to mood swings, depression and other related brain-related issues.  And it can be downright dangerous to the ol’ bod long term:  one study showed that going over 37 pg/ml led to a 133% increase in mortality. [3] Some believe estrogens are the prime cause of prostate cancer.  More on this below.

NOTE:  There are three estrogens (estrone or E1, estradiol or E2 and estriol or E3).  E2 is known as the “bad estrogen”, although a man needs to have sufficient estradiol for bone, brain and arterial health.

Testosterone Cypionate Protocols

1.  Weekly or Twice per Week. One of the most important factors for success with this injectable is that it should be administered weekly or even twice per week.  Some men even do a Monday, Wednesday, Friday schedule or even every other day.  These options avoid the roller coaster ride that we spoke of above due to cypionate’s relatively short half life.  Again, savvy docs give the patient smaller amounts weekly rather than one “horse dose” every two or three weeks like the old school methodologies.  Essentially, this makes the peaks less high and and valleys less low a and smooths the range of testosterone levels experienced. As we age, put on weight and have increased stress levels, a bigger percentage of our testosterone is converted to the estrogens.  These larger dosages tend to ramp up these pathways and a man can end up with a disproportionately large estradiol spike.

2,  Arimidex.  Many men on the forum are on Arimidex (anastrozole) and it is fairly common in any testosterone cypionate protocol. The reasons are that usually men are going to 900 to even 1200 ng/dl peak generally with cypionate and have put on weight over the years. This means that most men will end up with high estradiol levels for about a week.

Of course, talk to your doctor, but cypionate usually peaks on the 3rd of 4th day after the injection and so the first dose of Armidex will be given then (on a weekly cycle) with a second dose three days later. Common dosages are 1/4 mg or a 1/2 mg two times per week. From what I have seen, most of the anti-aging physicians and HRT clinics try to keep a man between about 20-30 pg/ml. Most men can get off of Armidex by losing weight, decreasing their dosage a little and going to more frequent injections. Arimidex is considered pretty safe and side effects seem to be low, especially in the lower dosages given for HRT. However, there is potentially the danger of knocking your estradiol too low and ending up with long term bone loss. I recommend scanning through these concerns on my site as well: Arimidex Problems.

NOTE: Although not very common, Arimidex can be given by itself to (most low T) men to raise testosterone levels as I document in my link on Testosterone and Arimidex . This is called by some Arimidex Monotherapy. Many men like the idea of simultaneously raising testosterone and lowering estrogen. See also my link on the Testosterone-to-Estrogen Ratio.  I don’t think I have seen a case of Armidex Monotherapy on the Peak Testosterone Forum, although some men have asked about it.

3.  Injection Options. There are several basic options here:  you can go to the physicians office for injections; you can self-inject; or you can get a family member to give you the injections.  Now not all doctors will allow injections outside of their office.  The argument is that testosterone is a controlled substance. I think the real reason is to get you in for an additional office visit reimbursement or payment.  However, on the forum, many men are self-injecting and I expect this percentage to increase over time.

The amount of fluid injected is relatively small and usually feels like a little ant bite.  It is possible to “hit a nerve” which stings a little more and can leave a small sore bump for a day.  But cypionate injections rarely cause issues if reasonable hygiene and procedures are followed.

NOTE:  Yet another option out there is called “SubQ”.  Standard injections are intramuscular, but for details on this other methodology, you can watch this training video by Dr. John Crisler, one of the most well-known online HRT docs that has been doing these sorts of things forever. According to Dr. Crisler, this has the advantages of 1) not poking so many holes in the muscle, 2) even more smoothing of testosterone and estradiol and 3) often reducing the need for Arimidex.

4.  Needle Size, Length and Gauge. Your doctor should have very specific instructions for you on how to self-inject if that is route and you and he/she decide to take.  But here are a few things to discuss and/or be informed of: [4]

a) The smaller the gauge number, the wider the needle.  Thus a 20 gauge needle is bigger than a 21.

b) You will typically be given two needles, one to draw and one to inject.  The larger is usually to draw.

c) Needle size can vary considerably.  18-22 is common for drawing and 21-27 for injecting from what I have seen.

d) You can inject with a 27 gauge needle, but it is much slower.

e) You also have varying needle lengths.  1.5 inch is very common, but your doctor may provide a slightly different length based on your body fat levels.

f)  You may be able to use a 25 gauge needle (for intramuscular quad injections) if you can use a 1 inch needle. If you’ve got some extra fat and need a 1 1/2 inch needle that may be too challenging. [5]

The above applies to intramuscular injections. SubQ injections use a much smaller needle and it is a one step process.

5. To HCG or not to HCG. One very common protocol with the HRT clinics and anti-aging doctors is called “The Trifecta” and includes testosterone cypionate, Armidex and HCG.  Short term results are pretty good but in my opinion you should avoid if at all possible the use of Arimidex. It is better to lose weight and lower your cypionate dose instead.  HCG is added primarily to reduce testicular shrinkage and, in some men, provide a modest boost in libido and/or mood.  See my link on Testosterone and HCG for additional details.

CAUTION: This page is NOT intended to be a guide for self-treatment.  Always work with a physician, who can give you proper dosing/procedures as well as careful monitoring of estradiol, red blood cell counts, liver function and PSA.  Also, realize that testosterone cypionate, and standard HRT in general, will lower fertility.  If you want to have kids, discuss possible alternative with your doctor, such as Clomid and HCG Monotherapy .

REFERENCES:

1)   https://peaktestosterone.com/forum/index.php?topic=121.0

2) https://peaktestosterone.com/forum/index.php?topic=620.msg5717#msg5717

3) https://www.lef.org/magazine/mag2010/may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

4) https://peaktestosterone.com/forum/index.php?topic=1178.0

5) https://peaktestosterone.com/forum/index.php?topic=1624.0

Decrease Wrinkles in Two Minutes per Night - Peak Testosterone

Is there a miracle skin chemical out there?  Well, no, but we can come close with Retin-A. Imagine rubbing some lotion into your face each night and watching the years roll right off your appearance.  Well, Retin-A can do that for a lot of you.

I mean let s assume you ve gotten your libido back, your testosterone is up, your erections are hard and life is perfect and good. But is it really? You may have had the same thought cross your mind that crossed mine at one point: what good is it to FEEL 15 years younger on the inside if you don t LOOK 15 years younger on the outside?!?

Well, this is where Retin-A can come to the rescue.  Retin-A is actually most famous as a treatment for acne, so a lot of people don’t realize that it is a great wrinkle reducer and even wrinkle remover in some cases.

Now there are a lot of guys out there that feel that trying to make your face and appearance is girly stuff.  We picture a bunch of women talking and giggling about some weird mud pack they put on their face.  Well, that’s not what I am talking about here – there is nothing girly about Retin-A.  In fact, I would argue that using Retin-A is man’s work, pure and simple.

Why do I say that?  Because Retin-A is easy, straightforward and backed by science. Most of the expensive wrinkle reducing creams that your wife or girlfriend buys in the mall has little to no research behind it and is a huge waste of money.  Retin-A, on the hand, has many studies under its belt and years of use by dermatologists and physicians.

And, most importantly, Retin-A use is low key so no one ever has to know.  Applying Retin-A each night takes all of two minutes – it’s really that simple.  There is no weird grape leaf mudback from the swamps of Brazil and two hours of sitting under a hot towel watching Oprah.  You just put a little lotion on each night and – voila! – you are done.

There is nothing girly about taking two minutes each night and there’s nothing girly about looking ten years younger either.  How does Retin-A work its magic?  It does so by actually “killing” the outer layers of the skin on your face so that your body replaces it with new, “baby-like” skin. In fact, it can actually create a little redness and, in some cases make you literally peel when you first start using it.  That’s why it is important when you are first starting out with Retin-A to slowly build up your tolerance.

If Retin-A is working for you, then you will notice the following as the weeks and months go by:  your skin will become softer and smoother – almost polished – all the while your wrinkles are reducing as well.  And all of that from 2 minutes of work each night.  Now I do have to give a warning here:  if you are eating the typical Western diet or smoking or overweight, Retin-A isn’t going to stem the tide of free radical and glycemic damage that you are doing to your skin.  Yes, Retin-A is a solid performer, but it’s not going to work miracles!

So is Retin-A natural?  Well, yes and no.  It is naturally occurring and is just an acid form of Vitamin A.  Is it safe?  It has an excellent track record with very few side effects if used correctly.  In fact, you are really not supposed to put on much Retin-A – just a very thin layer, i.e. this isn’t a lotion to slather on your face like an after shave lotion.  Furthermore, the typical solution is either .1% or .05%, so when all is said and done you absorb very little of it.  Plus, it may help to know certain leukemia patients actually take large amounts of a medication called Vesanoid, which is basically tretinoin (Retin-A). However, you should discuss this with your doctor after reading my link on Just How Safe is Retin-A?.

So let me give you a few guidelines for how to actually use and get the stuff:

A great body of research shows that Retin-A decreases wrinkles and improves the general appearance of skin.  It comes in .1% and .05% lotions or creaams and  (It can actually make you peel.) Of course, I realize that the vast majority of guys know next-to-nothing about such things, so let me explain a little more:

A thin layer of Retin-A is usually applied at night.  Strong sunscreen must be applied over any areas where the Retin-A was used because topically applied A Vitamins, such as that in Retin-A, can make your skin absorb sunlight much more rapidly.  Again, sunscreen is critical unless you live north of the Yukon.

In addition, you have to be careful not to get Retin-A in your eyes.  If fact, you have to be extremely cautious about using Retin-A on the eye socket area where the skin is much more thin and delicate that the rest of your face:  you can do more damage than good around the eyes if you are not careful. Some people use a .025% solution around the eyes a few days per week with success, but every person is different. Go easy and slowly because if you damage the skin around your eyes, you’ll look much older instead of younger. Remember:  do no harm!

So how do you get Retin-A?  It’s prescription only in the US and other Western countries.  It is actually a very cheap drug to make, so you can get it at a very reasonable price from Mexico or other overseas pharmacies. However, I would advise getting it from a doctor rather than self-treating.  The reason is simple:  you really need to have someone overseeing your results to make sure you are using the right concentration and frequency and not causing too much inflammation.

NOTE: They key is to get tretinoin, which is retinoic acid, as that is substance that actually reduces wrinkles.  Tretinoin is actually sold under other brand names such as Renova.  However, you should remember that Retinol, which comes in many over-the-counter skin preparations is NOT tretinoin or Retin-A.  Do not get the two confused as Retinol does not have nearly the strength as Retin-A for most individuals.  The reason is the Retinol has to first be converted by the body to retinoic acid and that is generally an inefficient and highly variable process. Go for what works and that is tretinoin, a.k.a Retin-A.  There is also Retin-A Micro to consider as well. Some say that Renova has the best moisturizer in it, but that is unlikely to make a substantial difference.  Remember:  you are trying to build new skin and reduce wrinkles.

Retin-A can cause irritation if you use too high of a concentration too quickly.  Both .10% and .05% can achieve clinical results, but for example .10% may be too harsh for you skin:  every person is different.  You really don’t want significant redness or too much flaking for a significant period of time.  A doctor can help you get started on the right foot so that the inflammation/healing process is at a reasonable pace so that you get the kind of results you want without potentially damaging your skin.

Remember also that Retin-A will decay.  I recommend that once you open it, you refrigerate it to keep its potency for as long as possible.  If you are trying to be more secretive for some reason, be sure to keep it in a cool dry place at as low of a temperature as possible.  Anecdotally, it will last for four months or more if you are careful and still work.

NOTE: One other benefit of Retin-A is with hair loss when coupled with Rogaine (minoxidil).  It works by “exfoliating” you skin, which means it removes much of the hard, dry outer layer of your skin.  And this allows other chemicals to be absorbed more easily such as Rogaine. In other words, you may get improved hair re-growth results using the combination of Rogaine + Retin-A! Don’t self-treat with this but talk to your doctor as there are a number of studies showing good results using this technique. [4] In fact, some studies have shown just Retin-A by itself can result in hair growth.  Get yourself a good doctor and find out what can be done if this is an issue for you.

NOTE: There are some OTC products that are reasonably priced that have a study showing (apparently) wrinkle reduction benefits. [6] One of these products is called Boots No7 Protect & Perfect SerumNow, admittedly, the study was funded by the manufacturer.  However, the results were so remarkable that it is doubtful that it could be fabricated in my opinion, but one always has to keep in mind conflicts of interest.  What was remarkable was that not only did this product reduce wrinkles, but it also increased fibrillin-1 in the skin.  Key components of skin are elastin, collagen and fibrillin.  Fibrillin is particularly vulnerable to photoaging, i.e. sun damage, and this product, Boots No7 Protect & Perfect Serum, appears to actually reverse some of this damage.  

It is critical with Retin-A that you protect yourself from the sun, since treated skin will tan/color differently.  However, modern sunscreens can be quite toxic and dangerous.  See this discussion on The Safety of Modern Sunscreens for more details.

Clinically what works best is a combination of topical (applied to the skin) antioxidants coupled with a strong antioxidant-laden diet.  In my case, however, I have not found topical creams necessary.

If you want to try topical preparations of various antioxidants, then you are certainly in good company:  study after study has shown the benefits even, in some case, to the point of reducing sun damage and reducing wrinkles.  For example, topical Vitamin C is a proven wrinkle remover.  Furthermore, Vitamin C strengthens and even stimulates collagen regrowth. (Note:  I have read that about 15% of oral Vitamin C gets to the skin which means that if you take 1+ g, a significant amount will actually be there to protect your skin.)

How do you make your own Vitamin C?  Well, it’s surprisingly easy and it’s in the Infopacks that Smart Skin Care sells for a very reasonable price.  (I am in no way associated with this site.)  Doing this yourself will save you a lot of money – trust me!

NEWS FLASH: There is a supplement, Evelle, with clinically proven results to improve skin elasticity and roughness. [8] And it is no wonder, they put many known antioxidants and skin-improvers into one pill including Vit E, Vit C, Pycnogenol and Biotin among others.

That’s another thing that separates most of us guys from most of the females in this category:  rationality about money.  The Journal of Cosmetic Dermatology found that dry patches on eczema patients experienced as much relief with a 12$ over the counter moiturizer as with a $100 prescription cream called Mimyx.  If you go with a woman to one of the mall shops with a cosmetic department, almost every skin care product she grabs will be in the $50-$100 price range.  By making it yourself, you can do most everything in the $5-$10 price range.  Again, the goal in my opinion for us guys is fast, affordable and very discreet.  If you make it yourself, after all, no one has to know.

Another thing you can find in the same Smart Skin Care Info Packs is how to prepare topical CoQ10 preparations for you skin.  Studies have shown that CoQ10 both reduces wrinkle depth and protects against UVA radiation. [5] CoQ10 is a powerful antioxidant that is involved in the most primordial processes of the cell:  making ATP for energy.  This cellular energy-production process can produce an abundance of free radicals and CoQ10 is one of your first lines of defense.

CONCLUSION:

It’s not as hard as you might think to turn back the clock.  A little Retin-A and sun screen and you will be shocked at the results in 3 months.  Now if you’ve been smoking or a heavy sun-worshipper for decades, then you may have to resort to Cosmetic Surgery for Males.  But, either way, the practical steps on this page will make a significant difference.  Try it!

REFERENCES:

4) J Am Acad Dermatol, 1986, 15:880-883;Clin Pharmacol Ther, 1990m 47:439-46

5) Biofactors 1999;9(2-4):371-8

6) Br J Dermatol, 2009 Apr 28, [Epub ahead of print], “A cosmetic ‘anti-ageing’ product improves photoaged skin: a double-blind, randomized controlled trial”

8) J of Dermatological Treatment, Jul 2004, 15: 222-226, “Supplementation with Evelle improves smoothness and elasticity in a double blind, placebo-controlled study with 62 women”

Retin-A UsageRetin-A Do-It-Yourself Substitutes

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.

Fish Oil - Peak Testosterone

Fish Oil has, in general, not been studied directly as an aid to erectile dysfunction. However, one European study found that it helped endothelial function and nitric oxide output (in diabetic pateints) and both of those are the stuff of erections as you know. [1] Yet another study showed that it improved arterial elasticity which will do nothing but help with erections.

Furthermore, fish oil is long-term protective of the entire cardiovascular system including your endothelium.  For those battling high triglycerides, one of the prime predictors of heart disease,  fish oil would be a strong contender as it is recognized for substantialy lowering triglycerides.  Fish oil also raises good cholesterol, HDL, by a few percent while it’s at it.  Its only negative is that does also raise LDL, the bad cholesterol by 5-10% in some cases. The net effect of fish oil, however, is definitely good. Triglycerides, in particular, are a strong predictor of heart disease (probably via ADMA) and a plague of Western societies with all of their Metabolic Disorders.

NEWS FLASH: One recent study shows that taking fish oil capsules dramatically increases the risk for advanced prostate cancer – this is the kind you don’t want! – and significantly increases it for all prostate cancers. See this article for more details. Based on this, the authors recommended eating just one or two meals of fish per week instead. Keep in mind that this is just one study, but the results were so pronounced that it should be carefully considered. For a nice rebuttal to this study, read this discussion for more information.

Fish Oil also helps with mental state, warding off depression and feelings of melancholy.  And avoiding depression is critical for your brain, neurons and testosterone.  One study of middle and senior aged men also found that Fish Oil lowered levels of SHBG [5] , the protein that binds to testosterone. Increasing levels of SHBG is one of the curses of increasing age in males as it leaves less and less testosterone available to do all. In other words, Fish Oil should increase free (but not total) testosterone in aging males.  (See my link on How Fish Oil Help with Testosterone for more details.)

Fish oil is also known for its inflammation-lowering properties and inflammation is recognized as a key ingredient to heart disease and autoimmune disorders. A fatty acid in fish oil, called human resolvin E1, does this by inhibiting both the migration of inflammatory cells to sites of inflammation and the turning on of other inflammatory cells. [3]. Fish oil has done very well in multiple studies with lowering fibrinogen, a key predictor of heart disease and a kind of inflammatory marker related to clotting.  But, strangely enough, fish oil has had mixed results in lowering one of the key inflammatory markers associated with heart disease, CRP (C-Reactive Protein).

Fish consumption is also associated with decreased dementia. Considering how good fish is in warding off depression, this should come as no shock.  Fish’s brain-saving properties may also be because Alzheimer’s and dementia, like so many other health problems, seems to have an inflammation component.  One recent large study of Asia and Latin American participants found that fish consumption was significantly correlated with lowered rates of dementia. [6]  By the way, meat consumption showed the opposite:  increased rates of dementia!

The bottom line is that fish and fish oil consumption are good for heart, penis, brain and skin.  (It is also good for  Raising and Protecting Free Testosterone.) One recent large meta-analysis recommended fish oil because it both prevents heart disease and reduces the risk of heart attack. [7]  This was yet another huge endorsement for omega-3’s, because the researchers looked at multiple studies over the last 30 years, aggregated the results and concluded that fish oil could “reduce the risk of hardening of the arteries (atherosclerosis), irregular heartbeat (arrhythmia), heart attack, sudden cardiac death, and heart failure”. Not bad, eh?

NOTE:  Many guys are plagued by DES, or Dry Eye Syndrome.  This can be quite bothersome and even debilitating depending upon how bad it is.  Researchers recently found that the higher the omega-3 fatty acid intake (and tuna consumption), the less the likelihood of DES.  This is just one study, but it makes sense that fish and fish oil will very likely help this condition. [10]

By the way, you will find some criticism of fish oil because, unfortunately, it has had mixed results with the mortality studies.  For an excellent summary of the research as of a few years ago, see the following summary from the prestigious journal  [4] at this link. But I think this is too rigorous of a requirement:  what supplement or food is so powerful that it can overcome all other aspects of lifestyle and diet?  (Green tea is the only one that comes to mind.) Again, many of the miraculously healthy cultures in our world eat fish and it is endorsed by, in my opinion, one of the greatest researchers of our day.

Studies have shown that fish oil, at high doses of 2 g DHA/day, does decrease the body’s Vitamin E to unacceptable levels. [9] It may be advisable to take additional Vitamin E.  I discuss this in more detail at the bottom of this link on How to Buy Fish Oil.

Also, if you are wondering about contamination: Consumer Labs did a study recently and found that all 41 fish oil brands they tested were safe from mercury and PCBs. (This is contrast with actually eating fish to get fish oil, because almost all fish, especially those on farms, are unacceptably contaminated.)

A recent study [8] broke cohorts up into varying dosages of DHA and then followed various known markers of heart disease to find the optimal dose.  What they found was that only relatively small dosages, 200 mg of DHA per day, were needed to achieve very high levels of protection.  We don’t have the details yet on this study, but the results line up with previous studies that found that only eating fish 1-2 times per week was sufficient to achieve substantial gain.  You may want to consider taking more than 200 mg (of DHA) due to fish oil’s Free Testosterone Raising Powers.

NOTE:  You may also want to read my link on How Fish Oil Can Help with Arthritis.

NOTE: Be very cautious about using flax seed to get try to get your omega threes. First of all, it does not have all the properties of fish oil, and, more importantly, it has been tied to a possible increase in prostate cancer.  For example, Mayo Clinic’s site states this: “Flaxseed oil contains only the alpha-linolenic acid component of flaxseed, and not the fiber or lignan components…Preliminary evidence suggests that alpha-linolenic acid may be associated with an increased risk of prostate cancer”.

REFERENCES

1) Diabetologia. 1993 Jan;36(1):33-8

2) Life Science 2006 April 18;78(21):2523-32

3) Jour Exper Med, Mar 2007, 201(5):713-722

4) Circulation: 2002,106:2747

5) Nutr Cancer, 2000, 38(2):163-67

6) 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”

7) J of the Amer Col of Cardiology, Aug. 11, 2009; 54:585-594, Lavie, C., News release, American College of Cardiology.

8) FASEB Journal, 2009, 23: 2909-2916, “Increasing intakes of the long-chain -3 docosahexaenoic acid: effects on platelet functions and redox status in healthy men“.

9) Brit Jof Nutr, Jul 1992, 68:163-173, “The influence of a fish oil high in docosahexaenoic acid on plasma lipoprotein and vitamin E concentrations and haemostatic function in healthy male volunteers”

10) Amer J of Clin Nutr, Oct 2005, 82(4):887-893, “Relation between dietary n 3 and n 6 fatty acids and clinically diagnosed dry eye syndrome in women”

Fish Oil – SafetyFish Oil – Dosage

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:

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

“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

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.

Why Regressing Plaque is So Important for Erections

I have already done a page on How to Reverse Your Arterial Plaque, so I on this page I want to focus on why it is so important to focus on reversing any arterial plaque that you may have. In fact, I want to show evidences that egressing your plaque will improve everything you want to do as a male.  That may sound like an exaggeration, but read below and you’ll see that the lining of your arteries is just as important as testosterone.

Here are just some of many examples as to Why Atherosclerosis Reversal is Critical for Men:

“Reversal treatment reduces the severity of coronary artery narrowing.  The abnormal endothelial lining heals, and the coronary arteries function more normally.  They are more likely to enlarge (vasodilate) rather than go into spasm (vasoconstrict).  Consequently, coronary blood flow to the heart muscle improves both at rest and druing stress.” [6]

Now, just in case the significance of this is not obvious, I will point out that this does not just apply to the heart.  All the arteries in one’s extremities will be positive effected, including those in the penis.  This means penile arteries will experience improved blood flow when a plaque regression program is undertaken (assuming of course that one has plaque to begin with).

NOTE:  Arterial Plaque Inversely Assoicated with Blood Flow Even In Young People! Common sense tells you that as the arteries fill up with plaque and lose their ability to dilate and the walls become fibrotic and hardened and nitric oxide decreases – need I go on? – that this is going to be bad for blood flow.  Well, common sense would be exactly right in this case and one study on young people showed just that.  Again, this study was not on 80 year olds in a nursing home but on a population of young people between the ages of 24 and 39 years old.  These young people were impervious, right?  And completely immune to any heart disease that might have developed, right?  Of course, the study showed the oppsoite and that “brachial FMD is inversely associated with carotid IMT.” [1]

Let me translate that a bit:  FMD (flow mediated dilation) is a measure of blood flow and IMT (intima media thickness) a measure of plaque buildup in the carotid (neck) artery.    So these authors basically stated that as plaque levels increased, blood flow decreased and, yes, in young people.  And this undoubtedly explains some of the difficulties these young men were having in the bedroom.  In my same page on Young Men and Erectile Dysfunction, I point out a study that shows as many as one fourth of all young men have erectile dysfunction.  These guys should be struggling NOT to have spontaneous erections at that age, but instead have the arteries of the typical senior from a few generations ago.

NOTE: How do you measure your atherosclerosis?  There are two ways that you can do it on your own (in the U.S. in 45 out of 50 states) without a doctors orders:  a) an IMT through Lifeline for $70 or b) a Heart Scan through one of your local heart institutes.  The former is an ultrasound of a neck carotid.  The latter is usually around $99 and does involve some radiation.  You can read hear about my  My Heart Scan Results.

Another one of the plaque regressors, Dr. Esselstyn, has found very similar results.  His strategy was to put men on a low fat vegan diet, which profoundly decrease inflammation and cholesterol.  And he noted the following at a 12-year follow up:

–About 3/4ths of them had regressed their atherosclerosis

–All of them had stabilized their atherosclerosis

–Angina and heart events were dramtically improved when compared to those that were initially in the program and then quit. [8]

3. Niacin and Statins Improve Endothelial Function. First of all, let me say that I am no fan of statins and, generally speaking do not even think they are necessary.  However, Dr. Gould, who reverses plaque day in and day out, uses statins effectively for that purpose.  And Dr. Esselstyn will occasionally use a statin with some of his patients as well.  I am also no huge fan of high dose niacin as it just does not seem natural to me.  However, I freely admit that Dr. Davis also used niacin very effectively to reverse plaque.  Basically, both of these strategies improve lipid parameters, especially LDL-P (apoB), and thus can decrease plaque.  Again, see my page on How to Reverse Your Arterial Plaque for some of the details.

Now let me make an observation:  both high dose niacin and statins have studies showing that they improve endothelail function.  Isn’t it just a bit odd that the two big gun compounds that regress plaque improve endothelial function?? For example, one study on men and women with Metabolic Syndrome (prediabetes – and probably well over half of those reading this have prediabetes – showed that niacin improved endothelial function by 22%. [2] Just one supplement did that!  Imagine if the particpants also ate nitric oxide boosting foods – see my book  The Peak Erectile Strength Diet for more information – and exercised!

Likewise, many studies have shown that statins improve endothelial function.  Yes, statins are have many issues with them, but one can’t deny that they can get the blood flowing and arteries dilating again for many men. [4][5] Again, isn’t it coincidental that these two anti-plaque agents immediately help with endothelial function and, therefore, will generally help with erections?

A Vicious Circle: Endothelial Dysfunction Predicts Future Plaque. We all know that the ultimate sign of poor endothelial function, high blood pressure, is a huge risk factor for atherosclerosis.  This is due to several reasons, but one is that the increase pressure hitting the arterial walls makes them more vulnerable to developing plaque.  This was shown in a different way from a study that found that “systemic endothelial function was associated with progression of preclinical carotid arterial disease over a 6-year period and was more closely related to cIMT changes than conventional risk factors.” [3] The authors stated that in their opinion it was likely due to the fact that the endothelial dysfunction created a ripe enivonment to actually increase damage to the lining of the arteries.  Yes, this is a vicious circle:  arterial plaque worsens endothelial function and endothelial dysfunction worsens plaque.  No wonder most people are limping around by their 50’s and on multiple medications!

CONCLUSION:  Regressing plaque will likely do the following for men:

By the way, plaque regression will likely also protect men from Alzheimer’s and Parkinson’s. New research is showing that these may just be part of “calcification of the brain” similar to the way heart disease is “calcification of the arteries.”

1)  Circulation, 2004, 110:2918-2923,”Interrelations Between Brachial Endothelial Function and Carotid Intima-Media Thickness in Young Adults: The Cardiovascular Risk in Young Finns Study”

2) International Journal of Clinical Practice, Nov 2007, 61(11):1942 1948, “The effects of extended-release niacin on carotid intimal media thickness, endothelial function and inflammatory markers in patients with the metabolic syndrome”

3) Circulation, 2009; 119: 1005-1012, Published online before print February 9, 2009, “Endothelial Function Predicts Progression of Carotid Intima-Media Thickness”

4) Circulation, 2005, 111:2356-2363, Published online before print May 2, 2005, “Simvastatin Versus Ezetimibe: Pleiotropic and Lipid-Lowering Effects on Endothelial Function in Humans”

5) Circulation, 2001, 104:376-379, “Cerivastatin, a Hydroxymethylglutaryl Coenzyme A Reductase Inhibitor, Improves Endothelial Function in Elderly Diabetic Patients Within 3 Days”

6) Heal Your Heart, by Dr. K. Lance Gould, Rutgers Univ. Printing, 5th edition, 2002, p. 36

7) Heal Your Heart, by Dr. K. Lance Gould, Rutgers Univ. Printing, 5th edition, 2002, p. 37

8) https://www.dresselstyn.com/reversal01.htm

Alcohol: Friend or Foe? - Peak Testosterone

Alcohol – is it good for you or bad for you?  Does it protect your heart or endanger it?  Well, the answer to those questions require more than just a simple “yes” or “no”.  The overwhelming consensus is that alcohol, one or two drinks per day, is heart-protective. And since heart disease is the number one killer of us males, this has often put alcohol center stage as a healthy addition to a fit lifestyle.

How does it do its cardiovascular magic?  Alcohol, again in doses of one or two drinks per day, raises HDL levels, [1] which is cardioprotective and can even stimulate erection-producing Nitric Oxide. It also seems to stabilize arterial plaques and somewhat reduce their formation as well. [15] Alcohol, in moderation of course, also thins the blood and reduces clotting and, of course, it is clotting that can contribute to MI’s (heart attacks). This also helps explain how several studies have also found that moderate alchohol consumption reduces the risk for stroke which are the results of clots. [8][9]

Alcohol has also other good properties as well.  Red wine, for example, has been found to be significantly protective of Prostate Cancer. A 2010 study found that moderate drinking was able to significantly protect the brain. [12]  Other cross-gender studies have shown the same thing. [13] [14]

So moderate alcohol consumption is a no-brainer, right?  As is often the case, the story is much more complex. Alcohol produces toxins and carcinogens, increases the risk for certain cancers and lowers levels of many critical nutrients and antioxidants.

The truth is that there is an alternative:  a Low Fat Diet.  A Low Fat Diet, such as the Ornish Diet, is so heart protective that it actually reverses arterial plaque. As I have pointed out, cultures and people that have maintained cholesterol below 150 for a substantial portion of their life have virtually no heart disease. In addition, Low Fat Diet also looks very protective against prostate cancer as well.

REFERENCES:

1) Diabetologia, Oct 2004,(47)10:1760-1767(8)

2) Eur J Cancer Prev,Feb 2006,15(1):69-73

3) Ann Intern Med,Apr 2004,20;140(8):603-13

4) Hypertension. 2005;45:851-852

5) Alcohol, Jan 2001,23(1):35-9

6) Alcoholism: Clinical and Experimental Research, Published Online: 23 Oct 2009, “Alcohol Stimulates Activation of Snail, Epidermal Growth Factor Receptor Signaling, and Biomarkers of Epithelial Mesenchymal Transition in Colon and Breast Cancer Cells”

7) Cancer Epidemiology, Biomarkers and Prevention, Dec 2003, 12:1540-1543, “Risk of Basal Cell Carcinoma in Relation to Alcohol Intake and Smoking”

8) NEJM, 319:267-273, Aug 4 1988, “A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women”

9) JAMA, Feb 5 2003, 289(5):579-588, “Alcohol Consumption and Risk of Stroke”

10) Nucleic Acids Res, 2005, 33(11):3513-20, “Polyamines stimulate the formation of mutagenic 1,N2-propanodeoxyguanosine adducts from acetaldehyde”

11) Alcohol and Alcoholism, 21(1):81-84, “ALCOHOL ENHANCES VITAMIN C EXCRETION IN THE URINE”

12) N Engl J Med 2005; 352:245-253, “Effects of Moderate Alcohol Consumption on Cognitive Function in Women”

13) Age and Ageing, 2007, 36(3):256-261, “Moderate alcohol consumption in older adults is associated with better cognition and well-being than abstinence”

14) British Medical Journal, 2004, 329:538-539, “Daily Alcohol in Your 40 s Increases Risk of Mild Cognitive Impairment” (NOTE: Authors found that moderate drinking improved cognition and more than that lowered it.)

15) American Journal of Epidemiology, 2005, 162(4):391-392, “ALCOHOL CONSUMPTION, BINGE DRINKING, AND EARLY CORONARY CALCIFICATION: FINDINGS FROM THE CORONARY ARTERY RISK DEVELOPMENT IN YOUNG ADULTS (CARDIA) STUDY”

16) Cancer Detection and Prevention, 2009, 32(5):352-362, “Lifetime consumption of alcoholic beverages and risk of 13 types of cancer in men: Results from a case control study in Montreal”

HANGOVER:  What about if you go overboard and drink more than 1-2 drinks?  It turns out that there is some research showing which foods are actual Legitimate Hangover Aids and Cures

Blood Pressure. Alcohol, at least beyond some threshhold which is probably around three drinks for most individuals, increases blood pressure. [4] Again, this is not an issue for moderate drinkers.

Glutathione and Vitamin C. Two of the body’s key antioxidants are glutathione and Vitamin C.  Alcohol consumption lowers levels of both of these key protective agents. In the case of glutathione, this occurs because it binds to carcinogens and toxins produced by alcohol in order to protect the body. Alcohol also leads to increased urinary excretion of Vitamin C. [11]

Nitric Oxide Replacement Therapy - Peak Testosterone

But how do you measure the above strategy? How do you know if those nitrates you are eating are actually creating nitric oxide? Well, one way we can fairly accurately measure this is through the new nitric oxide test strips that have hit Amazon – see Berkeley Nitric Oxide Test Strips (50 Count) for example – and the market in general. These strips measure nitric oxide indirectly, however, saliva is an obligatory step in the bioconversion for the body to form nitric oxide and nitrite is a well established biomarker or surrogate for nitric oxide; nitrite serves as both a precursor for nitric oxide through the chemical reduction and a byproduct of nitric oxide via oxidation, which, in turn, can be recycled to form nitric oxide.

I was fortunate to have a recent interview with Berkeley Test’s representatives and they explained the real power of these strips, which I have included below.

NOTE: For other ways to boost NO through food and also my Review of the Berkeley Nitric Oxide Test Strips

Q. Why should a man buy your current test strips when it’s not truly measuring endothelial NO?

A. The reality is that you can’t necessarily control the degree of endothelial NO gene expression or endothelial NO production, especially as you age, but you are able to compensate with a diet rich in vegetables with high nitric oxide potency. Hence, the strips are “enabling” — they provoke you to change your dietary lifestyle to ensure your nitric oxide levels are elevated.

From a practical standpoint, the strips empower you to identify, which foods are rich in nitric oxide potency, but they also help in the timing to achieve optimal levels with a nitric oxide potent diet. For example, optimal nitric oxide levels to enhance performance are typically found 2-3 hrs after eating nitric oxide potent natural beet juice derived from winter beets resulting in an elevation to Target-Threshold levels shown with Berkeley s saliva nitric oxide test strips.

To achieve Threshold levels with Berkeley Test strips through natural whole foods diets, such as DASH, reinforce the recommended multi-servings of leafy greens that exhibit the benefits of these diets.

Hence, the strips are helpful in screening what foods are producing the greatest NO response. And for those foods which exhibit nitric oxide potency, Berkeley Test strips provides insight as to when levels are optimal. A number of clinical studies have reported on the effects of nitric oxide foods and diets elevating saliva levels in context of lowering blood pressure (see Scientific Articles, The Science Behind Nitric Oxide and Nitric Oxide potent foods at Berkeley Test).

Q. So these test strips are not really measuring arterial nitric oxide levels? Thus, a young man with good endothelial nitric oxide production may be misrepresented by the strips, i.e. his arterial nitric oxide may be good even though he has not eaten much in the way of nitrates?

A. The strips are reflective of nitric oxide bioavailability and bioactivity that is reflective of both nitric oxide produced by the endothelial cells and dietary sources, i.e., nitrate-rich vegetables.

Regarding the dietary source, ie, nitric oxide-potent beets and spinach, the bio-conversion of nitrate to nitrite in saliva to make nitric oxide is an obligatory and necessary step for arterial pressure changes: in brief, if saliva is interrupted, blood pressure is elevated.

For example, Webb s work (Hypertension 51:784, 2008) elegantly reinforced the obligatory role of saliva in humans. They showed that ingestion of beet juice by healthy volunteers markedly reduced blood pressure (BP) and by disrupting saliva, either by spitting or interrupting the conversion of dietary nitrate to nitrite in the mouth, the reduction of blood pressure was abated; by blocking the saliva from recirculating, it prevented a rise in plasma levels, and blocked a decrease in blood pressure and abolished the inhibitor effects on platelets aggregation confirming both arterial pressure changes and cardio-protective effects were attributable to the conversion in the mouth. So, our mothers were right: eat your vegetables and do not spit. (Wink et al, Hypertension 51:617, 2008.) Sobko et al (Nitric Oxide 22:136, 2010 ) shows that Japanese traditional diets abundant in leafy greens elevated both plasma and saliva levels with a corresponding BP decrease, or the recent clinical correlate between saliva and blood pressure lowering with nitric oxide-potent spinach. Here, the consumption of spinach lowered systolic blood pressure and increased large artery compliance acutely in healthy men and women with a corresponding 8-fold increase in salivary levels (Liua et al, Nitric Oxide 35: 123, 2013 ).

Ahluwalia s reports in 2012 and 2013 re-enforces the concept among pre-hypertensives (Nitric Oxide 26:197, 2012). They showed in a cross over protocol of 14 volunteers who ingested inorganic nitrates, plasma and saliva level increased 3 hrs post ingestion with a significant reduction of BP. A follow on study (Kapil et al, Biology Medicine 55:93, 2013), showed that nitrite/nitrate is extracted from blood by the salivary gland, accumulates in saliva, and it is then reduced to nitric oxide to have a direct BP lowering effect. And when interrupting saliva levels in volunteers that already had elevated levels, a rise in systolic and diastolic BP resulted. In their most recent paper (Ghosh et al, Hypertension 61, 2013), they found that pre-hypertensives may be more sensitive to the BP lowering effects of the dietary nitrate-nitrite-nitric oxide pathway; it is a fascinating paper that sets the stage for an inexpensive antihypertensive strategy with beet juice.

As you well know this field is rapidly evolving. If we look to how other biomarkers evolved, such as serum cholesterol or blood pressure, new clinical correlates causes the scientific community to reassess how to interpret the information. For example, just this past year, new guidance was provided regarding BP measurements.

In like fashion, we envision saliva testing for nitric oxide status will evolve; eventually, we would like to see descriptive terms, i.e., low or depleted, move to quantitative ranges that provides guidance as to a physiological outcome, i.e. arterial pressure or endothelial dysfunction. This is something we are interested in providing some day, however, that will be driven by more clinical evaluations and correlates. So, this discussion will continue to evolve and will be on going.

Today, Berkeley Test strips are reflective of nitric oxide bioavailability and bioactivity that is reflective of both nitric oxide produced by the endothelial cells and dietary sources, i.e., nitrate-rich vegetables.

Fasting Insulin Levels and Your Sex Life - Peak Testosterone

Fasting insulin levles are, in my opinion, one of the most important numbers that you need to know and evaluate regularly.  Fasting insulin isn’t as sexy as testosterone, but it can sure affect your sex life!  (Actually, as we will discuss below, testosterone powerfully impacts insulin levels and this is one of the primary reasons that low testosterone is potentially so dangerous for hypogonadal men.) One study looked at the relationship between erectile dysfunction and insulin resistance/levels and found the following: [6]

a) Metabolic Syndrome, a.k.a prediabetes, was present in 43% of the participants compared to 24% in a control group.

b) About three fourths of the erectile dysfunction patients had insulin resistance compared to only a fourth in the general population.

c) Metabolic syndrome (P = 0.01), IR (P = 0.01), and fasting blood sugar (FBS) >110 mg/dL (P = 0.01) correlated positively and moderately with increasing severity of ED by SHIM score

So you don’t just want to monitor testosterone for bedroom performance but insulin as well.  In fact, I always say that you have two big enemies that create 90% of all health issues (and probably erectile dysfunction) for men in urban societies:  Insulin Resistance and Inflammation. These Two I’s wreak havoc in virtually every tissue of your body from the brain to the penis if allowed to go out of control.  And guess what?  Fasting insulin is currently the measurement of choice used by physicians for determining insulin resistance.

1)   DIABETES CARE, VOLUME 24, NUMBER 3, MARCH 2001, “Diagnosing Insulin Resistance in the General Population”

2) Int J Cardiol, 2002 Nov, 86(1):61-9, “Fasting insulin levels independently associated with coronary heart disease in non-diabetic Turkish men and women”

3) The Journal of Pediatrics, April 2007, “Fitness is a Stronger Predictor of Fasting Insulin Levels than Fatness in Overweight Male Middle-School Children”

4) Sports Medicine (Auckland, N.Z.), 1997, 24(5):321-336], “Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus”

5) Journal of Andrology, Jan/Feb 2009, 30(1), “The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes and Insulin Resistance”

6) The Journal of Sexual Medicine, Jan 2005, 2(1):96–103, “Incidence of Metabolic Syndrome and Insulin Resistance in a Population with Organic Erectile Dysfunction”

7) Diabetes, Nov 1991, 40(11):1397-1403, “Development of Muscle Insulin Resistance After Liver Insulin Resistance in High-Fat–Fed Rats”

8) Science, 21 Aug 1987, 237(4817):885-888, “Fish oil prevents insulin resistance induced by high-fat feeding in rats”

9) JAMA, 1998, 279(24):1955-1961, “Fasting Insulin and Apolipoprotein B Levels and Low-Density Lipoprotein Particle Size as Risk Factors for Ischemic Heart Disease”

10) 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”

11) Diabetes Care, 2006, 29:2688–2693, “Hyperinsulinemia and Cognitive Decline in a Middle-Aged Cohort”

12) Journal of Applied Physiology, Jan 1 2004,96(1)101-106, “Effect of the volume and intensity of exercise training on insulin sensitivity”

13) DIABETOLOGIA, 2007, 50(11):2298-2304, “Association of sleep duration with type 2 diabetes and impaired glucose tolerance”

14) Am J Respir Crit Care Med, Mar 1 2002, 165(5):670-676, “Obstructive Sleep Apnea Is Independently Associated with Insulin Resistance”

15) Am J Clin Nutr, Mar 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”

16) Am J Clin Nutr, July 2002, 76(1):274S-280S, “Glycemic index, glycemic load, and risk of type 2 diabetes”

17) Diabetes Care, Jun 2005, 28(6):1397-1403, “Dietary Glycemic Index, Glycemic Load, Fiber, Simple Sugars, and Insulin Resistance The Inter99 study”

18) Biochemical and Biophysical Research Communications, 8 Jul 2005, 332(3):885-891, “α-Lipoic acid increases insulinsensitivity by activating AMPK in skeletal muscle”

19) HORMONES, 2006, 5(4):251-258, “Improvement of insulin sensitivity in patients with type 2 diabetes mellitus after oral administration of alpha-lipoic acid”

20) Hypertension, 1987, 10:512-516″Fructose-induced insulin resistance and hypertension in rats”

21) Journal of Hepatology, Nov 2008, 49(5):821-830, “Probiotics improve high fat diet-induced hepatic steatosis and insulinresistance by increasing hepatic NKT cells”

What exactly is insulin resistance? The condition occurs when insulin does not push glucose into your cells at the normal rate, creating a toxic environment where both blood glucose and insulin levels rise. Insulin resistance is the hallmark feature of Metabolic Syndrome, or prediabetes, and it is a HUGE risk factor many kill-you-slowly diseases such as heart disease and erectile dysfunction. If you are a middle-aged or senior male in a Western society, you very likely have the beginnings of insulin resistance, whether you know it or not.

So what are safe fasting insulin levels and how can you bring them down? Well, first of all, your lab results will probably have a huge range associated with it.  My physical a few months ago showed a range of 2-25 mIU/l (or uIU/ml).  Physicians generally regard you to have an actual medical condition, insulin resistance and/or hyperinsulemia, in the 10-12 range.

However, I recommend that you try to get your fasting insulin well below 12 or even 10 mIU/l. (My doctor, for example, recommended getting it below 5, which, interestingly enough, is the level that some health indigenous populations have.) The reason is that researchers have found that blood glucose/insulin issues cause major health issues:

b)  Small, Dense LDL Particles.  As insulin resistance sets in, many men begin to produce smaller LDL particles and these smaller particles accelerate arterial/vascular damage and injury to your all-important endothelium.  As your endothelium as injured with the passing years, your nitric oxide levels fall and erectile dysfunction sets in. Many studies have verified that LDL particle size, fasting insulin and various inflammation factors are tightly related to heart disease. [9]

c) Cognitive Decline and Dementia. Almost everyone knows about the cardiovascular issues associated with insulin resistance. However, many men to do not know that as the decades roll by insulin resistance injures the delicate tissues in the brain as well. [11]

So how you control your fasting insulin levels?  It will probably not surprise you to find that all the key things I push on this site as a natural lifestyle greatly help control and reduce fasting insulin levels.  Below we have a list of some of thse key factors and the studies to go along with them:

Also, it should be noted that one study looked at men and women with lower or medium cholesterol levels (less than about 210), yet with many signs of Metabolic Syndrome. It found that insulin levels appeared to be independent risk factor for heart disease even when things like non-smoking, blood pressure, exercise levels and blood gluose were taken into account.  In fact, it conferred about twice the risk of heart disease. [2] So never ignore the signs of insulin resistance and discuss with your doctor.

So how can you control fasting insulin levels?  Below are 15 Ways to Control Your Insulin Levels based on the research.

CAUTION: If you are diabetic or on medications, be doubly sure to talk with your doctor before making any changes as low or high blood sugar is potentially very serious.

1.  Weight.  Get those high school abs back. Your woman will love it and it will drop your insulin levels significantly. Yes, those extra pounds around your gut have been found to be very correlated to fasting insulin levels. [1]  And many studies have verified that losing weight helps you drop your fasting insulin levels accordingly.

2.  Exercise. When it comes to lower insulin levels and decreasing insulin resistance, exercise is king. As we all know, physicians are reluctant to prescribe natural lifestyle solutions generally speaking. However, very often now, physicians will immediately tell type II diabetics to start an exercise program. The reason is simple: moving the body just as surely moves the blood sugar.  One interesting study on children found that fitness levels were actually a better predictor of fasting insulin levels than the degree of being overweight. [3]

Many studies have shown the power of exercise over insulin levels.  But one research summary pointed out that one of the surprising reasons that exercise is so effective is that it converts fast twitch glycolytic IIb fibres to fast twitch oxidative IIa fibres and increases the capillary density of muscle tissue. [4] Yeah, muscle is much more important than just simple appearance:  it helps you inside and out.

Early research did not show improved insulin sensitivity with low intensity workouts.  However, more up-to-date research using the latest technology did show virtually any type of exercise improved insulin sensitivity, which makes sense considering that the vast majority of human history is based upon simple walking. [12]

3.  Testosterone. Low testosterone is associated with both diabetes and Metabolic Sydrome. [5] And the reason is not well-know to many men.  However, in my book Low Testosterone by the Numbers, I document how testosterone has a very significant effect on insulin levels and men with low testosterone will very likely see their insulin levels and insulin resistance rise accordingly. This is one of the many reasons that low testosterone is correlated with increased cardiovascular mortality, arterial plaque, diabetes and Metabolic Syndrome. For more information, see my link on Testosterone and Insulin.

4.  Coffee. Counterintuitvely, coffee can be a big help with managing blood glucose and insulin levels due to a phytochemical that is naturally occurring in the coffee bean (chlorogenic acid).  Supplement manufacturers have actually begun creating “green coffee bean extracts” for just this reason.  You can read more about it in my link on The Benefits of Coffee Consumption, where I document how regular coffee consuption can reduce your risk for cardiovacular disease and diabetes.

5.  High Fat Diets. When researchers want to induce insulin resistance in laboratory animals, how do they do it?  Do they give them some kind of special drug?  No, it’s much simpler than that:  they simply feed them a high fat diet. [7] And, yes, you too can drive yourself into insulin resistance, just like a lab rat, if you eat enough fat in your meal.  Whole food, plant-based, high fiber diets are excellent choices to avoid insulin resistance.  NOTE:  Fish oil can offer some protection against the insulin promoting effects of high fat diets. [8]

6. Low Fat Diets: Triglycerides are very correlated with insulin resistance and some studies have even suggested using triglycerides along with fasting insulin as an excellent way to diagnose insulin resistance in the general populatiion.  It is a myth that a Low Fat Diet will push triglycerides and fasting insulin to unsafe levels. For example, I eat a predominantly Low Fat Diet and my triglycerides were 80 at my last checkup!  This is about half of the threshold usually given as a warning for patients. Furthermore, Dr. Barnard has actually used a Low Fat Diet to reverse diabetes quite successfully in his practice and you can read about it in his book.  Of course, the key is that a Low Fat Diet must be comprised of whole foods.  Cheating with sugars and refined carbohydrates ann calling those Low Fat could get you into trouble.  It may also be smart to avoid wheat as you’ll see in my link on Review on Wheat Belly.  But doing a true Low Fat Diet has been shown to actually increase LDL particle size, which is what you want. [10]

7. Mediterranean Diet. Several studies have shown that a Mediterranean Diet can help with insulin resistance and other features of the Metabolic Syndrome.  For more information, see this link on The Many Benefits of a Mediterranean Diet.

8.  Sleep. Yes, exercise is critical to control insulin sensitivity, but NOT moving is just as critical.  That’s right – your pillow time has a dramatic effect on your insulin levels.  In fact, one study on diabetics showed that those who slept 7-8 hours had almost half the insulin levels of those who slept 5-6 hours! [13] That’s an incredible reduction. Many studies have looked the nasty effects of sleep apnea upon insulin sensitivity as well. One study actually found that sleep apnea was an independent risk factor for loss of insulin sensitivity. [14] (See my links on Sleep and Testosterone, Apnea and Erectile Dysfunction and Apnea and Testosterone for more information.)

NOTE: Does having hyperinsulinemia (clinically high insulin levels) or elevated fasting insulin levels in young adulthood matter later in life? You bet!  According to a recent study, it did not matter what ethnicity or gender you were:  everyone was significantly more likely to develop hypertension 20 years later.

9.  Stress. Sleep is actually a stressor and lack of sleep usually increase cortisol levels. And, in fact, any stressor will do the same. The problem is that increasing cortisol increases Visceral Fat, which begins to affect the liver. I discuss the Visceral Fat/cortisol/liver connection in my link on Insulin Resistance and the Liver.

10.  Fiber. A number of studies have verified that fiber has a positive effect on insulin levels and insulin sensitivity. [17] Of course, it’s best to get this from vegetables, fruits and whole grains (excluding wheat and soy in my opinion). And, as expected, fiber consumption is tied to a lower risk of Type II diabetes as well. [16]

11.  Alcohol. Some study work has shown that moderate alcohol consumption leads to lower insulin levels. [4] This is likely one of the many reasons that (moderate) alcohol consumption is associated with reduced cardiovascular risks. However, there are defiites downsides to alcohol, including slighly elevated estrogen and increased risk for GI cancers.  See my links on Beer and Testosterone and The Pros and Cons of Alcohol for some additional information.

12. Dark Chocolate. Chocoholics might say it is too good to be true, but there is study out there showing that dark chocolate and dark cholocate alone improved insulin sensitivity. [15]

13. ALA (Alpha Lipoic Acid). This supplement improves insulin sensitivity in muscle tissue. [18] It works in diabetics as well [19] Of course, discuss with your doctor as it can change medication requirements. Also, it should be taken several time during the day since it has a relatively short half life in the body.

14.  Fructose. Actually, there is another way (besides high fat diets) that researchers use to induce insulin resistance:  high fructose diets. [20] If you have enough fructose, greater than about 25-50 grams/ day, you can increase your insulin resistance and many other nasty things that can affect your fasting insulin levels. For more information, see these Fructose Summary Links.

15. Probiotics. Perhaps the most counterintuitve way to improve insulin responsiveness is shoving good bacteria in your gut.  Well, it’s true, yet another reason to take probiotics is for their insulin-improving characteristics. [21]

REFERENCES:

Diabetes Prevention - Peak Testosterone

As we discussed in my link on Diabetes and Sexual Function, type II diabetes will assault your erectile strength in a hundred different ways.  Of course, it does many other nasty things to the male body and accelerates aging in general.  So the bottom line is to keep your blood sugar and glucose under control and do everything within your power to avoid diabetes in the first place. This is especially important if you have a family history of diabetes or are of certain ethnicites as well.

What’s a fella to do?  Fear not:  I’ve got a great list of preventative measures in my link on Metabolic Syndrome Solutions. Insulin resistance, one of the hallmark features of Metabolic Syndrome, is a risk factor in and of itself for diabetes.

In addition, below are the Many Key Ways to Drastically Reduce Your Risk for type II (adult onset) diabetes.  In addition, consider the book Reversing Diabetes, an M.D.’s program to dramatically help and sometimes even completely reverse diabetes.

1) NEWS FLASH (Testosterone): Perhaps testosterone’s most important effect is the fact that it decreases insulin levels in us males.  Anecdotally, I talked to an HRT clinic and the worker commented that every one of their Type II diabetic patients on HRT was able to completely get off of their insulin.  A few had to stay on Metformin, but still that is remarkable that they could completely eliminate insulin from their daily regimen.  It should be noted that this clinic raises testosterone to through weekly injections into the young male range, i.e. around 1000 ng/dl. Spread the word!

2)  Weight. “We found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of diabetes”. [7]  The “we” in this sentence are researcher for the journal Diabetes Care and they are merely echoing what a number of other studies have also discovered: waist size, BMI and any other measures of a guy’s spare tire or beer gut are strongly correlated with risk of diabetes.

3) Inflammation. Elevated inflammation levels of C-Reactive protein and IL-6 have been associated in multiple studies with the development of diabetes. [5]  Read my link on How to Control Inflammation for tips to keep this you for tips to keep this your body’s inflammatory response under control. This is further exemplified by the fact that people with gum disease are twice as likely to develop diabetes.  Again, this is probably due to increased inflammatory levels. [6]

4) Coffee.  This may seem too good to be true for many of you, but coffee is very protective against adult onset diabetes.  Read more about here in my link on The Many Advantages of Drinking Coffee.

5) Exercise. Being sedentary and not exercising is a huge risk factor for diabetes. In fact, even for those who have already developed poor glucose tolerance, exercise greatly reduces their risk of diabetes. [9]

6) Green Leafy Vegetables. Scientists are not sure why, but green leafy vegetables reduced the risk of developing diabetes signficantly.  [11]  They suspected, however, that it may be a unique combination of antioxidants or phytochemicals in plants such as spinach. [10]  CAUTION:  Remember that spinach is one of the dirtier, i.e. pesticide-ridden crops and, therefore, is better bought organic.

7) Vitamin D. Keep your Vitamin D levels up.  One recent study showed that 24% of study participants with low Vitamin D levels developed diabetes by ten years afterward, a very high percentage. [12] Yet another showed that the lowest Vitamin D levels can incur a 47% higher risk of developing prediabetes. [18]

8) Sitting.  Research shows that every two hours per day that you spend sitting increases your risk of diabetes by 7%. [13]  If you have a desk job or watch much TV – watch out!

9) Potassium. Potassium levels are strongly associated with the risk of developing diabetes in middle age. [14] In fact, there is a dose dependent risk, i.e. the lower the participant’s potassium levels, the greater the likelihood of diabetes.  Scientists have not verified that adding potassium through diet, which we recommend, or supplements is actually preventative, but it seems very likely to be the case.

10) Cokes and Sodas. Even one 12 oz. non-diet soda can substantially raise your risk of diabetes (by 15%). [16] Up that to two cokes per day and you increase your risk of diabetes and Metabolic Syndrome by 26% and 20%, respectively. [17]

11) Leucine / Branched Amino Acids (BCAA’s). Leucine is the key amino in Brached Chain Amino Acids that bodybuilders and athletes consume the world over.  Leucine has exhibited near miraculous powers in fighting insulin resistance and prediabetes in a number of studies. See my link on Branched Chain Amino Acids for more details.

Of course, a lot of guys in middle age and beyond have pre-diabetes and insulin resistance. With these come increased blood glucose levels and the possibility of slow long term tissue damage. Elevated blood sugar is hard on kidneys, eyes and dozens of other tissues around the body. So how do you protect yourself? Once again, the sulforaphane in brocolli comes to the rescue. This powerful phytochemical turns on genes that in turn pump out enzymes that protect your body from the damage of high blood sugar. [15]

And what do you do if you already have diabetes?  Well, start by dropping any excess weight if you have any.  No, it’s not “too late” for you.  One study showed that losing just 10% of body weight within a year gave participants much better control of their blood sugar. [8]

REFERENCES:

1) Population Health Metrics, 2009, 7:16, “Diabetes prevalence and diagnosis in the US states: analysis of health surveys”

2) Urol Clin North Am, 2005 Nov, 32(4):379-95, “Physiology of penile erection and pathophysiology of erectile dysfunction”

3) Diabetes Care, Apr 2003, 26(4)1093-1099, “Do Impotent Men With Diabetes Have More Severe Erectile Dysfunction and Worse Quality of Life Than the General Population of Impotent Patients?”

4) Eur Heart J, 2004, 25 (21):1861-1862, “The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe”

5) JAMA, 2001, 286(3), &qu5) JAMA, 2001, 286(3), “C-Reactive Protein, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus”

6) Men’s Health, Nov 2008, p. 40.

7) Diabetes Care, Sep 1994, 17(9):961-969, “Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men”

8) Diabetes Forecast, Nov 2008, p. 25.

9) Diabetes Care, April 1997, 20(4):537-544, “Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study”

10) BMJ, 2010; 341:c5306, “Is Nitrate the Answer?”

11) BMJ, 2010, 341:c4229, Published 19 August 2010, “Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis”

12) WCIR 2010; Abstract, “Prospective risk of hyperglycemia in a South Florida population with low levels of vitamin D”, https://www.medpagetoday.com/MeetingCoverage/WCIR/23202

13) Women’s Health, Nov 2009, p. 133.

14) Arch Intern Med, 2010, 170(19):1745-1751, “Serum and Dietary Potassium and Risk of Incident Type 2 Diabetes Mellitus”

15) Men’s Health, Nov 2008, p. 44.

16) https://www.physorg.com/news/2010-10-sodas-sugary-beverages-linked-diabetes.html

17) Diabetes Care, online Oct. 27, 2010, 33(11),  “Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes”

18) Men’s Health, Jul/Aug 2011, p.33.

Cacao: Raw Powder Benefits, Dosage and Suppliers .

Are you cuckoo for cacao?  All males should be loco for cocoa, because erection-boosting, artery-friendly superfood that is every middle aged guy’s dream-come-true. (Cacao and cocoa are, for a)

On many pages I have documented the benefits to erections, heart and general health of this magical plant. (See my links on agical plant. (See my links on Dark Chocolate and The Kuna for starters.) The bottom line is that cocoa increases blood flow and that is a very, very good thing for the bedroom.

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.

By the way, besides all the benefits to your sex life, cocao has numerous studies showing that it is a brain-booster.  The most recent, a 2012 study in the journal Hypertension, shows that seniors with mild cognitive impairment were significantly helped by consuming high-flavonol cocao. [2] A 2011 study on healthy adults had shown similar results, including an improvement in working memory.  [3] This is NOT the cocoa that is in the stores for the most part, as I’ll cover below.very high in cadmium.  [3] This is NOT the cocoa that is in the stores for the most part, as I’ll cover Of course, what’s the problem with almost any cocoa you can buy in the U.S. or other industrialized countries?  In fact, what’s the problem with any decent, respectable food we get our hands on?  Processing.  Processing. And more processing.

Or should I say overprocessing?  Modern cocoas are heated for lengthy times at high temperatures so that the original flavanol content is for all practical purposes lost, greatly reducing the blood flow benefits. Now why on God’s green earth would you do such a thing? Heating generally improves the flavor of food and raw cacao powder is no exception. Raw cacao has, for the unitiated, a very unpleasant taste.  Cacao is bitter to start with, but unprocessed cacao has a very “chemical”, pungent taste to it.  emical”, pungent taste to it.  emical”, pungent taste to it.

1) https://www.sciencenews.org/view/generic/id/7075/ title/Food_for_Thought__Prescription_Strength_Chocolate,_Revisited, Prescription Strength Chocolate, Revisited, By Janet Raloff

2) HYPERTENSION, AHA, Published online before print August 14, 2012, “Benefits in Cognitive Function, Blood Pressure, and Insulin Resistance Through Cocoa Flavanol Consumption in Elderly Subjects With Mild Cognitive3) Physiol Behav, 2011 Jun 1, 103(3-4):255-60, Epub 2011 Feb 12, “Consumption of cocoa flavanols results in an acute improvement in visual and cognitive functions”

4) Developmental Immunology, 2002, 9(3):135-141, “Modulation of TNF-α Secretion in Peripheral Blood Mononuclear Cells by Cocoa Flavanols and Procyanidins”

5) https://www.consumerlab.com/news/More_Popular_Cocoa_Powders_Contaminated/08_05_2014/

NOTE: Dove Dark is an exception:  it isdelicious, readily available and has a high flavanoid and epicatechin content. [1] However, it also has a fair amount of casein, the pro-inflammatory milk protein. Thus, it is questionable if you can get the long term benefits of The Kuna with this candy bar.

I remember the first time I broke open a package of raw, cacao powder.  I warmed up the water – not too much of course – and sat down with my first glass of cacao “tea”.  It was an experience not unlike Jim Carrey went through when he put on The Mask. My palette is not all that sensitive – I can eat almost anything – but I knew right then and there that this was simply not something I could handle on a daily basis.  And my admiration for The Kuna became almost endless!

Step 1:  The first few days with the raw cacao:  don’t breathe. In fact, hold your nose if you have to!  I know that sounds humorous, but it turns out the “unusual” taste of raw cacao for those not used to it comes from the aroma.  So by not breathing and drinking fast, I can down a teaspoon in almost no time.  In other words, I take it just like medicine.  In fact, that’s a good way to look at it:  cocoa is a great superfood medicine for all those years of abuse you put your body through.

Step 2:  Be patient. After a few days, or maybe a week or two for some, you find that the taste does not bother you. Many people find the same kind of effect when eliminating a lot of animal foods, dairy, fats, salt or sugar from their diet.  For a time, their food tastes bland and tasteless.  After a couple of weeks, though, they lose this memory – some would say addiction – to the original indulgence.

So why go through all of this? If you’re serious about lowering your blood pressure and boosting your blood flow in a natural, healthy way, you’ll consider raw cacao. (Always talk to your doctor first, of course, especially if you are on any medications.) Raw cacao has become very affordable and there are multiple suppliers hitting the market.

CAUTIONS:  Do not overconsume cocoa: you should consider it almost an “herb”. It is very powerful and, when I have consumed it, have stirred a half teaspoon or a little more into a warm glass of water as a kind of tea (twice per day). I have read stories of people substiting it in recipes with literally cups of the raw product and you cannot in my opinion use it this way as it is much more powerful than standard cocoa. One other caution: cocoa is relatively high in phytic acid which binds with magnesium, calcium and zinc. So this is best consumed at a separate time from your nutrient dense meals. Again, drinking it as a “tea” in between meals is probably a good idea.

REFERENCES:

The HCG Diet: Fact and Fiction - Peaktestosterone

Here is your health and wellness trivia question:

“What hormone, found only in the urine of females, is connected with an almost $40 million fine of a famous informercial hypester, numerous suspended athletes and a bounty of modern fertility clinics?”

If you answered HCG, you were dead on. It is also connected to a pop fad diet called the “HCG Diet” that is decades old.  For example, I recently ran across a middle-aged female who swore by the HCG Diet.  What was interesting is that the husband was a doctor and fully behind her new program.

So what does the science say?  One early double-blind study found that patients felt better, had less appetite and lost more weight when on HCG. [1]  So case closed, right?  Well, three years later the same journal came out with additional research showing the exact opposite. [2] In fact, the study concluded “HCG per se offered no advantage over placebo injections in regard to weight loss, distribution of fat lost or hunger index during weight reduction”.  The following year five obese women were put on the standard 500 calorie diets and injections of 125 IU of HCG with no results and, again, the authors concluded that it offered no advantage over straight calorie reduction. [3]  Study after study thereafter left HCG for weight loss in an ever-weakening position.

Finally, in 1995 a meta-analysis was undertaken that definitively concluded that “there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being”. [4] The bottom line is that the great majority of studies show no benefit from HCG, making it a big waste of time and money.  Yes, females can lose weight from an “HCG Diet” but it is almost for sure from the low calories that she is consuming and not the injections themselves.

And that leads to a big question:  why would a doc, the acquaintence I spoke of above, knowing full well that study after study has shown HCG to be completely useless for weight loss, push his wife to take the same?  My guess is simple:  the low calorie diet.  Most HCG diets are very low calories and so he knew that his wfie would lose weight anyway.  So the hundreds or thousands that he would spend would be well worth the investment.

Well, you know what I am going to say:  HCG diets, crash dieting, liposuction or any other very rapid way to take off pounds will not lead to long term health and vitality.  I cover the struggle with this sort of lifestyle in my link on Why Crash Dieting Often Does Not Work. In other words, Fix the underlying root problem or eventually you will put back on the pounds.  Remember:  a man with about a 40 inch waist or a woman with a 35 inch waist has substantially more heart attack risk (and often sexual dysfunction to go along with it). Gradual weight loss with a steady dose of exercise are always the answer (unless you have been diagnosed with thyroid, testosterone or other hormonal issues).

What about safety?  Well, in men it seem to have a good track record, although no long term studies have been done as far as I know, assuming an experience physician and adequate monitoring.  In women it does have some potentially nasty side effects, but it is fairly widely used for fertility treatments at significantly higher dosages, so some women will think, “What do I have to lose (except some extra pounds)?”  And prices have really come down at least in the HRT clinics.  I have heard that weight loss treatments charge much more for HCG however.

REFERENCES:

1) American Journal of Clinical Nutrition, Feb 1973, 26:211-218, “Effect of human chorionic gonadotrophin on weight loss, hunger and feeling of well-being”

2) American Journal of Clinical Nutrition, Sep 1976, 29:940-948, “Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study”

3) Arch Intern Med, 1977, 137:151-155, “Human Chorionic Gonadotropin (HCG) Treatment of Obesity”

4) Br J Clin Pharmacol, 1995 Sep, 40(3):237-43, “The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis”

But first a little history:  HCG is short for Human Chorionic Gonadotrophin.  HCG comes from the placenta and the embryo and is found, as I mentioned, in the urine of females. Interestingly enough, the biggest users of HCG have actually been male professional athletes.  HCG is similar to Leutenizing Hormone which stimulates testosterone output.  It is often coupled with steroids to maximize testosterone production.  A number of prominent athletes have been suspended for using HCG, including Manny Ramirez.

NOTE:  Many of the men on the Peak Testosterone Forum are using HCG as part of their HRT (testosterone therapy program).  A typical program will include testosterone cypionate, Arimidex (anastrazole) and HCG.  HCG, in this case, is used not to boost testosterone but rather preserve testicular volume and/or fertility and improve mood.  HCG is also used completely on its own, something I cover in my link on HCG Monotherapy. If you go too high with HCG, it creates a negative feedback loop that shuts down the body’s own endogenous testosterone production and it also can really ramp up aromatization to estradiol and so this must be carefully monitored.

In females, though, its initial use was primarily in the weight loss world.  The typical “HCG Diet” is a combination of weekly HCG injections coupled with very low calorie levels, typically in the 500-1000 range.  The HCG injections are supposed to do everything a woman could want in these circumstances, including accelerated fat reduction, decreased appetite and so on.

Here’s a few reasons to be suspicious of such claims:

1) If HCG really accelerated fat loss effectively, it would be a multi-million dollar industry and one would be reading about it constantly

2) Kevin Trudeau was a huge promoter of the HCG Diet.  Trudeau is the felon, conspiracy wacko – “I’ve been a member of the Trilateral Commision and FBI” – and infomercial wild man.  He was fined tens of millions for his overstatements regarding HCG.

Refractory Period-Lower Your Post-Intercourse Recovery Time

The male refractory period is simply the recuperative or restorative time required between orgasms. This has been a topic off and on in the Peak Testosterone Forum. Most men remember when they were younger and could orgasm many times during a 24 hour period. Suddenly, though, they find themselves in middle or senior age sometimes not able to orgasm at all for 24 hours or more! This can be very distressing since even no erections come during this time by definition.

Look at what this man wrote in a thread he entitled “My Arousal System is Not Working:”

“Please help I am quite a horny person , have lots of libido and desire but not the ability . I have a poor refractory period too so this is quite frustrating.  I have decided to change this situation as its making my life unhappy and complicated My new girlfriend is quite understanding but not sure how long for,as i sense frustration burning inside her…. I have lots of desire and libido but poor inadequate erections.  Help please.” [7]

Many people exlain this increase in refractory period by “aging”.  This is certainly true to a certain degree, but I would argue that most of the time an overly increased refractory period is a sign of an underlying medical condition or lifestyle issue that needs to be addressed.  Below we will look at several common causes of an inflated refractory period and how you can address them:

1. Nitric Oxide. There are indications that nitric oxide plays a powerful role in recovery from the refractory period. The reason is that some of the PDE5 inhibitors (Viagra and Levitra specifically) have significantly reduced the refractory period in younger, relatively healthy males. One study found that “sildenafil administration led to a marked reduction of the post-ejaculatory refractory time (10.8 0.9 min versus 2.6 0.7 min for placebo and sildenafil respectively; P < 0.0001). These results indicate that in normal subjects acute sildenafil treatment does not modify semen characteristics and has a positive influence over the resumption of erections following ejaculation in the presence of a continuous erotic stimulus.” [2] Similar results were found in men with actual premature ejaculation. [4]

1)  https://peaktestosterone.com/forum/index.php?topic=948.0

2) Hum. Reprod, 2000, 15(1):131-134., “Effects of sildenafil (Viagra ) administration on seminal parameters and post-ejaculatory refractory time in normal males*”

3) BJU International, Apr 2011, 107(8):1274 1277, April 2011″The effects of three phosphodiesterase type 5 inhibitors on ejaculation latency time in lifelong premature ejaculators: a double-blind laboratory setting study”

4) The Journal of Sexual Medicine, May 2005, 2(3):368 375, “Efficacy of Sildenafil Citrate (Viagra) in Men with Premature Ejaculation”

5) BJU International, Jun 2000, 85(9):1093 1096, “The postejaculatory refractory period: a neurophysiological study in the human male”

6) J Endocrinol, 2003 Dec, 179(3):357-65, “Effects of acute prolactin manipulation on sexual drive and function in males”

7) Eur J Endocrinol, 1999 Oct, 141(4):387-95, “Dopamine agonists both stimulate and inhibit prolactin release in GH4ZR7 cells”

8) https://peaktestosterone.com/forum/index.php?topic=948.0

9) Behav Brain Res, 1984 Jun, 12(3):267-73, “Brain monoaminergic control of male reproductive behavior. II. Dopamine and the post-ejaculatory refractory period”

10) https://peaktestosterone.com/forum/index.php?topic=1623.0

11) N Engl J Med, 1979 Jan 18, 300(3):141-2, “Dangers of vitamin B6 in nursing mothers”

12) Clinical Endocrinology, oct 2005, 63(4):381 394, “Effects of testosterone on sexual function in men: results of a meta-analysis”

13) https://www.psychologytoday.com/blog/ cupids-poisoned-arrow/201107/porn-induced-sexual-dysfunction-growing-problem?page=2

14) Behavioural Brain Research, Jun 1984, 12(3):255 265, “Brain monoaminergic control of male reproductive behavior. I. Serotonin and the post-ejaculatory refractory period”

In fact, PDE5 inhibitors have even been used to treat premature ejaculation for the simple reason that it helps young men with premature ejaculation to be ready for a second orgasm more quickly and thus builds their confidence in the bedroom. [3][4] This approach should be viewed with caution for all the reasons I outline in My Links on PDE5 Inhibitors.

Now it would be nice if they would have studied this in middle-aged or senior men, but such is not the case as far as I know.  However, anecdotally many men have noticed the accelerated recovery time after Cialis in particular.  This could be from a number of different factors, but one of them is likely the increased nitric oxide.

My site is packed, by the way, with ways to increase nitric oxide.  Look through these links on Improving Erectile Strenght for literally dozens of ideas.

2.  Prolactin and Dopamine. Prolactin and Dopamine provide a yin and yang effect on each other and both can play a signifcant role in the refractory period.  Elevated levels of prolactin, for example, will lower both testosterone and libido, something I document in my link on Testosterone and Prolactin. More to the subject, excess prolactin will also raise your refractory period significantly. Furthermore, one study of cabergoline, which lowers prolactin levels, showed significant improvements in the refractory period in ten healthy males. [6]

Of course, that is particularly interesting, because no one would be suprised if good results were obtained in men with a prolactinoma or high prolactin levels.  However, cabergoline helped even normal men reduce their refractory period, indicating that prolactin reduction probably applies across the spectrum.

What can cause dopamine problems.  Dopamine dysregulation can occur, ironically, from sleep deprivation. See my link on Sleep and Erectile Dysfunction for more details. Use of you-know-what has been shown to dull dopamine receptors. [13] And, finally, if you need to raise dopamine levels, you may want to see my link on Natural Dopamine Increasers.

What about natural ways to lower prolactin without having to resort to cabergoline, which is rife with side effects?  Well, on the forum both Vitamin B6 and mucuna pruriens have been touted for their natural prolactin lowering effects. [10][11] As always, I recommend talking to your doctor first before trying any new supplement.

3.  Nerve Sensitivity. This is pretty obvious, but almost anything that will improve penile sensitivity will likely help the refractory period.  The nerve involed here is the dorsal nerve of the penis and researchers have (one could argue rather cruelly) removed half the nerve fibers from the dorsal penile nerve in monkeys and found – lo and behold – that the refractory period increased significantly. [5] This same study found that “the refractory state after ejaculation in the human male is accompanied by an increased PST, and a state of hypoexcitability and hyposensitivity.” By PST, the authors were referring to the “Penile Sensory Threshold”, which was higher after an orgasm.

Basically, an orgasm “exhausts” your nerves in the area and raises the threshold for you to get excited and stimulated. Okay, so may it didn’t warrant a million dollar study to come to that conclusion, but it does allow us to focus on something important:  healing any neuropathy or pre-neuropathy that we might be experiencing. Many men, especially diabetics, begin to experience a decline  nerve sensitive in their limbs and extremeties.  And, yes, that can mean the penis is affected.  For natural solutions – of course, check with your doctor first – see this link on Neuropathy Remedies. And, of course, get your blood sugar and insulin parameters tested, including such tests as fasting blood glucose, fasting insulin, A1C and triglycerides.

4) Seratonin. SSRI’s for depression are a major source of sexual dysfunction. This occurs for a number of reasons, but one of the less known ones is the fact that seratonin plays a role in the male refractory period. One animal study looked at multiple ways to lower seratonin and found that they all decreased the refractory period. Thus, both dopamine AND seratonin seem to play a significant role in post-orgasmic recovery. [14]

5) Low Testosterone. Many of you hypogonadal men out there reading this will not at all be suprised to learn that low testosterone has been found in a couple of studies to lead to an increased refractory period. [12] So, if you can afford it, this is yet another reason to ask your doctor about getting your T checked. My guess is that high estradiol would do the same, although I do not have a study to prove that yet. But, generally, high estradiol sexual symptoms are identical to that of low testosterone.

REFERENCES:

Testosterone and Libido - Peak Testosterone

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]

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.

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”

Testosterone Cypionate Injections - Peak Testosterone

Cypionate injections actually had a very lackluster history in its early years and it is very important for any man interested in injections to understand why.  In fact, it’s not an overstatement to say that many men have had quite miserable experiences, but in the great majority of cases, you can’t blame cypionate!  Blame the docs who usually just did not know any better. Let me give you some examples from the Peak Testosterone Forum:

NOTE: For reasons unknown, in some countries testosterone enanthate is used almost exclusively over testosterone cypionate.  The two have similar half lives and virtually everything on this page that applies to cypionate also applies to enanthate as well.

1.  Time Between Injections. Ten or even five years ago, most doctors made the patient wait a ridiculous amount of time between injections – between two and four weeks in some cases!  Here are some examples of the suffering this can incur:

The problem is that testosterone cypionate has a half-life of 8-12 days!  So, after a couple of weeks, you have very little in your system.  Notice that this man said that he felt terrible for two-and-a-half weeks, which of course corresponds to the time period when he had very little testosterone left.  Basically, the doc gave him just enough testosterone to tease him!

Now most doctors do not do monthly schedules, but I get men all the time writing in via email or on the forum on two and three week regimens.  These are little better.  Even a two week regimen leaves a man hypogonadal for a few days at the end of the cycle.  Just when life seems good, the rug gets pulled out from under you.

2.  Roller Coster Rides.  Men on cypionate injections every two or three weeks usually have other issues.  The docs know that the patient is going to be low for the last week or two and so the tendency is to give more testosterone.  The thinking is basically to give a big initial dose knowing that the man will go close to zero so that the average is in a more “reasonable” zone.

Elevated estradiol can also lead to some of the symptoms that are associated with HRT, such as fluid retention and prostate enlargement.  For example, check out this poor guy whose doctor put him on a four week cycle:

“This progressed (after the first T injection) into heavier swelling, fatigue and bouts of shortness of breath along with several instances of dizziness leaving me in a position that I have now been out of work for nearly a month.” [2]

Again, it is likely his physician gave him a massive dose to try to compensate for the very long time between injections.

3.  Unmanaged Estradiol. Something related to #2 is the fact that some men are overweight and some are “high converters,” meaning that they will change a lot of their precious testosterone into estradiol and end up with overly high estradiol levels while on testosterone replacement.  Because of this, many HRT docs and anti-aging clinics try not to allow estradiol levels go too high or too low and generally keep men in the 20-30 pg/ml range for not only heart health but also to make sure that libido and mood do not crash as well.  (See my Estrogen (Estradiol) Links for Men for more information.)

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

One more important point:  some men seem very sensitive to estradiol.  A matter of just 3-5 points can help or hurt erectile strength and morning erections according to many reports.  This may seem like a placebo effect, but keep in mind that a healthy male has a very high ratio of testosterone-to-estradiol and so a small amount of estrogen must be matches by a lot of testosterone to make up for it.

Besides erectile and libido issues, men going too high with estradiol can be at risk for “water retention”, i.e. swelling of the feet, etc.  This can be frightening but is generally from estradiol going too high.  In fact, look at the post above where the man experienced swelling from HRT.

High estrogen can also lead to mood swings, depression and other related brain-related issues.  And it can be downright dangerous to the ol’ bod long term:  one study showed that going over 37 pg/ml led to a 133% increase in mortality. [3] Some believe estrogens are the prime cause of prostate cancer.  More on this below.

NOTE:  There are three estrogens (estrone or E1, estradiol or E2 and estriol or E3).  E2 is known as the “bad estrogen”, although a man needs to have sufficient estradiol for bone, brain and arterial health.

Testosterone Cypionate Protocols

1.  Weekly or Twice per Week. One of the most important factors for success with this injectable is that it should be administered weekly or even twice per week.  Some men even do a Monday, Wednesday, Friday schedule or even every other day.  These options avoid the roller coaster ride that we spoke of above due to cypionate’s relatively short half life.  Again, savvy docs give the patient smaller amounts weekly rather than one “horse dose” every two or three weeks like the old school methodologies.  Essentially, this makes the peaks less high and and valleys less low a and smooths the range of testosterone levels experienced. As we age, put on weight and have increased stress levels, a bigger percentage of our testosterone is converted to the estrogens.  These larger dosages tend to ramp up these pathways and a man can end up with a disproportionately large estradiol spike.

2,  Arimidex.  Many men on the forum are on Arimidex (anastrozole) and it is fairly common in any testosterone cypionate protocol. The reasons are that usually men are going to 900 to even 1200 ng/dl peak generally with cypionate and have put on weight over the years. This means that most men will end up with high estradiol levels for about a week.

Of course, talk to your doctor, but cypionate usually peaks on the 3rd of 4th day after the injection and so the first dose of Armidex will be given then (on a weekly cycle) with a second dose three days later. Common dosages are 1/4 mg or a 1/2 mg two times per week. From what I have seen, most of the anti-aging physicians and HRT clinics try to keep a man between about 20-30 pg/ml. Most men can get off of Armidex by losing weight, decreasing their dosage a little and going to more frequent injections. Arimidex is considered pretty safe and side effects seem to be low, especially in the lower dosages given for HRT. However, there is potentially the danger of knocking your estradiol too low and ending up with long term bone loss. I recommend scanning through these concerns on my site as well: Arimidex Problems.

NOTE: Although not very common, Arimidex can be given by itself to (most low T) men to raise testosterone levels as I document in my link on Testosterone and Arimidex . This is called by some Arimidex Monotherapy. Many men like the idea of simultaneously raising testosterone and lowering estrogen. See also my link on the Testosterone-to-Estrogen Ratio.  I don’t think I have seen a case of Armidex Monotherapy on the Peak Testosterone Forum, although some men have asked about it.

3.  Injection Options. There are several basic options here:  you can go to the physicians office for injections; you can self-inject; or you can get a family member to give you the injections.  Now not all doctors will allow injections outside of their office.  The argument is that testosterone is a controlled substance. I think the real reason is to get you in for an additional office visit reimbursement or payment.  However, on the forum, many men are self-injecting and I expect this percentage to increase over time.

The amount of fluid injected is relatively small and usually feels like a little ant bite.  It is possible to “hit a nerve” which stings a little more and can leave a small sore bump for a day.  But cypionate injections rarely cause issues if reasonable hygiene and procedures are followed.

NOTE:  Yet another option out there is called “SubQ”.  Standard injections are intramuscular, but for details on this other methodology, you can watch this training video by Dr. John Crisler, one of the most well-known online HRT docs that has been doing these sorts of things forever. According to Dr. Crisler, this has the advantages of 1) not poking so many holes in the muscle, 2) even more smoothing of testosterone and estradiol and 3) often reducing the need for Arimidex.

4.  Needle Size, Length and Gauge. Your doctor should have very specific instructions for you on how to self-inject if that is route and you and he/she decide to take.  But here are a few things to discuss and/or be informed of: [4]

a) The smaller the gauge number, the wider the needle.  Thus a 20 gauge needle is bigger than a 21.

b) You will typically be given two needles, one to draw and one to inject.  The larger is usually to draw.

c) Needle size can vary considerably.  18-22 is common for drawing and 21-27 for injecting from what I have seen.

d) You can inject with a 27 gauge needle, but it is much slower.

e) You also have varying needle lengths.  1.5 inch is very common, but your doctor may provide a slightly different length based on your body fat levels.

f)  You may be able to use a 25 gauge needle (for intramuscular quad injections) if you can use a 1 inch needle. If you’ve got some extra fat and need a 1 1/2 inch needle that may be too challenging. [5]

The above applies to intramuscular injections. SubQ injections use a much smaller needle and it is a one step process.

5. To HCG or not to HCG. One very common protocol with the HRT clinics and anti-aging doctors is called “The Trifecta” and includes testosterone cypionate, Armidex and HCG.  Short term results are pretty good but in my opinion you should avoid if at all possible the use of Arimidex. It is better to lose weight and lower your cypionate dose instead.  HCG is added primarily to reduce testicular shrinkage and, in some men, provide a modest boost in libido and/or mood.  See my link on Testosterone and HCG for additional details.

CAUTION: This page is NOT intended to be a guide for self-treatment.  Always work with a physician, who can give you proper dosing/procedures as well as careful monitoring of estradiol, red blood cell counts, liver function and PSA.  Also, realize that testosterone cypionate, and standard HRT in general, will lower fertility.  If you want to have kids, discuss possible alternative with your doctor, such as Clomid and HCG Monotherapy .

1)   https://peaktestosterone.com/forum/index.php?topic=121.0

2) https://peaktestosterone.com/forum/index.php?topic=620.msg5717#msg5717

3) https://www.lef.org/magazine/mag2010/may2010_Why-Estrogen-Balance-is-Critical-to-Aging-Men_01.htm

4) https://peaktestosterone.com/forum/index.php?topic=1178.0

5) https://peaktestosterone.com/forum/index.php?topic=1624.0

High Hemoglobin/Hematocrit from HRT? - Peak Testosterone

It can quite stressful for a man who has finally gotten on HRT, feels better and then finds out that his hemoglobin is high. Of course, he can always lower his testosterone dosage to try to solve the problem, but this may not be a solution that either doctor or patient want to pursue.  Many men have found that their erectile dysfunction is greatly helped and/or morning erections and libido have returned.  The last thing they want to do is lower their dose.

So why even worry about a high hemoglobin or RBC count?  What’s a few extra red blood cells anyway?

Unfortunately, high hemoglobin (or RBCs) is a risk factor for ischemic stroke, i.e. the standard kind of stroke where there is a loss of blood supply to tissues such that permanent damage is usually incurred. [1] Of course, a stroke can be a life-changing (or life-ending) event and should be avoided at all costs.  There is also a longer term risk as well:  elevated hemoglobin could lead to unhealthy iron store levels which is associated with heart disease and dementia. Iron in tissues can lead to oxidative damage.

Just look at what some recent studies have concluded:

“Low and high hemoglobin concentrations in older persons are associated with a lower level of cognitive function in old age, particularly in semantic memory and perceptual speed.” [2]

“In older persons without dementia, both lower and higher hemoglobin levels are associated with an increased hazard for developing AD [Alzheimers Disease] and more rapid cognitive decline.” [3]

NOTE: There are several standard ways to measure red blood cells: hematocrit, hemoglobin and RBC (red blood cell count). All of these are related and doctors will usually look at two or more. Hematocrit is the volume measurement, i.e. the percentage of blood that is taken up by the red blood cells. Hemoglobin, on the other hand, is a density or concentration measurement and is expressed in grams per liter or deciliter. (Hemoglobin is, if you will recall from your high school biology, the iron-based protein that transports oxygen.) RBC is a simple count and is usually expressed as the number of million red blood cells that you have per microliter.

1. Give Blood. This is a time-proven technique for men on testosterone therapy to lower their hemoglobin levels.  And you are helping out someone else while you’re doing it!  Look at what one of our senior posters wrote about this:

Notice that he dropped his hemoglobin by about 12%.  Not bad for about an hour of time, eh?

2. Lower Your TRT Dose. If you have high hemoglobin or hematocrit from testosterone therapy, then your doctor may require you to lower your dose.  This is not always a bad thing as some men are actually taking more than they actually need, which can lead to side effects in both the long and short term.  See my page on The Side Effects of Testosterone Therapy for more information.

3. Drink Water. It is important to remember that hemoglobin is very dependent on your hydration levels.  If you were dehydrated when you had your blood draw, this could have made things worse. If you think you were dehydrated, discuss a retest with your doctor.

4. Hyperthyroidism. Hypothyroidism can lower your RBC counts and hyperthyroidism can raise them some. [8]  If you haven’t checked your thyroid function lately, this might be wise.  And don’t forget to get a full workup, including antibodies, if you can afford it.  See my page on Testosterone and the Thyroid for more details.

5. Transdermal (Topical) Testosterone?  One research summary stated that topical lead, in general, to lowered levels versus intramuscular injections:

“Intramuscular testosterone is the only form that significantly increases hematocrit above normal levels. However, it does so strongly, with up to a 6% change from baseline. The runner-up is testosterone gel, with an average increase of 2.5% over baseline levels.” [9]

Therefore, if you are on intramuscular injections and struggling with high hematocrit or hemoglobin, going on topicals may help a little.  Discuss with your physician.  NOTE:  A cheap alternative is Compounded Testosterone Creams and Gels.

6. Avoid Red Meats. It is interesting because one of the criticisms that meat eaters level against vegetarians is that plant foods have many “anti-nutrients” that can slow down or bind with minerals such as iron. For example, organizations like Weston Price love to castigate vegetarians for their phytic acid consumption.  Phytic acid is present in plant foods and binds to iron, magnesium, phosphorous and calcium.  It can, if overconsumed, lead to mineral deficiences.  However, Dr. Bernard points out that usually it is likely very health protective for most people, because  these minerals, as in the case of zinc and iron, have been found to be neurotoxic at even relatively low levels of tissue accumulation.  Research has also shown that too much iron also contributes to heart disease and there may be a link to colon cancer as well. [7]

So avoiding red meats, which are high in heme iron, stands a good chance of lowering your hemoglobin scores and protecting your long term health unless some other preventative action is taken (such as giving blood).  For other cautions about meat consumption, especially red meat, seemy link on The Risks of Meat Consumption.

As a verification, one study of vegetarians and non-vegetarians found that females had significantly lower hemoglobin levels.  Males had lower levels but it may not have been statistically significant. [5] However, another study was more definitive and concluded: “It was found that hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, white blood cells, neutrophils, serum ferritin and serum vitamin B12 in vegetarian were significantly lower than control subjects.” [6] The ferritin is a key measure, by the way, because it indicates that tissue levels of iron are lower and thus will likely cause less permanent damage. (This study did show that some vegetarians were iron deficient it should be noted.)

7. Fix Sleep Apnea.  One of our senior posters was told that sleep apnea tends to thicken the blood in this Peak Testosterone Forum thread. And, sure enough, the studies confirm this as well. [10] So, if your hematocrit, hemoglobin or RBC’s are running high, think about getting tested for sleep apnea.  A recent study commented that “one possible explanation is that repeated episodes of nocturnal hypoxia lead to a hypercoagulable state that predisposes patients to thrombotic events. There is evidence supporting a wide array of hematological changes that affect hemostasis (eg, increased hematocrit, blood viscosity, platelet activation, clotting factors and decreased fibrinolytic activity).”

8. Inflammation. Hepcidin activity can be governed by inflammation.  Checking for infections, CRP levels, etc. and then treating the underlying cause may help. [11]

REFERENCES:

1)  Eur Neurol, 1996, 36(2):85-8, “A positive relation between high hemoglobin values and the risk of ischemic stroke. Progetto 3A Investigators”

2) Neuroepidemiology, 2008 December, 32(1): 40 46, “”Relation of Hemoglobin to Level of Cognitive Function in Older Persons”

3) Neurology, 2011 Jul 19, 77(3):219-26, “Hemoglobin level in older persons and incident Alzheimer disease: prospective cohort analysis”

4) https://peaktestosterone.com/forum/index.php?topic=1616.msg15511#msg15511

5) International Journal of Natural and Applied Sciences Vol. 2 (3) 2006: pp. 174-177, “Comparative study of the hemoglobin concentration of vegetarian and non-vegetarian subjects in Ogun state, Nigeria”

6) J Med Assoc Thai, 1999 Mar, 82(3):304-11, “Hematological parameters, ferritin and vitamin B12 in vegetarians”

7) World J Gastroenterol, 2006 September 21, 12(35): 5644-5650, “Hemoglobin induces colon cancer cell proliferation by release of reactive oxygen species”

8) Iran J Ped Hematol Oncol, 2013; 3(2):73 77, “Effect of Thyroid Dysfunctions on Blood Cell Count and Red Blood Cell Indice”

9) https://www.clinicalendocrinologynews.com/specialty-focus/men-s-health/single-article-page/aua-testosterone-may-not-deserve-its-reputation-as-a-cardiovascular-culprit/ea4d29a9ef50946413c64616369785cc.html

10) Can Respir J. 2011 Nov-Dec; 18(6): 338 348, “Coagulability in obstructive sleep apnea”

11) https://www.medscape.com/viewarticle/759688_4

12) https://www.peaktestosterone.com/forum/index.php?topic=5672.msg47476#msg47476

Can You Feel Worse on the Testosterone Therapy?

“I thought every low testosterone guy that went on HRT (TRT) felt great afterwards?”

No way is all I have to say.  Many men actually feel worse on testosterone therapy and then feel better when they quit, and below I am going to give you a couple of interesting examples of that.  Let’s start with a story from the Peak Testosterone Forum: [1]

Case Study #1. “So on Tuesday I ran some labs. My total T came back at 492ng/dl and free T came back at 13.1 pg/ml. My pre TRT levels were around 370-400. While being on TRT I lost around 50lbs and also ate a lot better I still have about 20lbs to lose so I still think there will be some improvements on levels. While on TRT I never felt right, but since quitting I realized some of the things TRT took away from me as well. One , a lot more mellow off it. I actually feel tired now around 10-11pm instead of a somewhat wired feel. Orgasms are also much more intense off the testosterone. Just wanted to give some insight that it is possible to come off TRT after years and have your levels come back even higher than before. I also will now focus on some of the things on this site to help out on the natural level.”

CAUTION: His estradiol is low enough to potentially experience some bone loss.  Hopefully, his doctor was monitoring it.  If his estradiol indeed stayed low, then this could be a reason to go on testosterone therapy.

Basically, he found that he was trading some anxiety and restlessness – a “roller coaster” as he put it later in the thread – for improvements in body composition and weight loss.  And, in the end, he decided TRT was simply not worth it.  Some might say, “Of course, he did not do well, because he did not boost his testosterone enough to feel better.”  Unfortunately, he had been on testosterone cypionate and got his testosterone up into the 700’s with no improvement.

Another unusual thing that about his story is that he felt better with testosterone in the upper 300’s.  This is well below the average level. See my article called Normal Male Testosterone Levels by Age for more information. This is yet another example as to how testosterone is very individual. Some men, like myself, seem to need higher levels. I did horribly, for example, in the 300’s. However, one clearly cannot assume that this is the case for all guys out there.

Case Study #2. Another of our long-time posters was a young guy who struggled with erectile dysfunction while on TRT.  He finally decided to quit cold turkey and was very glad he did.  Here is what he wrote in one post:

“Hi all just want to give a little update on my situation… I go to endo in two weeks.. I am 16 weeks off testosterone today…I have had sex everyday for 60 days now… at least once a day..sometimes twice a day….No E.D. whatsoever.. the only problem I am having is sometimes when I am on top my erections are weak and not strong .. but they are still strong enough for penetration… I weigh 230 pounds and im 5’9… if I were to lose 20-30 pounds would this harden erections up?? I remember when I weighed 200 lbs they were hard…im 36 years old.” [2]

His case is interesting, because he was struggling in the bedroom and his doctors just put him on TRT and gave him 5 mg of Cialis even though he was in his 30’s!  Unfortunately, this is the typical solution from Western medicine:  throw a bunch of pharmaceuticals at the problem.  Usually, young men in their 20’s and 30’s can easily fix their erectile issues with lifestyle changes such as those I mention in this page on Improving Your Erectile Strength. In fact, that he is he very overweight and could probably lose 70+ pounds.  Losing this much weight would very likely end up doubling his testosterone levels, something I document in my page on Testosterone and Weight Loss.

FINAL COMMENTS:  Notice that both of these were young men who did well with testosterone levels below the average for their age.

Does this mean that no one should ever go on HRT?  Of course not!  The Peak Testosterone Forum has many examples of men who have, like myself, had a miraculously positive experience with HRT. However, these two examples show that, clearly, men are sometimes put on HRT when they shouldn’t be.  This is not necessarily an indictment of doctors, because there are many other conditions that lead to hypogonadal-type symptoms.  I outline many of these common conditions in my Peak Testosterone Program page and it includes issues such as low cortisol, high cortisol, hypothyroidism, sleep disorders and many more. I urge anyone that is “just not feeling right” to scan through these pages.

One other important discussion point that many doctors leave out is that there are other common non-TRT options out there now for men who feel they need to boost their testosterone.  These don’t have quite the success rate of standard testosterone therapy in my opinoin but are definitely worth condiering:  HCG Monotherapy and Clomid.

1)   https://www.peaktestosterone.com/forum/index.php?topic=7458.0

2) https://www.peaktestosterone.com/forum/index.php?topic=6448.0

Supplements, Safe - Peak Testosterone

As you know I am very cautious about supplements, vitamins and minerals. The reason is that the research show taking a vitamin or supplement is simply not natural.  Our bodies have been around for ages eating natural foods from the environment and isolating one or two molecules from foods is, as it turns, simply not the same and often quite detrimental.

With just a couple of exceptions, your nutrients need to come from natural foods. This is a tried and true method that has worked for many of supercultures around the world, such as the Okinawans, the Kuna, the Ikarians, the Tarahumara, the Hunza – the list goes on and on.  These native peoples have proven time and again that superlative health comes from natural foods, abundant exercise and other common sense lifestyle factors and not from a pill.

Here are just a few examples:

Magnesium. This, like Vitamin D, is another must take supplement unless you’re eating extremely well.  Magnesium helps you sleep better, decreases migraine frequency for migraine sufferers, aids in glucose regulation, prevents insulin resistance [5], assists in protein synthesis and energy production [1], lowers risk of diabetes [4] and blood pressure [2] and decreases cardiovascular risk [3]. Again, you just want to make sure that you have enough:  low magnesium levels are bad enough and can lead to the opposite of all I wrote above.And keep in mind that  as you age, the kidneys excrete more Magnesium than during your youthful days.  It is suprisingly easy to become deficient in this all important molecule which is used in literally hundreds of bodily systems and reactions.

REFERENCES:

1) Am J Clin Nutr, 1987, 45:1305-12;Clinica Chimica Acta, 2000, 294:1-26

2) Circulation, 1992, 86:1475-84

3) Intl J of Epidem, 199928:645-51; Am Heart J, 1998, 136:480-90

5) Am Fam Physician, 1998, 58:1323-30

7) American Journal of Preventive Medicine, Feb 2007, 32(3):210-216

Testosterone and Arterial Plaque -Atherosclerosis -

“We showed that estradiol-induced nCAM sialylases are present in vascular endothelial cells and tested whether sex steroid pretreatment of human vascular endothelium could inhibit the capture of monocytes. Using in vitro techniques, pretreatment of human arterial endothelial cells with estradiol, testosterone, dehydroepiandrosterone and dihydrotestosterone all induced sialylation of endothelial cells and, in a dose response manner, reduced the capture of monocytes. Steroid hormones are protective against atherogenesis and its sequellae. Sex steroid depletion is associated with atherosclerosis.”

Now I’d like to point out that the study actually looked at not just testosterone, but also DHT, estradiol and DHEA.  However, in us men, DHT and estradiol are produced almost entirely from our testosterone.  So, as you boost testosterone, you also get a parallel increase in these two hormones as well.  Thus giving a low T man TRT will improve 3 out of 4 of the hormones in this study.

By the way, this complements nicely research done by Dr. Dzugan, who found that, if you correct all the “production hormones,” including testosterone, DHT, estradiol, progesterone, cortisol and DHEA, then cholesterol plummeted. His theory was that the body increased cholesterol to compensate for low hormone levels, since all of the above hormones are made ultimately from cholesterol as their intial buidling block.  Thus, his strategy was to find out where a man was low and then correct him to youthful levels and monitor lipids afterward.

The results were incredible, and I discuss them here:  Hormones, HRT (In Men and Women) and Cholesterol. What this means is that correcting hormone deficiencies will likely not only stop the monocyte issue but actually significantly lower cholesterol and lipid levels as well.  This also means that TRT physicians should not just be focused on testosterone and estradiol but look more at the big hormonal picture.

Now you may be thinking, “Well, if boosting a hypogonadal man with testosterone is so great, why don’t we see a reduction in heart disease in men on TRT (testosterone replacement therapy?!”  Well, we do!  We now have three large, well done and recent studies that show very significant reductions in heart disease outcomes. Check out these studies here:  Testosterone Therapy Cardiovascular Studies. Please read these and spread the word if you feel so inclined:, considering that heart disease is the #1 killer of men and a big percentage of men are low testosterone.  (I also encourage men to read my links on Arterial Plaque Regression, because arterial plaque is not a simple thing and must be attacked from many angles. Doing so can really help your sex life as well!)

“Testosterone retards atherosclerosis progression in animal models of atherosclerosis (33,34). In the LDL receptor-deficient mouse model of atherosclerosis, orchiectomy is associated with accelerated formation of early atherosclerotic lesions in the aorta. Testosterone supplementation retards the progression of atherosclerotic lesions, an effect that is blocked by concomitant administration of an aromatase inhibitor (34). Testosterone effects on atherosclerosis progression are independent of plasma lipids. Taken together, these data provide evidence that testosterone, through its conversion to estradiol, can retard the progression of atherosclerosis in these animal models.” [2]

This is an important point, because some men on TRT take aromatase inhibitors, the most common being Arimidex (anastrozole) to control estradiol  Some control of estradiol is a good thing if you are too high.  However, driving estradiol too low could actually negate all of testosterone’s benefits according to this line of research.

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

CONTROVERSY: It should be pointed out that one study on seniors actually looked to see if TRT effected atherosclerosis in seniors.  However, the study was criticized for methodological flaws.  Check out this commentary:

“The findings of the TEAAM trial appear to be consistent with previous studies that have demonstrated a lack of association between TST and cardiovascular morbidity in hypogonadal men [1] and [2]. However, this is in contrast to other studies that have reached the opposite conclusion [3] and [4], including the Testosterone in Older Men (TOM) trial [5]. Although these studies had potentially concerning findings, their credibility was limited by methodological flaws, such as exclusion of men with a history of myocardial infarction (MI) or stroke rather than being assigned to the no-testosterone arm [3], the use of men taking phosphodiesterase type 5 inhibitors as a purported benign control group [4], and recording of known side effects of testosterone (hypertension and lower extremity edema) as cardiovascular adverse events (AEs) [5].” [3]

That said, we have to admit that we are lacking a well done study in men that shows improvements in arterial plaque from TRT.  However, I think these will come soon enough, as there are eight other critical cardiovascular factors that TRT improves according to the research.  These are HUGE, including lowering arterial hardness – a little different than atherosclerosis – and insulin levels, decreasing inflammation and improving body composition and so on.  Check out the details on this page:  Testosterone and Heart Disease. CAUTION: Always discuss your medical situation with your doctor or naturopath. The research deals with certain subpopulations and your physician knows your individualized medical issues.

1) Reproductive Sciences, Dec 2016, 23(12):1620-1625, “Sex Steroids Block the Initiation of Atherosclerosis”

2) Diabetes Care, 2003 Jun, 26(6):1929-1931, “Testosterone and Atherosclerosis Progression in Men”

3)  European Urology, April 2016, 69(2):371-2, “Effects of Testosterone Administration for 3 Years on Subclinical Atherosclerosis Progression in Older Men With Low or Low-Normal Testosterone Levels: A Randomized Clinical Trial”

Weight Loss and Sleep - Peaktestosterone

Need to change that spare tire around your middle?  Well, lack of sleep will sabotage your best efforts in a dozen different ways. Or maybe you are someone who feels like you have suddenly packed on some extra pounds inexplicably.  One of the first places to look is the quality and quantity of time on your pillow.

One of the primary reasons has to do with appetite.  Everyone knows how they get “the munchies” much more frequently when they are tired and there’s a reason for that:  your body dramatically alters your hormones to compensate.  For example, one study looked at participants with ample sleep and then after four hours of sleep.  It was no surprise that they  “found that sleep restriction was associated with an 18% decrease in leptin, a 28% increase in ghrelin, a 24% increase in hunger, and a 23% increase in appetite”. [1] Leptin and gherlin are two of your primary hunger hormones and sleep shifts both of them in the wrong direction.

This means your appetite and hunger skyrocket correspondingly and, unless you are iron-willed, you will end up eating more on little sleep. One 2009 study showed that those with 5.5 hours sleep ate 22% more in snacks compared with when they had 8.5 hours of sleep. [2] That’s a hefty boost in calories – over 200 on average – that will pack on the pounds faster than you can say lardbutt.

And a little extra snacking is just the beginning of your endocrinological nightmare:  lack of sleep also lowers your testosteorne and growth hormone (as I document in my link on Sleep and Testosterone and Sleep and Growth Hormone).   The ensuing loss of testosterone will likely eventually result in a loss of muscle and we all know “muscle burns fat”. In other words, low sleep will eventually reset your metabolism in the negative direction.  This is further amplified by the loss in Growth Hormone, which is responsible for “leaning you out”.

Sleep loss will also boost your cortisol levels and cortisol is associated with the most deadly kind of fat gain:  visceral fat.  That’s the kind of fat that accumulates around your internal organs and is associated with heart disease.

Just as deadly is the fact that lack of sleep will also whack your blood sugar metabolism and make you insulin resistant.  Of course, insulin resistance is part of the deadly (and sexually devastating) Metabolic Syndrome, but it will also make you fat.  The high insulin levels are deadly because the block the breakdown of fats by adrenaline and lipase. [3]

Lack of sleep also makes you feel much less like exercising.  Your cortisol, insulin and appetite are all increasing and your testosterone and growth hormone are decreasing, yet you don’t have the energy to help compensate.  The bottom line is that burning the midnight oil is going to pack on the pounds and those pounds will lead you to extra estrogen, calcified arteries, poor mental performance and a look of bewilderment as you try to figure out how in the world you put on all those pounds.

REFERENCES:

1)  Annals of Int Med, 2004, 141:846 850,”Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite”

2) Am J Clin Nutr, 2009, 89:126-133, “Sleep curtailment is accompanied by increased intake of calories from snacks”

3) Kobe J Med Sciences, 2007, 53:99-106

Vitamin E Can Boost Nitric Oxide - Peak Testosterone

Can Vitamin E boost nitric oxide? You bet it can! It doesn’t directly raise nitric oxide levels like a Citrulline, Arginine or high nitrate foods However, there evidence clearly shows that in some men, especially those who need it, Vitamin E will do boost your NO levels.

Vitamin E is a powerful antioxidant and is known for the fact that it resides in lipids and thus provides protection where Vitamin C and virtually all other antioxidants cannot. For example, one set of researchers stated that “it is concluded that vitamin E, which is largely present as α-tocopherol, is the only significant lipid-soluble, chain-breaking type of antioxidant present in human blood.” [1]

Before we gone, it should be pointed out that Vitamin E really isn’t just one compound.  Vitamin E is actually composed of four tocopherols: alpha, beta, gamma and delta and there are also four tocotrienols that are part of the Vitamin E complex as well. Some men swear that tocotrienols help with keeping the hair on your head for example.  And gamma tocopherol plays a role in cardiovascular and prostate cancer protection.  However, most Vitamin E supplements are still the “old school” alpha tocopherol form.

And realize that the alpha tocopherol form is provided for only one reason:  to save money.  However,  you do NOT want in my opinion to take only the alpha form, because doing this can lower your gamma and delta tocopherol levels. [1] There is some research that even indicates this could put you at increased risk for prostate cancer, because the gamma form in particular plays a significant role there.  Because of this, you always want to buy Vitamin E as mixed tocopherols (and ideally tocotrienols), even though it is generally more costly.

1)  J Nutr, 2003 Oct, 133(10):3137-40, “Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans”

2) Am J Clin Nutr, Dec 2001, 74(6):714-722, “γ-Tocopherol, the major form of vitamin E in the US diet, deserves more attention”

<p3) med=”” hypotheses,=”” 2007,=”” 69(6):1367-70,=”” “gamma-tocopherol=”” may=”” promote=”” effective=”” no=”” synthase=”” function=”” by=”” protecting=”” tetrahydrobiopterin=”” from=”” peroxynitrite”<=”” p=””>4) Am J Hypertens, 1999, 12(8):839-844, “α-tocopherol increased nitric oxide synthase activity in blood vessels of spontaneously hypertensive rats”

5) Int J Vitam Nutr Res, 2002 Oct, 72(5):309-14, “Vitamin E can reduce blood pressure in mild hypertensives”

6) https://www.nutraingredients-usa.com/Research/Vitamin-E-reduces-high-blood-pressure-in-cases-of-kidney-failure

7) Hypertension, 2001, 38:606-611, “Antioxidant Effects of Vitamins C and E Are Associated With Altered Activation of Vascular NADPH Oxidase and Superoxide Dismutase in Stroke-Prone SHR”

8) Am J Cardiol, Jan 15 1998, 81(2):231-3, “Effects of increasing doses of alpha-tocopherol in providing protection of low-density lipoprotein from oxidation”

9) Journal of Hypertension, Jan 2007, 25(1):227-234, “The effect of vitamin E on blood pressure in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial”

10) Annals of the New York Academy of Sciences, Dec 2004, 1031:74–85, “α-Tocopherol and Endothelial Nitric Oxide Synthesis”

So how does Vitamin E raise nitric oxide levels?  Here are a few key ways:

1.  Increased eNOS Activity. Both gamma and alpha tocopherols increase nitric oxide synthase activity, the key enzyme involved in producing your precious nitric oxide. [2] Because of this, both of these increase nitric oxide generation. One study on hypertensive rats showed that Vitamin E lowered blood pressure at widely varying dosages of α-tocopherol. [4]

2.  Free Radical Protection. One of the free radicals (peryoxynitrite) that your arteries have to deal with can actually slow down your nitric oxide production but by a different means:

Again, it’s not alpha tocopherol, the most common Vitamin E supplement, that can help but rather gamma.  Gamma mops up the damaging molecule and the above study notes that in men with high cholesterol, vasodilation has improved, which means in this case that nitric oxide and blood flow were increased.

3.  Arteriosclerosis Protection. Vitamin E also may protect your endothelial nitric oxide by protecting your arteries from arteriosclerosis.  How does it do this?  Oxidized LDL, the “bad” cholesterol, is what lodges in the lining of the arteries and Vitamin E protects LDL from oxidizing in the first place. [8] And remember:  arteries that are lined with plaque cannot produce nearly as much nitric oxide for you.

This brings up an important point:  the man most likely to benefit from Vitamin E is someone with some kind of cardiovascular issue such as high blood pressure, erectile dysfunction and/or high cholesterol.  A young buck may want to take some Vitamin E for protective purposes, but he is probably not going to be able to discern a noticeable difference.

And are there any human studies to show this?  One study on mild hypertensive patients (“systolic blood pressure, SBP: 140-160 mmHg; diastolic blood pressure, DBP: 90-100 mmHg”) found that Vitamin E dropped systolic blood pressure, diastolic blood pressure and pulse by 24%, 13% and 4.3%, respectively. [5] These are big drops for just one supplement to achieve.  The decrease in systolic pressure is particularly impressive!  These kinds of big drops usually come from big boosts in nitric oxide, which is just what we would expect.

CAUTION:  If you are on any medications or have any medical conditions, please talk to your physician first before making any changes.  Some supplements have interaction or unexpected actions.  Also, one study showed increased in blood pressure in some diabetic patients.  This was with a very large dose and alpha tocopherol only. [9]

Other cohorts that have shown big drops in blood pressure were kidney failure patients, who have very high blood pressure and dropped around 30 points mm systolic. [6] The rule seems to be that the higher your blood pressure, the bigger the correction.

A couple of final thoughts:  some study work has shown that Vitamins C and E together can provide synergistic benefits. [7] Vitamin C is probably best taken in the “salt form”, i.e. Emergen-C or Ester-C on an empty stomach. Note the conclusions of this in vitro study:

“Coincubation with ascorbic acid (100 μM, 24 hr) amplified the effects of α-tocopherol on eNOS phosphorylation and NO formation, which is possibly related to the regeneration of oxidized α-tocopherol by ascorbate. Our data suggest that vasoprotective effects of α-tocopherol in vivo may be related to an increase of NO formation. The effect of α-tocopherol seems to be dependent on tissue saturation with ascorbic acid, and both vitamins may act synergistically to provide optimal conditions for endothelial NO formation.” [10]

REFERENCES:

Saturated Fat: Does It Raise Cholesterol? - Peak Testosterone

Now the difference from lowest to highest is not really that great, right? This is true and, furthermore, the amount of saturated fat in butter and coconut oil greatly exceeds that of safflower oil, so, if saturated fat were a big driver of cholesterol, you would expect a much greater difference.  This is the point of the authors I mentioned above:  saturated fat should not be demonized, because it simply does not change cholesterol that much even in very large quantities.  Now I respectfully disagree with that – remember I’m all about maximizing erectile strength – and I’ll discuss why below.  But, for now, I concede the point that saturated fat does not make a massive difference in most of the typical, high cholesterol Americans out there.

Before we leave this study, let’s look at the numbers that really count:  LDL.  LDL is the “bad cholesterol” and both small and large particles can lead to arteriosclerosis.  So let’s look at what happened in the above study to LDL levels:

In this case, the type of oil used makes a bit more of a difference – 16% from lowest to highest.  And please keep reading:  I make an important point regarding LDL below.

NOTE:  Yes, I know that coconut oil has some great properties.  For example, did you know that, while coconut oil will raise LDL some, it bumps by HDL more proportionately according to some research? [3] The reason is that it is a rich source of lauric acid. In fact, some very heart healthy cultures based their diet off of coconut oil and fish. See my page on The Diet of the Tokeluau and Pukapuka. There is also an older study that shows that beef fat does not have nearly the negative impact on lipids as one might think. [4] All I can say, though, is please keep reading.

2. Normal Cholesterol. There was a theory that a certain genotype (E4 or APOE4) responded much more strongly to saturated fat than the general population.  One study looked at all the different genetic variations in those with normal cholesterol levels and came to this conclusion: [5]

“Relative to the average American diet, both the Step 1 and Low-Sat diets significantly reduced total cholesterol, LDL cholesterol, and HDL cholesterol in all three apoE genotype groups. No evidence of a significant diet by genotype interaction, however, could be identified for any of the measured lipid and lipoprotein end points.”

Basically, this study showed that that everyone (with normal cholesterol) responds to saturated fat.

3. Mildly High Cholesterol. Another study a year later again looked at these same genotypes, but this time in those with “mildly high cholesterol.”  What they found was somewhat similar:  all genotypes were responsive but the most responsive was the Apo E4 group. [6] What they did was create a diet with about half of the saturated fat of the original diet and it dropped total cholesterol and LDL levels about 15% and 9%, respectively in the E4 group.  Again, other groups dropped but not as much.

So the bottom line is that there is lots of evidence that reducing saturated fat will reduce your cholesterol levels, but the magnitude of the reduction may be determined by your genotype.  The above experts are right in the sense that much of the population does not experience a huge drop.

However, their emphasis of this point I think is a huge mistake.  First of all, those with the E4 genotype are probably put at risk.  But the other point is this:  those of us on Low Fat Diets realize that lowering BOTH saturated and total fat will usually dramatically lower total cholesterol and LDL.  The Tarahumara Indians – arguably the healthiest culture on planet earth – have cholesterol levels below 130.  My last reading was also below 130. And the solid majority of people that go on a Low Fat Diet can get their cholesterol below 150.

NOTE:  Some studies show that dropping total fat does just as much to lower cholesterol as lowering saturated fat. [8]

So, in my opinion, these health writers are implying that you can’t really significantly lower your total cholesterol.  Well, this just simply is not the case and, again, it is common knowledge in the Low Fat community that cholesterol can be lowered easily and quickly.  And, by the way, it’s not just by reducing fat in the diet that cholesterol can be lowered:  many foods do the same as does losing weight. (You’ll lose about a point in cholesterol for every pound you lose.) You don’t have to blame bad genetics on your high cholesterol:  it’s almost always possible to get it down into a safe zone with just lifestyle changes.

Now on this page I am not going to get into the cholesterol controversy.  I’ve written about that on other pages.  And, to be honest, I don’t think total cholesterol matters that much anyway.  The number that really counts is LDL, or the “bad” cholesterol.  If you care about keeping your arteries clean and clear, then you should care about LDL.  All the researchers and clinicians that I know of that regress plaque and reverse heart disease pay attention to LDL.  See my page on LDL Thresholds to Arrest or Reverse Heart Disease.

Wonder why the American Diet kills your arteries very slowly over decades and not months?  Well, the studies above show that high saturated fat tweaks up your LDL just enough to help contribute to arterial plaque buildup but very slowly. Pretty insidious, eh?  Almost diabolical some would say.  Instead of killing you overnight, saturated fat may be a factor (along with inflammation) that kills you very gently and slowly – molecule by molecule. The typical pattern is that the penile arteries fill up with plaque first, because they are smaller, and the cardiac and neck arteries follow about five years later, leading to a major event like heart attack, stroke or angina.  See my page on the The Dangers of Erectile Dysfunction for the research in this regard.

REBUTTAL? Yes, there are a couple of large epidemiological studies that show that saturated fat really doesn’t matter.  And this is more or less what one would expect based on the above cholesterol/LDL numbers.  Of course, there are many factors that contribute to arteriosclerosis and arterial hardening of the arteries, but the biggest is LDL and saturated fat has a pretty small impact in that area.  However, I don’t drink decaffeinated coffee either.  Decaff coffee actually increases LDL a little – very similar to saturated fat – for reasons that are poorly understood.  I play it safe and avoid decaff coffee, though, as I don’t need that extra boost to my LDL.

And, if you don’t think total cholesterol matters, I’d ask you to consider the APOE4 genetic group that I mentioned above.  Their skewed lipid profiles put them at risk for “atherosclerosis, Alzheimer’s disease, impaired cognitive function, reduced hippocampal volume, HIV, faster disease progression in multiple sclerosis, unfavorable outcome after traumatic brain injury, ischemic cerebrovascular disease, sleep apnea, accelerated telomere shortening and reduced neurite outgrowth.” [7] The lesson to be learned is that it does not pay to ignore your LDL numbers.

And there are other reason to be cautious about satured fat as well:

NOTE:  To be clear, if you’ve read my page on Low Fat Meats, then you know that I have no issue with a range fed, humanely treated animals sources of protein.

REFERENCES:

1) J of Lipid Res, Aug 1995, 36:1787-1795, “Effects of coconut oil, butter, and safflower oil on lipids and lipoproteins in persons with moderately elevated cholesterol levels”

2) https://culinaryarts.about.com/od/culinaryreference/a/fattable.htm

3) Am J Clin Nutr, 2003 May, 77(5):1146-55, “Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials”

4) Am J Clin Nutr, Aug 1985, 42(2):190-197, “Plasma lipid and lipoprotein response of humans to beef fat, coconut oil and safflower oil”

5) Arterioscler Thromb Vasc Biol, 1997 Nov, 17(11):2914-23, “ApoE genotype does not predict lipid response to changes in dietary saturated fatty acids in a heterogeneous normolipidemic population. The DELTA Research Group. Dietary Effects on Lipoproteins and Thrombogenic Activity”

6) Am J Clin Nutr, 1998, 68:1215 22, “Effect of apolipoprotein E polymorphism on serum lipid response to the separate modification of dietary fat and dietary cholesterol”

7) https://en.wikipedia.org/wiki/Apolipoprotein_E

8) Br Med J. Mar 2, 1963, 1(5330):571 576, “Diet and Plasma Cholesterol in 99 Bank Men”

Saturated Fat and Cholesterol Conclusions

Cyclo Bolan: Testosterone Destroyer - Peak Testosterone

REFERENCES:

1) Digestive Diseases and Sciences, May 2009, 54(5):1144-6 Severe Cholestasis and Renal Failure Associated with the Use of the Designer Steroid Superdrol (Methasteron): A Case Report and Literature Review

2) American Journal of Gastroenterology, 2006, 101(11):2659-2662, “Cholestatic Jaundice and IgA Nephropathy Induced by OTC Muscle Building Agent Superdrol

“hi, read and printed out many of the articles from your site. Found it by accident when researching gynecomastia. I’m afraid I may have a mild form of it since I took a weight lifting supplement a year ago which wiped out my testosterone and HDL, while it skyrocketed my cholesterol and LDL. I read somewhere that when testosterone production halts, estrogen steps up to the plate.”

“Well your site was very informative and answered many questions. I suspect ALL of my health problems are directly or indirectly related, such as hair loss, low energy, low libido, etc. But it wasn’t until I noticed mild gynecomastia that I’ve become greatly concerned.”

“Do you have a program to reduce gynecomastia? There were some sites that said it is irreversable since scarring occurs after 12 months. Also there are many name brand supplements and foods – do you have a do and don’t list or are there any brand names you recommend in particular?”

This reader was quite casual about it all, which is unusual. Generally, young steroid users are very panicked. (From what I have seen, steroid users are almost always young, say, less than 35.) Notice the many nasty side effects that he noticed after taking this supplement:  “hair loss, low energy, low libido.”

What he doesn’t know is that he got off “lucky.”  Cyclo Bolan is composed of two steroids, halodrol and superdrol, both of which have heavy side effects. This reader didn’t know it, but he got off “lucky.”  Both superdrol and halodrol are very hard on the liver and many studies in the journals have reported the same. [1][2]  Testosterone can often be restored by a good doctor but you only have one liver. And on Cycle Bolan in just a few weeks you can find that your cholesterol has gone through the roof and you’re peeing brown urine and have jaundiced (yellowed) eyes and skin.  Oy vay!

Also, this young man was not exaggerating when he said that his testosterone was “wiped out.”  If you read what he wrote back below, you can see that he had a reading of 11 – yes, 11! – after taking this supplement. That is one of the lowest readings I have ever had reported:

“The supplement was Cyclo Bolan by Infinite Labs. it was banned by the FDA. Yes, I got blood tested today. My doctor says that it should be reversable so I’m hopeful. she also mentioned putting in Chrysin into a transdermal testosterone cream.”

“I know your article said that chrysin doesn’t work but did you mean oral adminstration only?…My testosterone dropped to 11 last year and has since returned back up to 340’s. But that was in March. My doc seems to think it could have dropped again since then.”

Is it a given that he will get his testosterone back?  Usually doctors can jumpstart testosterone in steroid users, but that is not a certainty.  Sometimes T levels are permanently damaged.

In any event, I wanted to pass along the dangers of this supplement as a warning.  Steroids are dangerous for professional athletes, but they are at least generally under experienced clinical supervision and monitoring.  I believe the original Cyclo Bolan was discontinued and Infitine Labs sells a similarly named product that is based on Tribulis. However, I would not touch anything from that supplement manufacturer as they clearly have no interest in your health.  Superdrol and halodrol are still widely available, though, and I advise everyone to stay completely away from either.

Yes, a lot of those mammoth, muscle bound young guys in the gym are risking life and limb and liver. I never heard back from this reader:  I hope everything came out well for him.  He told me that I could pass this information along, by the way, to maybe help out some other men out there.

Hair Loss, Factors and Natural Solutions - Peak Testosterone

Everything in middle age is easy – especially losing hair!  Part of the reason that’s it is so easy to lose hair is that there are so many factors that damage hair and hair follicles, leaving you looking a little less fuzzy and fluffy. And most of the factors are largely unknown by the great majority of men leaving them vulnerable to the onslaught of time and aging.

Futhermore, there are many kinds of hair loss, which only multiplies the ways your scalp line can expand.  Of course, the most common is Male Pattern Baldness or androgenic alopecia (AA).  Below we’ll cover all the major factors that can cause you to lose hair, whether they lead to Male Pattern Baldness or a more general form of hair loss. Realize that some of these factors can lead to thinning and damaged hair as well.

NOTE:  Read my link on Hair Loss and Male Pattern Baldness for other natural solutions (and a warning on the significant dangers of Rogaine/minoxidil and Propecia/Proscar/finasteride).

Here are just a few of the issues that can reinforce or sabotage your mountaintop warriors:

1.  Protein. High protein diets were found (in one older study) to inhibit 5-alpha-reductase, the enzyme that converts testosterone to DHT. [1] Of course, this is just one study, but it does show that dietary factors can significantly affect DHT formulation. Interestingly enough, there are a couple of studies that show that high protein

2. Thyroid Dysfunction. Any malfunction of the thyroid, hypothyroidism or hyperthyroidism, can lead to hair loss. [11] One of the reasons is that the thyroid plays an important role in the regulation of new to dormant hair phases and any disruption can send your follicles on vacation.

3. Iron Deficiency. Women can quite frequently experience some hair loss that experts feel may be related to iron deficiency. [3] What about in men? Although this has not been directly verified, one of the fairly common symptoms of hypergonadal men is anemia and thus this could potentially be a factor in hair thinning or loss.

4.  High Stress. Almost any major physical stress even, including “surgical trauma, high fever, chronic systemic illness, and hemorrhage,” can cause “telogen effluvium” hair loss. [4] Telogen effluvium refers to a disruption in the normal cycle of hair growth and resting that normally occurs. It is likely that severe psychological stressors may cause some hair loss as well. Note that Cushing’s Syndrome, which results in high cortisol, can also trigger hair loss.

5. Beta-sitosterol. One small study showed that this natural plant sterol (found in various nuts and seeds, rice, avocado, etc.) inhibited DHT when applied to the scalp. [5]

6.  Green Tea. Green tea is a 5-alpha reductase inhibitor [6] and one study on mice showed that an extract actually regrew hair on mice. [7]

7.  Hemp Protein and GLA (Gamma Linolenic Acid). GLA is a natural inhibitor of DHT and is abundant in certain plant fats, including hemp seed.  Hemp proteins, a nice addition for bodybuilding by many accounts, usually have an ample supply. GLA can also play a role in fighting inflammation – see Chilton’s Inflammation Nation for details.

8. Selenium. Selenium is a very important mineral, of course, for health.  However, it is possible to consume to much and this can result in hair loss. For example, those with non toxic dosages of selenium and selenium shampoos (for medical purposes) have ended up with hair loss. [8][9]  NOTE:  Selenium is an alpha-reductase inhibitor [10] and so normal amounts are good for hair.

9. Vitamins D and E. Both of these are 5aR inhibitors [10] and thus should be part of your arsenal for hair maintenance. I would not recommend megadosing on Vitamin E, especially without mixed tocopherols, but a little in your diet might just help the wear and tear on your hair. Vitamin D deficiencies have been associated with hair loss as well. (See my link on Vitamin D and Testosterone for more details.

10. Lysine. A deficiency in L-Lysine, one of the essential amino acids that must be obtained through diet can lead to general hair loss. Some vegetarians might be careful to consume enough protein and make sure that their protein sources are not low in lysine. (Many plants have low ratio of lysine in proportion to the other aminos.) However, many men who supplement with L-Arginine – see my link on The Pros and Cons of Arginine – need to realize that L-Arginine competes with L-Lysine and, therefore, over consumption of L-Arginine will lead to decreased levels of L-Lysine and potentially a deficiency.

CAUTION: Coconut Oil and Soy. I am not a big fan of either of these, but I must admit they are probably both good for your hair. Soy is a natural 5-alpha reductase inhibitor [10] and lauric acid, about half of coconut oil, has been shown in a couple of studies to do the same. [2] In fact, lauric acid actually inhibits both forms of 5aR (types I and II). (Of course, I am very cautious about all saturated fats, including coconut when it comes to heart health and erectile strength.  See my link on The Potential Dangers of Saturated Fat for more information.)

REFERENCES:

1) Proc Natl Acad Sci U S A, 1983 Dec, 80(24):7646–7649, “Nutrition-endocrine interactions: induction of reciprocal changes in the delta 4-5 alpha-reduction of testosterone and the cytochrome P-450-dependent oxidation of estradiol by dietary macronutrients in man”

2) The Journal of Steroid Biochemistry and Molecular Biology, Oct 2002, 82(2-3):233-239, “Inhibition of type 1 and type 2 5?-reductase activity by free fatty acids, active ingredients of Permixon”

3) Journal of the American Academy of Dermatology, May 2006, 54(5):824-844, “The diagnosis and treatment of iron deficiency and its potential relationship to hair loss”

4) Cleveland Clinic Journal of Medicine, Jun 2009, 76(6):361-367

5) Lancet 345 (8964): 1529–1532, ”  Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic  hyperplasia. Beta-sitosterol Study Group.”

6) https://www.clearogen.com/research

7) J Natl Med Assoc, 2005 Jun, 97(6):816–818, “The effects of tea polyphenolic compounds on hair loss among rodents”

8) JAMA, 1956, 160(16):1397-1398, “DIFFUSE HAIR LOSS ASSOCIATED WITH SELENIUM (SELSUN) SULFIDE SHAMPOO”

9) Annals of Clinical and Laboratory Science, 26(2):99-113, “Metabolism of subtoxic levels of selenium in animals and humans”

10) Int J Oncol, 2003 Jan, 22(1):5-13, “Chemoprevention of prostate cancer by diet-derived antioxidant agents and hormonal manipulation (Review)”

11) Arch Dermatol, 1972, 106(3):349-352, “Hair Growth and Alopecia in Hypothyroidism”

Depression: Natural Cures - Peak Testosterone

Depression is very hard to watch or live through if you have experienced it yourself. People who are depressed are just trying to survive and to function.   The tragedy is that while a depressed person is stuggling just with daily life, they are unknowingly self-destructing physiologically.  Depression is extremely hard on the body and mind, arguably as hard as being overweight or smoking.

We’ve already covered how Depression Can Lead to Erectile Dysfunction and I’ve even discussed how depression lowers testosterone. The problem is that depression raises cortisol and cortisol lowers this critical hormone.  Of course, lowered testosterone is bad for the male brain in general in and of itself, but you should all realize that elevated, long term cortisol actually shrinks the brain.

It’s true:  individuals with long term depression actually have a shrunken hipposcampus, the seat of memory for us human beings. I am bringing this up, because depression is very, very serious stuff – I’ve been there by the way – and should be treated with the highest priority.

CAUTION: Antidepressants are known for having erectile dysfunction as a side effect.  Even worse is the fact that evidence is mounting that they are little better than a placebo at curing depression.  Edronax was recently found in the British Medical Journal to be ineffective (and studies doctored). [16]  A recent, more extensive meta-analysis of twelve different antidepressants found the same thing:  drug companies were not submitting unfavorable study results leading to a misleading bias. [17] However, do not quit an SSRI or antidepressant without discussing it with your doctor first.

Below I’ve written some of the ways that science has shown that depression can be treated and helped.  If you (or someone you love) has mild to moderate depression, these may actually lead to a complete cure.  (Please see your doctor as well , of course, as depression is a serious medical condition.)  I am certainly not saying that one just make a few lifestyle changes, snap your fingers and get over major clinical depression. No, we humans are very complex creatures and some of us have had a nasty past.

However, I do want to help and believe that science has shown that the items below will help almost anyone with depression regardless of severity.  Some of you will be shocked at the results that can be achieved.  It is important to start right away, because depression is a viscious circle:  the lowered testosterone and erectile dysfunction often lead to more depression which then leads to increased stress and cortisol and so on.

NOTE: Depression can have very deep roots.  Childhood sexual abuse, for example, leads often to adult-onset depression particularly in females, but also in males as well.  See my page on Dysregulation of the HPA Axis for more examples.

Here is what the research has shown:

1. Weight Loss. Researchers just recently found that weight loss can significantly improve depression. [1]  A weight reduction of just 8% resulted in a significant loss of depressive symptoms.  In a 200 lb male that’s just 16 pounds.

2. Exercise. Numerous studies have shown that moderate exercise can very significantly help with depression. The results have often been just a little short of miraculous and every person with depression should consider exercise in their arsenal.  [2]  Furthermore, one study on females showed an improved hormonal – cortisol and norepinephrine – response thus demonstrating that exercise combats the most degenerative aspect of depression. [3]

3.5 Magnesium Therapy. Know anyone with severe, untreatable depression?

3. Folic Acid and Vitamin B12. Folic acid (or folate) helps builds a molecule called SAM that is imperative for neurological function.  Low folate levels are quite common and can be a major contributor to depression. One study concluded, “There is now substantial evidence of a common decrease in serum/red blood cell folate, serum vitamin B12 and an increase in plasma homocysteine in depression…On the basis of current data, we suggest that oral doses of both folic acid (800 g daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression”. [4] Furthermore, severe depression has even been linked to low folate levels based upon a study of Finnish middle-aged men. [13]

CAUTION: You must be careful not to take too much folate as folate is also used in DNA replication and repair, which is why it is so critical for pregnant mothers.  However, it also looks like too much folate stimulates cancer in some case for this same reason and it has been implicated in various GI cancers.  The problem is that we are supplementing many of our (more trashy) cereals and breads leading to, for some individuals that eat that kind of food, over-supplementation of folic acid. You can also take too much Vitamin B12 as well to where it actuallyis destructive to neurological function.

4. Fish Oil. The studies have been somewhat mixed, but study after study in the last few years has show quite consistently that fish oil improves mood and often helps with depression as well. For example, one study of heart patients found significantly more patients with depression when comparing those with the lowest levels of omega-3’s versus those with the highest. [5]  Furthermore, children with major depression showed significant improvement when put on fish oil compared with the control group. [6]  And a 2009 study of menopausal women found the same thing. [7]  Please read these pages about How Fish Oil Helps the Heart, How Fish Oil Helps Testosterone and How to Buy Fish Oil.

5. Food and Seratonin.  I also recommend that you read this link on How to Boost Seratonin and Other Neurotranmitters Through Food for additional help.  Depression is often linked to seratonin receptors and many of the modern medications target this neurotransmitter.

6. Sunlight. Scientists have recently found that sunlight has a significant impact on cognition, especially in depressed individuals. [8] The lead researcher, Shia Kent, pointed that light has actually been shown to affect not only melatonin but brain blood flow.  Bottom line:  open the drapes and go for a walk if you live in a non-sunny climate for the sake of your brain. Of course, sun exposure is also a major source of Skin Damage, so indirect exposure is best.

7. Moderate Drinking. This may be counterintuitive for some, but moderate drinking, one to two drinks per day, is associated with decreased rates of depression according to a recent study. [9] This backs up previous work that showed that ending moderate drinking was tied to increased depression rates as well. In other words, moderate drinking may be depression protective and possibly curative as well. [10] Read my link on Alcohol for more information. CAUTION: It may be unadvisable for someone who is depressed to begin drinking and, of course, if you have any history of alcohol issues, this will only make matters worse.  Heavy drinking is associated with increased depression and even shinkage of the brain.

8. Concussions. A surprising number of guys have had several concussions in sports such as football, soccer, biking accidents and so on. The evidence is coming out almost monthly on the damage that this does to the brain.  Concussions are very common:  a NeuroSurgery Today article estimates that between 4 and 20% of football players will end up with a concussion during the course of a season for a total of 300,000 per year in American alone! Concussions, especially repeated ones, create multiple kinds of damage including “neurofibrillary tangles” that are found in NFL players who have problems with depression, erratic behavior, suicide and quasi-dementia. If you’ve suffered a lot of sport-related head injuries, depression can surface in later years as a major issue.  A recent American College of Sports Medicine study found that 20% of retired NFL players who had had three or more concussions were experiencing depression.

9. Processed Foods. Processed foods have just been linked to depression. [11] 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.

10) Low Fat Diet.  A Low Fat (Ornish) Diet has been found to boost mood in multiple studies.  For more information, read this link on How to Control Appetite and Boost Mood through Diet.

11) Saffron. An extract of saffron, the expensive yellow spice valued from antiquity, has been found to be an antidepressant as powerful as Prozac. [12]

12) Potatoes.  No one has shown that potatoes are a cure for depression, but they may well help. Studies show that they actually stimulate seratonin production. [14]

13) Vitamin D. Vitamin D deficiency was recently found to increase the risk of depression by 85%. [15] This is no wonder since Vitamin D is ties into feelings of energy and alertness.

14) Light Therapy. Researchers have noted that light therapy helped with depressed patients and a recent study verified the same. [18]  If you’re depressed, light and lots of it, is your friend.

15) Low Testosterone. Testosterone profoundly affects the male brain and the lack of it can lead to mood issues and depression. One research summary points out that men with testosterone below about 290 ng/dl (10 nmol/l) are at increased risk for depression.[19]

15) Progressive Muscle Relaxation. A number of studies have shown this simple relaxation technique can help with depression.  For more information, see this link on Progressive Muscle Relaxation (#4).

16) Mindfulness Based Cognitive Therapy (MBCT). Mindfulness Meditation is incredibly powerful and, when combined with a form of cognitive therapy, results in a clinically effective strategy called Mindfulness Based Cognitive Therapy.  And it has built up an excellent research track record with depression.  One meta-analysis concluded that it prevented relapse into major depression at a rate of between 34-43%. Statistically, this are very good results for something as serious and difficult to treat as major depression. [20] The authors also noted that “in two studies, MBCT was at least as effective as maintenance antidepressant medication.”

REFERENCES:

1) Society for the Study of Ingestive Behavior, July 29 2009, Faulconbridge, Weight Loss Improves Mood In Depressed People, Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB), July 28 – August 1, 2009.

2) J of Affective Disorders, 93(1):79-85, “Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients”

3) The Eur J of Pub Health, 2006, 16(2):179-184, “Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms”

4) Journal of Psychopharmacology, (2005), 19(1):59-65, “Treatment of depression: time to consider folic acid and vitamin B12”

5) Journal of Psychotherapy and Psychosomatics, news release, June 2009

6) Am J Psychiatry, June 2006 , 163:1098-1100, “Omega-3 Treatment of Childhood Depression: A Controlled, Double-Blind Pilot Study”

7) Universit Laval, Feb 1 2009, “Omega-3 Fatty Acids Ease Depressive Symptoms”

8) Environmental Health, 2009, 8:34 (28 July 2009), “Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study”, Shia T Kent, et. al., Environmental Health (in press)

9) Addiction, Aug 3 2009, 104(9):1519-1529, “Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Tr ndelag Health Study”

10) https://www.sciencedaily.com/releases/2008/07/080708104521.htm

11) The Brit J of Psychiatry, 2009, 195: 408-413, “Dietary pattern and depressive symptoms in middle age”

12) Journal of Ethnopharmacology, Feb 2005, 97(2):281-284, “Hydro-alcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial”

13) Psychother Psychosom, 2004 Nov-Dec, 73(6):334-9, “Dietary folate and the risk of depression in Finnish middle-aged men. A prospective follow-up study”

14) YourHealth, Mar 2009, p. 29.

15) International Archives of Medicine, Nov 11 2010, 3:29, “Serum vitamin D concentrations are related to depression in young adult US population: the Third National Health and Nutrition Examination Survey

16) https://www.telegraph.co.uk/health/8051470/Antidepressant-ineffective-and-potentially-harmful.html

17) https://health.msn.com/health-topics/depression/articlepage?cp-documentid=100203204

18) Archives of General Psychiatry, 68(1), January 2011, “Bright Light Treatment in Elderly Patients With Nonseasonal Major Depressive Disorder”

19) Asian Journal of Andrology, 2010, 12:136 151, “Androgens and male aging: current evidence of safety and efficacy”

20) 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”

Boron and Testosterone - Peak Testosterone

REFERENCES:

1) J Trace Elem Med Biol, 2011 Jan, 25(1):54-8. Epub 2010 Dec 3, “Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines”

2) Reprod Toxicol, 1997 Jan-Feb, 11(1):123-60, “An assessment of boric acid and borax using the IEHR Evaluative Process for Assessing Human Developmental and Reproductive Toxicity of Agents. Expert Scientific Committee”

3) https://www.vrp.com/bone-and-joint/boron-higher-doses-necessary-for-cognitive-bone-and-joint-health

4) https://www.lef.org/magazine/mag2006/aug2006_aas_01.htm

5) https://robthoburn.wordpress.com/2011/02/02/boron-increases-testosterone-again/

6) https://www.traceminerals.com/ products/liquid-tablet-minerals/concentrace-ionic-minerals

6) https://www.bioimmersion.com/docs/fructoborate_monograph.pdf, “Vitamin D/ Steroid Hormone Homeostasis and Calcium Fructoborate Supplementation”

7) Biol Trace Elem Res, 1997 Mar, 56(3):273-86, “The effect of boron supplementation on its urinary excretion and selected cardiovascular risk factors in healthy male subjects”

It’s not very often I get excited about a trace mineral, but Boron is an exception. Boron ain’t boring – let me tell you. Below I am going to outline one thing after another that boron does that is going to help you in the bedroom, including boosting free testosterone.

First of all, boron is a trace mineral that your body needs and, like magnesium, is used by and positively influences many of your tissues and processes. There is no RDA for boron, but a significant percentage of the population is well below the 3 mg/day threshold that many experts would recommend. In fact, the average is considered to be about 1.5 mg/day. [2] Here is just a partial list of what boron is known to affect:  hormones, inflammation, blood plasma, vitamin D, bone maintenance and cognition/learning. [3] (NOTE:  Tell your woman that there is evidence that boron can help with osteoporosis. [4])

Boron can also be fickle to get in the diet.  Only certain plants contain boron and, unfortunately, things like soil and weather can affect boron content significantly. However, if you are eating one of the healthy, research-backed diets, then it is possible to get upwards of 10 mg/day. [2] Plant foods, such as lentils, nuts, peanuts, avocado and certain fruits and vegetables, all generally have significant boron content.

Researchers, in the above-mentioned study [1], decided to give participants boron levels near the upper end of what one can get through diet. They gave 8 healthy volunteers right around middle-age 10 mg of sodium tetraborate – Borax for you old-timers – on a daily basis.  The results were remarkable.

Looks at the sex life-boosting properties that Borax exhibited:

1.  Free Testosterone.  Increased 28%. [5] (See my link on Free Testosterone for more information.)

2. DHT. Increased (not statistically significantly however).

3. Vitamin D.  (not statistically significantly, but boron is a known increaser of Vitamin D)

4. C-Reactive Protein.  Statisically significant decrease.

5.  TNF-alpha.  Statisically significant decrease.

CAUTION:   Estradiol. One study in healthy men noted a significant increase in testosterone but also a jump in estradiol:  “Plasma estradiol concentrations increased significantly as a result of supplementation (51.9 to 73.9 pmol/L) and there was a trend for plasma testosterone levels to be increased. ” [7]

These five changes are a dream-come-true for us men. Notice the nice boost in free testosterone-to-estrogen ratio – this is going to do nothing but help the sex life of most men.  And that’s just the beginning of the good news.  Other studies have shown that Boron is a huge inflammation fighter.  (Some people even take it for arthritis.)  However, the one caution is the possible increase in estradiol.  If you decide to supplement with Boron, you may want to pull your testeosterone and estradiol before.  For more information, see my page on Inexpensive Self-Testing Testosterone Labs and Which Estradiol Test is the Best for Men?

So who cares?  Well, anything that fights inflammation, particular TNF-alpha and C-Reactive protein is very likely to improve your artery health, which will in turn improve blood flow, slow arteriosclerosis and do many other things to help you pump out more nitric oxide. Remember that C-Reactive protein is a broad measure of systemic inflammation that is strongly predictive of cardiovascular disease.  And TNF-alpha is strongly predictive not only of heart disease, but also erectile dysfunction, diabetes, arthritis and many other nasty conditions. See my link on TNF Inhibitors for more information.

NEWS FLASH:  We had a great forum thread on boron and the best form and one regular posted a study using calcium fructoborate to “increase Vitamin D 19.6%, DHEA 56%, and Free Testosterone 29.5%. One male participant had an increase of 50% in testosterone.” [6] Hard to argue with that, eh?

It’s hard for me to think of too many things that are worse for your sex life in the short term (and long term for that matter).  Sugar and corn syrup wreak immediate havoc on several key components of your sexual strength and function.  These nasty effects can last for hours and all for what?  Sugar and corn syrup add little to no nutritional benefits – in fact, quite the opposite.

CAUTION:  Boron is very powerful and little study work has been done to determine the proper dosage, side effects, etc. I personally am waiting a few years before taking this mineral, although I do get a little in my Concentrace Mineral Drops of which I take about 20-40 drops per day at the time of this writing, which is about 0.5-1.0 mg/day, a relatively small amount compared to the studies, which have been generally been on supplementation in the 10 mg/day range. [5][6] So my approach is cautious and may have little effect, but my goal is primarily to avoid a deficiency.

How to Lower Your Inflammation - Peaktestosterone

Feeling just generally lousy? There’s a good chance that inflammation is behind it. The reason is that, like a cancer, elevated inflammation slowly worms its way through your body, slowly doing its damage in unexpected places. In some men, it anhilates the arteries. In other men it leads to diabetes. In still other men it leads to arthritis, IBS, Crohn’s Disease, allergies or asthma. Of course, it very often damages multiple systems simultaneously in many men as well. And, as you get sicker, lose energy, exercise less, digest foods improperly, etc. – the downward spiral just accelerates.  This is why examining and, if necessary, lowering inflammation is “step 5” in the Peak Testosterone Program.

Remember that modern life seems almost designed to raise inflammation, making it a struggle for most men to keep inflammation in check.  The first step, as always, is to monitor you inflammation.  Probably the most well-known measures of inflammation are probably CRP (C-Reactive Protein) and TNF alpha (Tumor Necrosis Factor), but there are many others as well.  C-Reactive protein is a fairly standard test nowadays and many in-the-know doctors will order this as part of a standard physical.

Typical C-Reactive protein guidelines are given below (straight from the American Heart Association website):

Besides cardiovascular disease, high C-Reactive Protein levels are associated with these common maladies:

So what do you do to reduce inflammation? Here are 20 Ways to Reduce Inflammation:

1) Pomegranate (and Cranberry) Juice. This juice significantly lowers systemic inflammation. [6]  There are other juices that will also lower inflammation dramatically.  See the link on Juicing and Inflammation for more details.

2) Magnesium. Supplementation with this mineral dropped hsCRP like a rock in prediabetic individual and here in the U.S., a huge percentage of adults are struggling the beginnings of insulin resistance.  The study noted that “at the end of follow-up, participants who received magnesium chloride showed higher serum magnesium levels (0.86 0.08 vs. 0.69 0.16 mmol/L) and lower hsCRP levels (4.8 15.2 vs. 17.1 21.0 nmol/L) compared with participants in the control group.” [30]

3) Moderate Alcohol. Moderate alcohol consumption lowers many inflammatory markers. [7]  Of course, you should also read my links on Alcohol and Testosterone and Alcohol: The Pros and Cons first.

4) Exercise is well-known for its inflammation-lowering properties. [8]  Several studies have found that it lowers TNF alpha [17] and C-Reactive protein [18].

5) Avoid High Protein Diets. This type of eating has been shown in several studies to increase inflammatory markers such as fibronigen and C-Reactive Protein. [12] (This is not always true, though, but just passing along the research.)

6) Arachidonic Acid Reduction. Most guys need to lower their intake of Arachidonic Acid (AA). One study found that those who ate high levels of Arachidonic Acid (AA) (> 1500 mg/day) had 41% higher levels of inflammatory messengers in their blood than those with low levels (< 200 mg/day). [9] These extra and unneeded inflammatory messengers flooding the body lead to an unneeded and dangerous risk in bodily inflammation.  Here are common foods with high levels of Arachidonic Acid (AA):  farm-raised salmon (1306 mg), 2 egg yolks (140 mg), turkey (70 mg), pork (50 mg) and chicken (50 mg). [10]  Those middle aged and beyond should also be aware that the concentration of Arachidonic Acid (AA) in the blood rises with age.  And notice that the diets I advocate on this site fit in perfectly with this strategy:  the Ornish Diet eliminates all of these foods altogether and the Mediterranean Diet limits them.  NOTE: You may wonder why farm-raised salmon is so astronomically high in Arachidonic Acid (AA).  It is primarily because of diet:  farm-raised salmon are fed corn and soybean meal which is high in omega-6’s whereas wild salmon, which averages in at 175 mg of AA, eats omega-3 rich algae.

7) Low-Glycemic Foods.  High levels of insulin activate enzymes that actually cause the body to produce more Arachidonic Acid (AA). [11]

8) Fish and Fish Oil.  Many studies have shown omega 3’s to be proven inflammation fighters. [13]  See my link on Fish and Fish Oil for more details.

9)  Eliminate Periodontal Disease. Watch out for gum disease:  it leads to chronic inflammation and has recently been correlated to heart disease and recently erectile dysfunction. [14]

10) Decrease Saturated Fat.  Saturated fat impairs some of HDL’s good qualities, allowing inflammatory agents to accumulate in the arteries. [15]

11) Laughter.  Laughter in one study of diabetics lowered C-Reactive protein by 66%! [16]

12) Turmeric.  Turmeric, the yellow in yellow mustard and curry, is well-known for its inflammation-lowering properties and has been shown to provide relief for, among other things, Crohn’s Disease. [19]

13) Moderate Dark Chocolate and Cocoa. One study found that modest amounts of dark chocolate (20 g every 3 days) reduced C-Reactive protein levels by almost 20%. [20]  This is a very significant reduction, but it resulted from a relatively small amount of dark chocolate, about a square or two every 3 days. Another study gave volunteers 40 grams of cocoa and 500 ml of skim milk to patients at risk for heart disease.  What they found was that several key arterial inflammatory markers were reduced, an additional explanation as to why cocoa works its magic on cardiovascular disease. [22] CAUTION:  You may want to read my link on Does Chocolate Have An Ideal Dosage?

14) Cholesterol. A 2010 study revealed that one reason that high cholesterol destroys arteries is that it forms crystals leading to plaque-building inflammation along the arterial walls. [25]

15) Lack of Sleep.  Going to just four hours of sleep per night will significantly raise your C-Reactive protein levels and your Pulse as well. [26]

16) Testosterone. Perhaps surprisingly to some, that all-important male hormone reduces inflammation, specifically TNF-alpha and IF-1B, and is yet another reason to make sure you optimize your androgen levels. [27]

17) Salt. Salt intake can lower levels of adiponectin, a protein that inhibits inflammation. Dysfunctional levels of adiponectin have been associated with inflammation and many other nasty conditions.  See my link on Deadly Salt for more details.

18) Boron. Boron is a proven inflammation decreaser and some research has shown it lowering both TNF-alpha and C-Reactive Protein.  It also positively impacted free testosterone!  See my link on Boron and Testosterone for more information.

19) Progressive Muscle Relaxation. This simple tighten-and-release technique developed in the 1920’s has proven itself over the years as a huge physical (and mental/psychological) health booster.  Regular PMR practitioners receive a huge TNF-dampening effect that can lower cortisol, TNF-alpha and IL-6.  In short it is one of your best protectors against The Common Male Enemies, and you can read about it more here in my link on The Incredible Many Benefits of Progressive Muscle Relaxation.

20)  Tart Cherry Juice. This juice lowers TNF alpha levels.  See the link on Juicing and Inflammation for more details.

21) Vitamin C. Yes, there is a cheap supplement that lowers C-Reactive Protein (CRP) levels by 25%. At least that is what one study of men and womn with at risk CRP showed. [28] Furthermore, this was achieved with only a gram per days. For other reasons to consider this pennies-a-day supplement, see my link on The Many Benefits of Vitamin C.

22) Creatine. Creatine is known for its ability to fuel muscle growth throught satellite cells and increase your ability to workout.  Researchers have also found that it clamps down on post-exercise rises in TNF alpha and CRP (C-Reactive Protein), two of the biggest inflammatory cytokine troublemakers. [29] For more information on creatine, see my link on The Benefits of Creatine. The link says it is for vegetarians, but it will generally to meat-eaters and non. I also have some warnings about creatine in my page on The Potential Risks of Creatine.

Also, a must-read book that will potentially save your life is Inflammation Nation by David Chilton.  It exposes many of the major causes of inflammation as no other book or site that I have seen: Inflammation Nation. He explains how many of the underlying issues to our Western societies, such as diabetes, autoimmune disorders and heart disease, are really just inflammatory in nature.

REFERENCES:

1) JAMA,2004,291:585-590

2) Oncology Times,April 10, 2007,29(7):24-25

3) J Clin Oncol,2006 Nov 20,24(33):5216-22

5) International Journal of Impotence Research,2003,15:231 236

6) Nitric Oxide,Aug 2007,17(1):50-4 (Epub, May 5 2007)

7) Diabetologia, Oct 2004,(47)10:1760-1767(8)

8) Eur Heart J, 2006, 27(11):1385-1386

9) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 81.

10) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 81, 92, 94, 95.

11) Inflammation Nation, by David Chilton, Ph. D., 2006, p. 116.

12) Angiology, 2000, 51(10):817-826

13) Life Sciences, 2006, 78:2523-2532

14) See https://www.medicalnewstoday.com/articles/152856.php

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

16) Presented at the 122nd Annual Meeting of the American Physiological Society, Apri 18-22 New Orleans Experimental Biology 2009 scientific conference, “Mirthful Laughter, As Adjunct Therapy in Diabetic Care, Increases HDL Cholesterol and Attenuates Inflammatory Cytokines and hs-CRP and Possible CVD Risk”, Birk, Tan.

17) Nature, 2010; 464(7293): 1357, “NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals”

17) Intl J of Obesity and Related Metabolic Disorders, Sep 2000, 24(9):1207-1211, “Moderate-intensity regular exercise decreases serum tumor necrosis factor-alpha and HbA1c levels in healthy women”

18) Amer Heart J, 152(4):793-800, “Response of high-sensitivity C-reactive protein to exercise training in an at-risk population”

19) Inflammatory bowel diseases, 2008 Jun, 14(6):780-93, “Protective effects of dietary curcumin in mouse model of chemically induced colitis are strain dependent”

20) J Nutr, Oct 2008, 138:1939-1945, “Regular Consumption of Dark Chocolate Is Associated with Low Serum Concentrations of C-Reactive Protein in a Healthy Italian Population”

22) Am J Clin Nutr, 90: 1144-1150, 2009, First published September 23, 2009; “Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease”

24) J of Alzheimer’s Dis, 2007, 12(2):151-156, “Elevated Serum C-Reactive Protein Concentration in Bosnian Patients with Probable Alzheimer’s Disease”

25) Nature, 2010; 464(7293): 1357, “NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals”

26) J Am Coll Cardiol, 2004; 43:678-683, “Effects of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk”

27) J Clin Endocrinol Metab, 2004; 89: 3313 3318, “The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men”

28) Free Radic Biol Med, 2009 Jan 1, 46(1):70-7, “Vitamin C treatment reduces elevated C-reactive protein”

29) Nutrition, Sep 2013, 29(9):1127-1132, September 2013″Effects of creatine supplementation on oxidative stress and inflammatory markers after repeated-sprint exercise in humans”

30) Archives of Medical Research, May 2014, 45(4):325-330, “Oral Magnesium Supplementation Decreases C-reactive Protein Levels in Subjects with Prediabetes and Hypomagnesemia: A Clinical Randomized Double-blind Placebo-controlled Trial”

Estrogen: Do Men Need It? - Peak Testosterone

Do men need estrogen? The truth is that you need estrogen almost as much as the woman in your life needs testosterone.” And she needs testosterone – believe me.  It contributes greatly to her mood, libido, weight maintenance and insulin control just for starters.  Of course, if she gets too much, it can cause her issues – just read about what happens to most women with PCOS.

Estrogen is analagous in many ways for males. We all know that overly high estrogen levels will likely lead to prostate cancer, andropause and loss of erectile strength and libido. You can read my links on The Dangers of Estrogen for more details. At the same time we very much need some estrogen for certain critical health functions.

So just how does estrogen fall too low in males?  The primary way is  in senior males with long term andropause.  The typical pattern for an aging male is that his testosterone slowly declines by a percent or two per year after about his early to mid 20’s.  This decline in testosterone  leads to slow weight gain, which in turn leads to increased estrogen levels due to the additional aromatization of testosterone from extra body fat.

However, as the years go by, it is quite common for testosterone levels to fall so low that even with the increased aromatization rates, a man can find that his estrogen falls to dangerously low levels.  Thus, one could generalize and say that elevated estrogen is a middle-aged man’s nightmare and decreased estrogen a senior man’s.

NOTE:  Estrogen actually has several different subforms. The most “dangerous” estrogen is E2, or estradiol. Typically, when one is talking about estrogen, this is the form being referred to. Sister molecules are estrone (E1) and estrial (E3).

Here are three key ways showing how badly men need adequate estrogen levels and how low estrogen can endanger a man’s career, relationships and health:

1.  Bone Maintenance.  Estrogen is critically important for brain function, even in the men. Researchers have found that it is important for verbal memory in particular. [2] Estrogen is also essential for the growth of new neuronal connections and neuron maintenance. [3] Yes, testosterone has a profound effect on the male brain, but adequate estrogen is no less important.

2. Erectile Dysfunction. Results are preliminary, but it is clear that estrogen in males actually plays a significant role in nitric oxide production. [4] Of course, it is no secret that testosterone stimulates nitric oxide, but researchers were suprised to find that in men there were critical estrogen receptors that stimulate eNOS as well. Therefore, it may be almost as important to check estrogen levels as testosterone in aging males.

3. Verbal Memory and Brain Function. Estrogen is critically important for brain function, even in the men. Researchers have found that it is important for verbal memory in particular. [2] Estrogen is also essential for the growth of new neuronal connections and neuron maintenance. [3] Yes, testosterone has a profound effect on the male brain, but adequate estrogen is no less important.

4. HDL. Estradiol increases HDL and so it stands to reason that low estradiol levels could lead to low HDL levels as well.  See my page on Estradiol and HDL for additional information.

Many experts emphasize that the criticality of the ratio of testeosterone to estrogen. For more information, read my link on The Testosterone-to-Estrogen Ratio, where I discuss how it changes over the years and even how Cialis can affect it in a positive way.

CAUTION: I had one extremely fit and athletic young man write in who was taking a variety of supplements and foods that decreased testosterone’s aromatization to estrogen.  This included zinc supplementation and green tea extracts (EGCG). His claim was that, because he was so thin and had very low body fat, that his estrogen was likely too low and leading to a variety of health issues. It may be something to consider for the young and fit.

REFERENCES:

1) Arch Intern Med, 2008, 168(1):47-54, “Endogenous Sex Hormones and Incident Fracture Risk in Older Me: The Dubbo Osteoporosis Epidemiology Study”

2) https://www.webmd.com/brain/news/20001107/male-brains-need-estrogen-for-good-memory

3) https://news.columbia.edu/research/1983

4) Med Sci Monit. 2003 Mar;9(3):RA63-8,  “The nongenomic protective effects of estrogen on the male cardiovascular system: clinical and therapeutic implications in aging men”

Ginseng, The Many Benefits - Peak Testosterone

Supplements, especially herbs, scare me.  However, there are a few herbs, such as Korean Ginseng and Pycnogenol, that have very, very positive benefits and research results.  For example, Ginseng’s performance has been so outstanding that one could really qualify it as a food in terms of safety and beneficial properties.  Furthermore, and as we’ll show below, Ginseng seems tailor-made for the middle-aged and beyond guy battling some aging-onset maladies, including loss of erectile strength, mental sharpness and insulin resistance.  It’s not an inaccurate characterization to say that Ginseng is a turn-back-the-clock supplement in most of the key areas of health that males are interested in.  NOTE:  American Ginseng has many excellent properties as well, but we are only talking about the Korean variety here.

Side effects are rare with Ginseng.  Really the only major caution is that some supplement manufacturers have allowed lead contamination into their Ginseng products.  However, this can be avoided by buying brands, such as Solgar – Korean Ginseng Root Extract, 60 veggie caps , which have been tested for lead and pesticides (and deliver the active ginsenocides specified on the label).

REFERENCES:

1) 1) Diabetes Care October, 1995, 18(10):1373-1375, “Ginseng therapy in non-insulin-dependent diabetic patients”

2) Arch Intern Med, 2000, 160:1009-101, “American Ginseng (Panax quinquefolius L) Reduces Postprandial Glycemia in Nondiabetic Subjects and Subjects With Type 2 Diabetes Mellitus”

3) Curr Ther Res Clin Exp, 1996, 57:959 68, “A double-masked study of the effects of ginseng on cognitive functions”

4) J Ethnopharmacol, 1986;16:15 22, A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers”

5) Int J Clin Pharmacol Res, 1999, 19:89 99, “Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group”

6) Physiology & Behavior, Apr 2002, 75:739-751, “Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults”

7) Physiology & Behavior, Apr 2002, 75:739-751, “Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults”

8) Neurochemistry International, Jul 1992, 21(1):1-5, “Actions of ginsenoside Rb1 on choline uptake in central cholinergic nerve endings”

9) Horm Metab Res, 2005, 37(3): 146-151, “Improvement of Insulin Resistance by Panax Ginseng in Fructose-rich Chow-fed Rats”

10) ARCHIVES OF PHARMACAL RESEARCH, 27(7):790-796, “Wild ginseng prevents the onset of high-fat diet induced hyperglycemia and obesity in icr mice”

11) Acta Pharmacologica Sinica, Sep 2005, 26(9):1104-1110, “Antihyperglycemic effects of total ginsenosides from leaves and stem of Panax ginseng”

12) Life Sciences, Aug 8 2000, 67(11):1297-1306, “Anti-proliferative effect of ginseng saponins on human prostate cancer cell line”

13) Int. J. Epidemiol, 1998, 27 (3): 359-364″Non-organ specific cancer prevention of ginseng: a prospective study in Korea”

14) Int. J. Epidemiol, 1990, 19(4):871-876, “A Case-Control Study of Ginseng Intake and Cancer”

15) Annals of Pharmacotherapy, Published Online, 6 December 2005, “Systematic Review of the Effects of Ginseng on Cardiovascular Risk Factors”

CAUTION:  Ginseng does have a few drug interactions, such as with blood thinners, etc., so check with your doctor first as always.

What can Ginseng do for you?  Consider these benefits:

1) Erectile Strength and Libido.  As I document in my link on Ginseng and Erectile Dysfunction, Ginseng has been proven in many studies to boost your all-important Nitric Oxide and has even been shown to have a solid cure rate (two thirds to three fourths) for guys with erectile dysfunction.  In the same link, I also document Ginseng’s aphrodisiac qualities.

2) Blood Sugar Control.  Early work found that Ginseng had the admirable quality of lowering blood sugar in type II diabetics. [1] Of course, this was an important benefit of Ginseng considering that such a large percentage of individuals in industrialized societies struggle with blood sugar control.  Follow-up research showed that Ginseng lowered blood glucose even in non-diabetics. [2]  Many animal studies have shown Ginseng’s protective effects against insulin resistance, diabetes and hyperglycemia. [9][10][11]  This is a desireable property indeed, considering the erectile and health-damaging effects of Diabetes and Metabolic Syndrome.

4) Cancer.  Almost all males will get prostate cancer, a common and generally slow growing cancer.  One of ginseng’s many benefits, according to an in-vitro study, is likely protection against the most aggressive forms. [12] Other studies show significant protection against stomach and lung cancer [13] and cancers of all kinds. [14]

5) Blood Pressure.  Ginseng yields a small but significant blood-pressure lowering benefit. [15]

These are the major advantages that most guys are particular interested in.  However, it is important to note that Ginseng has also been found to benefit the central nervous system and battle certain neurodegenerative diseases and has excellent anti-inflammatory and antioxidant properties as well.  Again, as with Pycnogenol, the list of Ginseng’s benefits is difficult to summarize in one short page.

Some Super Sexual Herbs - Peak Testosterone

Sex – it seems so simple.  Well, until you hit middle age, right?  Then some guys find they need Cialis or Viagra or Levitra to boost their Nitric Oxide for increased blood flow.  Still other guys need prescription testosterone, i.e. Hormone Replacement Therapy, to rebuild those muscles at the base of the penis in order to trap and move the blood.  Finally, there are still other guys who have all the above chemical mechanics going on but have no sexual desire.  Their libido just isn’t there any more.  After all, when you’re the one saying, “Not tonight, dear”, you just might be in trouble, eh?

And, of course, you can have any combination or percentage of the above, but, either way, it spells trouble for life in the bedroom. That’s why it is ideal if you could find a herb that hits what I call The Big Three Bedroom Essentials:

1) Brit J Sports Med, Oct 2003, 37: 464 70. “The Ergogenic Effects of Eurycoma Longifolia Jack: A Pilot Study”

2) J of Ethnopharmacology, Nov 12 2009, 126(2):308-313, “Influence of Eurycoma longifolia on the copulatory activity of sexually sluggish and impotent male rats”

3) Ann Acad Med Singapore, 2000 Jan, 29(1):22-6, “Proerectile pharmacological effects of Tribulus terrestris extract on the rabbit corpus cavernosum”

4) Panminerva-Med, 1996 Dec, 38(4): 249-54, “Effects of Panax Ginseng C.A. Meyer saponins on male fertility.”

Interestingly enough, Viagra, Cialis and Levitra really only (directly) do one of these: raise Nitric Oxide. In other words, these are strictly One Hit Wonders.  NOTE:  Hormone Replacement Therapy will only hit two out of three of these.  It will definitely help with #3 by strengthening the pelvic floor muscles and testosterone definitely influences libido as well.

So what if I told you that there are herbs that work on all three of the above simultaneously!  Well, Tribulis Terristris actually does.  It is probably not going to dramatically raise any of these three, but it is well-known for increasing testosterone (by increasing leutenizing hormone) and an animal study showed it increasing both nitric oxide and libido. [3]  NOTE:  You can read more about Tribulis Terristris in my links on Aphrodisiacs (Male Libido Supplements) and the How to Increase Testosterone Naturally Guide.

Another herb that has studies increasing all three of these is Korean Ginseng. Ginseng is best-known for it’s nitric oxide boosting powers, which I cover in my Erectile Supplement Guide, but it also has been shown to boost libido and testosterone (in men with low sperm counts). [4]  Again, Ginseng is not going to send any of these through the roof, but it is rather remarkable that one herb will likely help with all three. (NOTE:  You can read more about it in this link on Ginseng and Erectile Dysfunction:  )

Finally, Tongkat Ali (Eurycomia Longfolia or LJ100) probably does #2 and #3.  There is one study showing an increase in muscle mass [1], which likely comes from somewhat of an increase in testosterone and a number of animal studies showing increased libido and sexual activity in animal studies. [2]

REFERENCES:

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.

Wheys, CFM - Peak Testosterone

Why let the manufacturer boil the life right out of your whey? This is exactly what happens to the great majority of whey, turning them from a superfood to a hideous industrial processed food. Yes, the typical whey that most builders use is likely excitotoxic and you can read about in my link on Whey and Excitotoxins for more information. Whey is a powerful protein that does not boost IGF-1 nearly as much as other animal proteins, due to its relatively low methionine levels, and also boosts the super-antioxidant glutathione. Anything that boosts glutathione is likely to have powerful anti-aging properties and so, hopefully, that has your attention as well.

But the key is that you must buy undenatured whey, which usually means that it has been extracted via CFM (Cross Micro Filtration) processes that are gentle on the proteins.  CFM means very low heat and thus very low excotoxicity. And, yes, undenatured whey is rich in muscle-building BCAA’s (Branched Chain Amino Acids).

NOTE:  I am currently consuming a Whegan Diet.  That’s my name for someone who eats vegan but includes Undenatured Whey for its powerful superfood properties.  (I am doing this because I had a high PSA reading and am trying to bring that down.)  If you are eating almost entirely plant-based, one serving of whey typically has about 20% of your calcium RDA.  Nice!

1.  Whey Factors.  This whey out of Canada clearly states on the bottle “Non-Denatured, Microfiltered, No Growth Hormones”.    The label also clearly states that there are no artifical preservative, color or sweeteners and no wheat or yeast or added sugars.  What is remarkable about this product is that it has a pretty good flavor and yet the ingredients clearly state that it is just whey and natural chocolate flavor inside.  (It may contain “traces of soy.”) It has a somewhat sweet taste, so I’m not quite sure how they pulled that off but kudos to them for making a decent-tasting product.

The container that I bought ahd12 ounces and had 17 servings of 15 grams of protein, i.e. 255 total grams of protein.  However, Amazon has a larger 2 lb container:  Whey Factors, Natural Double Chocolate Flavor, 2-Pound.

2.  Grass-Fed Whey Protein.  This is another product that seeks to be as natural as possible and clearly states on the label:

“Grass-Fed Whey is minimally processed and low in lactose, sodium and cholesterol.  Plus, our microfiltered, undenatured manufacturing process protects the beneficial co-factors and nutritents in whey.”

They also only use grass fed cattle that have not been given synthetic hormones such as rBST and rBGH.  The container that I got was a 12.7 ounce can containing 12 servings of 20 grams or 240 grams of total whey protein.  As far as taste, Grass-Fed Whey does a nice job with having a sweet, but not too sweet vanilla flavor.  It derives this from the following indredients:  “whey protein concentrate, natural vanilla flavors, stevia leaf extract, sunflower lecithin.”  If you’re interested in checking out the product, this one is also avaiable on Amazon: Grass-Fed Whey, Vanilla (12.7 oz)

3.  Biochem Whey.  Biochem Whey is the CFM product that I have used the most.  I have already given in coverage in my page a A Review of Undenatured Biochem Whey.

So the bottom line is that there are plenty of whey products out there that are very natural and will likely help boost your efforts at building muscle, immunity and detoxification.  I see guys on The Peak Testosterone Forum doing some strange things from time to time trying to “detox.” If you want to detox, is there any better way than boosting glutathione, the body’s natural detoxer? I doubt it and I have many ideas, including whey, in this link: Natural Ways to Increase Glutathione.

Antioxidants and Your Heart - Peak Testosterone

Researchers have recently uncovered a sobering fact that health-seeking men everywhere should be interested in:  too many antioxidants could potentially be bad for the heart and cardiovascular system.  Of course, the conventional wisdom is that antioxidants are always good, because they quench the overabundance of free radicals and oxidation that plagues and ages us as through the passing decades.

However, scientists found that some free radicals actually do important work and play critical roles in human tissues and one of those molecules is hydrogen peroxide.  It turns out that the same stuff that can clean a wound, due to its oxidative superpowers, also helps dilate your arteries. [2] The primary researchers of this subject are David Poole and Timothy Musch, K-State professors from the Cardiorespiratory Exercise Laboratory.  They have done a number of studies showing that anything that overly quenches H2O2 could potentially be bad for both heart and arterial health by limiting the ability of your arteries and vessels to relax. [1]

Of course, as men we are intimately interested in anything that might constrict the arteries in the penis, eh?  This has the potential to affect not just our sex lives, however, but our existence if it disturbs the heart muscle itself. Exercise performance and brain function could be disturbed somewhat as well.  One study on rats looked used just two antioxidants, including Vitamin C, and found that muscle tissue was actually affected by the decrease in hydrogen peroxide and ensuing vasocontriction. [3][4]

NOTE:  I discuss this study and several others in my link on The Dangers of Antioxidant Supplements that show that these supplements, at best, are poorly understood and may even cause more harm than good.

Clearly, the studies show that dietary antioxidants are a good thing and will help your cardiovascular system and long term health in many ways.  Some researchers have rightly pointed out that, when we get our antioxidants from whole plant foods, that we ingest many antioxidants in reasonable levels that can protect various cell lines and tissues in varied and multi-faceted way. [6]

And the proof comes from the fact that both a Low Fat Diet, which is generally high in plant foods and, therefore antioxidants, lowers blood pressure and increases blood flow.  There is no vasoconstrition going on with these diets – quite the opposite!  So, yes, you may want to think twice about megadosing on antioxidant supplements, but this does not seem to apply to the healthy diets known to epidemiologists and researchers.

There are dozens of studies showing the benefits of antioxidants from dietary sources and here are just a few:

1. Protection Against a High Fat Meal.  One study showed that eating a higher antioxidant meal helped protect participants from the nasty effects of a high fat meal. [5]

2.  Protection Against Dementia.  Low betacarotene levels (from food) were associated with increased risk for dementia in seniors. [7]

3. Bronchial Reactivity.  Vitamin C in the diet was linked to “bronchial reactivity” in children, leaving them vulnerable to various upper respiratory conditions. [8]

4. Coronary Heart Disease.  A study in Lancet of seniors  showed that levels of Vitamins C and E and betacarotene in the diet were correlated with heart disease. [9] The reasons for this are probably due to multiple pathways, but the primary cause is that dietary antioxidants can actually prevent or slow down the oxidation of LDL cholesterol, which play a major role in the buildup of arterial plaque and hardening of the arteries. [10] One big study on women found that Vitamin E intake from diet was particularly strongly associated with lower rates of cardiovascular disease. [11]

Again, the list of studies could go on and on, but a meta-analysis summarized it best:

“At this time, the scientific evidence supports recommending consumption of a diet high in food sources of antioxidants and other cardioprotective nutrients, such as fruits, vegetables, whole grains, and nuts, instead of antioxidant supplements to reduce risk of CVD.” [12]

Now none of these proves that there was no vasoconstriction going on in some cases.  However, clearly vasoconstriction does not seem to be any kind of significantl factor based on literally dozens of different studies such as these.  Why would asthma, heart disease and dementia risks – all dependent on and associated with blood flow in many ways – do so well with dietary antioxidants if dietary antioxidants are a health issue and restrict blood flow?  It just does not make sense.

And, again, why is increased fruit, vegetable and whole grain consumption associated with decreased blood pressure in patients with hypertension if antioxidants are quenching hydrogen peroxide.  Read about the DASH Diet, which is currently one of the common recommendations by the medical profession for high blood pressure:  it’s core is a plant-based diet loaded with antioxidants.

The bottom line is always:  eat a whole foods, low glycemic, primarily plant-based diet rich in antioxidants and anti-inflammatories for maximum health and sexual function. Study after study has show that this is the way to go.

NOTE: You may be interested to know that some antioxidants have been shown to boost testosterone (in large doses). See my link on Antioxidants and Your Testosterone for more information.

1)   hhttps://scienceblog.com/29428/ antioxidants-arent-always-good-for-you-and-can-impair-muscle-function-study-shows/

2) J Am Coll Cardiol,Epub 2007 Sep 10, 2007 Sep 25, 50(13):1272-8, “Important role of endogenous hydrogen peroxide in pacing-induced metabolic coronary vasodilation in dogs in vivo”

3) Experimental Physiology, Sep 2009, 94(9):961-971, The effects of antioxidants on microvascular oxygenation and blood flow in skeletal muscle of young rats”

4) https://onlinelibrary.wiley.com/doi/10.1113/expphysiol.2009.048223/full

5) Am J Clin Nutr, Jan 2003, 771(1):139-143, “Effect of dietary antioxidants on postprandial endothelial dysfunction induced by a high-fat meal in healthy subjects”

6) QJM, 1999, 92(9):527-530, “Interaction of dietary antioxidants in vivo: how fruit and vegetables prevent disease?”

7) Am J Epidemiol 1996; 144:275 80, “Dietary Antioxidants and Cognitive Function in a Population-based Sample of Older Persons The Rotterdam Study”

8) Thorax, 1997;52:166-170, , “Bronchial reactivity and dietary antioxidants”

9) Lancet, 23 Oct 1993, 342(8878):1007 1011, “Dietaryantioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study”

10) Arteriosclerosis, Thrombosis, and Vascular Biology, 1998; 18:1506-1513, “Dietary Antio11) N Engl J Med, 1996, 334:1156-1162, “Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in Postmenopausal Women”

11) N Engl J Med, 1996, 334:1156 1162, “Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women”

12) Circulation, 2004; 110:637-641, “Antioxidant Vitamin Supplements and Cardiovascular Disease”

Dangers Of Lower Carb Diets - Peak Testosterone

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:

Cardio: Do You Need It (for Erectile Strength and Arterial Health)

First of all, let me say that I hate cardio and I do not jog or bike. The way that I actually get a cardio-type workout is by walking and a kind of circuit type training when I work out. That said, I recently had a forum poster make the following comment and I see this quite often in the health press:

“As for my lifestyle,I should tell you that I know what you mean. There is no way I overtrain myself, because I use a HIT technique I “invented” I train once a week, one week upper body next week lower body. I set to failure for each muscle for example , squats for legs, military presses for shoulders etc etc It take me 45 minutes at the most each workout. No “cardio” at all, total waist of time, proved by me.” [1]

So is this gentleman correct?  Can one just exercise once per week as long it includes HIIT (interval training) and some weight lifting?

Now I am not trying to be disrespectful, but there are MANY reasons that guys should should not only include cardio but also WANT to do it.  Remember:  I hate traditional cardio and yet I am saying this!  So before you throw out cardio, consider these great reasons to hit the pavement or visit the gym:

1.  Baseline Nitric Oxide.  The experts with Berkeley Nitric Oxide Test Strips have pointed out – and they work with a lot of highly trained individuals – that athletes tend to have elevated baseline nitric oxide levels.  Now this is every guy’s fantasy!  Who doesn’t want nice, beefy nitric oxide levels day and night? (Just don’t overtrain or no amount of nitric oxide will do you any good.

1)   https://peaktestosterone.com/forum/index.php?topic=5425.0

CAUTION: I use the word “cardio” above, but it is actually moderate exercise that confers the most benefit with exercise.  Moderate exercise is defined based on VO2Max and/or heart rate and is bascially the kind of intensity you would get from brisk walking on the low end to jogging on the high end.  So, if you don’t like words like “cardio” or “aerobics,” just substitue the term “moderate exercise” instead and you’ll be in good company.  Also, I want to be clear that there are HUGE benefits from interval and weight training, which the original poster mentioned. I do these multiple times per week, but that is a subject for a separate page.

2.  Post-Exercise Nitric Oxide. Suppose just for a minute that you don’t exercise enough to raise your baseline nitric oxide levels like an athlete.  Well, the studies show that anyone who exercises gets a nice nitric oxide boost for 2-3 hours after exercise.  So the ideal would be for a guy to go for a brisk 20-minute walk 3 times a day after breakfast, lunch and dinner.  He would then have improved nitric oxide levels almost the entire day.

Now contrast that with someone who exericises just once or twice per week: he has to come up with some other way to boost his NO levels.  Now, if you’re young, you probably won’t notice, since your arteries are still relatively clear. But anyone with a decent amount of atherosclerosis or aging can really use any boost in nitric oxide.

3.  Triglyceride Removal. One of your big goals as a male, who wants to occasionally do the wild thing whenever his honey is so inclined, is to have a decent erection.  Well, that ain’t happening if your arteries are full of plaque and one of the primary reason for plaque build up is elevated triglyceride levels.  After you eat a meal with carbohydrates, your triglycerides will surge.  However, you can drop these levels by around 25% or even a little more simply by exercising.  Again, a little walk or exercise of some sort is a GREAT idea for us men.

5.  Weight Management. Do you have to exercise to keep the weight off?  Of course not.  It’s mostly about what you’re shoving down your gullet of course.  But consider this:  the average adult that is putting on the pounds usually will again, at most, ten pounds of fat in a year.  That is, if you do the math, around 35,000 extra calories per year.

Now divide those 35,000 calories by 365 days in a year and what doyou get?  Only 100 calories!  Thus, those who exericse are naturally burning the extra calories that we so easily consume in modern societies since food is so abundant and plentiful generally.  Exercising once per week is going to require you to have steely discipline when it comes to food consumption, something most of us do not have with a busy, stressful lifestyle.

6.  Sitting = Smoking. If you’re not sitting, what are you doing?  Smoking!  “Wait, I don’t smoke Lee!”  Yes,  you do if you are sitting.  Studies show that sitting is just as hard on the body as smoking, something I discuss in my link on Sitting: A Bad Way to Die. Some of the issue has to do with the fact that lipase, a digestive enzyme, is ground zero for lipid metabolism and transport.  Your lipase pools and does not circulate unless you are moving.

SUMMARY: Again, I mean no disrespect to the above poster.  He may do fine exercising once per week if he is very active doing yardwork and things around the house with family and friends.  If he moves a lot, then you have a lot of natural protection built in.  But, even so, there are huge benefits to “cardio,” or better termed “moderate exercise.”  For additional reasons, see my page on Sexual Function and Exercise.

REFERENCES:

Any Dangers of Vitamin C - Peak Testosterone

I’m a big fan of Vitamin C and feel much better when taking it.  In fact, it is really the only vitamin or mineral that I megadose simply because I feel the RDA / AI is much too low.  I also am a cautious follower of the Pauling Theory, simply because Vitamin C does some spectacular things at a megadose level ( >= 1 gram/day).  It’s hard to argue with a cheap supplement that can boost nitric oxide, improve weight loss, control cortisol, lower blood pressure, decrease inflammation, protect the brain – the list goes on and on.  You can check out my links on 10+ Great Reasons to Take Vitamin C and Vitamin C and Erectile Dysfunction for more information.

CAUTION:  In my link on Garlic and Erectile Dysfunction, I discuss how Vitamin C and garlic coupled together can dramatically increase nitric oxide and lower blood pressure. However, one should always consult with your doctor first if you have any medical condition or are on any medications. For example, lowering your blood pressure too much can have serious consequences.

In spite of all the praise I have for Vitamin C, a few cautions are in order.  In my opinion, Vitamin C’s track record is excellent, but a few potential “dangers” have been uncovered as well and I cover those below:

1. Blood Flow Reduction. One animal study showed that in some cases Vitamin C could possibly contribute to a loss of blood flow.  This study basically demonstrated that Vitamin C could increase a key oxidant, peroxide, that is responsible for supplying blood flow to the muscles and expanding arteries. [15] In my link on Antioxidants and the Heart I discuss how free radicals, supposedly the villains, actually play crucial roles in our health.  For example, nitric oxide is a free radical and dilates our arteries.  Researchers are concerned that taking too many antioxidants, such as Vitamin C, could quench the body’s requirement for these free radicals.

Now the rebuttal to this is that this study actually combined two antioxidants and thus may not really be a realistic scenario.  In fact, as mentioned above, researchers have found that combining garlic and Vitamin C increases nitric oxide by three times!  We have had guy on The Peak Testosterone Forum use this to cure their erectile dysfunction – that’s how powerful it for some men.  Nevertheless, it does beg the question as to whether we fully understand the complete impact of megadosing Vitamin C.

2. Loss of Exercise Benefits. Another disturbing study showed that 1000 mg daily of Vitamin C coupled with 235 mg daily of Vitamin E lowered key benefits of exercise.  The researchers summarized by saying that “daily vitamin C and E supplementation attenuated increases in markers of mitochondrial biogenesis following endurance training.” [18] Of course, some would argue that Vitamin C alone may not do the same and so it is too bad that the study did not also look at each supplement separately.  Again, though, this shows that one can have too much of a good thing.

3. Increase Arterial Plaque?.  And then came the real black eye: one study showed increased arterial thickness from Vitamin C.  This study reported that those who took Vitamin C had 2.5 times the thickening of the arteries compared with those who took none. [3]  This study has been criticized for being relatively small and one can’t help but ask the question, “If Vitamin C causes such accelerated hardening of the arteries, why aren’t its proponents dropping dead like flies?”  Personally, I doubt that Vitamin C causes arterial thickness as this was a small and controversial study, and there are many studies showing that Vitamin C improves arterial health.

1) Journal of Internal Medicine, 2000; 248 (5), 377-386

2) American Journal of Clinical Nutrition, Dec 2004, 80(6):1508-1520, December 2004 Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts Paul Knekt, et al

3)  Reported on March 2, 2000, by Dr. James Dwyer at an American Heart Association meeting in San Diego

7) The Lancet, 2002, 360(9347):1781-1782

8) Gut, 2007; 56:1678-1684, Published Online First: 4 September 2007, “Fat transforms ascorbic acid from inhibiting to promoting acid-catalysed N-nitrosation”

9) J Am Coll Nutr, 2005 Jun, 24(3):158-65

14) https://esciencenews.com/articles/2009/09/09/ study.reveals.new.role.vitamin.c.skin.protection

15) Experimental Physiology, Published Online: 21 Jul 2009, 94(9):961-971, “The effects of antioxidants on microvascular oxygenation and blood flow in skeletal muscle of young rats”

16) Am J Clin Nutr, Nov 2004, 80(5):1194-1200, “Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes?”

17) JAMA, 2008 Nov 12, 300(18):2123-33, “Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial.

18) J of Physiology, Published online before print Feb 3 2014, “Vitamin C and E supplementation hampers cellular adaptation to endurance training in humans: a double-blind randomized controlled trial”

4. Increasing Nitrosamines. One can’t help but wonder why Vitamin C does not fight cancer more effectively.  After all, it is one of our body’s most important antioxidants and it is used extensively throughout the immune system.  It only stands to reason that it should help with cancer outcomes. The reason is very likely that Vitamin C very likely has a dark side:  the journal Gut simulated conditions in the stomach and found that Vitamin C, when fat levels are low, actually inhibits the carcinogenic nitrosamine production but promotes nitrosamines when fat is present. [8] I’m not talking about fat as in overweight:  I’m talking about fat in your meal.  If you eat any fat in your meal – which almost every one in a modern society does – megadosing with Vitamin C will lead to a flood of carcinogenic nitrosamines and this may explain some of Vitamin C’s questionable cancer results.

By the way, did you know that ascorbic acid is sometimes added to meats to lower nitrosamine production.  The point is that there is data that shows the opposite of the above.  As always, it’s too bad there isn’t more study work.

5.  Raising Iron Absorption. Dr. Russell Blaylock and other recommend taking Vitamin C (in a “salt” or “Ester-C” form) in order to make sure that you do not increase iron absorption.  Unfortunately, most men in Western societies consume too much iron and this associated with cardiovascular and neurological disease.  Again, an easy solution is to take it on an empty stomach but not all men know about this.

So everything sounds like a “green light”, right?  Well, unfortunately, there have been a number of studies that have found that Vitamin C has no significant heart benefit.  One of the biggest was The Physicians Health Study II of 14,000 male physicians run by a Harvard professor.  In this study physicians were put on 500 mg Vitamin C and 400 IU Vitamin E daily.  The researchers found that neither vitamin decreased cardiovascular events whatsoever. [17] Then came a study on postmenopausal women with diabetes that showed an increased cardiovascular risk with Vitamin C usage. [16] Critics point that 500 mg of Vitamin C is a fairly low dosage according to Pauling Theory.

Another researcher, Rory Collins, looked at not just heart disease during a huge five year study involving 20,000 people who took daily 600mg of vitamin E, 250mg of vitamin C and 20mg of beta-carotene.  This study [7] in the prestigious journal Lancet found that there was no improvement in heart disease or cancer rates.  Once again, Vitamin C looked like a questionable use of one’s money.  Again, some have criticized this study for only supplementing with 250 mg of Vitamin, but keep in mind that is roughly the Vitamin C found in five oranges.

REFERENCES:

DHEA (and Pregnenolone) Got Rid of My Anxiety - Peak Testosterone

Two hormones that simply don’t seem to get enough airtime are DHEA and pregnenolone. Like testosterone, both can really help the brain, improving mental fog, cognition, alertness, mood, etc. They can also greatly help with sleep and anxiety.  Best of all, they can even restore morning erections and improve libido! Basically, if you are low in one of these hormones, supplementation can just plain help you feel better.

The tragedy in my opinion is that, since pharmaceutical companies cannot make money off of these two, they have taken a backseat and are ignored by virtually all physicians.  Yet I can easily make a case that they are just as important as testosterone.  To illustrate this let me relate a personal story (from early 2016):

MY SITUATION: I had been on TRT (testosterone therapy) using cypionate injections for a little over two years. I definitely felt much much better than I did pre-TRT.  However, I still didn’t quite feel right.  For example, TRT got rid of all of my pre-TRT depression and about half of my anxiety.  But there was still some anxiousness left.  Yes, I had worked hard on lifestyle factors, including diet and exercise, which is why I decided to pull labs for some of the other hormones (Jan of 2016). Here are the results:

Being low in any one of these three hormones could cause significant symptoms – similar to low testosterone -such as fatigue, mental fog, erectile dysfunction and lowered libido. In retrospect, I think the lifestyle changes and improved testosterone were what was allowing me to do so well in spite of low hormone output.

Fortunately, at about this same time I had signed up with Dr. Justin Saya of Defy Medical, who is one of the foremost HRT and TRT experts that I know of.  He immediately put me on a compounded preparation of 25 mg of pregnenolone and 25 mg of DHEA daily.

NOTE: While one can argue that compounded DHEA and pregnenolone are not absolutely necessary, they a) do provide pharmaceutical grade dosing and b) are without binders and fillers.

Dr. Saya recommended that I take this before bed, because the pregnenolone can have a mildly relaxing effect and  help many men with their sleep.  I noticed this benefit immediately.  I usually wake up feeling a bit “on edge” and “hyper.”  I had never really thought about it, but my sleep was obviously not providing the deep rest that I needed.  The pregenenalone and DHEA combination definitely gave me improved sleep.

The other thing that I noticed almost immediately was that my anxiety was gone.  For the first time in my life, I had no anxiety!  I remember thinking, “So this is what a normal person feels like.”  Testosterone had vanquished my depression, but it took DHEA and pregnenolone to get rid of my anxiety. I will add that I believe most of this anxiety-lowering effect is from the DHEA, because I had taken it briefly in the past and noted a similar effect.  And I believe that it is mostly the pregnenolone that helped with my sleep.

Pull your estradiol with the best test available..

Pull your estradiol with the best test available. (Always discuss everything with your doctor first.)

A lot of men (and physicians) do not realize that low and high estradiol can cause just as many of the classic symptoms that men deal with, such as erectile dysfunction, low libido, anxiety, depression, etc.

One big issue with men on HRT (Testosterone Therapy) is dialing in their estradiol to the correct level.  Nothing is quite as frustrating as finally convincing your physician to put you on testosterone, feeling better after he does and then finding out a few weeks later that all the benefits have gone.  You no longer feel as good; your libido has tanked; and your erectile strength is right back where it started.

More often than not, the reason for this has to do with estradiol.  When a man goes on HRT, his estradiol rises and, in some men, it can go too high to the point where the extra estradiol cancels out the benefit of his newfound testosterone.  And, from what I’ve seen, this effect usually takes a couple of weeks to kick in.

After that, yet another estradiol problem can arise.  Many doctors and HRT clinics will put a man with high estradiol on an aromatase inhibitor – usually Arimidex – and some guys are quite sensitive to it.  Their estradiol crashes to an abnormally low level and they feel miserable.  Often their joints will ache with an accompanying loss of libido and erections.

So getting estradiol tuned right is extremely important for a man on HRT and most clinics shoot for 20-35 pg/ml, although a few will go a little above or below that.  (This is controversial, so discuss with your doctor.)  Of course, estradiol is very important for men not on testosterone therapy, but, from what I’ve seen, very few doctors look at it.  You’re lucky if you can get a blood draw for testosterone out of them much less one for estradiol!  (In the last year there have been two studies on the important of estradiol in HRT, so, hopefully, it will hit the mainstream doctors sometime soon.)

CAUTION: You have to be extremely careful in lowering your estradiol. If you go too low for too long, you can end up with osteoporosis. In addition, setting an estradiol target is more difficult now, because the big labs are no longer using the old assays but rather a more accurate technology called LC-MS/MS. However, this test lowered the range and so more research needs to be done to correlate the old versus the new values.

So how do you find out your estradiol level?  You just get a blood draw similar to testosterone, right?  Wrong!  Estradiol is much more problematic.  A man’s estradiol levels are, of course, much lower than a pre-menopausal woman and so it’s actually trickier to read our estradiol levels.  There are potentially 4 kinds of estrogen/estradiol-related tests.  Here in the U.S., Labcorp is the biggest lab and so we’ll use them as an example:

NOTE: To make matters more confusing, Quest has an “ultrasensitive test” that is actually the LCMS technology. So, again, you should probably get the test number from your doctor and research exactly what kind of test it is. I wouldn’t go by the name. Get the actual number and look it up on the lab’s site for verification. Remebmber that most of these tests you can get for yourself: Inexpensive Self-Testing Testosterone and Estradiol Labs.

First of all, we will throw out #4 as this is just the wrong test, because it includes the other estrogens (estrone, estriol) in addition to estradiol.  However, I mentioned it, because I have seen (on the Peak Testosterone Forum) physicians who have mistakenly ordered this test.

That leaves us with three legitimate candidates for male estradiol testing. Here are the current ranges for an adult male for these LabCorp tests:

Now let me go to some comparisons of Labcorp’s Sensitive Test versus their regular test.  And the reason I am doing this is to emphasize that, at least in my opinion, the regular estradiol test is not very safe or accurate in many situation and illustrate that with some practical lab results.  As an example, one of our forum posters has actually had both of these estradiol tests pulled on the same day and same time and here are his results:

NEWS FLASH: These results are no longer valid as this test has now changed to LCMS.The first thing to notice is that he was easily in the range of both tests. Therefore, both tests should have provided reasonably accurate results. Yet there is a 73% difference! The standard test is almost double the value of sensitive test.

And here is what is so dangerous:  estradiol too high or too low has been shown in several studies to be dangerous to a man’s health, due to (primarily) increased cardiovascular risks.  Therefore, if you choose the wrong test, you could potentially be putting yourself at risk for heart disease or stroke.  Life Extension Foundation sites studies that show:

“The men in the balanced quintile with the fewest deaths had serum estradiol levels between 21.80 and 30.11 pg/mL. This is virtually the ideal range that Life Extension has long recommended male members strive for. The men in the highest quintile who suffered 133% increased death rates had serum estradiol levels of 37.40 pg/mL or above. The lowest estradiol group that suffered a 317% increased death rate had serum estradiol levels under 12.90 pg/mL.” [1]

Even worse in many cases, is the fact that low estradiol can easily slowly lead to osteopenia and eventually osteoporosis, a potentially crippling and painful condition.  Look at the man’s standard reading above of 33.  His doc could potentially decide to put him on some Arimidex (if he was on HRT) to get him closer to 20 pg/ml.  Yet, using the sensitive test, he would probably have estradiol of 12 or 13!

Making matters worse is the fact that many doctors are trying to save money by using the less expensive standard test and think to themselves, “Well, my patient is probably in range, so this is fine.”

Here is an example from another forum poster.  In this case, his doctor used the lab’s sensitive test and he the same morning pulled the regular estradiol test.  His numbers, which includes total testosterone, were:

Total Testosterone=1080; Estradiol regular = 34.8  pg/ml

Sensitive: TT=1252; Estradiol sensitive = 25 pg/ml

Again, notice the identical pattern:  he is in range more than likely on both tests but the regular estradiol test reads significantly higher (40%) than the sensitive.  Since that time we have had several other posters end up with similar results.

The important things:

Stay in range for any lab test you do.

The gold standard should probably be the LCMS technology, but you will probably find some knowledgeable doctors still using the sensitive test.  Deciding on the best test is something, in this case, that you have to do with your physician, but make sure that he/she is knowledgeable and not just prescribing the cheaper test to save money.

1) https://www.lifeextension.com/

Beer and Testosterone - Peak Testosterone

REFERENCES:

1) Journal of Endocrinology, 2006, 191:399-405, “The hop phytoestrogen, 8-prenylnaringenin, reverses the ovariectomy-induced rise in skin temperature in an animal model of menopausal hot flushes”

2) J Clin Endocrinol Metab, 2000 Dec, 85(12):4912-5, “The endocrine activities of 8-prenylnaringenin and related hop (Humulus lupulus L.) flavonoids”

3) https://www.newswise.com/articles/hops-compound-may-prevent-prostate-cancer

4) Biochem J, 1983 January 15, 210(1): 29 36, “Inhibition of testosterone biosynthesis by ethanol. Relation to hepatic and testicular acetaldehyde, ketone bodies and cytosolic redox state in rats”

5) Med Sci Sports Exerc, 2013 Sep, 45(9):1825-32, “Postresistance exercise ethanol ingestion and acute testosterone bioavailability”

6) Nutrition, Sep 2013, 29(9):1122-1126, “Acute effects of beer on endothelial function and hemodynamics: A single-blind, crossover study in healthy volunteers”

NEWS FLASH: There was a recent study that showed that beer consumption post-workout (weight lifting) increased testosterone levels (free and total) by about 20 percent. [5] This should be interpreted with great care as a number of past studies have shown that alcohol consumption is hard on muscle recovery and repair. It is interesting, though, because yet another recent study found that alcohol reduces arterial stiffness, which is a problem (potentially) associated with weight lifting that I discuss in my page on Weight Lifting and Your Arteries. [6] A more natural solution in my opinion is to cardio after lifting weights to “de-stiffen” your arteries.

There’s no sign of consumption dropping:  there are a good 10 billion bottles of the stuff consumed worldwide annually and no sign of that diminishing any time soon.

Here’s five reasons to avoid or limit your intake of your next brewski:

1. 8-PN. 8-Prenylnaringenin (8-PN) in hops is such a potent phytoestrogen that it has been reproted to reduce menopausal hot flashes! [1] This study points out that some women who pick hops by hand have menstrual disturbances (from the estrogens) and used it to reduce the skin temperative in rats, i.e. anti-hot-flash.  Furthermore, other researchers expressed concern about the unrestricted concern about the unrestricted use of hops in herbal preparations for women because of 8-PN’s “very high estrogen activity”. [2]  (I knew there was a reason I liked tequila.)

2. Xanthohumol. This compound in beer has researchers excited:  it has potent anticancer properties.  Unfortunatly, it also blocks testosterone. [3]

3. Estrogen. Ethanol in beer or any other alcoholic beverage will slow down the P45 enzyme system in the liver allowing estrogen to stay in your system much longer.  And the more estrogen, in general, the less testosterone.  See my link on Alcohol Consumption for more details.

4. Testes. Alcohol also lower testosterone levels in the testes yourself.  [4]  In other words, it goes directly after the engine of your testosterone production.  If that’s not hitting below the belt, I don’t know what is.

5. Weight Gain. They don’t call it a “beer gut” for no reason.  Those extra few hundred calories every day add up and, next thing you know, you’ve got a nice big spare tire around your middle that is associated with reduced testosterone levels.

I know beer consumption is religious for a lot of guys, but “eyes wide open” I always say…

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”

Testosterone and Your Adrenals - Peak Testosterone

Testosterone is one of those ubiquitous molecules that affects just about everything in us men. One of the connections that few men realize is that testosterone even affects your adrenals, the “stress glands” of the body. The adrenals are the endocrine glands that sit next to the kidneys and produce such critical stress hormones as cortisol, ephinephrine (adrenaline) and norepinephrine (noradrenaline). In addition, the adrenals also make an important stress modulator, DHEA, that acts in a complimentary fashion to cortisol in particular. The adrenals even make a little testosterone, although you get the lion s share of your T from the testes of course.

So how does testosterone affect the adrenals?  Let’s look at a few of the comments from men who have gone on HRT (Hormone Replacement Therapy) in the Peak Testosterone Forum and see how their enthusiasm might relate to their adrenals and stress and cortisol levels:

Notice this man’s comments before HRT:

“I suffered from extreme fatigue, muscle pains and weakness. (which are not ‘common’ side effects of low T). The fatigue is remarkably better (so much better I no longer need prescription stimulants to make it through the day!…I suffered from extreme fatigue, muscle pains and weakness.” [1]

If you read through his post, he suffered from all the classic symptoms of what some call “adrenal fatigue”.  Adrenal fatigue is basically the controversial theory that a number of prominent many alternative practitioners subscribe to and posits that the adrenals can become “exhausted” from chronic overstimulation, leading to decreased output of key hormones such as cortisol.  The standard symptoms are very similar to what this man described:  fatigue, aches, mental fog, weakness.

Now notice his description as to how he felt after testosterone therapy in the same post:

REFERENCES:

1)  https://peaktestosterone.com/forum/index.php?topic=433.0

2)  https://peaktestosterone.com/forum/index.php?topic=513.120

3) Neuropsychopharmacology, 2005 October, 30(10):1906 1912, “Testosterone Suppression of CRH-stimulated Cortisol in Men”

4) Medicine and Science in Sports and Exercise, 1998, 30(7):1140-1145, “Autonomic imbalance hypothesis and overtraining syndrome”

5) Sports Medicine (Auckland, N.Z.), 1995, 20(4):251-276, “Blood hormones as markers of training stress and overtraining”

“After 4 weeks my sex drive is “through the roof”…The fatigue is remarkably better…I no longer need prescription stimulants…The weakness I felt is totally gone! I don’t ‘feel sick’ like I did for the past 5 years!”

Many men who go from low testosterone to higher testosterone on HRT (assuming their estradiol levels are managed properly as well) experience this same remarkable transformation from Mr. Seeming Adrenal Fatigue to, well, the complete opposite.

NOTE: Please see my link on Testosterone and Cortisol for additional information.

I could go on with posts like this, but I’m sure you get the idea.  HRT very often makes a huge difference in hypogonadal men and the reasons are many:  it lowers insulin; it lowers inflammation; it boosts neurotransmitters and so on.  But one question remains:  could it also be “boosting” the adrenals?

The answer is that the research shows that there is actually a testosterone-to-adrenal link and one that could possibly help the adrenals to “heal” and “recover”.  One study looked at young men and basically suppressed their testosterone pharmaceutically and then compared it when testosterone replacement was introduced.  So, basically, the researchers were comparing a hypogonadal state versus a high testosterone state.

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Now many people would probably expect the higher testosterone state to have higher cortisol levels.  The guys should be more “wired” and “restless”, right?  Wrong!  The hypogonadal state had significantly higher cortisol levels, indicating that the adrenals had to work harder without sufficient testosterone.  The authors summarized by stating “CRH-stimulated cortisol was significantly decreased during the testosterone-replaced condition compared with the induced hypogonadal (relatively testosterone deficient) condition created by leuprolide with placebo replacement .” [3]  (It is not just this study that shows this link between T and the adrenals:  many animal studies have as well.)

How does testosterone do this, i.e. inhibit the overreaction to stress?  It does it, actually, by acting on the adrenals themselves, i.e. acting at “ground zero” of cortisol production.  Cortisol is actually produced via trigger hormones:  CRH is released from the hypothalamus, which in turn triggers ACTH from the pituitary that then tells the adrenals to pump out cortisol.  Testosterone works by, according to the above study, inhibiting sensitivity of the adrenals to ACTH. This has many advantages, because under stress conditions, more ACTH may be produced but the adrenals are significantly protected.

There are some who are claiming that one should first fix any adrenal exhaustion.  However, I feel this is likely misguided IF the man is low testosterone in the first place.  The above study shows that a man likely needs ample testosterone in order to dampen his stress response.  Again, the authors pointed this out by saying “in contrast, our data demonstrate that the effect of testosterone in young men is to inhibit rather than augment the cortisol response to CRH stimulation.” [3]

NOTE:  For related information, see my Stress and Cortisol Links.

Many men with low or lowish testosterone begin experiencing anxiety and the same can be said with men who believe they have adrenal fatigue.  I cannot help but wonder how often the latter do not realize that their testosterone levels have fallen, leaving them vulnerable to overreacting to the stressors that life, especially modern life, seems to naturally bring.

So the bottom line is get tested and start monitoring if at all possible. Find and work with a good physician who will test your cortisol and testosterone levels.

CAUTION:  One last note: many men are competitive and high octane if you will.  It is very difficult for them to exercise in a relaxed and steady manner.  (I’m one of them.)  Are you attracted to HIIT, interval training, bodybuilding, triathlons, marathons, etc.?  If so, then you need to ask yourself if you are possibly overtraining.  It is very easy to do, especially if you are natural and have the right personality. Overtraining can easily lead to disturbed sleep, lowered immunity and – you guessed it – adrenal/cortisol issues as well.

Researchers have noted that a typical pattern is increased ACTH (to the stress of overtraining) which leads to decreased sensitivity to the same and so cortisol levels, initially increased, start to fall.  Eventually, ACTH levels actually start to decrease as well, exemplifying a kind of “fatigue” or “exhaustion” response. [4]  Remember:  our bodies were built to walk.  High octane men do not like to walk and often speak of it as a “waste of time” and in a derogatory manner.  But, like it or not, we weren’t meant to be Formula One or Indy every day.

So, based on what I’ve seen in Peak Testosterone Forum, probably 5-10% of the men reading this will have lowish testosterone and “adrenal fatigue-like” symptoms simply because there are one stage or another of overtraining.  See my link on How to Overcome Overtraining for some more information.

Young Men: Reasons for Your Erectile Dysfunction

One of the things I have found baffling on the Peak Testosterone Forum is how common erectile dysfunction is in young men.  We have just one young guy after another on the forum struggling in the bedroom.  This is verified by recent stats that show that a very high percentage of younger males are struggling with E.D. In fact, one recent study showed that 1 out of 4 men under age 40 at an outpatient clinic in Europe had erectile dysfunction!. This is an incredible statistic as men that age are usually “unstoppable” in the bedroom and able to orgasm many times per day, etc. However, I have no doubt that the rates are similar here in the U.S. based on what I am seeing. Also, this same study showed that half of the above men under 40 had not just E.D. but severe E.D.

Clearly, this is a big issue and I have also been surprised to find that the reasons for erectile dysfunction are not necessarily as different from us older guys as you might think. Below I give you the Three Research-Backed Reasons for Erectile Dysfunction in Young Men:

1. Testosterone. I don’t have any statistics, but I find quite often on the Peak Testosterone Forum that the young guys tend to have less arterial issues than the middle-aged or senior crowd. This just stands to reason due to the fact that a young man has had less years to damage his cardiovascular system through the typical Western Diet and lifestyle. (More on that below.)  Although arteries are less often an issue, young guys are certainly not immune to the effects of low testosterone.

The good news is that it is at least straightforward to get tested for low T:  it is a simple and relatively inexpensive test.  You just get a blood draw first thing in the morning and you should have your results the next day. If only I had done this test in my 20’s!  I had many standard low testosterone issues:  anxiety, depression and lack of morning erections just to name a few.  These caused me many problems over the decades.

1)  https://www.wiley.com/WileyCDA/PressRelease/pressReleaseId-108896.html

2) Heal Your Heart, Rutgers Univ Press, 1998, by K. Lance Gould, p. 43.

3) JAMA, May 17 1971, 216(7), “Coronary Artery Disease in Combat Casualties in Vietnam”

4) Circulation, 1995, 91:1706-1713, “Occult and Frequent Transmission of Atherosclerotic Coronary Disease With Cardiac Transplantation”

5) Heal Your Heart, Rutgers Univ Press, 1998, by K. Lance Gould, p. 44.

2.  Atherosclerosis. Because of what I wrote above, you might think that young men rarely have artery-related erectile dysfunction like the middle-aged and senior men have.  Of course, it is true that young men have less. That said, there is actually substantial evidence that MANY young men are suffering a loss of erectile strength due to arerial issues.  I know that the traditional line of thinking is that this is close to impossible, because a young guy in his 20’s or 30’s could not damage his arteries that quickly.  However, let me explain the evidence that that is simply not the case.

While it is true that we know that arterial plaque tends to build up slowly, what many men (and doctors) do not realize is that a Western lifestyle is almost designed to be hard on your cardiovascular system.  And, after reading Heal Your Heart by K. Lance Gould I realized that young men can easily build sufficient atherosclerosis to reach the point where it affects nitric oxide output for reasons I will discuss below.

Dr. Gould provides abundant evidence that a high percentage of men in their 20’s have significant atherosclerosis.  For example, he cites one study of 21 to 26 year olds where they examined the bodies of men that had died of noncardiac deaths.  15 to 21 percent had the diameter of a major artery reduced by 25%!  Now, granted, this is probably not representative of the general population, but keep in mind that these were noncardiac patients. [2]

So the key is that penile arteries can clog and lose proper blood flow before the bigger arteries. And arterial bloackages do not respect age or seniority. Therefore, some of these younger men were probably struggling in the bedroom and could not figure out why.  And remember:  it’s not just a blockage issue.  As the lining of your arteries (the endothelium) gets covered up in plaque, it loses its ability to pump out nitric oxide.  And, as nitric oxide lowers, erectile strength and hardness factor falter.

Another interesting study cited by Dr. Gould was one of Vietnam War veterans back in 1971.  Of course, these are generally young, very healthy males.  This particular study found that 45% of them had atherosclerosis and their average age was 22! [3] Other studies on trauma victims and Korean War veterans had similar rates for guys in the 20’s. [4] Gould lists a total of five more that he lists from prominent journals such as JAMA and Circulation that show that young guys in the 20’s and 30’s have a prevalence rate of between 41% and 77% for artherosclerosis.  Ouch!  No wonder so many die of heart attackes:  about half of them have a ton of plaque in their 20’s!

Are you a young guy that has lost some of his erectile strength?  Are your morning erections weaker?  Have you lost the ability to get spontaneous erections?  Well, based on the above, atherosclerosis is something to look at as a possibility.  And I mention it, because it not something that one’s doctor will think of.  He will probably just hand you some Viagra or Cialis and call it a day.

So how can you tell if you have atherosclerosis?  This can be done through what is called a Calcium Score or Heart Scan without a doctor’s orders in most locales for a minimal fee.  (I had one of these last year and my cardiac arteries came back perfectly clear, due, more than likely, to the Low Fat Paleo Diet that I was consuming. You can read about it My Heart Scan Results if you’re interested.) A Heart Scan does require some radiation though.

A less invasive way is through an ultrasound IMT of the neck artery. This is now available without a doctor’s orders through Life Line Screening for a minimal fee. A good starting point to regression of plaque and improving blood flow is to lower both LDL and triglycerides. I recommend the above book by Gould and also Track Your Plaque by Dr. William Davis for a fantastic summary and discussion as to how to do that. You should also scan through my links on LDL Levels to Reduce or Arrest Arteriosclerosis and How to Increase Your Nitric Oxide Levels Naturally for additional information.

I also recommend using the new Berkeley Nitric Oxide Test Strips to get a gauge on your arterial nitric oxide levels due to food.

3. Psychogenic (Psychological). One very common problem for young men is psychogenic, or psychological erectile dysfunction. Of course, it is possible to have a combination of both physicial and psychogenice reasons as, in particular, some failure in the bedroom can really affect many men psychologically. Believe me I have seen young men depressed and/or nearly hysterical over the issue. It’s a lot of pressure and – let’s be honest – by far our biggest source of dopamine. In any event, you can read more about the subject in my page on Psychogenic Erectile Dysfunction.

REFERENCES:

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.)

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]

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

Icariin: 10 Superpowers of This Erectile Supplement.

Most supplements are like shooting stars:  they look good in the first study or two and then take a slow dive into obscurity.  Extracts of icariin, the primary phytochemical in Horny Goat Weed (Epimiedium), are exceptions to the rule:  one study after another has come out showing its beneficial properties.

Icariin extracts are also one of the three supplements that I would say gets the most “Wow” comments on the forum and in emails for improving erectile function.  Below you’ll some of the many reasons why.

I have already categorized Horny Goat Weed as a Super Sexual Herb, something I call a plant that will help you in the bedroom in multiple ways, so this should be no surprise.  However, Icariin extracts are actually a little different animal than straight Horny Goat Weed itself, because they have concentrated the Icariin in the Epimedium, creating a much more potent supplement in many ways. (I have received a few comments about Horny Goat Weed tea as well though.)

First of all, here are 10 Icariin Superpowers that make it one very interesting herbal extract:

REFERENCES:

1) Asian J Androl, 2006 Sep, 8(5):601-5, “The testosterone mimetic properties of icariin”

2) Clinica Chimica Acta, 9 October 2011, 412:21–22, “A novel case of a raised testosterone and LH in a young man”

3) British Journal of Pharmacology, Feb 2010, 159(4):939-949, “Special Issue: Themed Section: Imaging in Pharmacology: Guest Editors: AP Davenport and C Daly”

4) “Study on the estrogen-like effects of Epimedium extractive”, YU Yan,YAN Hong,HU Sen-ke,ZHANG Jing-hua(Department of Public Health,Medical5) Eur J Pharmacol, 2010 Jun 10;635(1-3):40-8, “Icariin exterts negative effects on human gastric cancer cell invasion and migration by vasodilator-stimulated phosphoprotein via Rac1 pathway”

6) Zhong Yao Cai. 2000 Sep;23(9):554-6. “Experimental studies of icariin on anticancer mechanism”.

7) horny_goat_weed_viagra.php

8) Biological and Pharmaceutical Bulletin, 2006, 29(12):2399, “Effects of Icariin on Hypothalamic-Pituitary-Adrenal Axis Action and Cytokine Levels in Stressed Sprague-Dawley Rats”

9) Pharmacology Biochemistry and Behavior, Dec 2005, 82(4):686–694, “Antidepressant-like effect of icariin and its possible mechanism in mice”

10) Brain Research, 23 February 2011, 1375:59–67, “Neuroprotective effects of icariin on corticosterone-induced apoptosis in primary cultured rat hippocampal neurons”

11) Vascular Pharmacology, July 2007, 47(1):18–24, “Icariin enhances endothelial nitric-oxide synthase expression on human endothelial cells in vitro”

12) Lab of Integrative Medicine for Lung, Inflammation and Tumor, 2009, 29(4):330-4, “Effects of icariin on inflammation model stimulated by lipopolysaccharide in vitro and in vivo”

13) Brain Research, June 2010, 1334(2):73–83, “Neuroprotective effects of icariin on memory impairment and neurochemical deficits in senescence-accelerated mouse prone 8 (SAMP8) mice”

14) Clinical and Experimental Pharmacology and Physiology, Aug 2007, 34(8):792–795, “PROTECTIVE EFFECTS OF ICARIIN AGAINST LEARNING AND MEMORY DEFICITS INDUCED BY ALUMINIUM IN RATS”

15) Neuropharmacology, 2010 Nov, 59(6):542-50, “Icariin attenuates ?-amyloid-induced neurotoxicity by inhibition of tau protein hyperphosphorylation in PC12 cells”

1. PDE5 Inhibition (w/ Many Less Side Effects).  Viagra, Cialis and Levitra are the big 3 blockbuster PDE5 Inhibitors that boost nitric oxide for men with erectile dysfunction. (Actually, these drugs only cause nitric oxide to remain in one’s system longer, one of the reasons that they are ineffective in many men.) The problem is that they have a strong crossover into other PDE enzyme systems in the body and can very significantly affect vision, hearing and the stomach. Icariin seems to have much less of a crossover effect and thus a significantly decreased side effect profile. (However, Icariin is a less powerful PDE5 Inhibitor as well.)

NOTE:  Icariin has a relatively short half life – about 4 hours I believe – so for maximum short term benefits, one should take it shortly before any anticipated love making sessions. Furthermore, it is about 1/80th as powerful of a PDE5 inhibitor, but about 1/10th at boosting cGMP (which is the real goal). [7]

2. Dose Dependent Increases in Nitric Oxide. Many studies have shown that Icariin increases cGMP, nitric oxide, etc as mentioned in #1. One nice property, at least according to in vitro studies, is that Icariin increases nitric oxide in a dose dependent manner. [11] Thus, the more you take, the more blood flow that should be gained and, blood flow after all, is what it is all about.

4. Healing Gonad and Bone Mass Tissues. The same study [1] found Icariin did actual healing on the reproductive organs and helped restore bone mass.  Many studies have verified the latter and bone loss, of course, is experienced by many men with low testosterone.  See my link Don’t Let Your Estrogen Get Too Low for more details.

5. Anti-Cancer For Many Cancers.  Preliminary research makes Icariin appear to be a potent cancer fighter in the case of some cancers at least.  Researchers on gastic cancer cells commented that “these results indicate that icariin exerts negative effects on tumor cell invasion and migration via the Rac1-dependent VASP pathway and may be a potential anti-cancer drug.” [5]  Similar results have been found in lung cells. [7]

6. TNF Alpha (Inflammation) Reduction. One study on mice showed decreased TNF alpha levels. As mentioned on other pages, TNF alpha is the “root of all evil” and may be significantly responsible for arterial plaque and various cancers. [12]

7. Cortisol Control and Antidepressant Properties. Icariin’s real magic may have to do wtih stress. A number of animal studies have shown that Icariin blunts the typical overly high cortisol rise that results from chronic stress. [8][10] Know anyone who struggles with chronic stress? In fact, it is so powerful in this regard that some experts have recommended that it be studied as a possible therapy in depression. [9]

8. Anitoxidant Protection. Many studies have shown Icariin’s strong anitoxidant abilitlites against oxidative damage.  One of the things it does is protect against ox

9. Memory Protection.  Animal studies strongly indicate that Icarrin can protect against certain kinds of memory loss. [13] That includes memory loss resulting from aluminum damage. [14] See my link on Aluminum and the Brain for just how common aluminum exposure is in modern, industrialized societies.

10. Alzheimer’s Protection.  It looks like Icarrin can protect the brain from the deadly tau proteins that are characteristic of Alzheimer’s. [15]

You’ll quickly notice that Icaarin seems to battle all of the standard middle-aged and senior male issues:  testosterone reduction, cortisol and TNF alpha increases, loss of nitric oxide/bone mass/cGMP.  In addition, it may provide protection against such brain-related orders as memory loss, Alzheimers and depression.

All of these reasons point to Icariin as a legitima All of these reasons point to Icariin as a legitimate male anti-aging supersupplement that has strong anecdotal evidence to support it as well.  Furthermore, it seems to be much better tolerated than Viagra or Cialis, making it a viable contender for erectile dysfunction relief as well. As I document in the last half of my book on the Peak Erectile Strength Diet , it can be coupled with other erectile supplements to achieve synergies as well.  And since it is extracted from a time-proven and well-used herb, it has a certain safety record associated with it.

It should be noted, though, that the new Icariin extracts are now at 10%, 20 and even beyond. These are obviously at much higher levels than one would get from merely having some Horny Goat Weed tea. Furthermore, any study of Icariin’s androgenic versus estrogenic properties will make your head hurt. Some commentary seems to say that Icariin is estrogenic and still others that it an estrogen antagonist. One study says that it dramatically boost testosterone and yet another that it lowers it. The bottom line is that it would be nice if additional research wold be done.

For those interested: Source Naturals, a supplement manufacturer that seems to have a good reputation, has a Horny Goat Weed extract with 10% Icariin: Source Naturals Horny Goat Weed Extract (Epimedium) 1000mg, 60 Tablets .

CAUTION: Don’t take any supplement without talking to your doctor first, especially if you are on medications. Also, Icariin has occasionally been associated with some of the same symptoms as the PDE5 Inhibitors so long term safety is not really known.  In addition, Consumer Lab recently tested four Horny Goat Weed products and found that one of them was contaminated with lead. (The other three did not pass either for a variety of reasons, including poor labelling and low quantity.)

However, my caution has to do primarily with the fact that the new Icariin extracts are now at 10%, 20% and even beyond.  These are obviously at much higher levels than one would get from merely having some Horny Goat Weed tea.  Essentially, modern supplement manufacturers have created an entirely new animal.nc

Reverse Diabetes & Arteriosclerosis While Losing Weight.

So can you be Low Fat and reverse diabetes? The standard propoganda from the Low Carb crowd goes something like this:

“Of course not!  A Low Fat Diet is a high carb diet and carbohydrates will always raise blood sugar and make diabetes worse.”

The logic here may seem sound to some, but, as is so often the case, the human body often operates counterinuitively.  First of all, what really affects insulin sensitivity is, surprisingly, a high fat diet.  So, generally speaking, someone eating a Low Carb Diet will have to consume very high fat levels in order to get enough calories during their maintenance phase.  If this happens, insulin resistance is often induced.  In fact, this property of Low Carb Diets is used all the time with lab animals:  researchers will put animals on a high fat diet in order to study insulin resistance and, unfortunately, humans are no different.

Now it is true that if someone cheats and eats a Low Fat Diet with a bunch of refined carbs and high glycemic foods, he is bound to get into trouble.  Cheaters never win, eh?  However, there is a Low Fat researcher who has shown something remarkable:   you can actually reverse diabetes with a Low Fat Diet!

What is the secret?  It is very simple:  you simply eat low fat and low glycemic at the same time.  This is not as hard as it sounds as many low fat foods are low glycemic, such as beans, legumes, vegetables, many fruits, etc. We’ll discuss this a bit more below but think of the significance of this for many middle-aged and senior men:  they can likely reverse their diabetes and partially reverse their arteriosclerosis at the same time.  This is a chance to actually get their life back.

And one other huge benefit of going on this type of diet:  easy weight loss! Most men will steadily (and effortlessly) lose weight on a Low Fat Diet initially.  The reason is simply:  starchy foods are generally bulky, low fat, high fiber foods that fill you up.  These kind of foods are low calorie simply because a carb is only 4 calories per gram whereas fat is 9 calories per gram.

I get men writing in and asking, “How can I get enough calories on a Low Fat Diet?”  The issue with a Low Fat Diet is actually NOT to lose weight.  My answer, by the way, is to add some supplemental protein.  In my case, I add in undenatured whey, egg whites and rice proteins to round out my diet. And, practically speaking, most clinicians would agree that anything below 7% is a reversal of diabetes. If you have more questions, please visit the Peak Testosterone Forum.

Most men who have arrived at the stage of Type II (adult onset) diabetes have gotten there slowly over time, having passed long ago throught the prediabetic stage.  During this long and unhealthy transition period, significant damage to their cardiovascular and endothelial systems has ensued, leaving them (very likely) with a substantial buildup of arterial plaque.  With one simply dietary regimen, they can very likely get their life back and reverse both conditions.

NOTE: Of course, if you are diabetic or on medications, you need to work with your doctor as an lifestyle change can modify the need for medication which alter blood sugar levels.

A great guidebook on the mechanics of doing this is Dr. Neal Barnard’s Program for Reversing Diabetes.  Dr. Bernard has done a number of classic studies on Low Fat diets in diabetics and found that:

1) Insulin sensitivity improved by 24% in 14 weeks. [1]

2) A1C was reduced from 8.0 to 6.8 in 22 weeks.  [1] A1C is a marker called “glycated hemoglobin” that essentially measures your average blood glucose over the last three months.

Now some may object that, according to the 2009 standards set up by the International Expert Committee of the American Diabetes Association, an A1C of 6.5% is technically the official marker of diabetes. [2] Their reasoning was that at this level, diabetes complications such as retinopathy are quite uncommon.  However, Bernard’s achievements of lowering down to 6.8% in just a few months is remarkable.

Futhermore, with additions such as weight loss, exercise and possibly HRT (for low testosterone men) going below 6.5 could often be achieved.  One example of this is a study that combined a low fat, high fiber, high complex carbohydrate along with exercise and found that “this decrease in fasting glucose was achieved along with the discontinuation of oral hypoglycemic agents in 24 of 31 patients and of insulin in 13 of 18 patients;.” [3]

NOTE:: Low testosterone greatly increases the risk for developing diabetes, because it raises insulin levels and eventually reduces insulin sensitivity.  Furthermore, many men with Type II diabetes can actually completely eliminate their need for insulin with properly done HRT.  See my links on Testosterone and Diabetes and Testosterone and Insulin.

These men also very likely experienced many other key aspects of going on a Low Fat Diet, including a) increased blood flow, b) increased nitric oxide and c) decreased blood pressure.  Of course, all of these are good for erectile strength and you can read more here in my link on The Many Benefits of Low Fat Diets.

Again, though, the key is that one must eat low glycemic foods.  For those who may not be familiar with the term, the glycemic level of food is simply a score as to how much a given food raises blood sugar levels for a given weight of food.  Of course, refined carbs will almost always elevate your blood sugar rapidly.  There are many foods which are low fat, cheaps carbs and sugars for example, that will do just this.  Again, though, this is NOT the spirit of a whole foods, high fiber, Low Fat Diet.

And it’s not that hard.  For some of the details check out Dr. Bernard’s book above.  The books by Drs. Ornish and Esselstyn are also excellent.

One last recommendation:  get yourself an inexpensive blood glucose monitor if you do not have one.  You want to watch to make sure that your blood glucose levels do not rise too rapidly after a meal and this is an relatively inexpensive way to do some self-monitoring.  (If you are diabetic, please follow your doctor’s monitoring instructions of course.)

CAUTIONS:  There are many ways to do a Low Fat Diet.  Dr. Bernard’s methodology outlined in this book includes both soy and wheat.  Personally, I am very cuatious about both for the reasons outlined here in my links on Soy and Men and a Review of Wheat Belly.

REFERENCES:

1) Dr. Neil Bernard’s Program for Reversing Diabetes, Neil Bernard, p. 19-20.

2) Diabetes Care, 2009 July; 32(7): 1327 1334, “International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes”

3) Diabetes Care, May/June 1983, 6(3):268-273, “Long-Term Use of a High-Complex-Carbohydrate, High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM Patients”

Compounded Testosterone - Peak Testosterone

This is where a compounding pharmacy comes in.  A good compounding pharmacy takes the same bioidentical testosterone and puts into a gel or cream at the dosage the doctor specifies.  (Again, this is MUCH cheaper than either Testim or Androgel as testosterone is a relatively cheap molecule to manufacture.)  Many guys who cannot seem to get past the 200’s or 300’s with Testim or Androgel break those barriers easily with compounding.  (Most docs will try to get you right around 500 from what I have seen.)

WHAT ABOUT INSURANCE?  I was actually able to get compounded testosterone through insurance because Androgel did not work for me. However, compounded testosterone is so inexpensive that my copay was not that much below the cost of just paying cash!

Besides cost and effectiveness what are the other big advantages to using compounded testosterones?

2) Diurnal Rhythm. If you apply the cream in the morning every day, you will be somewhat mimicking the body’s natural diurnal rhythm of higher testosterone levels in the morning that then taper off in the evening.  This may be important for physiologically in some way that we do not yet understand.

3) Increased DHT Levels. This is a pro or con depending on how you look at it.  All topicals will tend to raise DHT levels more than other delivery systems.  This can be good for middle-aged and older men from the libido standpoint.  You do have to be careful in my opinion as you can go supraphysiological, i..e well over the top of the lab range, which is true for any compounded or brand name cream or gel.  You can pull your DHT levels here:  Inexpensive Testosterone Labs.

4) Control Over Concentration. With the name brand name products, you get what you get when it comes to concentrations.  For example, Androgel is 1.62% and virtually all men using Androgel use this concentration.  Want 3% Androgel?  Too bad – it’s not offered.  But with a compounded cream or gel, your physician can order almost any reasonable strength.

Compounded Testosterone Dosage

Figuring out the dosage of the prescription that your doctor wrote is not as difficult as it might seem.  Think of 1,000 mg of water, or the cream, as the starting point.  Let’s say you mixed in 10 mg of testosterone into that 1,000 mg.  That would be considered a 1% compounded solution. A 2% solution would be 20 mg mixed into the 1,000 mg.  Common prescriptions are anywhere from about 3% to 20%.

So why can’t you go above 20%?  Technically, you can go get about 30% into a cream or gel from what I have heard.  However, it starts to get “gritty” at that levels and so 20% seems to be the maximum out there in the real world.

“I’m now using about 1.5 grams of 5% compounded T cream. I mix it with a splash of water to make it spread out. I then apply to shaved shoulders, shaved armpits and any remainder to shaved scrotum/thighs. I spread it thin and rub it in vigorously. It takes a bit to dry. Works like magic. Last T levels were at 700. I’ve been low T for a very long time, so I have a good “feel” for when it’s right and when it’s not. I cannot use Androgel. Even with massive doses, it simply does not work for me.” [1]

Cujet also thins his out with a little water.  He said, otherwise, it is like trying to spread “peanut butter.”  For both cujet and myself, compounded testosterone was a life saver.  (Androgel never raised my testosterone a nonogram.)

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

Compounded Testosterone Costs

My monthly supply of testosterone was about $50!  This was quite a few years ago and now costs tend to be about $75 per month usually from what I have seen.  Compare that to a month of Androgel, which is about $250 the last time I checked.  In my opinion this is a ridiculously high price for something that has been around for decades.  It is like Good Year suddenly declaring  that only their tires are safe and then charging the consumer $500 a tire! Remember: bioidentical testosterone, which is in all topicals, is not an expensive molecule to manufacture and compounders were safely dispensing testosterone creams for years before the large pharmaceutical companies got involved.

Compounded Testosterone Delivery System

The reasons that compounding can deliver so much more testosterone has mostly to do with the increased concentration.  The delivery systems from what I have read are comparable in absorption rates to Androgel, or at least close.  The most common system used is called PLO(Pluronic Lecithin Organogel), “penetration enhancer”.  Many drugs are delivered in PLO, which helps the drug pass through the stratum corneum, a big name for the upper layer of your skin.  PLO is usually made from soy but can be made from eggs as well.  It is composed primarily of lecithin, isopropyl palmitate and Pluronic F127.  Isopropyl palmitate helps the testosterone penetrate the skin and is also a solvent.  It can definitely cause skin irritation, clogged pores, etc. and this is one of the potential downsides to PLO.

The Pluronic F127 is a “surfactant”, which means that it spreads the product out evenly so that it does not bind or coagulate together.  These two chemicals are considered safe and they are pretty widely used.  Isopropyl palmitate is a low hazard expection compound according to the Environmental Working Group for example. [4]  And the Pluronic F127 is in mouthwashes and toothpastes for what that is worth. Again, this has not bee tested long term as far as I know.

The only other disadvantage that I know with compounded testosterone is that its effect on family members is undocumented.  After reports of children being affected through their father’s topical application of testosterone therapy, the FDA asked for the manufacturers to do additional testing to make sure this wasn’t an issue with their product.

Personally, I doubt that Testim or Androgel has unusual potent penetration capabilites as a significant percentage of guys find they get little to no penetration.  Plus, again from what I have heard, these cases are usually from fathers who are being careless. Androgel, for example, is applied to the chest and upper arms.  Some dads go shirtless or forget to wash off the product before doing physical things with their family.

If you thoroughly wash the area of application, your family members should be safe, i.e. your wife and kids should not be overabsorbing supplemental testosterone.  However, you should realize that the FDA is only working with the mainline manufacturers and not with compounding pharmacies. Talk to your doc, of course, about all of the above. CAUTION: Be careful about love make sessions with your woman unless you’ve thoroughly washed the product off:  her testosterone is just a fraction of yours!

1) https://www.peaktestosterone.com/forum/index.php?topic=8082.0

2) https://www.peaktestosterone.com/forum/index.php?topic=7881.0

3) https://www.medpagetoday.com/MeetingCoverage/ENDO/50372

4) https://www.ewg.org/skindeep/ingredient/703207/ISOPROPYL_PALMITATE/

How Sex is Good for Males - Peak Testosterone

It is interesting because science has discovered, mostly in the last decade, literally a dozen major ways that sex is good for you.  I want to go into here three of the most important for us guys.

This is critical to understand, because there are guys who have become discouraged with relationship(s), are depressed, have given into erectile dysfunction and other things to where they have turned themselves into a modern day monk without sexual activity.  I am going to show below that a life without sex is dangerous.

You are literally wired from puberty on and the ground up for a lifetime of sexual activity.  By the way, I emphasize a lifetime of sexual activity because that’s one of the things Peak Testosterone is all about:  giving you the tools you need in order to stay healthy, fit, full of energy

Below is what one might call the Big Three List of the just what the studies show sex does for men.  I would argue Sex is on an equal, or very nearly equal, footing with diet, exercise and sleep with regards to your health.

NOTE:  Show my page Why Sex Is Important for Women for other great reasons to spend more time in the bedroom.

1)  Sex Raises Testosterone.  I discuss this at length in this link about How Sex Increases Testosterone. One of the reasons for this is explains why sexual intercourse is so much more satifsying than masturbation.  The reason?  Simple – four times as much prolactin is released after intercourse. [3] And this applies, perhaps counterintuitively, to both males and females. Prolactin is associated with sleep, which is likely one of the reasons we sleep so soundly after intercourse, and sleep is one of the Best Natural Ways to Increase Testosterone. In addition, prolactin itself may increase testosterone levels to a certain extent as well. [4] Another reason is likely the chemical soup released during orgasm, including vasopressin, prolactin and dopamine may stimulate testosterone in ways that we do not understand yet.  We already know how much Attitude Boosts Testosterone, for example.

4) Sex Improves Blood Pressure Response. That’s right – researchers found that penile-vaginal intercourse (PVI) improved stress reactivity, i.e. arterial blood pressure response to stress. [2]  And you thought research was dry and boring? Now it’s important to not 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.

5) Sex Increases Sensitivity. Oxytocin is released from touch, as I cover here, and a nice burst during orgasms in both men and women. It is known as the “love hormone” because it creates feelings of bonding, intimacy and empathy. And let’s face it: most of us guys could use a good dose of all three.

6) Sex Reduces the Risk of Prostate Cancer. In one study men who ejaculated over 21 times per month had a significantly reduced risk of prostate cancer. [5] As a side note, we know that sex raises testosterone so notice that this implies both sex AND testosterone are good for the prostate.  (Yes, it could be stress reduction and other factors, but this ties in with the fact that HRT, i.e. testosterone therapy has not been shown to increase cancer risk.)

7) Sex Boosts Immunity. Yes, indeed, one study of healthy young males revealed a signficant increase in natural killer cells post-orgasm. [6]  Other studies have shown an increase in IgA, one of your body’s automatic weapons against colds and flus. [7]

CAUTION: Recent research shows that having sex more than a couple times per week may actually regress this immunity boost. [10]  This may be because opioid peptides, which sex stimulates, boosts immunity in moderate doses but actually acts as an immunosupressant at higher levels. What about the studes that say that show a dose-dependent reduction in mortality as you increase orgasms per week?  Unfortunately, these studies have maxed out at about two times per week and this is the first study that shows there may be a point of diminishing returns. However, this may be a cause worth dying for, eh?

8) Sex May Grow Your Brain. Increased stress levels increase cortisol and cortisol is a known hippocampus-shrinker.  Researchers recently decided to show in a study of rats that repeated sexual activity would increase stress hormones and shrink the rats’ hippocampus. And it would serve ’em right, don’t you think? Instead scientists found that stress hormones increased for a few days, decreased to normal levels and then something surprising happened:  the rats hippocampus starting growing!  They conclused that repeated sex, for these lucky adult male rats, “stimulated the growth of dendritic spines and dendritic architecture.” C’mon – if a bunch of rats can do it, why can’t you? [8]

9) Sex Lowers Stress Hormones. The study above found that the lucky rats had lowered levels of the nastiest stress hormones called glucosteroids. [9]  In fact, they speculated that this may be one of the primary reasons that sex caused the brain cell growth. A number of studies have shown that immediately after sex, cortisol actually increases.  However, this study indicates that in the medium term, the picture becomes significantly different. This may be because an orgasm release oxytocin and oxytocin lowers cortisol. [11]

10) Decent Exercise. A recent study shows that the typical guy will burn about 101 calories per love making session. [11] That’s enough to significantly help with weight management and the researchers even noted that it achieved moderate exercise intensity.

REFERENCES:

1) BMJ, Dec 20 1997, 315:1641-1644, “Sex and death: are they related? Findings from the Caerphilly cohort study”

2) 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”

3) Biological Psychology, Mar 2006, 71(3):312-315, “The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety”

4) Journal of Clinical Endocrinology & Metabolism, Received May 25, 1977, 47(2):447-452, “Effects of Prolactin and Prolactin Plus Luteinizing Hormone on Plasma Testosterone Levels in Normal Adult Men”

5) JAMA, 2004,291:1578-1586, “Ejaculation Frequency and Subsequent Risk of Prostate Cancer”

6) Neuroimmunomodulation, 2004, 11(5):293-298,”Effects of Sexual Arousal on Lymphocyte Subset Circulation and Cytokine Production in Man”

7) BBC News, “Sex The Cold Cure”, Wednesday, April 14, 1999

8) PLoS ONE, 2010, 5(7): e11597, “Sexual Experience Promotes Adult Neurogenesis in the Hippocampus Despite an Initial Elevation in Stress Hormones”

9) https://www.livescience.com/culture/sex-boosts-brain-cells-100728.html

10) Psychology Today, Mar/Apr 2011, p. 42.

11) PLoS ONE, 8(10):e79342, “Energy Expenditure during Sexual Activity in Young Healthy Couples”

11)

2)  Sex Boosts Erectile Strength. This is due to a variety of factors including exercising the pelvic muscles, boosting neurotransmitters, lowering stress, improving sleep,, increasing testosterone and much, much more.  Please read my link on How Sex Fights Impotence and Erectile Dysfunction for more information.

A Cure? (Supplement-based) - Peak Testosterone

Something that gets me really excited is when I see a nutraceutical approach that rivals or even beats traditional pharmaceutical approaches.  It turns out that one of top three financial bloggers, Mike “Mish” Shedlock, likely stumbled across just such an approach.  Mr. Shedlock was gracious to even grant me a short interview and discussion of what he did and why and I’ll discuss some of the highlights below.

NOTE: Mike has one great financial article after another and I highly encourage you to give his site a visit: Global Economic Analysis. Kudos to him also for doing some incredible fund raising for various medical conditions such as ALS and autism.

First, let’s discuss what happened to him and it all started with a high PSA reading of 6.65 in August of 2012.  He then had a biopsy which – and I’ll quote from his very detailed and informative article called How I Beat Prostate Cancer – that “of the 12 samples, only one had cancer and one was questionable. The cancerous sample was 10% cancerous.” His PSA climbed further to a peak of 17.65 on November 15th, which is a very high reading.

So he definitely had a cancerous sample, albeit 10%, and another sample that might be termed “precancerous” as well.  Coupled with the high PSA numbers, this paints a very serious picture.  Mr. Shedlock did not panic and then created a “Prostate Cancer Cocktail” of 10 different supplements in order to try to control or reverse his cancer and bring down his PSA.  His oncologist told him it would not help but would not hurt either and, of course, his urologist was generally opposed.

The results that he achieved from his strategy seemed to be nothing short of spectacular.  His PSA dropped like a rock from the 17.65 value to 2.99 on 12/13/2013.  All of his reads since then have trended downward and the last one listed was actually below 2.0!

In my discussion with him, he mentioned that he really thought that it was the first four supplements that really produced the lion’s share of the results.  I would agree with him but think that it may be very important to include the fifth for reasons that I discuss below.  Here is the list along with his dosages:

CAUTION: Always work with your urologist if you have a high PSA or prostate cancer. Mr. Shedlock very wisely showed his supplement regimen to both a urologist and oncologist ahead of time.  Prostate cancer is usually slow moving, but it can metatastize and spread to other organs, so get the experts involved.

What I find really fascinating is that Mr. Shedlock put together a formula that addresses almost every major aspect of a rising PSA:

These three, along with an enlarged prostate, are the conditions that can really elevate PSA according to what I have read.  Some men have high PSA’s and appear to have no prostate cancer.  Inflammation and abacterial prostatis are likely to blame.  This is one of the reasons that PSA as a prostate cancer test has really been under fire lately:  it does not always indicate prostate cancer but rather prostate problems, because some non-cancer issues can cause a rising PSA. Does this mean you should ignore a rising PSA?  Well, I sure don’t think so and I think Mr. Shedlock did the right thing by getting a biopsy done and working with his docs.

NOTE: There has actually been an abundance of research showing natural methods to lower PSA and prevent and treat prostate cancer.  I had just completed a page that summarizes a lot of this research and, interestingly enough, none of it overlaps with Mr. Shedlock’s formula.  This just goes to show how many techniques and strategies one can have in his arsenal and you can read about these in my link on How to Lower Your PSA. Of course, the real tragedy is that the great majority of urologists seem completely unaware of all this new research on prostate health that has been pouring out of the labs.  I think it is prudent for any man, even with normal PSA levels, to begin to shift to a more prostate-protective lifestyle, because asymptomatic prostate cancer is VERY common in men (~15% per one study). [1] In other words, it is very common for men to have underlying prostate cancer and not even realize it.

Also, it is possible that this small amount of cancer did not cause his rise in PSA.  Mr. Shedlock did not have the symptoms of chronic prostatits, but it is possible that inflammation of some sort caused his rise in PSA.  Perhaps he had more than one issue going on at a time – it is impossible to know for sure.  But this is the beauty of his formulation:  it addresses all the major players in one shot.  Let me explain in more detail:

1. Resveratrol. Resveratrol has many studies behind it showing that it attacks prostate cancer.  In vitro studies have been excellent and one researcher summarized by saying:

“Resveratrol affects all three discrete stages of carcinogenesis (initiation, promotion, and progression) by modulating signal transduction pathways that control cell division and growth, apoptosis, inflammation, angiogenesis, and metastasis.” [2]

However, recent followup work indicates that resveratrol may at times inhibit prostate cancer growth and at still other times promote it.  For example, a 2013 study on mice with transplanted prostate cancer cells found: [4]

“Resveratrol was associated with significantly worse survival with LAPC-4 tumors, but unchanged survival with LNCaP. Based on these preliminary data that resveratrol may be harmful, caution should be advised in using resveratrol for patients until further studies can be conducted.”

Now I asked Mr. Shedlock about this and he said that he was unfamiliar with the study.  However, he stated that his philosophy was to not take too much of any one supplement.  This is why he took a cocktail of ingredients so that one got synergies from all the ingredients.  He said that he considered his resveratrol protocol relatively low dose.  And keep in mind that he had a post-cocktail biopsy and no cancer was detected.  So not only did he have a monstrous drop in PSA to youthful levels but he also had a cancer-free biopsy.

The bottom line, as always, is that you’ll have to do your own research, talk to your doctors and make some kind of decision about resveratrol for yourself.

2. Quercetin and Bromelain. One very common male plumbing problem is prostatitis and, interestingly enough, the most common form of prostatitis is actually very poorly understood by modern science.  Although prostatitis is often caused by bacteria, more often than not it is caused by runaway inflammation and other poorly understood factors.  This type is called non-bacterial or chronic prostatitis and is sometimes accompanied by a rather painful condition called Chronic Pelvic Pain Syndrome.

Doctors do not currently have a reliable treatment for this condition and certainly have not been able to find a reliable pharmaceutical solution to the problem as far as I know.  This is where nutraceuticals have offered some hope according to several studies and bromelain and quercetin are leading the way.  One study found a nice reduction in symptoms from the combination of these two. [5]

3. Turmeric (Curcumin). If there is one thing that you want to combat when it comes to the prostate, it is inflammation, a root cause of both prostate cancer and chronic prostatitis.  It can inflate PSA levels as well.  Of course, turmeric is famed for its anti-inflammatory powers and is one of the most widely used supplements in this area.  It is used, for example, to fight arthritis (when coupled with quercetin in one study). [6] Like resveratrol, it has done very well in in vitro and mice studies.

Excited by the successes, researchers then decided to combine it with another proven prostate cancer fighter, soy, and found that it produced stellar results.  Dosages were relatively small – soy isoflavones (40mg) and curcumin (100mg) – and yet they found that PSA levels were significantly reduced by this combination.  The study examined men with existing cancerous or pre-cancerous cells but with elevated PSA.  In the group with PSA’s > 10 – these were all seniors – the average PSA went down from 18.8 to 10.2!  Needless to say, these are very impressive results by simply combining an Asian food with an Asian spice.

CONCLUSION: The evidence points to Mr. Shedlock not only dropping his PSA to a fraction of it’s peak levels but also to remission of his prostate cancer.  None of this can be proven, however, as biopsies are notorious for missing underlying cancer.  But keep in mind that the studies use the exact same techniques – biopsies and PSA – to evaluate the effectiveness of a prostate cancer treatment and so Mr. Shedlock is in good company if you ask me.

The only way to really be absolutely 100% that you eliminated all the prostatic cancer would be a prostatectomy.  Unfortunately, this procedure has not been perfected yet and, more often than not, the patient experiences short and sometimes long term incontinence and erectile dysfunction.  Thus, his decision to attack a non-aggressive form of prostate cancer with nutraceutical firepower will seem to many like a very reasonable approach until we come out with more reliable and less invasive prostate cancer-fighting techniques.

Hats off to Mike Shedlock for his bravery. It reminds of the story of Nathan Pritikin who was told that he would probably die if he ate a Low Fat Diet. He was very nervous to undertake such a program but found instead that he felt great and was vindicated when the coroner examined his arteries decades later and found that they were perfectly clean, like those of a teenager. [8] Again, diet, spices, juices and a few natural supplements can have powerful clinical effects that often exceed what can be achieved by standard medical practice.

REFERENCES:

1) https://www.lef.org/magazine/mag2008/dec2008_destroying-the-myth-about-testosterone-replacement-prostate-cancer_01.htm, “Destroying the Myth About Testosterone Replacement and Prostate Cancer”, By Dr. Abraham Morgentaler

2) Cancer Prev Res, May 2009, 2:409, “Cancer Prevention and Treatment with Resveratrol: From Rodent Studies to Clinical Trials”

3) https://www.nutraingredients-usa.com/Research/Researchers-Resveratrol-a-double-edged-sword-for-prostate-cancer

4) Prostate, 2013 May, 73(7):754-62, “Resveratrol worsens survival in SCID mice with prostate cancer xenografts in a cell-line specific manner, through paradoxical effects on oncogenic pathways”

5) Urology, Dec 1999, 54(6):960–963, “Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial”

6) Inflammation Research, Apr 2006, 55(4):168-175, “The antioxidants curcumin and quercetin inhibit inflammatory processes associated with arthritis”

7) The Prostate, 2010, 70:1127-1133, Combined Inhibitory Effects of Soy Isoflavones and Curcumin on the Production of Prostate-Specific Antigen”

8) N Engl J Med, 1985, 313(1):52, “Nathan Pritikin’s heart.”

-Surprising Causes of High Prolactin - Peak Testosterone

One common situation on the Peak Testosterone Forum is a man having fairly high prolactin levels, say 15-30 ug/L, and yet the doctor says there is nothing “wrong” with him. Of course, prolactin of 15-30 ug/L is over the lab range and this will drive down dopamine/libido and often testosterone. So why does the doctor say nothing is wrong? The reason usually is that an MRI has revealed no prolactin-secreting tumors in the brain, which is called a prolactinoma and something I cover in my page on Testosterone and Prolactinomas.  (If you have high prolactin, always consult with a doctor for this very reason.)  In the doctor’s mind, this man does not have a tumor, so he’s not really doing that bad – case closed.

However, men with high prolactin and no prolactinoma can still feel lousy.  Remember that prolactin is a “lactation hormone” and can trigger gyno.  It lowers dopamine.  It raises inflammation. [1] So you don’t definitely don’t want too much of it, and guys can feel it very often.

So the question becomes “how do you lower it?”  Well, you can take one of the big gun pharmaceuticals such as cabergoline.  However, from what I have seen, most doctors will not prescribe it to men without unless a prolactinoma is present.  Basically, one is just left alone to “deal with the high prolactin symptoms.”  Now I have a page on a few natural solutations that may help some men in these situations:  How to Lower Prolactin. (Always disucss with your physician first.)  However, as is so often the case, it is usually better to find the root cause of the high prolactin and directly deal with that.  Here are Four Common and Surprising Causes of High Prolactin That Few Physicians Mention to Their Patients:

1. High Estradiol. It is no secret that, if you increase estradiol, you will increase prolactin release. [2] Some of the older research showed that this effect was dose dependent, i.e. the more estradiol you added, the higher prolactin increased.  [3] And researchers have discovered one of the key mechanisms:  estradiol regulates the transcription of the prolactin gene. [4]  So, if you are on the high side with prolactin, one of the first things you should probably pull is estradiol.  Remember that, as men, we need the appropriate LC-MS/MS test that can pick up our relatively low levels of estradiol (compared to a female).

2.  Hypothyroidism. An underactive thyroid will also drive up prolactin levels in us men.  Of course, this is an especially ugly situation, because hypothyroidism tends to lower testosterone and sap your energy levels.  So, if you have hypothyroidism and high prolactin, you have potentially got a nasty set of symptoms to manage.  Furthermore, hypothyroidism is underdiagosed, because so few doctors really test adequately for low thyroid function, something I discuss at length in my page on Testosterone and the Thyroid. In addition, I have a page on Hypothyroidism and High Prolactin, so you can check out the latest research there as well.

3. Drugs. Many very common classes of drugs can raise prolactin levels.  No, they didn’t put that on the label, did they? Look at this list from one set of researchers: “antidepressant drugs with serotoninergic activity, including selective serotonin reuptake inhibitors (SSRI), monoamine oxidase inhibitors (MAO-I) and some tricyclics, can cause hyperprolactinemia. A long list of other compounds may determine an increase in prolactin levels, including prokinetics, opiates, estrogens, anti-androgens, anti-hypertensive drugs, H2-receptor antagonists, anti-convulsants and cholinomimetics.”  [6]

There are lots of men on SSRI’s, painkillers and meds for their hypertension with fairly high prolactin, and it is a shame that their doctors do not inform them of the potential sides there. I think more often than not, it is out of ignorance.  And I do want to mention that not all blood pressure medication or painkillers raise prolactin, but it is a question you should discuss with your doctor if it is a possible issue.  (Don’t stop any medication without talking to your physician first!)

4. Stress. Generally, it is thought that psychological stress cannot raise prolactin levels.  However, it probably can in some extreme cases, and, if you just had surgery or something other physicial trauma, prolactin levels can definitely shoot up.

CONCLUSION: There are many common culprits of fluctuating and high prolactin levels that often can be treated or dealt with naturally.  Please also check out my pages on Prolactin Levels in Men, Prozac and Prolactin and The Meaning of Low Prolactin in Men as well.

REFERENCES:

1)  Eur Cytokine Netw, 2004 Apr-Jun;15(2):99-104, “Prolactin triggers pro-inflammatory immune responses in peripheral immune cells”

2) J Clin Invest, 1974 Feb; 53(2): 652 655, “Augmentation of prolactin secretion by estrogen in hypogonadal women”

3) PNAS, “Estrogen control of prolactin synthesis in vitro”, Dec 1 1978, 75(12):5946 5949

4) The Journal of Biological Chemistry, March 10, 1982, 257, 2133-2136, “Estradiol regulates the transcription of the prolactin gene.”

5) Bailli re’s Clinical Endocrinology and Metabolism, May 1987, 1(2):391-414, “8 Prolactin, growth hormone and thyrotropin-thyroid hormone secretion during stress states in man”

6) Ther Clin Risk Manag. 2007 Oct; 3(5): 929 951, “Pharmacological causes of hyperprolactinemia”

Natural Causes of Low Testosterone Level - Peak Testosterone

So you found out you are low testosterone or hypogonadal, eh? A natural question for many men is:

“What in the world caused this?  What happened to me??”

Sometimes wives and girlfriends are wondering the same thing!

It turns out that is not as easy to answer these kind of questions as you might think.  For example, it is rare for someone to come to the Peak Testosterone Forum and have any idea what caused their low testosterone. Occasionally, someone has taken steroids or a “prohormone” that has left them without testosterone and the answer is obvious.  Or perhaps a man has a brain injury and suddenly develops low testosterone symptoms, indicating a damaged pituitary or other CNS issues.  These situations are fairly obvious and are not what I am going to discuss here.

What is very important to look at are the cases that might escape a physician’s eye, because he/she 1) is not looking or 2) is ignorant.  And this is case (much) more often that not on forum  and, as I will show below, this can in some cases have detrimental outcomes.  When one develops hypogonadism, there are many things that should be checked:

1. Empty Sella Syndrome. This is a fairly common problem with the pituitary where the size of the pituitary is greatly decreased due to injury, a tumor, anatomical injury, etc.  One study looked at men with erectile dysfunction and low testosterone levels and found that 6.7% of them likely had empty sella syndrome. [1] Yet another study looked at men with low testosterone and found a still higher percentage:  17.6%. [2] Of course, empty sella will lead to secondary hypogonadism because of improper signalling from the pituitary, since it is the pituitary that actually signals the testes to produce testosterone.

It should be noted that sometimes it can be better termed “partially empty sella,” because some of the gland still remains.  However, still other times the pituitary is not even visible on the MRI.

2. Micro and Macroadenomas of the Pituitary. Related to #1 are pituitary tumors that can cause empty sella syndrome.  In fact, if you read the first study above, you will see that most of the empty sella syndrome cases were related to tumor growth. [1] Microadenomas were identified in 7.8% of the cases in the second study as well.

3. Prolactinoma.  Another reason that larger pituitary tumors can cause hypogonadism is that they frequently raise prolactin levels.  A prolactinoma can stay within the sella, the little “pouch” area where the pituitary sits, or can extend out and cause headaches, visual issues and other medical problems.  Only about 10% of macroadenomas fall into this category. [3] If you do have a prolactinoma, it is usually treated with a dopamine agonist which shrinks the tumor substantially and lowers prolactin levels.  Sometimes surgery is required however.

By the way, the second study indicates that serum prolactin levels are a good predictor of a macroadenoma.  There were actually four men with macroadenomas and 3 of them had prolactin levels > twice the upper limit, which was probably around 30.  So, if your prolactin is high, you’ll want to discuss it immediately with your doctor.

4. The Two O’s: Overweight and Obese. Fat cells contain aromatase and, as you gain weight, those fat cells enlarge and build up extra aromatase, the enzyme that converts testosterone to estradiol.  Yes, that means that an overweight or obese man will tend to have more estradiol, the “bad” estrogen, and less of his precious testosterone. [4][6]

And if the free estrogen to free testosterone ratio gets high enough, obesity can actually create a form of secondary hypogonadism and very significantly turn off your testosterone production.  Research shows that testosterone may be as much as 2.5 times lower in obese men. [7] Ouch!  Verifying this is the fact that one study found that massive weight loss (57+ pounds) resulted in an average 58% increase in testosterone levels. [8] If you lose enough weight, it is possible to even double your testosterone.

Even relatively thin guys like myself can benefit:  I had accumulated about 10 pounds of visceral fat and dropped most of it off and found that my estradiol levels plummeted.  This gave me a much nicer testosterone-to-estradiol ratio, which is very important.  (See my link on The Testosterone-to-Estrogen Ratio for other ideas as well.

5.  Hemochromatosis. This common genetic disorder affects about 1 in 200 of people of European ancestry. [9] You have to have two copies to have the potential to develop the disease but 1 out of every 8-10 people are carriers!  Persons with hemochromatosis are much more likely to build up iron, which is very hard on the body.  The brain, cardiovascular system and liver can all be negatively impacted.

One other thing that can be affected is testosterone.  One study found that 6.4% of men with hemochromatosis were hypogonadal. [10] This may sound like a fairly low percentage, but keep in mind that they set their definition of hypogonadal at the incredibly low of about 4.1 nmol/l.  This translates to about 120 ng/dl in our units here in the U.S., which is about a third of LabCorp’s current threshold!  So the reality is that a very significant percentage of men with heriditary hemochromatosis likely have low testosterone.

Other common symptoms include:

If you have low testosterone symptoms and some of these other standard symptoms, talk to your doctor.

6) Stress. There have been reports that very high levels of stress can induce a type of hypogonadism. One study looked at this by giving men high doses of hydrocortisone (cortisol) and, sure enough, testosterone came crashing down. [11] Animals studies have shown that one way this occurs is through an enzyme called 11 HSD-1 that, under normal circumstances, keeps your cortisol from hammering your testosterone levels.  Extreme stress, however, can overwhelm 11 HSD-1 with too much cortisol and result in a kind of hypogonadism. [12]

7) Zinc Deficiency. One study took young men (average age 27.5) and then artificially created a zinc deficiency in them by putting them on a zinc-restricted diet.  Serum testosterone fell like a rock after 20 weeks from 1173 ng/dl to 311 ng/dl!  The same study showed testosterone doubling in those who were only mildly zinc deficient.  See my link on Zinc Deficiencies and Low Testosterone for additional information.

8) Weight Loss and Intense Exercise.  My page A Protocol to Lose Weight Rapidly and Maintain Muscle discusses a study where the male participants were able to do 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 covering the subject for men that are interested in short term, accelerated weight loss.

However, one of the guys on the Peak Testosterone Forum noticed that the testosterone levels of the men in the study dropped from 507 to 126 ng/dl! That is a severe fall in testosterone and left those men deep in hypogonadal territory.  Of course, the moral of the story is that you can powerfully suppress your body’s testosterone production with such a stressful weight loss and thus it may not be appropriate for anyone except men on testosterone therapy, whose levels are held fixed through the administration of exogenous T.

9) Kallmann Syndrome. Kallmann Syndrome is basically hypogonadism that usually affects puberty with an accompanying lack of sense of smell.  It is fairly rare, but when you aggregate it with other similar conditions that result in low LH/testosterone going through puberty, it is probably around 1 in every 5,000 males.  Delayed puberty and small testes/penis are common accompanying symptoms as well.  HH (hypergonadotropic hypogonadism) is the broader term and we had one man who was diagnosed with the same.  He wrote:

“I like probably many people on this forum had unusually low sex drive for several years, and kept getting told my T was “normal” consistently testing in the 320-330 range. i finally did research and discovered that is not at all normal for someone in their 30s who is otherwise very healthy and who lifts heavy weights 3-4x/week. so i went to an endo and got complete tests w/pituitary MRI done and he agreed my T was low. he asked what treatment options i was interested in, and i said HCG looked interesting to me because i still wanted to have children. he said there is also low dose Clomid to consider. when i went back for results he said i had “abnormally normal” LH levels, in other words that i should have a natural pituitary response to produce more LH given my testosterone levels and that was not occurring. otherwise my system was functioning fine. he even diagnosed me with HH as a result. (i also have a weak but not nonexistent sense of smell, and my belief is that i have a milder form of Kallmann Syndrome, as although i went through puberty on time, i never grew much bodily hair and was a very scrawny kid until i hit the weights hard in my 20s. i think it doesn’t get called Kallmann by the medical profession because it is rare and doesn’t get diagnosed since puberty occurs)”. [16]

10) Klinefelter’s Syndrome. This surprisingly common genetic condition, where a male ends up with an extra X (female) chromosome, affects up to 1 in 500 males. [14] (Concerning is the fact that one 2007 study found that one type of Klinefelter’s seemed to be dramatically increasing in prevalence, so this may be an issue for an ever increasing number of young men.)   Sometimes it is “obvious” that there is an underlying condition due to symptoms such as undescended testicles. However, that is not always the case with Klinefelter’s and symptoms are less severe.  In these cases, many boys are never diagnosed with the condition and limp into early adulthood. There are many common symptoms that often affect someone with Klinefelter’s, including a characteristic pear-like body shape, gynecomastia, slow motor development, social awkwardness and so on. In addition, a man with Klinefelter’s is frequently hypogonadal. The good news is that hypogonadal Klinefelter’s males respond well to HRT treatment, at least according to a couple of studies. [16]

11) Sickle Cell Disease. Studies show that this disease can lead to low testosterone.  One small study of men with sickle cell found that 24% of them had low LH and FSH and, therefore, were likely secondary hypogonadal.  The authors concluded that it was not due to ferritin (tissue iron) levels. [13]

12) The Perfect Storm. Now this model, that I call the “Perfect Storm”, is, admittedly, speculation on my part.  First of all there are several quite common underlying issues with men that can lower testosterone in the 30% range, which I cover in various place on my site.  This is not an exhaustive list, but here are a few:

a) Vitamin D Deficiency. (See my link on Testosterone and Vitamin D for more details.)

b) Varicocele. (See #11 in my link on Improving Male Fertility.)

c) Apnea. (See my link on Apnea and Testosterone for details.)

d) Depression. (See my link on Testosterone and Depression for additional details.)

e) Mercury.  (We have had a few men write into the Peak Testosterone Forum who have been eating fish every day or nearly every day, not realizing that, depending on the type of fish, they could be poisoning themselves with methylmercury.  See my link on Fish Safety.)

In addition, we already mentioned above other T-related factors, including stress and being overweight. Simple lack of sleep could do it as well. Basically, I cannot help but wonder that if a man has 2 or 3 of these issues, which would not be terribly uncommon, that he could get a combined effect and perhaps drop his testosterone 50% or more?  As far as I know, no study has looked at the combined effects of one or more of these testosterone-lowering issues, but it certainly could happen.  In this case, it is prudent to troubleshoot each individual issue and get to the root cause.

13) Concussions and Head Injuries. It is very likely that head injuries can lead to hypogonadism and complete dysregulation of the HPA axis.  We had an ex-athlete discuss his battle with just this phenomenon, and you can read the interview I had with him on this page called https://www.peaktestosterone.com/.

14) GI (Gut) Issues. This is one I cannot prove, but is just common sense:  GI or gut issues likely lower testosterone significantly.  The reason I say this is that certain nutrients (Vitamin E, Vitamin C, magnesium, zinc, etc.) all play a role in the body’s production of testosterone.  Therefore, anything that significantly affects your absorption of these same nutrients can likely lower testosterone levels.  And this is important, because there are a host of GI issues that affect men in modern societies:  atrophic gastritis, IBS, ulcerative colitis, Crohn’s, diverticulitis, etc.

15) Parasites. We had one low testosterone man on the Forum of who found that he had a parasite (a tapeworm) and then eradicated it only to find that he felt much better and his testosterone climbed significantly. See my page on Testosterone and Parasites for his story.

16. Overtraining. This ties in with #6 and #8 above.  If you overtrain long enough, it is a HUGE stressor for the body and brain.  Your immunity is suppressed, your adrenal hormones end up fried, your libido and erections are negatively impacted and testosterone can be lowered as well.  See my pages on Testosterone and Overtraining and The Best Signs of Overtraining for some information.

REFERENCES:

1)  The Journal of Urology, Feb 1996, 155(2):529-533, “Prevalence of Hypothalamic-Pituitary Imaging Abnormalities in Impotent Men with Secondary Hypogonadism”

2) The Journal of Urology, Sep 2003, 170(3):795-798, “The Value Of Pituitary Magnetic Resonance Imaging In Men With Hypogonadism”

3) The Journal of Clinical Endocrinology & Metabolism, Aug 1 2007, 92(8):2861-2865, “Long-Term Management of Prolactinomas”

4) Medical Hypotheses, April 1998, 50(4):331-333, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

5) International Journal of Impotence Research, 2003, 15:38 43, “Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction”

6) Med Hypotheses, 1998 Apr, 50(4):331-3, “The role of estradiol in the maintenance of secondary hypogonadism in males in erectile dysfunction”

7) 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”

8) 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”

9) https://www.clinicalkey.com/topics/hematology/hemochromatosis.html

10) The Journal of Clinical Endocrinology & Metabolism, Apr 1 2005, 90(4):2451-2455, “Hypogonadism in Hereditary Hemochromatosis”

11) Clin Endocrinol Metab, 1983 Sep, 57(3):671-3, “Acute suppression of circulating testosterone levels by cortisol in men”

12) J Androl, 1997, 18:475-4791997, 18:475-479

13) Acta Haematol, 2012;128(2):65-8, “Hypogonadism in patients with sickle cell disease: central or peripheral?”

14) European Journal of Human Genetics, 2008, 16:163 170, “Is the prevalence of Klinefelter syndrome increasing?”

15) Clinical Genetics, April 1988, 33(4):262 269, “Follow-up of 30 Klinefelter males treated with testosterone”

16) https://www.peaktestosterone.com/forum/index.php?topic=223.msg1764#msg1764

STEP 5A. Find if you have one of the less well-known causes of low testosterone:

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

Semen Volume: How to Increase It Naturally - Peak Testosterone

Do you have normal semen volume?  Researchers say it is usually between 2 and 6 ml. [11] with an average of 3 ml. (A teaspoon is 5 ml).  Keep in mind that you lose a little with aging as well, about .03 ml/year according to one study. [12] Semen volume has a lot to do with simple genetics and anatomy.  Very roughly half of the semen comes from the prostate, where it fills up the ejactulatory tubes upon stimulation.  The tubes are kind of like the missile tubes in a sub ready for launch. The PC muscles contract during orgasm and deliver the goods along with another batch of fluid from the seminal vesicles in the testes for the final explosive, potentially life-changing mixture.

However, some men notice their semen volume has gone down and become concerned. Of course, this can be from ejaculating too much and also from aging.  It can also be from retrograde ejaculation as I dicuss in my link on  Causes of Low Semen Volume. If it is indeed retrograde ejaculation, it needs to be handled a little differently and so I recommned that you read the above link.

However, in most other cases a man should be able to increase his semen volume a little and I discuss these below.  (It is always a good idea to talk to your doctor about it, especially if you are concerned about fertility.)

1.  Increased Libido. There’s a belief out there that libido is boosted greatly by the tank “filling up and needing emptying”.  I don’t know of any scientific evidence for that, but many men are convinced that this is the case.

2.  HRT (Hormone Replacement Therapy). I find that some men on testosterone therapy want to increase their semen volume, because they feel they have lost so much.  And they may have.  However, the reason is usually not so much the HRT as simply being hypgonadal, which is associated with decreased semen volume in men who have secondary hypogonadism. This condition works from dysfunction of the hypothalmus or pituitary and is characterized by low or low-normal LH (leutinizing hormone).

NOTE:  For non-HTR methods to raise your testosterone, see my pages How to Increase Your Testosterone Naturally and Common Causes of Low Testosterone for more information.

3.  Inadequacy.  For many men semen volume is a symbol of their identity as a male.

Regardless of the reason, I have some natural ways to increase semen volume that have a study or two behind them.  These are listed below:

HO HUM:  Of course, there is always the ultimate boring way to increase semen volume:  abstinence. Well, that’s a lot of fun, eh?  It is true that if you wait a few days between ejaculations, your semen volume will increase accordingly. However, I am not even going to include this as an option, because, unless you are going to join a monastery or switch careers to Arctic Explorer, this is probably not a good option for you.

1.  Maca. The herb from South American is synonymous with sexual passion and energy. And it is no wonder: it was used for ages by the ancestors of the Incas for increasing libido. Interestingly enough, this herb, which often served as food for the native peoples, also increased semen volume as well. I cover this in my link on The Superpowers of Maca.

2. Zinc. One study put young men on a controlled diet and varying levels of zinc supplementation .  Those with the least zinc had about a third less ejaculate than those with highest. [1] For more information, see my link on Zinc and ZMA.

NOTE #1:  If you are on HRT, there are no guarantees that any of these natural methods will increase your semen volume.  The studies are typically not done on males undergoing testosterone therapy obviously.

1) 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”

2) Biotechnology in Animal Husbandry, 2008, 24(3-4):139-146, “Effect of Tribulus terrestris extract on semen quality and serum total cholesterol content in White Plymouth Rock-mini cocks”

3) Hum. Reprod, 1999, 14(4):1028-1033, “Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study”

4) Animal Reproduction Science, Mar 2003, 76(1-2):99-111, “Effect of ascorbic acid and Vitamin E supplementation on semen quality and biochemical parameters of male rabbits”

5)  Urology, Oct 2000, 56(4):669, “Acquired hypogonadotropic hypogonadism presenting as decreased seminal volume”

6) Fertility and Sterility [1991, 56(2):319-324], “Subcutaneous gonadotropin therapy in male patients with hypogonadotropic hypogonadism.”

7) Fertility and Sterility, 1979, 32(5):556-561, “Male hyperprolactinemia:effects on fertility”

8) Systems Biology in Reproductive Med, 1993, 30(1):47-54, “Semen Analysis in Insulin-Dependent/Non-Insulin-Dependent Diabetic Men with/without Neuropathy”

9) BJU International, Feb 2006, 97(2):324 326, “Cigarette smoking is related to a decrease in semen volume in a population of fertile men”

10) Systems Biology in Reproductive Medicine, 1992, 29(2):177-183, “Blood Concentrations of Lead, Cadmium, Mercury, Zinc, and Copper and Human Semen Parameters”

11) “Speman in Male Sterility”, [Probe (1970): (IX), 4, 159], Vaze, V.H., M.S., F.C.P.S., Ambai Hospital, Kolhapur, India.

12) Hum. Reprod, 2003, 18(2):447-454, “The association of age and semen quality in healthy men”

13) http://www.nbcnews.com/id/5263250#.UXyUd7U4tPM, “Not just good, but good for you”, By Brian Alexander (msnbc.com contributor)

3.  Tribulis. Tribulis Terristris is what I call one of the Super Sexual Herbs. Admittedly, it has a spotty record in raising testosterone levels in men. However, this herb is known, among other things, for mimicking leutinizing hormone and, as such, it should not be surprising that it boosts semen volume in a couple of animal studies. [2]  Does it in humans?  Well, you may have to just try it to see if it works for you.  (Always check with your doctor first of course.)

4. Vitamin C and Vitamin E? One study showed that daily megadoses of Vitamins C and E on infertile men did not significantly improve semen volume. [3] However, the jury may still be out as a study on rabbit just a few years later showed an increase in ejaculate volume with the same two vitamins. So it may be dosage levels, times per day, etc. [4] Also, I always recommend mixed tocopherols if you take Vitamin E as taking just the traditional alpha tocopherol form will lower levels of the tocopherols (gamma and delta, which is not a good idea as these serve very different functions generally).

NEWS FLASH: There is some decent evidence that sperm acts as an antidepressant when absorbed through the vagina post-intercourse and can even lower her blood pressure when taken orally. [13]

5.  HCG.  Some of my might bristle a little that I would call this “natural”.  Well, HCG is natural in the sense that it is a placental hormone that the body is used to at some stage in its development.  It’s remarkably similar, as well, to leutinizing hormone and so the body responds extermely well to it. Its use is on the rise with men on HRT, who have some shrinkage of the testes.  HCG allows men to stay on testosterone therapy with no loss in volume.  (HCG can really ramp up estradiol production, so regular monitoring is required.  See my link on Testosterone and HCG for more information.)

6. Prolactin. High prolactin generally means lower testosterone and lower libido for us guys.  And, interestinly enough, one study shows that it can mean decreased semen volume as well. [7] If you feel you’re not squeezing out the juice like you used to, you might want to have your prolactin pulled as well,  For more information, see my link on Prolactin and Prolactinomas.

7. Retrograde Ejaculation. This condition occurs when some of the semen actually gets pushed into the bladder upon ejaculation. How would something this occur? Actually, it is surprisingly common, because there is a valve (sphincter) that normally keeps this from occurring. A number of things (surgery, drugs, local nerve damage, etc.) can lead to a state where this valve becomes overly relaxed and semen is allowed to flow down the wrong path. Men with this condition may notice that they literally have no ejaculate upon orgasming. If so, talk to your urologist.

8. Diabetes. Retrograde ejaculation (#5) can occur due to nerve dysfunction or damage, because proper signaling never reaches the sphincter valve. Of course, neuropathy is one of the hallmark symptoms of diabetes and so it is no wonder that this condition is so common. In fact, one study found that diabetic men actually had increased sperm output and sperm concentration but decreased semen volume and they speculated that this was due retrograde ejaculation. [8]

9. Smoking.  We all know smoking is bad for you, but if you’ve never quit given them up, keep in mind that they will likely reduce your semen volume as well. One study looked at fertile men and grouped them into non, mild, medium and heavy smokers.  What is interesting is that hormone levels (testosterone, LH and FSH) as well sperm motility (mobility) and density did not differ significantly among the groups.  The one characteristic that did differ was semen volume, which decreased with increasing levels of smoking. [9]

10. Cadmium.  High levels of cadmium were correlated with lower semen volume in one study. [10]

REFERENCES:

Low Carb High Fat Diets and Why They Are So Risky - Peak Testosterone

Right now high fat diets are very popular, and, unfortunately, if you implement them wrong, you can get yourself into trouble, potentially affecting testosterone and/or erections as I will explain below.  But, first of all, how do I definite high fat?  A high fat diet is one that gets about 40+% and above of total calories from fat.

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.

Most meat sold in the supermarkets here in the U.S. is between 30-50% fat.  These are incredibly high fat levels, due to modern livestock methods, with few equivalents in nature.  Yes, some fish are an exception, but then they are loaded with omega-3’s.  Can this possibly be good for a man, especially in the bedroom? I would argue that it is rarely going to help him and I explain why below based on what I am seeing in the research:

1.  Too High in Total Fat. One common middle-aged nightmare is insulin resistance.  Insulin resistance allows glucose levels to rise, leading to damaged tissues throughout the body and accelerated aging.  It also results in a number of metabolic changes that often lead to sexual dysfunction and put a man at risk for many medical conditions such as heart disease, dementia, high blood pressure and diabetes.  Another name for insulin resistance is “prediabetes”, which I cover here in my link on Metabolic Syndrome and Erectile Dysfunction.

Now what many men do not realize is that a High Fat Diet is so reliable at bringing about insulin resistance that researchers use it in lab animals all the time.  In the above link, I document some studies where research have found just how high fat diets do this and it includes alterations to the mitochondria, the powerhouses of your cell which are linked to aging and oxidative damage.

Now will a High Fat Diet always induce insulin resistance in all men?  Of course, I cannot say that.  But the bottom line is that one is clearly living on the “razor’s edge” and should carefully monitor his blood sugar parameters in my opinion.

2.  Too High in Saturated Fat. This is something that I cover in great detail elsewhere on the site, such as in my link on The Problems with Saturated Fat.  What you should know is that saturated fat slows down blood flow. Saturated fat literally stuns arteries and sludges the cells in the blood disrupting blood flow.  This is why young men can usually eat a lot of saturated fat with minimal impact on their sex life, simply because they still have ample nitric oxide to compensate for the negative effects of saturated fat.  This is NOT true for many 40+ men, however, and is something to really watch out for.  Decreased blood flow negatively impacts many tissues especially, of course, those in the penis and, according to some research, those in the brain.

I find on The Peak Testosterone Forum that few men over abou 45 will argue with me about saturated fat. It’s always the young guys pushing the higher fat meals.

3.  Too Low in Carbs. A big percentage of men on higher fat diets are actually Low Carb or Ketogenic.  There are different variabtions of these diets, but men will consume less than about 50 or  60 grams of carbs per day.  These diets have really struggled in the research lately and researchers have found that they signficiantly increase the risk for a) arrhythmias, b) heart damage, c) high LDL-P, d) decreased mood and on and on.  You can read about these in my page on The Potential Dangers of a Low Carb Diet for more information.  The also greatly limit your abilitity to do higher intensity exercise, something I hope all Peak Testosterone readers are doing.

  What is even more stunning is that a Low Carb Diet caused inflammation while losing weight!  This goes against the conventional wisdom that any diet will improve health markers as long as you are experiencing weight loss.  It takes a nasty diet indeed to increase inflammation under these circumstances.  And that is exactly what a Low Fat Diet did in the above study:  while CRP was actually lowered by 43% in the high carb, CRP in the Low Carb group increased by 25% even though the Low Carb participants lost more weight. [2] Ouch!

And here is a fact in a study that should catch every man’s eye:  endothelial vasoreactivity was reduced by the Low Carb Diet. [3] This means that the lining of the arteries were not as responsive to stimuli to relax and open and increase blood flow.  That could easily translate to worsened erections.  Again, high fat diets, from what I have seen on the Peak Testosterone Forum are almost always enjoyed only by the younger guys.

4. Too High in Carnitine? At least here in the U.S., most men consuming a lot of fat in their diet will also be consuming a lot of beef and pork.  Sure, it’s possible they could be slurping down coconut oil and/or fatty fish but this is unlikely from what I have seen.  (Doing the latter could lead to low grade mercury poisoning as I discuss in my link on The Safety of Fish Consumption.) Most men are going to consume meat and, at least here in the U.S, two of the most affordable and well-liked options are beef and pork.

However, in 2013 researchers found beef and pork and unique in that they contain MUCH more carnitine than is found in any other dietary source.  Furthermore, the carnitine uniquely fires up your gut bacteria which releases a chemical called TMAO that the researchers argued likely acclerates arteriosclerosis.  For more information, see #3 in my list of The Risks of Meat Consumption for more information.

REBUTTAL: This is a controversial result and there are studies that show that various forms are carnitine are of cardiovascular benefit, so some experts are skeptical that it is actually the carnitine that is the underlying issue.  More on that below.

5. Too High in Added Antibiotics, Hormones, . When the study in #5 came out showing that carnitine can cause arterial issues, the Paleo Diet gurus quickly rallied against it and attempted to counter the conclusions. And a good debate is always healthy of course. One of the Paleo objections was that modern livestock here in the U.S. are injected rather heavily with antibiotics and some of the antibiotics end up in the meat and can alter gut flora. In other words, the argument is simply that it’s not the carnitine changing the gut but rather the antibiotics that is causing the problems. [4]  However, this highlights a huge problem in my opinion with most men consuming Paleo and Low Carb Diets here in the U.S.:  few men can afford to pay for range fed meats and end up eating factory farm livestock.  These animals are corn fed. hormone and antibiotic injected, GMO BT toxins and arsenic (eggs and fowl).  How is this going to be good for long term health.

REFERENCES:

1)   https://well.blogs.nytimes.com/2012/11/07/can-exercise-protect-the-brain-from-fatty-foods, “Can Exercise Protect the Brain From Fatty Foods?”

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

3) 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”

4) https://www.bulletproofexec.com/the-red-meat-scapegoat-the-new-york-times-carnitine-heart-disease-and-science/

Yes, Saturated Fat Lower Nitric Oxide and Blood Flow

Yes, nitric oxide is just as important as testosterone as far as how you feel and your ability to avoid chronic disease.  And, yes, significant saturated fat lowers nitric oxide.  Yet, when I tell most men on the Peak Testosterone Forum that any significant amount of saturated fat will lower nitric oxide, I can tell that they usually don’t believe me.  This always shocks me, because there is such a huge body of research that shows this fact.  Below I will show you study after study that demonstrates that higher saturated fat meals not only lowers nitric oxide but also lower blood flow and endothelial function as well (of course).

I always get the same objections:

“That’s not right:  I can get an erection just fine, and I eat a ton of saturated fat.”

“I eat a lot of saturated fat, and I never felt better.”

“I get a great pump at the gym.  What are yout talking about?!?”

To those saying, the above, I ask you your age.  If you are under 40, you can still pump out enough endothelial nitric oxide to more than compensate for the negative effects of a saturated fat meal.  But guys in late middle or early senior age will usually know what I am talking about.  Eating a high fat meal can hit them right below the belt.

1)  http://news.bbc.co.uk/2/hi/6036409.stm

2) Amer J of Cardiology, Feb 1 1997, 79(3):350 354, “Effect of a Single High-Fat Meal on Endothelial Function in Healthy Subjects”

3) Arterioscler Thromb Vasc Biol, 2005 Feb, 25(2):406-10, “Acute Effect of High-Fat Meal on Endothelial Function in Moderately Dyslipidemic Subjects”

4) ADA Diabetes Pro, 2008, “Can a Single High-Fat Meal Impair Endothelial and Autonomic Function?”

5) The Journal of Physiology, 8 SEP 2004, 517(2), “Cholesterol-independent endothelial dysfunction in virgin and pregnant rats fed a diet high in saturated fat”

6) Heart Vessels, 2010 May, 25(3):254-62, “Caloric restriction reverses high-fat diet-induced endothelial dysfunction and vascular superoxide production in C57Bl/6 mice”

7) Circulation, 1997, 96:3287-3293, “Endothelial Dysfunction Is Associated With Cholesterol Levels in the High Normal Range in Humans”

8) Nutrition Journal 2011, 10:8, “Improvements in vascular health by a low-fat diet, but not a high-fat diet, are mediated by changes in adipocyte biology”

9) J Am Coll Cardiol, 2006 Aug 15, 48(4):715-20, “Consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins and endothelial function”

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”

1.  HACK: Walnuts Needed to Reduce Loss of Arterial Flexibility from Saturated Fat. “Tests showed that both the olive oil and the walnuts helped to reduce the sudden onset of harmful inflammation and oxidation in arteries that follows a meal high in saturated fat…However, unlike olive oil, adding walnuts also helped preserve the elasticity and flexibility of the arteries, regardless of cholesterol level. Arteries that are elastic can expand when needed to increase blood flow.” [1]

2.  STUDY: High Saturated Fat Meal Lowers Vasocactivity (and a Low Fat Meal Did Not). Remember that vasoactivity refers to the ability of the arteries to relax and lower blood pressure and increase blood flow.  “Flow-dependent vasoactivity decreased from 21 5% preprandially to 11 4%, 11 6%, and 10 3% at 2, 3, and 4 hours after the high-fat meal, respectively (all p <0.05 compared with low-fat meal data). No changes in lipoproteins or flow-mediated vasoactivity were observed after the low-fat meal…These results demonstrate that a single high-fat meal transiently impairs endothelial function. These findings identify a potential process by which a high-fat diet may be atherogenic independent of induced changes in cholesterol.” [2]

NOTE: In some of these studies you will researchers reference a “high fat meal” rather than a “high saturated fat” meal.  However, keep in mind that, generally speaking, this are referring to the same phenemenon, because other research has shown that polyunsaturated fats and omega-3’s do not decrease nitric oxide, blood flow or endothelial function.

4. STUDY:  Healthy Patient Crossover Feeding – Effects Within Two Hours.  “In this study, we showed an effect (decrease) on vascular endothelial function only 2 hour after a single HF meal. Forearm BF response after vascular occlusion was 25% lower in the HF meal versus the LF meal. Skin BF response after vascular occlusion was 20% lower in the HF meal versus the LF meal. Therefore, we suggest that cardiovascular impairment, potentially, can start immediately after a single HF meal ingestion.” [4]

5. STUDY: Reduced Nitric Oxide Independent From Cholesterol.  The title of this study says it all:

“Cholesterol-independent endothelial dysfunction in virgin and pregnant rats fed a diet high in saturated fat.”

Researchers found that “endothelial dysfunction was attributable to a reduced nitric oxide component of relaxation in VHF [very high fat] rats, and blunted prostacyclin and endothelium-derived hyperpolarizing factor components in PHF rats.” [5]

6. STUDY: Dieting with Lower Fat Improves Blood Flow; Low Carb Makes It Worse.  “After 6 weeks, the percentage of flow-mediated dilation improved  in the LF [Low Fat] diet but was reduced in the LC [Low Carb] diet versus baseline. Dilation to nitroglycerin and lipid panels was similar at 0, 2, and 6 weeks. Despite similar degrees of weight loss and changes blood pressure, LF diets improved brachial artery flow-mediated dilation over LC diets. LF diets may confer greater cardiovascular protection than LC diets.” [8] By the way, a “low fat diet” to these researchers actually has fat levels similar to Meditteranean levels.  Undoubtedly, a “true” low fat diet would have improved things even further.

7.  STUDY:  Similar Study Shows Even Worse Results for Low Carb. “Body weight decreased (P < 0.05) in both groups (HF: -6.6 0.5 kg, LF: -4.7 0.6 kg). Fat mass and waist circumference were reduced (P < 0.05) in the LF group only (-4.4 0.3 kg; -3.6 0.8 cm, respectively). FMD improved (P < 0.05) in the LF [Low Fat] group (7.4 0.8% to 9.8 0.8; 32% increase) and was impaired in the HF [High Fat] group (8.5 0.6% to 6.9 0.7; 19% reduction). Increases in plasma adiponectin (P < 0.05, 16 5%), and decreases in resistin (P < 0.05, -26 11%), were shown by the LF [Low Fat] diet only.” [8]Notice that the high fat dieters lost more weight, yet still had worse blood flow results.

NOTE:  Recent research has discovered even more disturing research regarding low carb diets, which you are read about here:  The Potential Dangers to Some Men of Low Carb / Ketogenic / Atkins Diets.  (I am NOT saying ALL men will have issues with Low Carb Diets.)

8. HACK: Caloric Restriction Needed to Reverse Endothelial Dysfunction of High Fat Diet in Mice.  “Male C57Bl/6 mice were fed with normal-fat diet (fat 17%) or high-fat diet (fat 60%) for 150 days. After establishment of obesity at day 100, a subgroup of obese mice were put on caloric restriction (CR) (70% of ad libitum energy intake) for an additional 50 days. At day 100, aortic rings from obese mice receiving high-fat diet showed impaired endothelium-dependent vasodilation in response to acetylcholine (ACh). Caloric restriction reversed high-fat diet-induced endothelial dysfunction.” [6]

9. Dose Dependent Increase in Cholesterol Associated with Drop in Endothelial Dysfunction. Although saturated fat does not raise cholesterol by as much as some claim, it does raise cholesterol levels and this study found that “there was a negative correlation between total cholesterol levels and maximal endothelium-dependent vasodilation (total cholesterol).” [7]

10.  STUDY: Impaired HDL and Endothelial Function.  “Consumption of a saturated fat [meal] reduces the anti-inflammatory potential of HDL and impairs arterial endothelial function…These findings highlight novel mechanisms by which different dietary fatty acids may influence key atherogenic processes.” [9]

11. HACK:  Exercise Protects Against the Endothelial Dysfunction Following a High Fat Meal. “These findings suggest that a single aerobic exercise session cannot only counteract the postprandial endothelial dysfunction induced by the ingestion of a high-fat meal, but also increase brachial artery FMD in apparently healthy adults.”

CONCLUSION:  I could go on and on with more studies showing this, but these 10 should be enough for anyone to get a good idea what is going on.

Why isn’t the word getting out?  Well, my theory is that none of the major Paleo or Low Carb bloggers admit the NO-hammering effects of higher fat meals from what I can tell.  In fact, I see quite the opposite where some of these sites make half-hearted attempts to try to refute the mountain of reseach that show the exact opposite of what they are saying.

In fact, one of the studies that I deliverately left out was the “Cake and Shake Study” that showed that coconut oil lowered blood more than safllower oil. One group, who shall remain nameless, had an article that went to great and laborious pains to try to explain away the fact that these Cake and Shake researchers found what several dozen others have, i.e. that saturated fat literally stuns or numbs arteries for hours after a meal.  And the danger is that, unless you are very carefully doing the HACKs above, you are leaving your arteries in that less flexible and vasoreactive state which is associated with the buildup of plaque (atherosclerosis).  In fact, it is even worse than that, because significant saturated fat causes the cells in your blood to tend to clump together, literally “sludging” arteries.

The bottom line is that, if you want to eat a bunch of saturated, then you won’t hear me preaching at you.  Eating is religious, and I certainly don’t want to argue with anyone about it.  The only thing I ask is that you don’t try to convince me that it won’t affect your nitric oxide and blood flow…  flow…

REFERENCES:

-Surprising Causes of High Prolactin - Peak Testosterone

One common situation on the Peak Testosterone Forum is a man having fairly high prolactin levels, say 15-30 ug/L, and yet the doctor says there is nothing “wrong” with him. Of course, prolactin of 15-30 ug/L is over the lab range and this will drive down dopamine/libido and often testosterone. So why does the doctor say nothing is wrong? The reason usually is that an MRI has revealed no prolactin-secreting tumors in the brain, which is called a prolactinoma and something I cover in my page on Testosterone and Prolactinomas.  (If you have high prolactin, always consult with a doctor for this very reason.)  In the doctor’s mind, this man does not have a tumor, so he’s not really doing that bad – case closed.

However, men with high prolactin and no prolactinoma can still feel lousy.  Remember that prolactin is a “lactation hormone” and can trigger gyno.  It lowers dopamine.  It raises inflammation. [1] So you don’t definitely don’t want too much of it, and guys can feel it very often.

So the question becomes “how do you lower it?”  Well, you can take one of the big gun pharmaceuticals such as cabergoline.  However, from what I have seen, most doctors will not prescribe it to men without unless a prolactinoma is present.  Basically, one is just left alone to “deal with the high prolactin symptoms.”  Now I have a page on a few natural solutations that may help some men in these situations:  How to Lower Prolactin. (Always disucss with your physician first.)  However, as is so often the case, it is usually better to find the root cause of the high prolactin and directly deal with that.  Here are Four Common and Surprising Causes of High Prolactin That Few Physicians Mention to Their Patients:

1. High Estradiol. It is no secret that, if you increase estradiol, you will increase prolactin release. [2] Some of the older research showed that this effect was dose dependent, i.e. the more estradiol you added, the higher prolactin increased.  [3] And researchers have discovered one of the key mechanisms:  estradiol regulates the transcription of the prolactin gene. [4]  So, if you are on the high side with prolactin, one of the first things you should probably pull is estradiol.  Remember that, as men, we need the appropriate LC-MS/MS test that can pick up our relatively low levels of estradiol (compared to a female).

2.  Hypothyroidism. An underactive thyroid will also drive up prolactin levels in us men.  Of course, this is an especially ugly situation, because hypothyroidism tends to lower testosterone and sap your energy levels.  So, if you have hypothyroidism and high prolactin, you have potentially got a nasty set of symptoms to manage.  Furthermore, hypothyroidism is underdiagosed, because so few doctors really test adequately for low thyroid function, something I discuss at length in my page on Testosterone and the Thyroid. In addition, I have a page on Hypothyroidism and High Prolactin, so you can check out the latest research there as well.

3. Drugs. Many very common classes of drugs can raise prolactin levels.  No, they didn’t put that on the label, did they? Look at this list from one set of researchers: “antidepressant drugs with serotoninergic activity, including selective serotonin reuptake inhibitors (SSRI), monoamine oxidase inhibitors (MAO-I) and some tricyclics, can cause hyperprolactinemia. A long list of other compounds may determine an increase in prolactin levels, including prokinetics, opiates, estrogens, anti-androgens, anti-hypertensive drugs, H2-receptor antagonists, anti-convulsants and cholinomimetics.”  [6]

There are lots of men on SSRI’s, painkillers and meds for their hypertension with fairly high prolactin, and it is a shame that their doctors do not inform them of the potential sides there. I think more often than not, it is out of ignorance.  And I do want to mention that not all blood pressure medication or painkillers raise prolactin, but it is a question you should discuss with your doctor if it is a possible issue.  (Don’t stop any medication without talking to your physician first!)

4. Stress. Generally, it is thought that psychological stress cannot raise prolactin levels.  However, it probably can in some extreme cases, and, if you just had surgery or something other physicial trauma, prolactin levels can definitely shoot up.

CONCLUSION: There are many common culprits of fluctuating and high prolactin levels that often can be treated or dealt with naturally.  Please also check out my pages on Prolactin Levels in Men, Prozac and Prolactin and The Meaning of Low Prolactin in Men as well.

REFERENCES:

1)  Eur Cytokine Netw, 2004 Apr-Jun;15(2):99-104, “Prolactin triggers pro-inflammatory immune responses in peripheral immune cells”

2) J Clin Invest, 1974 Feb; 53(2): 652 655, “Augmentation of prolactin secretion by estrogen in hypogonadal women”

3) PNAS, “Estrogen control of prolactin synthesis in vitro”, Dec 1 1978, 75(12):5946 5949

4) The Journal of Biological Chemistry, March 10, 1982, 257, 2133-2136, “Estradiol regulates the transcription of the prolactin gene.”

5) Bailli re’s Clinical Endocrinology and Metabolism, May 1987, 1(2):391-414, “8 Prolactin, growth hormone and thyrotropin-thyroid hormone secretion during stress states in man”

6) Ther Clin Risk Manag. 2007 Oct; 3(5): 929 951, “Pharmacological causes of hyperprolactinemia”

Weird Things That Can Make You Fat - Peaktestosterone

“Must be my thyroid.”  That’s what a lot of us say after we’ve packed on the pounds. It can’t be the 3,500-calorie, high sugar and high fat diet we’re consuming, eh?  Well, I have good news – there are some weird things out there that can truly make you fat and give your excuse-making a little flare and savoir faire.

1. Viruses. Many viruses have been found to promote obesity in animals and scientists are now speculating that they likely cause the same in humans. [1]  Turns out they can harm the hypothalamus and pituitary which control appetite, metabolic rate and energy consumption.

2. Your Father. This one is really bizarre.  It turns out the way your Dad ate at conception, as in yours, can profoundly influence your DNA and make it easier for you to put on weight for the rest of your life. Scientists are just now discovering that if dear ol’ dad ate a high fat diet when he was busy bringing you into the world, it actually can change your epigenome.  Epigenomes are molecules attached to our DNA that either turn on or turn off genes. [2] And, for the coup de grace, your dad’s high fat diet also predisposes you to diabetes as well.  For more details, read my link on the Strange World of Epigenetics.

3.  Obesogons. Chemicals can also program you for a lifetime of fatness. Scientists have discovered a whole family of chemcals that induce the birth of new fat cells during organogenesis, i.e. the very earliest stages of your development when organs and tissues are first forming. That’s the last thing any of us need are new fat cells, that we wouldn’t have had in the first place, terraforming around our precious midsection. Remember:  unless you do lipo, you get to keep those fat cells for the rest of your life.  For more information, see my link on Obesogons.

4. Your Mom’s Pregnancy Diet. Scientists recently discovered that if your mom ate a low carb diet when she had you, she unknowingly changed your epigenome (via methylation) and switched on a gene that greatly increases your chances for obesity. [3] (For more dangers of a low carb diet, see my link on The Potential Dangers of a Low Carb Diet.

REFERENCES:

1) Obes Rev, 2010 Apr, 11(4):289-96. Epub 2009 Oct 27, “Viral obesity: fact or fiction?”

2) https://www.wbur.org/npr/130703719/lifestyle-factors-may-alter-genetic-traits-study-finds

3) Diabetes, April 6, 2011,”Epigenetic Gene Promoter Methylation at Birth Is Associated With Child�s Later Adiposity”

Walking: Drop Your Blood Pressure the Easy Way .

Just walk.  Those two words can save your life.  They can also save your sex life, as I discuss in my link on Walking and Erectile Dysfunction. On this page I want to go into the study results that show how walking and walking alone can lower blood pressure and protect you from hypertension. In fact, I will show you that, particularly if you have high blood pressure or are a senior with normal blood pressure, walking is likely to lower that mercury as much as any medication.  (Of course, talk to your doctor if applicable.)

Of course, physicians do not usually mention the power of a simple, natural solutions such as walking to help with hypertension, so this is why I mention it here.  High blood pressure is a huge risk factor for erectile dysfunction, stroke and cardiovascular disease, so it is something to take very seriously.  Get that blood pressure below 120/80 and never give up.  It can take some effort and work, but I believe most men can do it naturally without pharmaceuticals as long as they are willing to put in the effort and time to see what works.  And walking can be a huge part of that plan as I will show below.

NOTE:  I have other great ideas to lower your blood pressure in these pages on Erectile Dysfunction and High Blood Presure and How I Lowered My Blood Pressure.

Here are some of the key studies that should encourage you to start walking and drop your blood pressure:

1.  10,000 Steps.  Some of you may have heard of the 10,000 Steps Program.  It’s a great concept where you basically strap on a pedometer and try to reach 10,000 steps from waking to sleeping.  (Pedometers can be tactully hidden under your shirt.) I know that when I walk a mile, I take about 1,850 steps and you are probably roughly the same.  This may make 10,000 steps may seem like a lot, but it’s really not.  The reason I say that is that the pedometer will record not just when you walk on a treadmill or in a park but also when you do yardwork or play with the kids.  10,000 steps comes more quickly than you might think in the course of a normal day and is a great measure of total physical activity.

1)  Hypertension Research : Official Journal of the Japanese Society of Hypertension, 2000, 23(6):573-580, “Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension.”

2) Arteriosclerosis, Thrombosis, and Vascular Biology. 2013; 33:1085-1091, “Walking Versus Running for Hypertension, Cholesterol, and Diabetes Mellitus Risk Reduction”

3) https://mx1.ishib.org/journal/17-2s4/ethn-17-03-503.pdf, Ethnicity & Disease, Summer 2007, 17, IMPACT OF EXERCISE (WALKING) ON BLOOD PRESSURE LEVELS IN AFRICAN AMERICAN ADULTS WITH NEWLY DIAGNOSED HYPERTENSION

4) Medicine and Science in Sports and Exercise, “Increased Daily Walking Lowers Blood Pressure in Postmenopausal Women”

5) Preventive Medicine, Aug 2001, 33(2):120-127, “Walking and resting blood pressure in adults: A Meta-analysis”

6) The American Journal of Cardiology, Jun 1 1994, 73(15):1124-1128, “Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age”

2.  13-Point Drop in Middle-Aged Males.  One study looked at the effect of walking on newly diagnosed (with hypertension) African-American males.  Although the study design made it impossible to come to any direct conclusions [3], the results were impressive to say the least.  Average measurements dropped from 147.7 to 134.4 and 95.7 to 88.6 for systolic and diastolic blood pressures, respectively.  And this is even more remarkable when you consider that the only real difference from the control group was that the intervention group was encouraged to walk an extra 30 minutes beyond their normal daily activity.  Again, researchers noted that results were as good as the typical pharmaceutical solution.

NOTE: These big drops in blood pressure mean more blood flow and more nitric oxide.  And increases in blood flow and nitric oxide mean better erections.  Walking also avoid overtraining syndrome.  This is a big problem with guys – they overtrain and actually make their hormones and health worse in many cases.

3.  Protection from High Blood Pressure.  The power of walking was also shown in a recent study where researchers put participants in a walking group and a running group of equal energy expenditure.  In other words, they made the walkers walk longer to match the calories burned of an equivalent runner.  The authors concluded that “equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.” [2] In reality, the walking actually produced greater risk reductions in every category, but apparently not with statistical significance.  For example, running reduced the risk of developing hypertension by 4.2% but walking reduced it by 7.2%.

5.  Meta-analysis of Many Studies.  Results in this meta-analysis were not as dramatic – 3 and 2 mm decreases for systolic and diastolic – but this undoubtedly included normotensives, i.e those with normal blood pressure. [5] Obviously, walking lowers blood pressure much less dramatically (if at all) in healthy individuals with no blood pressure issues.

6.  Normotensive Elderly.  One study looked at seniors with normal blood pressure and found that 45 minutes of walking at 70% of Heart Rate Reserve, a measure of exercise intensity,  or 35 minutes at 85% of HRR yielded impressive drops in blood pressure:  8-9 mm in systolic and 4-8 in diastolic. [6] Again, these are in those with blood pressure lower than the standard 120/80.

REFERENCES:

If You High Cortisol, How Do You Lower It? - Peak Testosterone

One of the very common issues that I see on the The Peak Testosterone Forum is men with high morning or evening cortisol. I think that a 3-point cortisol test is usually the most useful and predictive, because it corresponds so well to symptoms that a man is experiencing. For example, high evening cortisol often leads to sleep issues and difficulties falling asleep, and high morning cortisol to generalized feelings of anxiety and lowered mood during the day. Elevated cortisol levels can also contribute to acclerated visceral (belly) fat and prediabetes along with an increased risk for depression,  lower testosterone and libido. Worst of all, high cortisol is hard on the cardiovascular and neuronal systems and appears to even shorten telomeres, i.e. accelerate aging.

The obvious point is that we need to pay attention to this hormone and find natural ways to reduce inflated levels.  Below are 10 Great Research-Backed Ways to Lower Cortisol Significantly.  I start out with lifestyle solutions – because these will generally really get at the root of the problem and are side effect free and then follow with supplement (nutraceutical) based solutions:

NOTE:   Of course, if you self-test and find you have high cortisol, I highly recommend that you talk to a physician and make sure that there is not some type of serious underlying medical condition.

1. Mindfulness Meditation (Baseline and Peak). In modern, industrial cultures cortisol and stress are generally related to perceived psychological and social issues.  Mindfulness meditation is a fantastic tool to combat the chronic stress that we so often face.  One example was a study on PTSD victims.  Results were very impressive: [5]

—The mindfulness group dropped cortisol area unde the curve (AUC) by about 15%

–Peak cortisol levels were dropped by about half!

Another study from three years prior had found even more profound cortisol reduction from the same Abbreviated Progressive Muscle Relaxation technique. Participants did a 20-25 minute session and lowered their cortisol before and after the session from 18.96 to 10.45 nmol/l (day 1) and 19.31 to 11.31 nmol/l (day 8).  These are cortisol reductions of 45% and 42%, respectively!  As in the first study, pulse was also substantially reduced as well.

NOTE:  See my page on The Benefits of Progessive Muscle Relaxation for more information.  On that page I also describe how to actually do PMR.

3.  Low Carb Diets (Baseline). Low carb diets work by raising stress hormones such as cortisol and adrenaline.  Most low carb men do not even notice, but that is certainly not always the case.  In my mind the obvious thing to do if you are high cortisol and on a low carb diet is to add in some carbs and then see if your cortisol improves.  If so, then you may need to go more “classic Paleo.”

4. Phosphatidylserine (Post-Exercise Cortisol Increases and Possibly Baseline Cortisol Levels). Hopefully, everyone reading this is doing some kind of an exercise program. If so, then I can almost guarantee you that right after exercise, you are experiencing a very significant rise in cortisol.  This is the body’s natural response to a “stressor” like exercise, and some of you may even have exaggerated levels since many men push themselves to the point of overtraining.  Phosphatidlyserine (PS) can help with any such post-exercise increase in cortisol according to some research.

Now, before I discuss this supplement any more, let me mention that only recent studies on phosphatidlyserine should be considered.  For years, stellar results were achieved using bovine-based PS, but this was considered unsafe at a certain point and plant-based products – usually soy – were utilitzed thereafter.

One recent study using plant-based PS found that “mean peak cortisol concentrations and area under the curve (AUC) were lower following PS (39% and 35%, respectively) when compared to placebo. PS increased AUC for testosterone to cortisol ratio (184 5%) when compared to placebo. PS and placebo supplementation had no effect on lactate or growth hormone levels.” [1]

This are very significant reductions in peak cortisol needless to say.

Besides helping with cortisol rises during exercise, PS is used by quite a few alternative medical practitioners to lower baseline cortisol.  As far as I know, there is no study (on soy-based PS) that confirms this however.

The biggest problem that I see is expense:  it’s not a cheap supplement and the dosages generally prescribed are fairly high.  Dosages of 200 – 300 mg per day are pretty common for example. However, this seem to be the go to supplement by physicians interested in lowering cortisol naturally.

CAUTION:  Always discuss the addition of any new supplement with your physician if you have a medical condition or are on any medication.  Also, long term effects of almost all supplements are poorly understood and should generally be considered a short term solution.  TESTING IS CRITICAL: Don’t just assume you are high cortisol because you have anxiety or sleeplessness. It is always important to confirm with measurements, because many things can cause similar symptoms. In addition, you can pull your measurement inexpensively at any of the following without a doctor’s orders:  Testosterone Labs.

5. High Protein.  Higher protein levels can raise cortisol according to some research.  See my page on The Potential Dangers of Excess Protein for more information.

6. Vitamin C (Baseline Cortisol). One older study examined “13 lean, healthy male volunteers aged 25 to 35 on no medications” and found a very significant lowering of cortisol with 4 grams daily of Vitamin C. [2] (1 gram was given every 6 hours to be precise.) Cortisol levels were monitored at many times during the day and participants were not put under any sort of stress, exercise of otherwise, i.e. this was a measure of baseline cortisol levels throughout the day.  The results were impressive:  cortisol was lowered from 19.6 to 14.8 ug/dl on average, a drop of approximately 25%.

There are several important comments to be made about this study.  First of all, individual responses to supplements is similar to that of pharmaceuticals in the sense that there is no formula that works for everyone.  For example, a couple of the participants experienced rather profound cortisol reductions of 50% or over and a few others a cortisol rise. In addition, most participants experienced a rise in DHEA levels, another hormone that was monitored during the study.  In fact, average DHEA rose from 426  to 755 ng/dl after one week.Therefore, it would seem prudent to monitor cortisol and DHEA before and after.

CAUTION: Vitamin C should usually be taken on an empty stomach for two reasos:  1) it increases iron absorption and 2) there is study that shows if you have fat in your stomach > ~10%, it will increase nitrosamine production.  Here are some other Potential Risks or Dangers of Vitamin C.

7. Rhodiola Rosea (Morning Cortisol). The herb has been studied extensively with some good results in the area of athletic performance. It also has several studies behind it showing that it can lower a variety of stress markers.  It has also one study that shows it can lower baseline morning cortisol levels.  For example, one study on men and women with chronic fatigue found that morning cortisol levels were reduced by around 7% upon awakining and then around 12% for up to an hour afterward. [3]

8. DHEA?. There is one study one senior men and women that shows that DHEA can lower cortisol. [4] It did not lower it by much in the case of the men. The big problem is that the men took a large dose (200 mg daily) in order to achieve this effect.  50 mg is much more common from what I have seen and some experts recommend significantly less than that.  CAUTION:  I do have a few concerns about DHEA listed Here:The Risks and Potential Dangers of DHEA.

9. Testosterone Therapy (HRT / TRT). If you are hypogonadal, going on (well done) HRT can lower your “cortisol reactivity.”  Basically, this means that cortisol will likely not increase to as high of a peak during stressful situations, i.e. there is a dampening effect.  This is one of the reasons that many men, such as myself, on HRT experience substantial reductions in feelings of stress and anxiety.  (Some men have a side effect where they experience the opposite however.)  For more information, see my pages called Testosterone and Cortisol and Testosterone and the Adrenals. CAUTION:  Some men report that on TRT their cortisol falls due to a “shutdown” effect.

10. Ashwagandha (Corticosterone). Ashwaganha has two studies behind it showing that it can lower corticosterone, a stress-related hormone. [8][9] Corticosterone is an intermediate to aldosterone for those interested.

REFERENCES:

1) Journal of the International Society of Sports Nutrition, 2008, 5:11, “The effects of phosphatidylserine on endocrine response to moderate intensity exercise”

2) Annals NY Acad of Sciences, Jul 1987, 498:487 490, “Bimodal Effects of Megadose Vitamin C on Adrenal Steroid Production in Man”

3)  Planta Med, 2009 Feb,75(2):105-12, “A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue.

4) https://www.ergo-log.com/dhea-supplementation-lowers-cortisol-levels.html

5) Medical Care, Dec 2014, 52:S25 S31, “Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD”

6) Applied Psycholphysiology and Biofeedback, Dec 2005, 30(4), “The Impact of Abbreviated Progressive Muscle Relaxation on Salivary Cortisol and Salivary Immunoglobulin A (sIgA)”

7) Biological Psychology, 2002, 60:1-16, “The impact of abbreviated progressive muscle relaxation on salivary cortiisol”

8) BMJ Case Rep, Sep 17, 2012, “Ashwagandha root in the treatment of non-classical adrenal hyperplasia”

9) N Am J Med Sci, 2011 Jul, 3(7):320 324, “Immune enhancing effects of WB365, a novel combination of Ashwagandha (Withania somnifera) and Maitake (Grifola frondosa) extracts”

Mindfulness meditation will help you in a dozen other key ways that I outline in my page on The Benefits of Mindfulness Meditation. One of the things that many men struggle with is something called “ruminative thinking,” which is the psychological term for getting stuck thinking about one thing over and over.  Men with depression or high anxiety often struggle with this issue and mindfulness meditation is a fantastic tool to get partially reverse it.  Mindfulness meditation trains you to passively observe things that enter your mind or your perception without strong emotional reactions .

2. Progressive Muscle Relaxation. One study grabbed a bunch of male and female psychology students and taught them Abbreviated Progressive Muscle Relaxation (APMR). They then measured cortisol and pulse immediately before and after the students actually practed the APMR.  The results were very impressive: [6]

–Heart rate dropped from ~72 to about 66.1-66.7

—Cortisol dropped from 16.96 nmol/l to 14.11 nmol/l. (The controls did not change.)

That’s a drop of about 8% in pulse and 17% in cortisol by making a simple lifestyle change that has absolutely no side effects and costs nothing. That’s what we call a “no brainer” in the health and fitness world!

Low Fat Diet: The Mind-blowing Bedroom Benefits

A Low Fat Diet is, quite simply, looking like the most powerful and promising diet on the planet right now. It is particularly important for most middle-aged and senior men to consider, because modern living is so hard on the endothelium and prostate and, as we’ll show below, some of the big benefits of a Low Fat Diet deal with these.  NOTE:  This diet is sometimes called the Ornish Diet, because it was popularized in several studies from famed researcher Dr. Dean Ornish.

1) Lancet,1990,336:129-33;Am. J. Cardiol,2003,91:1316-22

2) https://findarticles.com/?noadc=1

3) Circulation, 1992, 86:1-11

4) The Lancet Oncology, 9(11):1048-1057, “Increased telomerase activity and comprehensive lifestyle changes: a pilot study”

5) https://www.sciencedaily.com/releases/ 2011/10/111025135931.htm

6) Ann Med, 2005, 37(5):347-56, “Fat in the liver and insulin resistance”

7) Am J Med, 1985 Jan, 78(1):23-7, “Effects of a high-complex-carbohydrate, low-fat, low-cholesterol diet on levels of serum lipids and estradiol”

Really the Low Fat Diet might better be called The Last Chance Diet as it offers a final chance for healing to all those who have destroyed their health through a Western diet and lifestyle. Think I’m exagerrating?  Judge for yourself. Below are some of the key benefits – and they are huge – of a Low Fat Diet:

NOTE:  One diet that has done poorly in the research, contrary to popular opinion, is the Atkins (or Low Carb) Diet. This type of diet is okay for weight loss, but for most people will likely lead to issues. Read about it here.)

14 Powerful Reasons To Go On a Low Fat Diet

1. Testosterone-to-Estrogen (Estradiol) Ratio. It is true that for some men, they may experience a slight reduction in total testosterone levels by going on a Low Fat Diet depending on how they have been eating. However, what most men do not know is that they will likely experience a very significant improvement in their all-important testosterone-to-estrogen ratio. This is what many of your tissues really care about: how many “male” hormones you have floating around versus “female”. The more male hormones you have proportionately, the more those receptors will get activated after all. (See my link on the Testosterone-to-Estrogen Ratio for more details.)

And what a difference a Low Fat Diet can make!  One study examined the hormones of 21 males who went on a Lowf Fat Diet and found that there estradiol (the “bad” estrogen or E2) dropped from 47.2 to 23.8 pg/ml on average.  This is a reduction of over 50% and effectively halved their estradiol levels. [7] And the remarkable thing is that their testosterone stayed constant at 510 ng/dl!)  This means that their testosterone-to-estrogen ratio was effectively doubled just by this simple dietary change.

CAUTION:  Low testosterone or hypogonadal men generally should not reduce their estrogen any more or they can go too low and be at risk of low estrogen.  See my link on Why Men Need Estrogen for more information.

2. Reversing Arteriosclerosis. One of the curses of modern living is accelerated arterial plaque buildup.  In addition, men with low testosterone are even more at risk for arteriosclerosis (likely due to increased insulin levels).  One of the huge benefits Dr. Ornish’s research showed was that one could actually partially reverse the plaque buildup in the arteries.  Just as important, a Low Fat Diet stabilizes the plaque, because it is the unstable plaque breaking off that generally leads to most heart attacks.

So what’s the big deal about removing a little arterial plaque?  Remember that this plaque is covering your precious endothelium, which is supposed to be pumping out nitric oxide to lower your blood pressure and give you erections.  A diet that can actually partially reverse arteriosclerosis is proving that not only can you stop the normal plaque buildup from aging, but you can actually heal and repair your arteries and blood vessels.  What middle-aged guy would not want the chance to de-age his arteries, especially the ones inside his penis??

And remember that for a normal sedentary person on a Western Diet, arterial plaque just keeps building and building at a rapid rate.  Many men, by their late middle age or early senior years have 80% or 90% blockages. So it would be a remarkable accomplishment to halt this relentless process much less reverse it.

Also, consider the a Low Fat Diet does what no other technology or diet has ever been able to do.  For example, Big Pharma tried to reverse arteriosclerosis by throwing various drugs at the situation and have had very limited success.  Astra-Zeneca, for example, funded a study on patients with high C-Reactive Protein (CRP) levels.  Patients were given a placebo or a huge dose of their statin drug called Crestor, or rosuvastatin by its generic name, and did successfully reverse heart disease.  However, this was a massive dose and I probably don’t need to tell you about the https://www.peaktestosterone.com/.

In other words, Big Pharma has pulled out their biggest guns and still cannot do what the Low Fat (or Ornish) Diet does.  The Low Fat (or Ornish) Diet, as you will see below, does much, much more than just simple reduction of arterial plaque ad all without any known long term side effects!

3.  Reduced Liver Fat.  Decreasing arterial plaque is incredibly impressive, but just as impressive and critical to ones health is the fact that a Low Fat Diet can reduce liver fat.  Fat storage in the liver has become recognized as one of the leading causes of heart disease and, undoubtedly soon, of erectile dysfunction. A Low Fat Diet can put the brakes on liver fat and even decrease it according to the latest reserach. [6] For more information, read my links on The Liver and Inflammation and https://www.peaktestosterone.com/. (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.)

4. Blood Pressure and Hypertension. Besides cleaning out your arteries, a Low Fat Diet usually very significantly lowers high blood pressure. 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 Low Fat (or Ornish) Diet.  This is a nice drop and put people with very serious medical condition(s) just a hair above normal! Similar results were found in individuals with ‘1,245 participants who had coronary heart disease (55%), diabetes, and/or at least three other risk factors (hypertension, hyperlipidemia, and obesity)’. [2] High blood pressure is a huge risk factor for both erectile dysfunction and stroke.  (You can also read about healthy the How Incredibly Healthy Grains For the Penis.)

How does a Low Fat Diet lower blood pressure?  First of all, a Low Fat Diet is primarily plant-based and plant-based diets generally lower blood pressure, because they are high in 1) glutamic acid (NOT the excitotoxin), 2) flavanoids, 3) linolenic acid and 4) nitrates. I cover this more in my book The Peak Erectile Strength Diet. Put all these compounds together and you can make a very significant difference.

By the way, cleaning out the arteries may decrease blood pressure a bit in and of itself.  The less narrow the arteries, the less pressure.

5. Erections and Erectile Dysfunction. Low Fat Diets will help many men with their erectile dysfunction simply because of #1 and #2.  In this link on Low Fat Diets and Your Sex Life, I discuss how there is a direct and almost linear relationship between cholesterol and erectile strength.  And, as we’ll discuss below, a Low Fat Diet is the most powerful diet for lowering cholesterol.

NOTE: Have you heard that Low Fat Diets hammer testosterone? I have!  The truth is that there are several studies that show either zero change or very little change in testosterone. For more information, see my link on Low Fat Diets and Testosterone.

6. Prostate Protection. Most meat eaters hammer their prostates for decades with risky heterocylic amines, the delicious black charred stuff on your meat from high temperature cooking. These HCA’s as they are called slowly injure the cells in the prostate, leaving men much more prone to cancer. Couple that with rising estrogen levels from weight gain and you have a deadly combination that leads almost all men down a path of prostate cancer.  (Most men in Western societies, if they live long enough, will have at a minimum some of the slower-growing prostate cancer cells residing in their prostate.)

7.  Morning Erections. You must give this a few weeks or even months, but, anecdotally, some men will experience increased morning erections as your endothelial function is restored by the Low Fat Diet.  As your arteries are cleared out and your blood pressure is lowered, you may notice some pleasant surprises.

8. Telomerase. One of the key theories of aging deal with telomeres, the shortening of one’s chromosomes, and the enzyme, telomerase, that controls this process.  As your body ages, most tissues have a certain number of cell divisions that they can undergo before they begin to “wither” and become dysfunctional.

As it turns out, research by Dr. Ornish showed that a Low Fat Diet increased telomerase activity in immune cells. [4] For more information, read my link on Telomeres and Telomerase.

9. Cholesterol. Many men suffer with chronically elevated cholesterol levels.  They have tried everything they can think of, including medications, and just cannot get their cholesterol under control.  What they and their doctors have missed:  some men are very sensitive to saturated fat.  Even small amounts of saturated fat in their diet sends their cholesterol through the roof.  A Low Fat Diet is famed for its cholesterol lowering abilities.

Vitrually all men that go on a Low Fat Diet will find their cholesterol below 150.  Remember that 150 is the magic number at which no heart disease occurs. Research has shown – read the China Study by Campbell for details – that cultures with cholesterol below 150 have dramatically reduced heart disease.

10. Mood. A Low Fat Diet has been found to boost mood in a couple of  studies. For example, one study looked at dieting via Low Carb or Low Fat and found that Low Fat was clearly superior in the area of mood and cognitive function. See also How to Control Appetite and Boost Mood through Diet.

11. Unbeatable with Exercise. If you couple a Low Fat Diet with exercise, the combination appears to be unbeatable.  For example, researchers studied just this scenario:  they put patients with mild heart problems – and a high percentage of middle-aged and beyond me on a Western Diet would be in that category – on a Low Fat Diet (not as strict as the Ornish however) along with intense exercise.  What did they find?  You guessed it:  drastically reduced heart disease and dramatically reduced injury to the arterial walls. [3] This stuff works.

The Tarahumara are yet another example of this.  This native people in northern Mexico eat a Low Fat Diet and have cholesterol levels in the 120’s!  They also exercise intensely, both in normal daily mountain living, and in ultramarathon sporting events that are part of their culture.  This society has NO heart disease and almost imperectible rates of hypertension in both young and old.  They also are known for incredible longevity and energy.  Again, a Low Fat Diet and exercise are a powerful combination.

12.  Weight Loss. Another big benefit of a Low Fat Diet is weight loss.  I have had me write into me on a Low Fat Diet and ask how they can get more calories.  The reason is that Low Fat foods, such as whole grain, vegetables, beans/legumes, etc. are almost all high volume foods that fill you up with minimal calories.  Remember that fat is the much more dense calorically than either protein or carbohydrate.  So most men find that it gives a lean, muscular fit look that you had back in your early twenties.  And, by the way, that’s what most women want! I talk about this more in my link on Muscle Madness.

13. Save Money.  A Low Fat Diet can be a great money saver. Let’s face it:  the most expensive items in your diet are, by far, meat.  Brown rice, beans, etc. – these are pennies on the dollar relatively speaking.

14. Reduced Supplement Costs.  The Low Fat Diet is so powerful that you will likely be able to throw away many supplements. Some of you are dropping a hundred bucks or more a month, trying to fix your erectile dysfunction and other issues. You may be able to completely eliminate almost all of that.

NOTE:  All the signs point to the Low Fat (or Ornish) Diet being very good for erectile strength.  Read this link on How the Low Fat Diet is Good for your Sex Life.

So are there any cautions?  Just a few and I include them below:

CAUTIONS:

1. You have to let your colon adjust for a few days. All those veges and beans and fiber can make your belly feel like the Hindenburg.  But, trust me, the pressure dies down quickly as your GI tract adjusts as well.

2.  Grains are a common source of food allergy. If you have any issues – usually in adults it is a feeling the throat tightening or possibly nausea – then you may want to get tested.

3.  Depending on your dietary pattern before going on a Low Fat Diet, there is some chance that it could lower your testosterone a little.  Usually, one is more than compensated by the improved endothelial function, blood flow and nitric oxide, but it may be something watch out for.  However, if you have heart disease and erectile dysfunction, then you should – ask your doctor first of course! – go on the Ornish Diet anyway to partially reverse your problems. Remember that erectile dysfunction is primarily a cardiovascular problem.  The Low Fat Diet will help the great majority of guys out there with this issue.

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